JDN_20NL_Oct2020

JUNIOR DOCTORS
NETWORK
empowering young physicians to work together towards a healthier
world through advocacy, education, and international collaboration
Published by the Junior Doctors Network of the World Medical Association
The information, perspectives, and opinions expressed in this publication do not
necessarily reflect those of the World Medical Association or the Junior Doctors
Network. WMA and WMA-JDN do not assume any legal liability or responsibility
for the accuracy, completeness or usefulness of any information presented.
Junior Doctors Network Newsletter
Issue 20
October 2020
ISSN (print) 2415-1122
ISSN (online) 2312-220X
Junior Doctors Leadership 2019−2020
Junior Doctors Network Newsletter
Issue 20
October 2020
Dr Yassen Tcholakov
Canada
Dr Christian Kraef
Germany
Dr Julie Bacqué
France
SOCIO-MEDICAL
AFFAIRS
OFFICER
SECRETARY
INTERIM
CHAIR
Dr Lyndah Kemunto
Kenya
Dr Uchechukwu Arum
Nigeria
Dr Lwando Maki
South Africa
EDUCATION
DIRECTOR
MEDICAL
ETHICS
OFFICER
MEMBERSHIP
DIRECTOR
Dr Maki Okamoto
Japan
Dr Helena Chapman
Dominican Republic
Dr Chukwuma
Oraegbunam
Nigeria
PUBLICATIONS
DIRECTOR
COMMUNICATIONS
DIRECTOR
IMMEDIATE
PAST
CHAIR
Page 2
Dr Konstantinos
Roditis
Greece
Dr Jeazul Ponce H.
Mexico
Dr Mariam Parwaiz
New Zealand
Dr Vandrome Nakundi
Kakonga
Democratic Republic
of the Congo
Dr Suleiman A. Idris
Nigeria
Dr Ricardo Correa
Panama/United States
Dr Victor Animasahun
Nigeria
Junior Doctors Network Newsletter
Issue 20
October 2020
Editorial Team 2019−2020
Dr Nneka Okafor
Nigeria
Page 3
Table of Contents
TEAM OF OFFICIALS’ CONTRIBUTIONS
08 Words from the Interim Chair
By Dr Yassen TCHOLAKOV (Canada)
09 Words from the Communications Director
By Dr Maki OKAMOTO (Japan)
10 Words from the Publications Director
By Dr Helena CHAPMAN (Dominican Republic)
SPECIAL SERIES: 10th JDN ANNIVERSARY
11 JDN 10th Anniversary Working Group Update
By Dr Julie BACQUÉ (France)
12 Words from the WMA Secretary General
By Dr Otmar KLOIBER (WMA)
14 Reflections by the JDN Founders
By Dr Xaviour WALKER (New Zealand/United States) and Dr Lawrence LOH
(Canada)
15 Reflection by the Inaugural JDN Chair
By Dr Xaviour WALKER (New Zealand/United States)
20 Reflection by the Inaugural JDN Deputy Chair
By Dr Lawrence LOH (Canada)
22 JDN Management Teams (2011−2020)
25 Reflections by Former JDN Chairs
By Dr Thorsten HORNUNG (Germany), Dr Nivio MOREIRA (Brazil), Dr Ahmet
MURT (Turkey), Dr Caline MATTAR (Lebanon/United States), and Dr
Chukwuma ORAEGBUNAM (Nigeria)
Junior Doctors Network Newsletter
Issue 20
October 2020
Page 4
Table of Contents
32 Reflections by Former JDN Officers
By Dr Kostas RODITIS (Greece), Dr Wunna TUN (Myanmar), Dr Paxton
BACH (Canada), Dr Yassen TCHOLAKOV (Canada), and Dr Maki OKAMOTO
(Japan)
41 Reflections about the Future and Memorable Experiences by Former
JDN Officers
By Dr Kazuhiro ABE (Japan), Dr Gbujie Daniel CHIDUBEM (Nigeria), Dr Mike
Kalmus ELIASZ (United Kingdom), Dr Chibuzo NDIOKWELU (Nigeria), Dr
Mariam PARWAIZ (New Zealand), and Dr Fatima Cody STANFORD (United
States)
43 Reflections about the Future by the JDN Management Team
(2019−2020)
By Dr Yassen TCHOLAKOV (Canada), Dr Julie BACQUÉ (France), Dr
Christian KRAEF (Germany), Dr Uchechukwu ARUM (Nigeria), Dr Lwando
MAKI (South Africa), Dr Lyndah KEMUNTO (Kenya), Dr Helena CHAPMAN
(Dominican Republic), Dr Maki OKAMOTO (Japan), and Dr Chukwuma
ORAEGBUNAM (Nigeria)
48 Reflections about the Future by the JDN Publications Team
(2019−2020)
By Dr Helena CHAPMAN (Dominican Republic), Dr Victor ANIMASAHUN
(Nigeria), Dr Ricardo CORREA (Panama/United States), Dr Suleiman Ahmad
IDRIS (Nigeria), Dr Vandrome NAKUNDI KAKONGA (Democratic Republic of
the Congo), Dr Nneka OKAFOR (Nigeria), Dr Mariam PARWAIZ (New
Zealand), Dr Jeazul PONCE HERNÁNDEZ (Mexico), and Dr Kostas RODITIS
(Greece)
51 Accomplishments of the JDN Publications and Communications
Teams (2012−2020)
54 Reflection by a Former Communications Director
By Dr Wunna TUN (Myanmar)
Junior Doctors Network Newsletter
Issue 20
October 2020
Page 5
Table of Contents
56 Reflections about the Future by JDN Members
By Multiple Authors
64 Reflections about the Impact of Global Health Contributions by JDN
Members
By Multiple Authors
66 Reflections about Memorable Collaborations by JDN Members
By Multiple Authors
69 Junior Doctors Lead COVID-19 Response Efforts: Session at the JDN
Virtual Meeting 2020
By Dr Dabota Yvonne BUOWARI (Nigeria) and Dr Wunna TUN (Myanmar)
71 JDN Offers an Optimal Platform for Collaboration
By Dr Dabota Yvonne BUOWARI (Nigeria)
75 Fostering Global Health Collaborations among Junior Doctors: Eight
Years of Achievements
By Dr Helena CHAPMAN (Dominican Republic) and Dr Victor ANIMASAHUN
(Nigeria)
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
79 Personal Experiences of Public Health Doctors in the Republic of
Korea
By Dr Keyhoon KIM (Republic of Korea) and Dr Sejin CHOI (Republic of
Korea)
82 My JDN, My Passion
By Dr Dabota Yvonne BUOWARI (Nigeria)
83 My Face Mask
By Dr Dabota Yvonne BUOWARI (Nigeria)
Junior Doctors Network Newsletter
Issue 20
October 2020
Page 6
Table of Contents
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
84 Challenges of Residency Training and Early Career Doctors in Nigeria
By Dr Ugo ENEBELI (Nigeria), Dr Oladimeji ADEBAYO (Nigeria), Dr
Okhuaihesuyi UYILAWA (Nigeria), Dr Aliyu SOKOMBA (Nigeria), and Dr
Olusegun Olaopa (Nigeria)
88 Transition to Telehealth and Telemedicine: The “New Normal” in the
Training of Surgical Residents in the Philippines
By Dr Maymona CHOUDRY (Philippines)
91 Doctors’ Well-being: Igniting the Light Inside You
By Dr Uchechukwu ARUM (Nigeria)
94 Telemedicine Applications during the COVID-19 Pandemic in
Myanmar
By Dr Hsu MYAT (Myanmar)
97 COVID-19 and Children: Global Dialogue for Junior Doctors
By Dr Rujvee PATEL (India)
100 International Collaborations in the Post-Pandemic Era: Focus on the
After Action Review
By Dr Chiang Kuan YU (Taiwan)
JUNIOR DOCTORS’ ACTIVITIES
103 Junior Doctors Advocate for Justice: The 30-Day Record
By Dr Jaehyeon JANG (Republic of Korea)
107 Managing COVID-19 Contact Tracing Teams in Las Vegas, Nevada
By Dr Kristina Mihajlovski (United States)
INTERNATIONAL CONFERENCES
109 Inclusive Participation in Global Surgery at the UN General
Assembly during the COVID-19 Pandemic
By Dr Manon PIGEOLET (Belgium) and Dr Fabiola CASTEDO CAMACHO
(Bolivia/Uruguay)
Junior Doctors Network Newsletter
Issue 20
October 2020
Page 7
Dear colleagues from around the world,
It is my pleasure to introduce the 20th issue of the Junior Doctors Network (JDN)
Newsletter. As the JDN celebrates its 10th anniversary this fall, it is only appropriate to
reflect on the progress made over these last few years, and how the world has changed.
❑ Ten years ago, some junior doctors (now JDN alumni) were dedicated to develop the
JDN, while current JDN members had not yet started medical school.
❑ Ten years ago, the JDN consisted of only a handful of members, whereas now we have
over 500 members from all parts of the world. JDN membership continues to increase
each month.
❑ Ten years ago, junior doctors had few opportunities to become involved in health policy
activities at an international level, whereas the JDN now offers these professional
opportunities.
As we celebrate this JDN milestone, I reflect on the halfway point of being a junior doctor.
As I have been actively involved in the JDN for the past five years, I have appreciated the
opportunities to meet colleagues, exchange novel ideas, and understand our different
experiences and perspectives in the medical field. As these experiences have shaped how
I perceive the world, I sincerely hope that the JDN will continue fostering such experiences
for all junior doctors.
Over the past few months, there have been many unexpected and unwelcome changes in
the world. Although we had hoped to meet face-to-face with many old friends and new
members in Córdoba, we will encourage our global dialogue through this virtual meeting.
Nevertheless, I am hopeful that we will foster meaningful connections among junior
doctors. The written words of our colleagues in the pages to come are one important way
to highlight leadership efforts, and I hope that you enjoy the reading as much as I did.
Sincerely,
Yassen Tcholakov
Junior Doctors Network Newsletter
Issue 20
October 2020
Words from the Interim Chair
TEAM OF OFFICIALS’ CONTRIBUTIONS
Yassen Tcholakov, MD MScPH MIH
Interim Chair (2019−2020)
Junior Doctors Network
World Medical Association
Page 8
It is my pleasure to welcome you to the 10th Anniversary Edition of the Junior Doctors
Network (JDN) Newsletter.
My JDN history began in 2016, when I joined the Japan Medical Association – JDN. At that
time, I was unaware of JDN. Now, JDN has become an essential part of my life!
Through my participation in international conferences, I was inspired by energetic junior
doctors from all over the world and interactive discussions regarding the future of medical
practice and global health. We must continue to develop collaborations that allow shared
learning and foster professional networks across nations.
Supported by the World Medical Association (WMA), the JDN provides this international
platform, where JDN members can share their passion and enthusiasm to enhance
medical practices and support global health initiatives.
We hope that you enjoy the articles! Please join our JDN activities, where you can make
lifelong friendships, share your leadership activities, and be inspired by your colleagues!
We look forward to your participation, so that we can strengthen our future collaborations!
Take care and stay safe,
Maki Okamoto
Junior Doctors Network Newsletter
Issue 20
October 2020
Words from the Communications Director
Maki Okamoto, MD
Communications Director (2019−2020)
Junior Doctors Network
World Medical Association
Dear colleagues,
TEAM OF OFFICIALS’ CONTRIBUTIONS
Figure 1. List of JDN media resources.
To learn more information about
JDN activities and updates,
please visit the JDN media
accounts (Figure 1).
Media Resource
Website https://www.wma.net/junior-doctors/
Mailing List https://goo.gl/forms/jCP774K1fldLIoWj1
Twitter @WmaJdn
Facebook (Members) WMA-JDN
Facebook (Public) WMA JDN
Instagram wma_jdn
Page 9
Junior Doctors Network Newsletter
Issue 20
October 2020
Words from the Publications Director
Dear JDN colleagues,
On behalf of the Publications Team (2019-2020) of the Junior Doctors Network (JDN), we
are excited to share the JDN 10th Anniversary Special Edition of the JDN Newsletter with
junior doctors across the world.
As the coronavirus disease 2019 (COVID-19) pandemic affects all nations, we have
observed that junior doctors are a valuable resource for all national health systems. Our
medical and public health expertise in clinical management, community health, medical
education, policy activities, and research applications is fundamental to advance scientific
inquiry and discovery.
This JDN 10th Anniversary Special Edition of the JDN Newsletter includes narratives and
scientific articles from former and current JDN members from across the globe. JDN
founders highlight valuable reflections that provide a timeline of essential steps and
encountered challenges during the development of this global network. Their historic
leadership and commitment will forever be remembered and appreciated as the next
generation of junior doctors join the JDN.
The JDN Newsletter offers a global platform where junior doctors across the globe can
share their expertise and leadership activities in local and national health initiatives. Their
experiences can encourage other junior doctors to lead health promotion efforts as well as
enhance communication between World Medical Association (WMA) and JDN members.
We acknowledge the enthusiasm and leadership of all editors of the JDN Publications
Team 2019-2020 as we finalized this Special Edition. We appreciate the continued support
of the JDN Management Team and WMA leadership as we disseminate this key junior
doctors’ resource. We invite you to learn about the JDN history and the inspiring work of
junior doctors across the world!
Together in health,
Helena Chapman
Helena Chapman, MD MPH PhD
Publications Director (2019−2020)
Junior Doctors Network
World Medical Association
TEAM OF OFFICIALS’ CONTRIBUTIONS Page 10
The Junior Doctors Network (JDN) 10th Anniversary Working Group was created by junior
doctors in May 2020, motivated by their enthusiasm to formally report the accomplishments
of the JDN since its foundation in October 2010 in Vancouver, Canada.
JDN members planned to hold this special 10th Anniversary event during the World Medical
Assembly (WMA) General Assembly, which was scheduled to be held in October 2020 in
Cordoba, Spain. With the emerging coronavirus disease 2019 (COVID-19) pandemic – and
the need to transition from an in-person to virtual event – the JDN Management Team and
Working Group worked collaboratively to organize a two-day virtual event with an
energizing agenda that accommodates time zones and JDN member participation.
Special thanks to all members and supporters of the JDN 10th Anniversary Working Group!
We have come a long way in the past 10 years, and we will go even further in the next 10
years!
Junior Doctors Network Newsletter
Issue 20
October 2020
JDN 10th Anniversary Working Group Update
SPECIAL SERIES: 10th JDN ANNIVERSARY
Julie Bacqué, MD
Secretary (2019−2020)
Junior Doctors Network
World Medical Association
❑ WMA/JDN conference presentations
❑ JDN articles for the World Medical
Journal and JDN Newsletter
❑ “Question and Answer” session with
JDN members
❑ Biannual JDN Newsletter (Theme: JDN
10th Anniversary)
❑ Medical Ethics video with interviews of
previous officers
❑ Social media campaign
Figure 1. Coordinated activities for the
WMA/JDN Meeting in October 2020.
The Working Group, consisting of 26 JDN
members, coordinated their first meeting in June
2020 to discuss their proposed action plan
(Figure 1). The primary goals were to highlight
the JDN history, milestones, and achievements
over the past 10 years; showcase junior doctors’
global leadership and activities; and encourage
JDN members to engage in future projects.
“Empowering young physicians to work together towards a
healthier world through advocacy, education, and international
collaboration”
Page 11
In celebration of the 10th Anniversary of the Junior Doctors Network (JDN), we are humbled
to include some reflections from Dr Otmar Kloiber, Secretary General of the World Medical
Association (WMA). On behalf of the JDN Management Team, we are indebted to the
strong support of WMA leadership for JDN activities, including the JDN Newsletter (Photo
1).
Junior Doctors Network Newsletter
Issue 20
October 2020
Words from the WMA Secretary General
SPECIAL SERIES: 10th JDN ANNIVERSARY
Otmar Kloiber, MD
Secretary General (2005−2020)
World Medical Association
What element has been the most satisfying in
knowing that you have helped to create and
support the JDN over the past 10 years?
The JDN has become a real global platform, bringing
together young physicians to discuss and join in
national and global health care issues. Since its
inauguration ten years ago, it has been continuously
working with a steady increase in participation and
activities – a real success story.
What has surprised you the most about how the
JDN has evolved over the past 10 years?
Working together with the JDN requires significant
financial and time investment as well as stamina to
sustain these efforts. Yet, the JDN has developed
steadily over time. In a very short time, the JDN has
been recognized by other organizations as the global
organization for young physicians. This external
recognition of the JDN is fantastic and beyond
anything that we could have predicted.
Photo 1. WMA leadership.
Credit: Dr Maki Okamoto.
Page 12
What do you think are the most pressing issues that junior doctors around the world
will have to address in the coming decade?
The JDN has vividly engaged in the big contemporary global health questions – Universal
Health Care, Climate Change, and Digitization – among other pressing issues. However,
the patient-physician relationship is under constant attack. Economic pressure and
commoditization of health care, coupled with command and control ambitions by
governments and payers, threaten the professional autonomy of physicians. The patient-
physician relationship is a generational challenge that starts with junior physicians’ working
conditions and leads to the question of clinical independence in the future. It is now when
the decisions are being made about how well and how freely physicians can best serve
their patients in the next decade.
The WMA currently serves as a role model to National Medical Associations (NMAs)
by showing that junior doctors have a voice and can contribute positively to the
organization. What else do you think that the WMA can do to further encourage
NMAs to empower junior doctors nationally to engage in international work?
Our NMAs are very different. About half of the NMAs are private organizations, and the
other half are statutory bodies, where membership is usually defined by the law. The latter
group often comprises the regulatory body in their respective countries. In both groups,
some NMAs are simultaneously trade unions. In the past, the participation of young
physicians has been very different in our member organizations. As an organization, the
WMA is traditionally comprised of the senior leadership of the NMA. During the past
decade, it has become far more sensitive to the next generation’s questions and problems.
This has triggered substantial interest related to the involvement of young leaders in their
NMAs from both sides. In some NMAs, this has already considerably changed the
cooperation with young physician groups. As the WMA has been and will continue to be a
catalyst for such change, the JDN has been an important facilitator for these actions.
Regarding the role of junior doctors in national health systems, what advice would
you offer current JDN leaders and members on potential leadership and training
activities in global health?
The physician community has always been and still remains under the threat to be divided.
There is always a threat to be divided between family physicians and other specialists,
employed and self-employed, and young and senior physicians. Global health must be an
integral part of all of our thinking. Another dichotomy would not be productive for our global
health efforts.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY Page 13
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections by the JDN Founders
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Xaviour Walker (Inaugural Chair, 2010−2012)
The development of the JDN has been a joy to watch and a privilege to serve
as co-founder and Inaugural JDN Chair.
Dr Lawrence Loh (Inaugural Deputy Chair, 2011−2012)
I am so pleased to see how JDN has turned into the leading platform and
voice for the interests of young physicians and physician trainees around the
world.
Page 14
In 2006, I had just attended the International Federation of Medical Students’ Associations
(IFMSA) General Assembly (March 2006) in Australia, followed by the IFMSA Asia-Pacific
Regional Meeting (March 2007) in Japan. I was now a first-year doctor and an IFMSA
alumnus. As president of the New Zealand Medical Students’ Association (NZMSA), I was
actively involved in joining the NZMSA to IFMSA at the IFMSA General Assembly (August
2006) in Serbia. Prior to this meeting, I was introduced by a mutual friend to Lawrence Loh
(Canada), who was the IFMSA Americas Regional Coordinator. This key introduction was
the start of a long friendship (Photo 1).
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflection by the Inaugural JDN Chair
Xaviour Walker, MD
Inaugural JDN Chair (2010−2012)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
The initial idea for the Junior Doctors Network (JDN) began in 2007.
Photo 1. Dr Xaviour Walker.
Credit: Dr Maki Okamoto.
At the IFMSA General Assembly (August 2006) in
Serbia, Lawrence Loh helped support our
successful NZMSA application for IFMSA
membership. As my graduation approached and
my IFMSA participation ended, my interest in
global health had increased. During my time as
NZMSA President (2005−2006), I had observed
the implementation of the Doctors-in-Training
Council (DITC) in the New Zealand Medical
Association (NZMA) and learned about a similar
program in Australia. This step had filled the
national void of junior doctor advocacy
representation in New Zealand and also allowed
the NZMSA President to sit as an ex-officio
member on the DITC. Ultimately, this model
successfully increased communication between
NZMSA and junior doctors.
Page 15
When I was at the IFMSA Asia-Pacific Regional Meeting (March 2007) in Osaka, Japan, I
was traveling on a bus with Ahmed Ali (IFMSA President). He described his participation in
the World Medical Association (WMA) meeting and interest to increase IFMSA alumni
involvement at these meetings. I discussed how the Doctors-in-Training model had
successfully worked in New Zealand and Australia. Next, we researched other junior doctor
bodies – namely, the British Medical Association junior doctors and the American Medical
Association Residents and Fellows section – and developed an initial steering committee to
work on increasing junior doctor representation in the WMA.
Over numerous Skype meetings and emails, we developed a proposal on the
establishment of a Doctors-in-Training Chair and Committee within the WMA committee
structure. At this time, I was pursuing my medical residency in the United States
(Massachusetts), and Dr Lawrence Loh was completing his public health training in the
United States (Maryland) and Canada. Through our frequent communication, we presented
the proposal at the WMA General Assembly (May 2010) in France and received initial
acceptance but no firm commitment. With the IFMSA General Assembly (August 2010) in
Montreal, Canada, near my residence, I traveled by bus and met the Dr Dana Hanson
(WMA President). Dr Dana Hanson was extremely supportive of increasing junior doctor
representation in the WMA and shared that a similar idea was previously raised by the
Canadian Association of Internes and Residents (CAIR). Notably, I met Dr Adam Kauffman
(CAIR President) who had incredible energy and support at this important time.
As I attended the WMA General Assembly (October 2010) in Vancouver, Canada, I
connected with Dr Adam Kauffman and other CAIR members. Dr Dana Hanson suggested
that individuals join as WMA Associate Members and that a group of individuals could form
a group or platform, where we would be able to present our proposal.
As I met other junior doctors from the Asia-Pacific region, I learned that Korean junior
doctors had a strong national medical association, and Japanese junior doctors wanted to
develop a national association. As a result of these conversations and networks, Japanese
junior doctors coordinated their national medical association, which is one of the strongest
junior doctor networks to date.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
In October 2010, we created the first global representation of
junior doctors at the WMA General Assembly in Canada.
Page 16
After this foundation in 2010, we revised the provisional name (Junior Doctors Committee,
JDC) to Junior Doctors Network (JDN) to highlight the team synergy and collaboration. We
developed the terms of reference with brief descriptions to allow flexibility within the bylaw
restrictions as the JDN grew. We prepared for our next participation in the WMA General
Assembly (April 2011) in Sydney, Australia, where Dr Will Perry and several Australian
junior doctors attended. We also focused our efforts on the WMA General Assembly
(October 2011) in Montevideo, Uruguay, to coordinate a one-day meeting before the
General Assembly. We realized that since the WMA General Assemblies occurred around
the world, we could coordinate our JDN meetings by connecting with junior doctors of the
respective country. As such, we worked closely with junior doctors from South America,
including Brazil, where coincidentally Dr Nivio Moreira would later become the JDN Chair
(2013−2014). Hence, at the WMA General Assembly (October 2011) in Uruguay, we
conducted our first election, where three leadership positions were filled by JDN members
with previous IFMSA experiences – JDN Chair (Dr Xaviour Walker, New Zealand/United
States), Deputy Chair (Dr Lawrence Loh, Canada), and Secretary (Dr Thorsten Hornung,
Germany) (Photos 2-3).
As subsequent JDN meetings were held in the Czech Republic (April 2012), Thailand
(October 2012), Indonesia (April 2013), Brazil (October 2013), Japan (April 2014), and
South Africa (October 2014), each meeting increased in attendance and involved more
junior doctor networks developed across different countries (Photos 4-5). We had JDN
meetings in the Eastern Mediterranean Region in Turkey (2013) and Lebanon (2014),
which was fundamental for growth and support of this region. Likewise, The Junior Doctors
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 3. JDN Executive Board
(2011−2012) at WMA General Assembly
2011 in Uruguay. Credit: JDN.
Photo 2. JDN delegation at the WMA General Assembly 2011 in
Uruguay. Credit: JDN.
Page 17
of Africa was established in 2014 by Dr Patrick Ezie (Nigeria) and other African junior
doctors, providing a network of support and advocacy for this region. Over time, there has
been continued communications with IFMSA medical students and formal relationships
with the World Federation of Medical Education (WFME), guided by the leadership of Dr
Ahmet Murt (Chair, 2014−2016) and other JDN members.
As the JDN became active in World Health Organization (WHO) activities, we attended the
pre-World Health Assembly (WHA)with senior WMA leadership and the WHA (2013). Over
that year, the JDN involvement in WHA, WHO, and UN activities grew significantly, and two
major steps were taken. First, JDN leaders – including Dr Lawrence Loh (Canada), Dr
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 5. JDN delegation at the WMA General Assembly 2014 in South Africa.
Credit: JDN.
Photo 4. JDN delegation at the WMA General Assembly 2012 in Thailand.
Credit: JDN.
Page 18
Jean-Marc Bourque (Canada), Dr Elizabeth Wiley (United States), Dr Caline Mattar
(Lebanon/United States), Dr Paxton Bach (Canada), Dr Yassan Tcholakov (Canada) – led
contributions to numerous WMA policies. Some policies included the Social Media and
Medicine (white paper), Physician Wellbeing, Ethical Considerations in Global Medical
Electives, Nuclear Weapons (revision), Trade Agreements and Policy Health, and Delhi
Declaration on Climate Change (revision). Second, JDN Communications and Publications
Directors – Dr Wunna Tun (Myanmar), Dr Ricardo Correa (United States), Dr Kazuhiro Abe
(Japan), and Dr Helena Chapman (Dominican Republic) – led the development of the JDN
Newsletter that highlight junior doctors’ leadership activities across their nations. JDN
Communications Directors also strengthened the JDN presence on the WMA/JDN
webpage and other social media channels.
The development of the JDN has been a joy to watch and a privilege to serve as co-
founder and inaugural JDN Chair (Photo 6). It has and still very much a team effort
focused on representing junior doctors on a global level. Although I have acknowledged
several names in this reflection, there are many more JDN leaders who have played pivotal
roles.
On behalf of the JDN founders, I would like to sincerely thank the WMA senior leadership
for their support and trust that encouraged JDN members to turn our vision into a reality. To
the current and future JDN leadership and members, we wish you all the very best, and I
am grateful to virtually celebrate this 10th Anniversary with our JDN family.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
The development of the JDN has been a
joy to watch and a privilege to serve as
co-founder and inaugural JDN Chair.
Photo 6. Reflection by Dr Xaviour Walker.
Credit: Dr Maki Okamoto.
Page 19
As I have had the privilege of serving as co-founder and inaugural Deputy Chair of the
Junior Doctors Network (JDN), it is amazing to see the progress over the past 10 years
(Photo 1). While the idea of a young physician’s platform had been kicked about for a long
time in the early 2000s, it was a conversation with Dr Xaviour Walker (New Zealand) in his
kitchen in Boston on a cold weekend in March 2010 that brought me on board and
launched us on the path to making it a reality.
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflection by the Inaugural JDN Deputy Chair
Lawrence Loh, MD, MPH, FCFP, FRCPC, FACPM
Co-founder and Inaugural Deputy Chair (2011−2012)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
I am so pleased to see how JDN has turned into the leading
platform and voice for the interests of young physicians and
physician trainees around the world.
The best part of being a JDN leader was
witnessing the shared idealism that exists among
young doctors worldwide (Photo 2). Our
collaborative tasks aimed to advance the interests
of JDN members and supported the broader
agenda and discussions of the World Medical
Association (WMA). These experiences offered me
insight into global health diplomacy and physician
leadership. Since those formative years, I went on
to serve in public health at all three levels of the
Canadian government and currently have the
privilege of heading up a large county health
department in the Greater Toronto area.
Photo 1. Dr Lawrence Loh.
Credit: Dr Maki Okamoto.
Page 20
I hope that the next 10 years of the JDN will continue to see this premier platform for young
physicians grow and mature further, continuing to confidently find its voice within the WMA
and among all JDN members. As this network can expand the dialogue on pressing
medical challenges of our time, new young physician champions can continue to make a
difference in global health. The JDN has always been a place where you can collaborate on
climate change − or on a karaoke song − and the platform will continue to influence the
trajectory of the WMA, JDN member activities, and global health initiatives, for years to
come (Photo 3).
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 3. Inaugural JDN officers hard at work at the WMA
General Assembly 2011 in Uruguay. Credit: JDN.
My JDN memories – including the
enthusiasm and idealism – are a
wellspring that I tap into when the going
gets tough – like this year! The
professional network and friendships
still remain beyond my JDN leadership.
Photo 2. Reflection by Dr Lawrence Loh.
Credit: Dr Maki Okamoto.
Page 21
Junior Doctors Network Newsletter
Issue 20
October 2020
JDN Management Teams (2011−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Table 1. List of the JDN Management Team members (2011−2014).
Position 2011−2012 2012−2013 2013−2014
Chair
Dr Xaviour Walker
New Zealand/United
States
Dr Thorsten Hornung
Germany
Dr Nivio Moreira
Brazil
Deputy Chair
Dr Lawrence Loh
Canada
Dr Jean-Marc Bourque
Canada
Dr Caline Mattar
Lebanon/United
States
Secretary
Dr Thorsten
Hornung
Germany
Dr Nivio Moreira
Brazil
Dr Ahmet Murt
Turkey
Socio-Medical
Affairs
Dr Fatima Cody
Stanford
United States
Dr Elizabeth Wiley
United States
Education
Dr Ricardo Correa
Panama/United States
Dr Ian Pereira
Canada
Medical Ethics
Dr Paval Mankal
United States
Dr Paval Mankal
United States
Membership
Dr Caline Mattar
Lebanon/United States
Dr Alexandros
Papadopoulos
Greece/France
Publications
Dr Kostas Roditis
Greece
Dr Hyunyoung
Deborah Shin
Republic of Korea
Communications
Dr Hyunyoung
Deborah Shin
Republic of Korea
Dr Wunna Tun
Myanmar
Immediate Past
Chair
Dr Xaviour Walker
New Zealand/United
States
Dr Thorsten
Hornung
Germany
Immediate Past
Deputy Chair
Dr Lawrence Loh
Canada
Dr Jean-Marc
Bourque
Canada
Page 22
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Table 2. List of the JDN Management Team members (2014−2017).
Position 2014−2015 2015−2016 2016−2017
Chair
Dr Ahmet Murt
Turkey
Dr Ahmet Murt
Turkey
Dr Caline Mattar
Lebanon/United States
Deputy Chair
Dr Patrick Ezie
Nigeria
Dr Elizabeth Wiley
United States
Dr Paxton Bach
Canada
Secretary
Dr Guillaume Dedet
France
Dr Kostas Roditis
Greece
Dr Kostas Roditis
Greece
Socio-Medical
Affairs
Dr Elizabeth Wiley
United States
Dr Kimberly
Golding Williams
Canada
Dr Yassen Tcholakov
Canada
Education
Dr Ian Pereira
Canada
Dr Ghaisani
Fadiana
Indonesia
Dr Mariam Parwaiz
New Zealand
Medical Ethics
Dr John Zorbas
Australia
Dr Fehim Esen
Turkey
Dr Chukwuma
Oraegbunam
Nigeria
Membership
Dr Naira Costa
Brazil
Dr Chiaki Mishima
Japan
Dr Chiaki Mishima
Japan
Publications
Dr Ricardo Correa
Panama/United
States
Dr Ricardo Correa
Panama/United
States
Dr Gbujie Daniel
Chidubem
Nigeria
Communications
Dr Wunna Tun
Myanmar
Dr Wunna Tun
Myanmar
Dr Mardelangel
Zapata
Peru
Immediate Past
Chair
Dr Nivio Moreira
Brazil
Dr Ahmet Murt
Turkey
Immediate Past
Deputy Chair
Dr Caline Mattar
Lebanon/United
States
Dr Elizabeth Wiley
United States
Page 23
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Table 3. List of the JDN Management Team members (2017−2020).
Position 2017−2018 2018−2019 2019−2020
Chair
Dr Caline Mattar
Lebanon/United
States
Dr Chukwuma
Oraegbunam
Nigeria
Dr Audrey Fontaine
France
Deputy Chair
Dr Chukwuma
Oraegbunam
Nigeria
Dr Yassen
Tcholakov
Canada
Dr Yassen
Tcholakov*
Canada
Secretary
Dr Kostas Roditis
Greece
Dr Sydney Mukuka
Zambia
Dr Julie Bacqué
France
Socio-Medical
Affairs
Dr Yassen
Tcholakov
Canada
Dr Mike Kalmus
Eliasz
United Kingdom
Dr Christian Kraef
Germany
Education
Dr Audrey Fontaine
France
Dr Audrey Fontaine
France
Dr Uchechukwu
Arum
Nigeria
Medical Ethics
Dr Sydney Mukuka
Zambia
Dr Lwando Maki
South Africa
Dr Lwando Maki
South Africa
Membership
Dr Chiaki Mishima
Japan
Dr Chiaki Mishima
Japan
Dr Lyndah Kemunto
Kenya
Publications
Dr Kazuhiro Abe
Japan
Dr Helena Chapman
Dominican Republic
Dr Helena Chapman
Dominican Republic
Communications
Dr Chibuzo
Ndiokwelu
Nigeria
Dr Anthony
Chukwunonso Ude
Nigeria
Dr Maki Okamoto
Japan
Immediate Past
Chair
Dr Caline Mattar
Lebanon/United
States
Dr Chukwuma
Oraegbunam
Nigeria
Immediate Past
Deputy Chair
Dr Paxton Bach
Canada
Page 24
*Interim Chair from June−October 2020
The Junior Doctors Network (JDN) is a group of young doctors with a vision to work
together to improve health for all people through a powerful network to address common
problems. As junior doctors, we experience numerous challenges throughout our medical
training. During my tenure, I have interacted with other JDN members and gained insight
into challenges faced by junior doctors across nations (Photos 1-2). As global health
leaders, we should continue to advocate for robust medical training and improved access
to health care services for all global citizens. Together, we should stand up for our patients
each day!
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections by Former JDN Chairs
Thorsten Hornung, MD
Chair (2012−2013)
Secretary (2011−2012)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 1. Dr Thorsten Hornung.
Credit: Dr Maki Okamoto.
Photo 2. Reflection by Dr Thorsten Hornung.
Credit: Dr Maki Okamoto.
Page 25
The Junior Doctors Network (JDN) is a group of young doctors from around the world who
seek to improve global health by working together and exchanging experiences (Photos 1-
2). Even though we are from different countries, languages, and cultures, we have more in
common than we imagine. After all, we are friends for life from all over the world!
Junior Doctors Network Newsletter
Issue 20
October 2020
Nivio Moreira, MD
Chair (2013−2014)
Secretary (2012−2013)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 1. Dr Nivio Moreira.
Credit: Dr Maki Okamoto.
Photo 2. Reflection by Dr Nivio Moreira.
Credit: Dr Maki Okamoto.
Page 26
It is a great pleasure to see that the Junior Doctors Network (JDN) is celebrating the 10th
anniversary (Photo 1). Looking back, it was not easy to start a new network in today’s
world – plus keep it active for a decade. The JDN has all the reasons to celebrate this
victory. While the internal rules and procedures have been shaped over this first 10-year
period, the second 10-year period will offer additional leadership experiences to strengthen
this foundation.
Junior Doctors Network Newsletter
Issue 20
October 2020
Ahmet Murt, MD
Chair (2014−2016)
Secretary (2013−2014)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
I am confident that the JDN will become a more powerful voice
over the next decade, highlighting innovative leadership,
strong ethical values, and creative applications in community
health and policy.
The JDN offers the opportunity to network with
fellow junior doctors, share training experiences,
and build essential skills like negotiation. Notably,
the lives of junior doctors are composed of multiple
challenges – such as work-life balance, economic
stress, and career development – that can increase
anxiety. For this reason, the JDN advocates for
policies that protect junior doctors’ health and well-
being during their training. I believe that the support
of World Medical Association (WMA) leaders has
been the most important during this journey.
Photo 1. Dr Ahmet Murt.
Credit: Dr Maki Okamoto.
Page 27
During my JDN leadership, my biggest challenge was the difficult discussions of the WMA
Governing Working Group regarding the future of the JDN. However, by developing an
organized agenda with clear objectives to facilitate dialogue between JDN and National
Medical Association members, we observed that members identified challenges and
offered potential solutions to strengthen the future outlook of the JDN.
The JDN family provides essential support for medical training, career planning, ethical
scenarios, and other social aspects of medicine (Photo 2). As a JDN member, your
innovative perspectives to emerging health topics are valuable contributions to global
dialogue. Your participation in JDN activities will strengthen your career development as
you continue your path in global health!
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
As a JDN member, you belong to a global
family of passionate health professions
who want to contribute significantly to
improve community health!
Photo 2. Reflection by Dr Ahmet Murt.
Credit: Dr Maki Okamoto.
Page 28
The Junior Doctors Network (JDN) has gathered a very diverse group of junior doctors from
around the world. The bonds that we build in the JDN are unique. Our common identity
brings us together and our friendships, despite being miles away from each other, will last a
lifetime. Looking back, I fondly remember our JDN meeting at the World Medical
Association (WMA) General Assembly (October 2017) in Chicago, Illinois (United States). It
was a very exciting moment when the WMA Council Chair recognized the JDN’s efforts,
advocacy, and expertise at the WMA General Assembly.
Junior Doctors Network Newsletter
Issue 20
October 2020
Caline Mattar, MD
Chair (2016−2018)
Deputy Chair (2013−2014)
Membership Director (2012−2013)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 1. Dr Caline Mattar.
Credit: Dr Maki Okamoto.
During my time as JDN Chair, I learned about
myself and grew both as a leader and physician
(Photo 1). I understood that patience, empathetic
listening, and staying calm in the face of adversity
are essential leadership strategies to address
difficult situations. I also faced my biggest
challenge related to the skepticism about being the
first female leader of the JDN. However, through
cohesive teamwork and transparent
conversations, this skepticism quickly resolved,
and the team thrived. The network grew in
membership and gained its place on the WMA
policy scene, with external partners as a strong
advocate for young physicians and early career
health professionals to collaborate on an array of
global health issues.
I truly saw how far we have come as an organization by building
our global network and encouraging in-depth discussions on
pressing health issues.
Page 29
The JDN has come so far in just 10 years to become the voice of young physicians globally
(Photo 2). It has brought like-minded people together from across the globe, with a true
belief that as the next generation of doctors, we have the duty and the power to improve
health for all. I see the JDN continuing in this path, and growing exponentially to ensure
that voices of junior doctors from low- and middle-income countries are heard. I continue to
be inspired every day by my JDN colleagues, and I know that they will be building an even
stronger network to make the world a better, healthier place.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photo 2. Reflection by Dr Caline Mattar.
Credit: Dr Maki Okamoto.
JDN was accepted as not only the
voice of youth in the WMA, but also as
a wealth of expertise on different
matters, which helps further the
mission of the organization as a whole.
Page 30
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
The Junior Doctors Network (JDN) is a network that continues to expand its reach among
junior doctors across the world. I have enjoyed connecting with junior doctors who share
the same zeal and passion for health promotion for all. Over my tenure, I have learned
about the central role of policy development and impact on global health systems (Photos
1-2). Over the next 10 years, I am confident that the JDN will continue to provide more
opportunities for junior doctors to influence change in the World Medical Association
(WMA) and lead global health initiatives that promote health for all global citizens.
Chukwuma Oraegbunam, MWACP MRCPSYCH
Chair (2018−2019)
Junior Doctors Network
World Medical Association
Photo 1. Dr Chukwuma Oraegbunam.
Credit: Dr Maki Okamoto.
Photo 2. Reflection by Dr Chukwuma
Oraegbunam. Credit: Dr Maki Okamoto.
Page 31
I envision the year 2030, when the Junior Doctors Network (JDN) is celebrating its 20th
anniversary. Junior doctors from all over the world onboard the JDN-World Medical
Association (WMA) continue making significant changes in their communities with their
innovative ideas and leadership towards a healthier and more prosperous society. They
work together in smaller teams to achieve a better tomorrow for future generations.
Over my tenure, I was honored to have served as the JDN Publications Director for one
year and Secretary for three consecutive years. Notably, I still remember our excitement
when the Paris Agreement on Climate Change was passed, as JDN was a key contributor
to the successful outcome. This action led to WMA’s delegation at the UN climate
meetings.
During my term, my biggest lesson learned was that nothing can be done without teamwork
and mutual enthusiasm. One of the greatest challenges I faced was how to increase
participation on our monthly JDN teleconferences and how to encourage productive and
inclusive dialogue. I will always remember establishing new friendships from different
countries and cultures, and I look forward to connecting at future WMA and JDN meetings!
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections by Former JDN Officers
Kostas Roditis, MD MSc
Secretary (2015−2018)
Publications Director (2012−2013)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
The JDN serves as the main conduit for junior doctors to bring
positive change locally, nationally, regionally, and internationally.
Page 32
Over the past few years, my leadership with the Junior Doctors Network (JDN) has
influenced my personal and professional development. I have expanded my global network
through valuable interactions with fellow junior doctors from around the world.
In 2012, Prof S. Kyaw Hla, vice president of the Myanmar Medical Association, informed
me about JDN activities and offered the business cards of Dr Thorsten Hornung
(Germany), Dr Xaviour Walker (New Zealand), Dr Lawrence Loh (Canada), and Dr
Hyunyoung Deborah Shin (Republic of Korea) from the World Medical Association (WMA)
General Assembly in Bangkok, Thailand. At this event, Myanmar reestablished the WMA
membership after 40 years of separation. Reflecting on the past, I remember my Medical
Ethics course that had described the WMA and Declaration of Geneva.
In 2013, after I contacted Dr Thorsten Hornung (Germany), I formalized my WMA associate
membership and became a JDN member. In May 2013, I attended my first JDN meeting at
the WMA General Assembly in France, where I met with JDN members – Dr Thorsten
Hornung (Germany), Dr Xaviour Walker (New Zealand/United States), Dr Lawrence Loh
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Wunna Tun, MBBS MD
Communications Director (2013−2016)
Junior Doctors Network
World Medical Association
Photo 1. WMA and JDN delegations to the first
pre-World Health Assembly meeting at the WMA
General Assembly 2013 in France. Credit: JDN.
(Canada), Dr Ian Pereira (Canada), Dr Jean-
Marc Bourque (Canada), Dr Ahmet Murt
(Turkey), Dr Fernando Rivas (Spain), Dr Kostas
Roditis (Greece), Dr Nivio Moreira (Brazil), Dr
Caline Mattar (Lebanon/United States), and Dr
Elizabeth Wiley (United States) – and WMA
leadership and staff – Dr Mukesh Haikerwal
(WMA Chair of Council), Dr Cecil Wilson (WMA
President), Dr Otmar Kloiber (WMA Secretary
General), Yoonsun (Sunny) Park (WMA Head of
Operations), Anna-Marie Delage (WMA Office
Secretary), and Lamine Smaali (WMA Associate
Member Office Secretary) (Photo 1).
As people say, memories are significant in our lives.
Page 33
By spending over two weeks at this WMA/JDN meeting, we were able to collaborate
together to build the WMA statement for the World Health Assembly (WHA), which fostered
our professional relationships as colleagues.
In October 2013, I was selected as the JDN Communications Director with the
responsibility of preparing the JDN Newsletter and maintaining communication with the
JDN membership via the website and listserv. After discussing the website with the WMA
Secretariat, we agreed that there would be biannual webpage updates after each WMA
General Assembly and WMA Council Meeting.
In 2014, I enjoyed worked directly with Dr Chiaki Mishima (Japan), Dr Kazuhiro Abe
(Japan), and other Japan Medical Association-JDN members on coordination efforts for the
WMA Council Meeting in Tokyo, Japan (Photo 2). In 2015, I continued to work with the
Confederation of Medical Associations in Asia and Oceania (CMAAO) meeting in Myanmar
and attend the WMA/JDN meetings in Norway and Russia. As I transitioned out of my
position as Communications Director in 2016, I continued to lead the Working Group on
Working Conditions with Dr Heng-Hao (Leo) Chang (Taiwan) and attended the WMA/JDN
Meetings in Argentina (2016), Taiwan (2016), Kuwait (2016), Zambia (2017), Iceland
(2018), and Georgia (2019).
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
I was enthusiastic to educate the JDN
membership about the incredible work that JDN leaders
completed to strengthen the JDN foundation.
Photo 2. WMA and JDN delegations at the WMA General Assembly 2014 in Japan. Credit: JDN.
Page 34
It was an honour to be a part of the Junior Doctors Network (JDN) leadership, and it brings
me great pride to watch the JDN grow and evolve as an organization. My most memorable
moment as a member of the JDN leadership team was chairing the group tasked with the
development of a new strategic plan. As this task was finalized at the World Medical
Assembly (WMA) General Assembly (October 2017) in Chicago, Illinois (United States), it
allowed me to reflect on the JDN history and aspirations for the future.
These friends continue to inspire me to be a better physician, advocate, and human being.
I congratulate the new leadership team and look forward to watching them continue to
empower young physicians to work together towards a healthier world.
Junior Doctors Network Newsletter
Issue 20
October 2020
Paxton Bach, MD
Deputy Chair (2016−2017)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY
Most importantly, I will always remember the incredibly
talented friends that I made throughout my JDN tenure.
Page 35
During the summer of 2010, between my first and second years of medical school, I
attended my first International Federation of Medical Students’ Associations (IFMSA)
General Assembly (GA) in Montreal: IFMSA August Meeting 2010. I had the unusual
pleasure of attending my first GA while also on the Organizing Committee for the event. I
met some colleagues whom I would only meet again many years later, as they were
finishing their tenure in IFMSA and working towards the creation of the Junior Doctors
Network (JDN). Indeed, only a few months later, unbeknown to me, the 61th World Medical
Association (WMA) GA was held in Vancouver, Canada. Notably, the JDN was founded at
this GA. During the following years, I continued my involvement with IFMSA and assumed
a variety of roles, which eventually led me to interacting with my JDN colleagues during the
66th World Health Assembly (May 2013) in Geneva, Switzerland.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Yassen Tcholakov, MD MScPH MIH
Interim Chair (2019−2020)*
Deputy Chair (2018−2020)
Socio-Medical Affairs (2016−2018)
Junior Doctors Network
World Medical Association
*Interim Chair from June−October 2020
Photo 1. Dr Yassen Tcholakov.
Credit: Dr Maki Okamoto.
Throughout medical school, I continued to pursue my
global health interests through my IFMSA leadership.
However, during this time, I also observed that some
colleagues graduated and ended their global health
engagements, while others transitioned into the JDN
and continued their engagement in similar global
policy activities. As I was reflecting on my own future
plans in global health, I participated in the first
meeting of the United Nations Framework
Convention on Climate Change (UNFCCC) group
tasked with drafting the Paris Agreement in 2015 in
Geneva, Switzerland. At this point, I decided that I
wanted to continue participating in global policy
processes, selecting a public health residency
instead of an anesthesiology residency.
There is no single path to becoming involved with the JDN, yet I am
sure that my story shares similarities with those of my JDN colleagues.
Page 36
In 2015, I continued to attend these climate change negotiations, as I transitioned from
IFMSA to WMA membership. As I interacted with JDN members, I observed their same
curiosity about global health, same desire to meet colleagues with diverse ideas, and
passion to collaborate on important issues to the role of junior doctors in their health
systems (Photos 1-2). While I know that many JDN members also share similar global
health experiences through IFMSA, I have developed key friendships with other junior
doctors who were not IFMSA members. While I initially joined the JDN with the instrumental
goal of continuing certain global health activities, I have enjoyed the multiple opportunities
to meet colleagues with similar global health interests yet different perspectives (Photos 3-
4). These professional encounters have fostered friendships over time.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Photos 3-4. JDN delegation to the 72nd World Health Assembly (WHA72) in Switzerland.
Credit: JDN.
The JDN has always been an amazing
gathering space to meet peers, junior
doctors, and senior colleagues who share
their diverse experiences in clinical
specialties and health systems.
Photo 2. Reflection by Dr Yassen Tcholakov.
Credit: Dr Maki Okamoto.
Page 37
Over the last five years, I have learned to appreciate three elements. First, as the JDN
offers numerous opportunities to confront ideas and opinions and learn from others, it is
important to allow individual opinions to grow and change. Second, when in a position of
power, it is crucial to learn to care about the topics of shared interest with others, in order to
work collectively to achieve these goals with the same energy as if they were your own
goals. Finally, although professional activities are important, karaoke sessions can serve as
valuable entertainment after a long day of meetings, while enhancing connections and
fostering teamwork.
In 10 years, I imagine that the JDN will remain as a group with whom I can still feel at
home, and which will also continue to impress me. I hope to see even greater diversity than
we see today as well as closer interactions between current JDN members and alumni.
This network can offer opportunities for commitment and leadership in meaningful long-
term projects, positioning the WMA and JDN as key international players in global health.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Moving into this new decade, I am confident that the JDN will
continue to grow and develop robust collaborations on
emerging global health issues.
When I finish my tenure in the JDN, I am hopeful that I will
still feel the vibrant connections with JDN colleagues and
remain impressed by the next leadership of junior doctors
across the world.
Page 38
As the World Medical Association – Junior Doctors Network (WMA-JDN) welcomes the
10th anniversary, I reflect on the moment when I first joined the JDN. I still clearly
remember the details of my first international conference as an unforgettable experience in
my medical career! These professional experiences and interactions with JDN colleagues
have inspired me to the present day (Photos 1-2)!
Four years ago, I joined the management team of the Japan Medical Association – JDN
(JMA-JDN). I was enthusiastic to form part of this leadership team, where I was able to
collaborate on national and international initiatives. At the national level, I aimed to expand
the network of junior doctors in Japan and seek opportunities to foster stronger connections
between junior doctors and senior doctors. Some of these activities included inviting junior
doctors to professional networking events that were hosted or co-organized with the
regional medical association.
Junior Doctors Network Newsletter
Issue 20
October 2020
Maki Okamoto, MD
Communications Director (2019−2020)
Junior Doctors Network
World Medical Association
SPECIAL SERIES: 10th JDN ANNIVERSARY Page 39
Photo 1. Dr Maki Okamoto.
Credit: Dr Maki Okamoto.
At the international level, I was able to participate in
several WMA conferences – WMA General
Assembly 2016 in Taiwan and 2017 in the United
States – and was inspired by energetic colleagues
and interactive discussions on essential health
topics (Photos 3-4). After the conferences, JDN
members would continue these discussions during
social hours, sharing ed perspectives on the future
of medical practice. I was surprised to observe the
efficiency of JDN leadership, dynamic discussions
on pressing health issues, and energetic junior
doctors who aimed to contribute to global health
initiatives.
Although the world has been changed dramatically due to the emergence of the
coronavirus disease 2019 (COVID-19) pandemic, we must continue to develop robust
collaborations that allow shared learning and foster professional networks across nations. I
dream of a day in the near future when our JDN family can interact with our in-person
activities again!
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
As change agents, our dedicated
efforts will advance the future of
medical practice and global health!
Page 40
Photo 4. JDN delegates at the WMA General Assembly
2017 in the United States. Credit: JDN.
Photo 3. JDN delegates at the WMA General
Assembly 2016 in Taiwan. Credit: JDN.
Photo 2. Reflection by Dr Maki Okamoto.
Credit: Dr Maki Okamoto.
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about the Future and Memorable
Experiences by Former JDN Officers
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Kazuhiro Abe (Japan)
As more junior doctors become involved in JDN activities, their
global health leadership will be recognized across national health
systems. The JDN Newsletter will continue to serve as a robust
communication platform, which will encourage junior doctors to
share their scientific perspectives and experiences in valuable
article contributions.
Dr Gbujie Daniel Chidubem (Nigeria)
The JDN offers junior doctors an opportunity to connect with
colleagues across geographic regions and serve as advocates for
critical public health issues. During my tenure, our team was able
to establish social media platforms to project JDN activities in the
African region. Over the next decade, I am sure that the JDN will
support the continued growth of the JDN Newsletter. This essential
resource provides insight on emerging global health issues and
dialogue on how nations can take future steps to achieve the
targets of the Sustainable Development Goals.
Dr Mike Kalmus Eliasz (United Kingdom)
In 10 years, I am confident that the JDN will continue to provide a
space for early career physicians to discuss global health issues,
with initiatives such as the pre-WHA. The JDN will grow in number
and become more diverse in its membership and leadership, with
more participating physicians from national organisations. With a
scope to shape global health policy-making as a WMA/JDN
network, the JDN will be recognized as a global forum for all junior
doctors.
Page 41
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Chibuzo Ndiokwelu (Nigeria)
The JDN is a network of junior doctors who are passionate about
contributing to global health leadership in clinical care, community
health, and policy activities. During my tenure, my most
memorable experiences were the networking, fraternization, and
sharing of medical knowledge at the WMA General Assemblies. In
10 years, I believe that the JDN will serve as an integral branch of
the WMA, with speaking rights at the WMA Council and General
Assemblies.
Dr Mariam Parwaiz (New Zealand)
In 10 years time, I believe that the JDN will continue the amazing
efforts related to advocacy on climate change, safer working hours
for junior doctors, and research and publications on antimicrobial
resistance. The JDN will also strengthen the network and foster
relationships with other junior health professional associations. I
believe that the current JDN leaders will serve as future WMA
leaders and will provide mentorship and support to future JDN
leaders. I am excited for the next 10 years of the JDN!
Dr Fatima Cody Stanford (United States)
In the JDN, I was enthralled with the cohesion between members
and the genuine respect we shared. It gave me hope that there
were like-minded individuals ready to engage in optimal patient
care.
Page 42
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about the Future
by the JDN Management Team (2019−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Yassen Tcholakov (Interim Chair, 2019−2020)
The JDN will be a role model for inclusiveness and equity within the WMA and in front of
other global organizations. The breadth and scope of the JDN’s influence around the world
will expand as the network grows, and alumni remain engaged and contribute their
mentorship to current JDN members.
Dr Julie Bacqué (Secretary, 2019−2020)
I imagine that the JDN will become more engaged in WMA’s activities as core
representatives and advocates for junior doctors. Due to our professionalism and
collaborations over the past decade, our network has continued to expand globally. The
JDN founders have instilled a spirit that continues to unite and empower all JDN members,
which will perpetuate for the next 10 years!
Page 43
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Christian Kraef (Socio-Medical Affairs Officer, 2019−2020)
The JDN is a much needed global network of junior doctors to organize dialogue across the
world. We share knowledge and ideas and aim to communicate the most pertinent topics
within and outside the medical profession. For the next 10 years, I hope for more
autonomous structures appropriate to the role and contribution of junior doctors in health
systems.
Dr Uchechukwu Arum (Education Director, 2019−2020)
For me, JDN is a symbol of the youthful enthusiasm towards achieving a healthier world. It
represents selfless engagement in advocacy, interaction, and exchange of ideas. In the
next 10 years, I would like to see JDN as a strong voice in health advocacy on the global
stage.
Page 44
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Lwando Maki (Medical Ethics Officer, 2019−2020)
I imagine that the JDN will reach its full leadership potential, where junior doctors can
engage in global activities that address pressing issues across health systems.
Dr Lyndah Kemunto (Membership Director, 2019−2020)
I envision the JDN as a global leader in advocacy for young physicians and other emerging
fields in health care.
Page 45
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Helena Chapman (Publications Director, 2019−2020)
Over the next 10 years, the JDN will continue to serve as an international platform for junior
doctors to share their significant leadership activities related to clinical care, community
health, education, policy, and research. Through JDN working group activities, JDN
Newsletter issues, and WMA/JDN meetings, junior doctors will showcase their
indispensable role in the implementation of local and national initiatives that aim to
minimize community risk of endemic and epidemic health threats.
Dr Maki Okamoto (Communications Director, 2019−2020)
The JDN has allowed junior doctors to connect and collaborate across the globe! I am
confident that the JDN will continue to develop collaborations that allow shared learning
and foster professional networks across nations!
Page 46
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Chukwuma Oraegbunam (Immediate Past Chair, 2019−2020)
I would like to see the JDN as a network that continues to expand its reach among junior
doctors all over the world. I am confident that the JDN will provide more opportunities for
junior doctors to influence change in the WMA and lead global health initiatives that
promote health for all citizens.
Acknowledgments: Special thanks to Dr Maki Okamoto (Communications
Director, 2019−2020) for her dedicated efforts to showcase our JDN
leadership in these captivating images!
Page 47
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about the Future
by the JDN Publications Team (2019−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Helena Chapman (Dominican Republic)
Over the next 10 years, the JDN Publications Team will continue to
offer an important platform for the global community of junior
doctors. The JDN Newsletter will serve as an avenue for junior
doctors to share their expertise, reflections, and leadership activities
related to clinical care, community health, education, policy, and
research. This network will allow junior doctors to identify
knowledge gaps and develop approaches that encourage scientific
inquiry and discovery for emerging One Health challenges.
Dr Victor Animasahun (Nigeria)
In 10 years, I believe that the JDN will gain more popularity and
acceptance among junior doctors globally. High-quality information
from the JDN Newsletters will empower junior doctors to build
capacity in global health education and research, emerging One
Health issues, and cultural competence. The JDN Publications
Team will offer opportunities for JDN collaborations, which will result
in a geometric increase in social and human capital and make them
agents of positive change in our world.
Dr Ricardo Correa (Panama/United States)
Within the next five or 10 years, I envision the JDN Newsletter
transitioning into a JDN scientific journal, as a valuable resource
produced by junior doctors for the global scientific community. This
would provide an opportunity for JDN members to publish their
global health activities and learn about the rigorous editorial process
of peer review. Since the JDN Newsletter provides real-time
information about JDN activities, this dynamic platform can
strengthen interactions between junior doctors around the world.
Page 48
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Suleiman Ahmad Idris (Nigeria)
The JDN Publications Team constitutes a group of young early-
career leaders in global health who work together to strengthen
scientific communication. A decade from now, I believe that team
members will continue to expand the potential impact of these
scientific contributions of junior doctors across the globe.
Dr Vandrome Nakundi Kakonga
(Democratic Republic of the Congo)
Two years ago, I joined the JDN Publication Team and contributed
to the editorial review of JDN articles. Through these article
submissions, I observed that junior doctors are prepared to manage
real-time health challenges as they are already involved in
community health activities in their countries and international
organisations. In 10 years, I remain optimistic that the JDN will
remain a strong advocate at all levels for the accessibility of the
basic health services to all populations.
Dr Nneka Okafor (Nigeria)
In 10 years, I would like the JDN Publications Team to continue
promoting high-quality content of junior doctors’ global health
leadership and activities through the JDN Newsletters.
Page 49
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Mariam Parwaiz (New Zealand)
In 10 years time, I envision the JDN Newsletter as a regular and
highly-anticipated feature of the JDN calendar. It will continue to
be an avenue for junior doctors to share articles, stories, events,
and research of note, while also providing a safe and friendly
opportunity for junior doctors to learn more about the editorial
process. I believe in the next 10 years, the reach of the JDN
Newsletter will grow even further, and it will be globally recognized
across all country-level junior doctor organisations.
Dr Jeazul Ponce Hernández (Mexico)
In 10 years, I believe that the JDN Publications Team will expand
in size and increase in cultural diversity, uniting more junior
doctors from across the globe. Junior doctors will be able to share
diverse perspectives on the best approaches to strengthen health
initiatives that focus on disease prevention. During the COVID-19
pandemic, we have observed that robust public health and
preventive medicine are keys to population health.
Dr Kostas Roditis (Greece)
I envision the JDN Publications Team serving as a core
component of the JDN-WMA structure and the JDN Newsletter
being read by thousands of junior doctors from all over the world. I
believe that junior doctors will have joined forces under JDN-
WMA’s family by 2030, working together in smaller teams and in
unison towards achieving a better tomorrow for future generations.
The JDN would then serve as the main conduit for junior doctors
to bring on change locally, nationally, regionally, and
internationally.
Page 50
Junior Doctors Network Newsletter
Issue 20
October 2020
Accomplishments of the JDN Publications and
Communications Teams (2012−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Table 1. List of the Publications and Communications Directors (2012−2020) and published JDN Newsletters.
Year
Publications
Director
Communications
Director
JDN Newsletters
2019−2020
Dr Helena Chapman
Dominican Republic
Dr Maki Okamoto
Japan
Issue 20 (October 2020)
Issue 19 (July 2020)
Issue 18 (April 2020)
Issue 17 (March 2020)
2018−2019
Dr Helena Chapman
Dominican Republic
Dr Anthony
Chukwunonso Ude
Nigeria
Issue 16 (October 2019)
Issue 15 (April 2019)
2017−2018
Dr Kazuhiro Abe
Japan
Dr Chibuzo
Ndiokwelu
Nigeria
Issue 14 (October 2018)
Issue 13 (April 2018)
2016−2017
Dr Gbujie Daniel
Chidubem
Nigeria
Dr Mardelangel
Zapata
Peru
2015−2016
Dr Ricardo Correa
Panama/United States
Dr Wunna Tun
Myanmar
Issue 10 (July 2016)
Issue 9 (March 2016)
2014−2015
Dr Ricardo Correa
Panama/United States
Dr Wunna Tun
Myanmar
Issue 8 (October 2015)
Issue 7 (June 2015)
2013−2014
Dr Hyunyoung
Deborah Shin
Republic of Korea
Dr Wunna Tun
Myanmar
Issue 6 (October 2014)
Issue 5 (August 2014)
Issue 4 (April 2014)
Issue 3 (March 2014)
2012−2013
Dr Kostas Roditis
Greece
Dr Hyunyoung
Deborah Shin
Republic of Korea
Issue 2 (July 2013)
Issue 1 (February 2013)
Page 51
Junior Doctors Network Newsletter
Issue 20
October 2020
JDN Publications Directors (2012−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Kazuhiro Abe
(2017−2018)
Dr Helena Chapman
(2018−2020)
Dr Ricardo Correa
(2014−2016)
Dr Gbujie Daniel
Chidubem
(2016−2017)
Dr Hyunyoung
Deborah Shin
(2013−2014)
Dr Kostas Roditis
(2012−2013)
Page 52
Junior Doctors Network Newsletter
Issue 20
October 2020
JDN Communications Directors (2012−2020)
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Hyunyoung
Deborah Shin
(2012−2013)
Dr Maki Okamoto
(2019−2020)
Dr Anthony
Chukwunonso Ude
(2018−2019)
Dr Chibuzo Ndiokwelu
(2017−2018)
Dr Mardelangel Zapata
(2016−2017)
Dr Wunna Tun
(2013−2016)
Page 53
In October 2013, I was selected as Communications Director (2013−2014) and assumed
the responsibility of Editor-in-Chief of the Junior Doctors Network (JDN) Newsletter. I
followed in the footsteps of Dr Hyunyoung Deborah Shin (Republic of Korea), who served
as the first Communications Director (2012−2013). Throughout my tenure as
Communications Director (2013−2016), I am appreciative for the support and guidance
from previous JDN leadership – Dr Hyunyoung Deborah Shin (Republic of Korea), Dr
Kostas Roditis (Greece), Dr Ricardo Correa (Panama/United States), and the JDN
Management Team.
The JDN Newsletter has seen and weathered many monumental changes to become the
current version today. However, the ambition of the World Medical Association (WMA)
leadership, JDN Management Team, and JDN founders have helped the JDN Newsletter
achieve milestones. The publication frequency was typically three times per year, as a
realistic and sustainable goal for the editorial team.
During my first year as Communications Director, I contacted the International Standard
Serial Number (ISSN) office to learn the steps to obtain an ISSN, a global identification
code used by publishers for the citation of journals, newspapers, and newsletters. As the
ISSN would offer international recognition of the JDN Newsletter by automatic inclusion in
the International Serials Directory Database, our team submitted supporting evidence that
the online and paperback versions of the JDN Newsletter had a regular publication
schedule throughout the year. Subsequently, we received two separate ISSN for the online
(2312-220X) and paperback (2415-1122) versions, respectively.
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflection by a Former Communications Director
SPECIAL SERIES: 10th JDN ANNIVERSARY
Wunna Tun, MBBS MD
Communications Director (2013−2016)
Junior Doctors Network
World Medical Association
The Junior Doctors Network (JDN) Newsletter is a platform for
sharing JDN activities around the world between its members and
National Medical Associations.
Over my three-year tenure, our team produced a total of eight
resourceful JDN Newsletters.
Page 54
Our team disseminated our call for articles from JDN and National Medical Association
(NMA) members on topics related to local and regional meetings, ongoing projects, team
updates, interviews, and country or association issues related to junior doctors. We also
prepared editorials on pressing health topics to share with JDN members. Notably, we
received support for the layout (similar to WMA documents) and printing by Dr Nivio
Moreira (JDN Chair, 2013−2014) and the Brazilian Medical Association, and the JDN
Newsletter was distributed online via the WMA/JDN listserv and in paperback format at the
WMA General Assembly and JDN meetings each year. On behalf of our team, we are
grateful for the combined leadership efforts – JDN Management Team, Communications
Team, and JDN authors and readers – toward achieving the established goals of the JDN
Newsletter.
After my tenure, other JDN members led the development of the JDN Newsletter – Dr
Mardelangel Zapata (Communications Director, 2016–2017), Dr Kazuhiro Abe (Publications
Director, 2017–2018), and Dr Helena Chapman (Publications Director, 2018–2020). I am
inspired by our JDN Publications and Communications Directors as they contribute their
expertise to developing this essential publication, even in times of limited schedules.
Notably, Dr Helena Chapman led the JDN Publications Team as they developed the
COVID-19 Special Edition of the JDN Newsletter, in efforts to showcase the dedicated
efforts of junior doctors during the global COVID-19 response efforts.
My memories will always include my inspirational interactions with my JDN family!
Stay safe everyone!
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
The JDN Newsletter continues to serve as a high-quality
resource for junior doctors and demonstrates this successful
collaboration between authors and editors.
Over the next 10 years, I am confident that the JDN Newsletter
will continue to offer valuable insight, leadership experiences,
and scientific updates for junior doctors worldwide!
Page 55
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about the Future by JDN Members
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Hashim Abdeen (Australia)
In 10 years, I hope to see the JDN continue to build upon its strong
links and networks with global National Medical Association’s Junior
Doctor Committees and aid those countries looking to create their
own JDN to support junior doctors in their countries. The WMA and
JDN should continue to be the peak representative body of junior
doctors worldwide, supporting their education, training, and overall
well-being. I see the JDN as a group of motivated and empowered
junior doctors who foster an environment of collaboration and
ultimately a network which builds lifelong colleagues.
Dr Vyom Agarwal (India)
Although new to the JDN, I have observed high enthusiasm and
warm interactions over the past few months. I am confident that in
the coming decade, JDN members would scale greater heights and
play a fundamental role in fostering shared information exchanges,
supplementing global expertise, and influencing policy making.
Dr Victor Animasahun (Nigeria)
Over the next decade, I am confident that the JDN will provide more
opportunities where junior doctors can participate in skill-building
activities that strengthen their expertise in an array of medical and
public health topics. As a JDN family, our continued collaborations
across borders will advance scientific knowledge and offer insight to
national health systems. After all, we are proud to be global agents
of positive change!
Page 56
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Dabota Yvonne Buowari (Nigeria)
In the next decade, I expect the JDN membership will increase and
include all junior doctors and medical students from developing
countries. The JDN should be involved in collaboration with junior
doctors’ national medical associations across different countries. I
believe that new JDN working groups will include research, medical
education, and mentoring. I also foresee the JDN to serve as a
platform for medical exchange programmes, where junior doctors
can connect with colleagues, share essential scientific information,
and produce high-quality resources such as manuscripts and books.
Dr Fabiola Ruth Castedo Camacho (Bolivia/Uruguay)
The JDN is a solid bridge that will contribute to advance access and
quality of health care services, connecting the expertise of our
predecessors and enthusiasm of new generations. Junior doctors
will continue to collaborate on research and community initiatives
that promote the development of ethical and timely health policies
that can guide health systems to improve health promotion and
disease prevention programs.
Dr Sejin Choi (Republic of Korea)
I imagine that the JDN will become more global, united in health
collaborations, and strong in advocacy for pressing health issues.
Through technological advancements, borders and geographic
distance will no longer present barriers in global collaborations. By
encouraging active participation of junior doctors across different
countries, the JDN can exercise its innate power from its
representation − diverse, unique, and innovative junior doctors −
over the next 10 years.
Page 57
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Maymona Choudry (Philippines)
I think that the WMA-JDN will continue to unite young doctors from
around the globe in order to collaborate and share concepts and
ideas toward creating solutions to pressing health challenges. In the
next 10 years, I think that the JDN will expand membership across
countries and create sustainable and innovative solutions to current
health challenges to meet community needs. Junior doctors will
continue to inspire future colleagues to actively participate and
engage in community health projects that aim to achieve the SDGs.
Dr Pablo Estrella Porter (Ecuador)
In 10 years, I imagine the JDN as one of the most relevant global
networks for young doctors who are passionate about global health.
This network will continue to offer a platform for sharing ideas and
collaborating on essential community projects, regardless of cultural,
geographical, and language barriers. Together, we can keep
encouraging junior doctors from across the globe to contribute their
expertise to WMA-JDN activities.
Dr Suleiman Ahmad Idris (Nigeria)
In the next 10 years, I believe that the JDN will continue to unite
junior doctors who strive to collaborate on critical health topics and
make a sustainable impact on health policies on a larger scale.
Page 58
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Yamen Jabr (United Kingdom)
As we move closer to 2030, the JDN will continue to support junior
doctors around the world, in their individual and collective efforts, to
ensure global health equity and sustainability toward achieving the
SDGs!
Dr Jaehyeon Jang (Republic of Korea)
Since the beginning of the JDN, more junior doctors across the
world have joined and actively participated in JDN meetings and
activities. Over the next 10 years, I expect that more junior doctors
will join the JDN family, which will expand country representation,
strengthen activities and initiatives, and enhance the representation
of junior doctors’ voices.
Dr Arturo Julca (Peru)
As an institution with active participation and advocacy across
countries and national medical associations, I believe that the JDN
will continue to participate in international conferences, promote
professional exchanges and scientific collaborations, and organize
advocacy campaigns to inform national decision-makers and
stakeholders.
Page 59
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Keyhoon Kim (Republic of Korea)
I believe that the JDN will increase its membership and scientific
activities. Over the past few months, we have observed that sharing
expertise and resources across our global networks – especially
firsthand experiences and challenges of frontline healthcare
professionals – has been crucial to enhance COVID-19 response
efforts. For this reason, the JDN serves a fundamental role as the
hub for information and resource sharing across the globe.
Dr Benny Loo (Singapore)
In 10 years, I imagine that the JDN will have member
representation from more countries, and together, JDN members
will have a stronger voice in international medical affairs. The JDN
offers junior doctors an array of opportunities to engage in the
discussion of national and international health topics.
Dr Nneka Okafor (Nigeria)
The JDN gave me a sense of belonging, especially when I
discovered that I was not alone in the struggles of being a newly
recruited soldier in the field of medicine. In 10 years, I would like the
JDN to have maintained the highly acclaimed status and become
more organized, where all newly inducted junior doctors would
immediately be incorporated into the JDN network.
Page 60
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Kristina Mihajlovski (United States)
Joint efforts of medical doctors from all around the world during the
COVID-19 pandemic have indicated the importance of international
collaborations in the medical field. Therefore, the significance and
beauty of the JDN relies on strong collaborations between young
physicians globally. In the future decade, I perceive the JDN as a
growing, sustainable, and inspiring organization that young doctors
can rely on for new learning opportunities, support, resources,
fellowships, and creative international projects.
Dr Larisa Mihoreanu (Romania)
On this celebratory occasion of the 10th year anniversary, I would
like to wish the JDN to grow and to create new opportunities of
collaboration across borders. Diversity is the incredible strength of
this network and could also pave the way for new global solutions
for future medical specialists. As the SARS-CoV-2 pandemic is an
unprecedented global challenge, it provides an opportunity for
specialists to accelerate exchanges between disciplines and learn
from each other by providing and implementing appropriate
solutions. With all its energy and creativity, the JDN can be a
global driving force of the present generation to make historic
contributions to safeguard global health and design the future of
health care systems.
Dr Hsu Myat (Myanmar)
I expect that the JDN will create more opportunities to learn, share
experiences, and encourage innovative brainstorming for junior
doctors. In addition to online activities, I hope that the JDN can
extend their network across more countries and implement high-
impact healthcare-related projects within global communities.
Page 61
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Kingsley Ojeikere (Nigeria)
In 10 years, I envisage a JDN with thousands of active members
who work together and contribute to the development of essential
health initiatives across global communities.
Dr Rujvee Patel (India)
Over the past decade, the JDN has had a period of exponential
growth, where JDN leadership and working groups have contributed
high-quality work for their global health activities. Over the next 10
years, the JDN will undoubtedly grow in terms of membership,
networking, and successful projects. I share my warm wishes to all
JDN members as we celebrate our 10th Anniversary and hope for
brighter years coming ahead!
Dr Manon Pigeolet (Belgium)
I believe that the JDN has clearly shown the power of junior doctor
engagements and initiatives in the field of medicine and public
health. For me, the next 10 years will help us consolidate this
position and enable us to address more important topics to junior
doctors all over the world. I wish to see the JDN as a brand of junior
doctor engagement – a brand known across the entire global health
arena and among residents across the world.
Page 62
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Mineyoshi Sato (Japan)
Over the next decade, I hope to see the JDN continue to grow with
more representation from young doctors across the globe. The JDN
serves as an essential platform for young doctors’ voices to
advocate for ethical and appropriate policies that mitigate risk for
emerging global health risks.
Dr Chiang Kuan Yu (Taiwan)
Over the next 10 years, the JDN will continue to provide a global
platform for junior doctors to strengthen their leadership and
networking skills. They can also collaborate on innovative health
initiatives – such as the After Action Review –and participate in
national calls to action for enhanced global health security
measures. Together, as enthusiastic junior doctors, we can
advocate for essential health initiatives and resolutions that
strengthen health policies across the globe.
Page 63
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about the Impact of Global Health
Contributions by JDN Members
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Dabota Yvonne Buowari (Nigeria)
With the existence of the JDN, Nigerian Association of Resident
Doctors (NARD) members have expanded their network and
developed global health programs. First, the Doctors Reach Out
Program (T-DROP) promotes good health for the Nigerian populace
and offers a gratuitous community clinic after each NARD General
Assembly to offer primary health care services to vulnerable
populations. Second, the NARD Medical Education Committee
provides continued professional development activities. Last year,
committee members published the book, “Emergency Handbook: A
Spot Guide”. Finally, the Research Collaborative Network fosters
research collaborations among Nigerian junior doctors.
Dr Jaehyeon Jang (Republic of Korea)
The JDN has served as an essential network for Korean junior
doctors. Even for junior doctors living at far distances, the JDN has
offered opportunities to connect colleagues and expand
collaborations to enhance our global health career development.
Dr Arturo Julca (Peru)
The JDN is a global platform that has allowed professional
networking across geographic regions. It will continue to allow junior
doctors in Peru and the Americas region to strengthen our
knowledge and experiences within the global health sector.
.
Page 64
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Lyndah Kemunto (Kenya)
The WMA and JDN continue to provide an avenue for experienced
and junior professionals to become involved in the global health
agenda. I am incredibly pleased with the network and the
opportunities. We are in a new era, when junior doctors seek non-
clinical career options, recognizing that healthcare is more than
service delivery in a hospital setting. The WMA-JDN network
facilitates this exploration into emerging career options. The JDN
has provided young doctors in Kenya an opportunity to attend
global health events such as the World Health Assembly, WMA
Council Meetings, and NMA conferences. Kenyan doctors have had
the chance to present scientific papers and share local health
experiences with the world. Kenya is excited to host the WMA
224th Council Meeting and JDN Meeting in 2023! #KaribuKenya
Dr Mineyoshi Sato (Japan)
The JDN has offered Japanese junior doctors with opportunities to
collaborate with junior doctors across the globe, regardless of the
selected medical specialty. These collaborations have been
especially evident over the COVID-19 response efforts. This
network is key to foster shared learning and participation in global
health advocacy.
Page 65
Junior Doctors Network Newsletter
Issue 20
October 2020
Reflections about Memorable Collaborations
by JDN Members
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Dabota Yvonne Buowari (Nigeria)
I have gained significant insight and expanded my expertise
through collaborations with JDN members. Through one of these
collaborations, I met Dr Shiv Josh (India) who invited me to serve
as a panelist for the “MED MEET” International UG Medical
Conference (World Amidst Pandemic: Will the Human Race Fight it
Down?) (August 2020). As an international platform for junior
doctors, I encourage JDN members to participate in all JDN
activities as they focus on health promotion, advocacy, and
continuous learning.
Dr Maymona Choudry (Philippines)
As a recent member, I am inspired and motivated by all JDN
activities, especially the development of COVID-19 Working Group
and COVID-19 Special Edition of the JDN Newsletter, where junior
doctors shared their experiences on COVID-19 response efforts.
As these events highlight the dedicated efforts of JDN
members, their leadership continues to empower other junior
doctors like myself to actively participate in future initiatives.
Dr Sejin Choi (Republic of Korea)
Sharing our junior doctors’ experiences with COVID-19 response
efforts was memorable. It was empowering and inspiring to witness
the comradery of JDN members in this global response to mitigate
transmission. I was inspired by the leadership of JDN members in
the COVID-19 Working Group, reflecting on the indispensable role
of JDN in the global health sphere.
Page 66
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Jaehyeon Jang (Republic of Korea)
Without a doubt, organizing the COVID-19 Working Group and the
related survey was the most exciting collaboration. Since the
Republic of Korea was one of the countries that experienced early
COVID-19 transmission, many Korean junior doctors were
enthusiastic to launch the Working Group to share information
across countries. As frontline health care providers, junior doctors
have a pivotal role in COVID-19 response efforts!
Dr Arturo Julca (Peru)
I remember that junior doctors from the Peruvian Medical College
participated in the WMA General Assembly and JDN Meeting (April
2016) in Argentina. This meeting offered valuable professional
networking for our Peruvian junior doctors!
Dr Benny Loo (Singapore)
Without a doubt, the most exciting collaborations have been the
current COVID-19 projects – ranging from the COVID-19 Working
Group, the COVID-19 Special Edition of the JDN Newsletter, and
the COVID-19 discussions at the JDN Meeting 2020. These
activities are fundamental resources for global junior doctors.
Page 67
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dr Mineyoshi Sato (Japan)
The most exciting collaborations have been the opportunities to
invite JDN members – both in-person and virtually – to share their
expertise on global health agendas and career development with
junior doctors in Japan. Without the JDN, sharing valuable scientific
information and expanding these professional networks would not
have been possible!
Page 68
Due to the coronavirus disease 2019 (COVID-19) pandemic, most international
conferences have transitioned to virtual platforms or have been postponed until 2021. The
World Medical Association (WMA) and Junior Doctor Network (JDN) meetings were no
exceptions.
With the dedicated efforts by junior doctors to contribute and lead COVID-19 response
efforts in their communities, the JDN Publications Team prepared a COVID-19 Special
Edition of the JDN Newsletter in July 2020. This issue included 21 articles from JDN
members, highlighting their inspirational leadership efforts across the globe.
Junior Doctors Network Newsletter
Issue 20
October 2020
Junior Doctors Lead COVID-19 Response Efforts:
Session at the JDN Virtual Meeting 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Dabota Yvonne Buowari, MD
Department of Accident and Emergency
University of Port Harcourt Teaching Hospital
Port Harcourt, Rivers State, Nigeria
Wunna Tun, MBBS MD
Fellow in Medical Education
Founder, Myanmar Medical Association
Young Doctor Society
Yangon, Myanmar
“In honour of junior doctors who have been and still are on the
frontline fighting the COVID-19 pandemic as well as to the
colleagues who lost their lives in this fight”
− Dr Wunna Tun
Photo 1. WMA and JDN delegations at the JDN
Meeting 2020. Credit: Dr Yassen Tcholakov.
As the JDN Management Team planned the
agenda of the WMA-JDN meeting on October
3-4, 2020, Dr Dabota Yvonne Buowari
(Nigeria) and Dr Wunna Tun (Myanmar) were
enthusiastic to continue sharing these unique
efforts of junior doctors and developed a
special session for this virtual meeting: “How
COVID-19 Impacts Junior Doctors”. They
coordinated this session, which was open to
all JDN members who wanted to share their
personal experiences from their work during
the COVID-19 pandemic (Photo 1).
Page 69
In this session, “How COVID-19 Impacts Junior Doctors”, brief talks were presented by
junior doctors from 11 countries – Australia, Canada, Greece, India, Indonesia, Malaysia,
Myanmar, Nigeria, Philippines, Republic of Korea, and the United States (Table 1). After
the country presentations, Dr Dabota Yvonne Buowari (Nigeria) and Dr Wunna Tun
(Myanmar) displayed a special video that included inspiring words, photographs, and
videos of junior doctors in their clinical and community activities during the COVID-19
response efforts.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Title Presenter
COVID-19 Response Efforts of Junior Doctors in the
Republic of Korea
Dr Sejin Choi
Junior Doctors Combat COVID-19: The Nigerian Experience Dr Dabota Yvonne Buowari
Impacts of COVID-19 on Junior Doctors in Myanmar Dr Wunna Tun
Junior Doctors Contribute to Expanding Scientific Networks
for COVID-19 Response Efforts in the United States
Dr Kristina Mihajlovski
Dr Helena Chapman
Impacts of COVID-19 on Junior Doctors in the Philippines Dr Maymona Choudry
COVID-19 in Greece: The Junior Doctors’ Perspective Dr Kostas Roditis
Junior Doctors in Indonesia: A Susceptible Group during
the COVID-19 Pandemic
Dr Andi Khomeini
Dr Takdir Haruni
Impacts of COVID-19 on Canadian Junior Doctors Dr Whenzhen (Jen) Zuo
Impacts of COVID-19 on Junior Doctors in Malaysia Dr Myelone Tharmaseelan
Australian Medical Association Council of Doctors in
Training 2020
Dr Hash Abdeen
Dr Gavin Wayne
Impacts of COVID-19 on Junior Doctors in India: Impact
and Proposing Solutions
Dr Rujvee Patel
Dr Bharat Sharma
Table 1. List of country presentations and presenters during the How COVID-19 Impacts Junior Doctors session.
“This JDN session − to better understand the COVID-19 experiences
of junior doctors − aligns with the JDN objectives of encouraging
professional networks and sharing expertise toward scientific
advancement”
− Dr Dabota Yvonne Buowari
Page 70
Networking represents one of the objectives of the Junior Doctors Network (JDN) which
can foster the development of collaborations, made easier by globalization and
technological advancements. Collaboration is key in health professions and can be
achieved through efficient teamwork to support the preparation of manuscripts, technical
reports, and educational resources. Leadership and enthusiasm of junior doctors are
symbols of collaboration as this encourages members to share their reflections and
experiences (1). Collaboration involves coordination, cooperation, and partnership. All the
collaborators benefit from the collaborative partnership (2). This was the sentiment that
prompted Dr Ahmet Murt (JDN Secretary, 2013−2014) to write the article, A Commentary
for International Collaboration among Junior Doctors, in the JDN Newsletter of October
2014.
Collaborations among JDN Members
Since JDN was founded a decade ago, JDN members have developed several working
groups in an array of topics including antimicrobial resistance, global surgery, medical
ethics, primary healthcare, postgraduate medical exchanges, and the coronavirus 2019
(COVID-19). This article will describe selected achievements by JDN members, including
scientific manuscripts (Table 1) and educational webinars and videos (Table 2).
Junior Doctors Network Newsletter
Issue 20
October 2020
JDN Offers an Optimal Platform for Collaboration
SPECIAL SERIES: 10th JDN ANNIVERSARY
“Alone we can do so little, together we can do so much”
− Helen Keller
Dabota Yvonne Buowari, MD
Department of Accident and Emergency
University of Port Harcourt Teaching Hospital
Port Harcourt, Rivers State, Nigeria
“Individual commitment to a group effort − that is what makes a
team work”
− Vince Lombardi
Page 71
Scientific Manuscripts
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Year Title
2011 Social Media and Medicine (WMA/JDN White Paper)
2012 Junior Doctors Network (World Medical Journal)
2014
Junior Doctors’ Work Hours: From Regulations to Reality (World Medical
Journal)
2015
Health in Intended Nationally Determined Contributions (INDCs) (WMA
Technical Report)
Beyond Chlor Hühner & Nürnberger Bratwürste: The Case for Physician &
Organized Medical Advocacy to Promote Health in Trade Agreement
Negotiations (World Medical Journal)
Health and Asylum Seekers in Europe (World Medical Journal)
The Climate/Health Nexus at COP21 & Beyond (World Medical Journal)
2016 Physician Wellbeing: A WMA-JDN Priority (JDN Newsletter)
One Health and Antimicrobial Resistance (World Medical Journal)
2017
Antibiotic Stewardship: Future Steps to Reduce Antimicrobial Resistance in the
Global and Clinical Setting (World Medical Journal)
2018 World Antibiotic Awareness Week 2018 (JDN Newsletter)
Intellectual Property: Who Owns the Right to Good Health? (World Medical
Journal)
Global Surgery: A New and Emerging Field in Global Health (JDN Newsletter)
2019 The Role of Physicians in Fighting Climate Change (World Medical Journal)
2020
Sharing Binational Experiences during the COVID-19 Response: Collaboration
between the Republic of Korea and Japan (JDN Newsletter)
Challenges and Opportunities in Providing Primary Health Care during the
COVID-19 Pandemic in Six Countries (JDN Newsletter)
Table 1. List of selected scientific manuscripts published from 2011−2020.
Page 72
Educational Webinars and Videos by the JDN Global Surgery Working Group
Other Activities
Over the past decade, the JDN Working Group leads – including Antimicrobial Resistance,
Climate Change, Global Surgery, and Medical Ethics – have contributed updates to the
biannual issues of the JDN Newsletters. Notably, over the past year, the JDN Publications
Team collaborated with the Medical Ethics Working Group (Dr Lwando Maki, Chair) to
develop a Medical Ethics Special Section (October 2019) and Special Edition (March 2020)
of the JDN Newsletter.
In light of the COVID-19 pandemic, junior doctors from the Japan Medical Association and
the Republic of Korea designed the Binational Collaborative Virtual Teleconference to
discuss response efforts across nations in April 2020 (3). Likewise, to showcase the
leadership efforts of junior doctors during the COVID-19 response efforts, the JDN
Publications Team prepared a COVID-19 Special Edition of the JDN Newsletter in July
2020.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Year Title Speaker
2019
Webinar: An Introduction to Global
Surgery – How Can Residents and
Junior Doctors Participate in and
Contribute to Global Surgery?
Dr Kathleen Casey (United States)
2019
Video: Advocacy of Global Surgery on
the Challenges of being a Physician
Panelists from Belgium, Morocco,
Nepal, Nigeria, Russia, Uruguay, and
Venezuela
2020 Webinar: Global Surgery Policy
Dr Emmanuel Malabo Makasa
(Zambia)
Table 2. List of selected educational webinars and videos by JDN Global Surgery Working Group from 2019−2020.
Page 73
Conclusion
Over the past 10 years, JDN members have been actively involved in robust collaborations.
Currently, JDN members of several working groups are collaborating on research projects
and scientific projects. It is timely that JDN also launches a formal research working group
to encourage collaborative research among JDN members from different countries and
specialties. All these collaborations have highlighted the words on the JDN Newsletter
cover page: “Empowering young physicians to work together towards a healthier world
through advocacy, education and international collaboration”.
References
1) Chapman H. Words from the publications director. JDN Newsletter. 2020;17:9.
2) Green BN, John CD. Interprofessional collaboration in research, education and clinical practice: working
together for a better future. J Chiropr Educ. 2015;9:1-10.
3) Sato M, Okamoto M, Choi S. Sharing binational experiences during the COVID-19 response:
collaboration between the Republic of Korea and Japan. JDN Newsletter. 2020;19:56-58.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY Page 74
As we reflect on the year 2020, we realize more than ever before that distance is not a
barrier to communication and collaboration. Due to limited international travel during the
coronavirus disease 2019 (COVID-19) pandemic, global societies have adapted to using
virtual platforms for the organization of relevant meetings and summits to achieve their
respective goals. As junior doctors, we can be the driving force for global health action,
using virtual technology to prioritize remote collaborations that highlight knowledge gaps in
medical education, emerging One Health topics, and global health research and practice.
As junior doctors from the Dominican Republic and Nigeria, we describe our fruitful
collaborations over the past eight years – without the opportunity to meet in person – that
highlight the value of global health collaborations among junior doctors.
Junior Doctors Network Newsletter
Issue 20
October 2020
Fostering Global Health Collaborations among Junior Doctors:
Eight Years of Achievements
SPECIAL SERIES: 10th JDN ANNIVERSARY
“Never doubt that a small group of thoughtful, committed, citizens
can change the world. Indeed, it is the only thing that ever has.”
− Margaret Mead
Helena Chapman, MD MPH PhD
Publications Director (2019−2020)
Junior Doctors Network
World Medical Association
Victor Animasahun, MBChB MPH
Member, Publications Team (2019−2020)
Junior Doctors Network
World Medical Association
As physicians-in-training, we served
on the editorial board of the
Auscultate Magazine of the Africa
Region of the International Federation
of Medical Students’ Associations
(IFMSA) from 2012 to 2014 (Photo
1).
Photo 1. The Auscultate Magazine of the International Federation
of Medical Students’ Associations (IFMSA). Credit: IFMSA.
Page 75
As we represented IFMSA-Dominican Republic (Organización Dominicana de Estudiantes
de Medicina, ODEM) and IFMSA-Nigeria (NiMSA), we formed a collegial relationship that
unknowingly matured our connection as significant research collaborators, authors, and
lifelong friends. From 2016 to date, we have published 10 articles in nine medical journals,
averaging two publications per year. Our publication record has included two letters to the
editor, two research publications on cross-sectional designs, two research publications on
reviews, and four publications on scientific perspectives in these nine medical journals
(Table 1). We have also collaborated to present one poster presentation, Innovative
strategies to educate urban communities about Ebola: The case in Sierra Leone and
Guinea, at the XII Central American & Caribbean Congress of Parasitology & Tropical
Medicine in the Dominican Republic in 2015.
Over the past eight years, although we have gained tangible outcomes for our professional
development, most importantly, these valuable collegial interactions have resulted in a
supportive friendship during our formidable years of medical specialty training. Hence, we
highlight three specific lessons that have allowed us to strengthen our roles as physicians,
researchers, and global health leaders.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY
Table 1. List of the collaborative publications and their respective medical journals.
Journal name Article title
Academic Medicine More on Medical Education in Africa
African Health Sciences Psychosocial Health Challenges of the Elderly in Nigeria: A Narrative
Review
International Journal of
Adolescent Medicine and Health
Prevalence of Communication between Mothers and Daughters on
Sexuality and Associated Factors in Sagamu, Southwest Nigeria
Lancet Lassa Fever in Nigeria: The Tale of a Reactive Health System
MEDICC Review Increasing Research Productivity across Africa
Perspectives in Public Health Medical Students as Human Resources for Health to Promote Effective
Physician-patient Communication
Perspectives on Medical
Education
Addressing the Role of Medical Students using Community
Mobilization and Social Media in the Ebola Response
PLoS One A Survey on the Effectiveness of WhatsApp for Teaching Doctors
Preparing for a Licensing Exam
Tobacco Use in Nigerian youth: A Systematic Review
The Clinical Teacher Social Media to Guide One Health Initiatives
Page 76
Contributing Expertise for Shared Learning
“To raise new questions, new possibilities, to regard old problems from a new angle,
requires creative imagination and marks real advance in science” (Albert Einstein). As
junior doctors representing different geographic regions and cultures, we contribute our
unique clinical, community health, and research training to our global health collaborations.
We have shared our personal strengths, medical and public health expertise, and
perspectives on how national and global health systems can be strengthened. Since we
represent different academic institutions, we were able to offer an array of resources – such
as access to scientific journals, connections to professional networks, and waiver
applications for article processing charges – for these successful collaborations. Using
virtual platforms like video teleconferencing and electronic communications, our regular
communication has supported significant contributions that prioritize shared learning.
Gaining Supportive Friendships
“Coming together is a beginning; keeping together is progress; working together is
success” (Henry Ford). Our consistent, transparent communication and empathetic
understanding have offered a safe space to share personal and career goals and express
challenges and hardships. As trust was developed over time, mutual accountability and
peer mentoring were key to learn together and encourage our continued contributions to
global health education, practice, and research. As colleagues and friends, physical
distance was not a barrier but rather served to acknowledge the fact that we are siblings of
the same global health family.
Providing Encouragement and Inspiration
“I can do things you cannot, you can do things I cannot; together we can do great things”
(Mother Teresa). Our mutual collaborations have provided numerous opportunities to
challenge each other to “be more” and “do more” in our respective medical specialty
training. By sharing career success stories with each other, we continue to ignite our global
health passion as we strive to make a positive difference in the health of our local, national,
and global communities. Although the path can often be lonely, when we avail ourselves of
the many brilliant colleagues across the world, we can stimulate positive energy and
continue our journey of pursuing excellence in global health education, practice, and
research.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY Page 77
Together, as junior doctors, we can stress the importance of global health collaborations in
an array of disciplines – clinical care, community health, medical education, and research –
to strengthen our medical and public health training, gain new insight and tangible skills,
and expand our professional networks. Sharing perspectives with one another,
collaborating and learning from each other and leveraging on each other’s strength are
exceptional strategies to develop social and human capital as a framework to building a
strong and impactful global health family.
Junior Doctors Network Newsletter
Issue 20
October 2020
SPECIAL SERIES: 10th JDN ANNIVERSARY Page 78
In the Republic of Korea, public health doctors (PHDs) have always served a cardinal role
in the national scheme for universal health coverage. As an alternative to completing the
18-month compulsory military service, they choose to provide primary care services and
promote community health in medically underserved communities for three years. In this
article, we aim to share some experiences of working as PHDs in rural communities and
correctional facilities, which are the two most common locations for PHD placements
(Figure 1).
Placements in Rural Communities
In rural communities, PHDs serve as primary care physicians at public health centers
located in the areas with limited private medical facilities. On some occasions, PHDs are
assigned to the public health centers of small islands with less than 1000 residents, often
Junior Doctors Network Newsletter
Issue 20
October 2020
Personal Experiences of Public Health Doctors in the
Republic of Korea
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
Keyhoon Kim, MD
Public Health Doctor
Director of International Relations
Korean Association of Public Health Doctors
Seoul, Republic of Korea
Sejin Choi, MD
Public Health Doctor
Vice President, Korean Association of Public
Health Doctors
Seoul, Republic of Korea
Figure 1. Traditional emblem of the Korean
Association of Public Health Doctors. [Translation:
Today and always, we are filling the gap in
medical services of Korea]. Credit: KAPHD, 2020.
as the only medical experts on the island. They
immerse in civic events and gain community trust
as an integral part of the primary care services. In
their clinics, most patients are of elder age (70-80
years old) and require chronic disease
management for diabetes, hypertension, and
dyslipidemia. They educate patients about the
importance of balanced nutrition, physical activity,
and preventative immunizations like influenza to
optimize health and well-being. In addition to these
primary care services, PHDs provide other socio-
medical consultations, including regular visits to the
homes of immobile residents and medical support
at local town festivals.
Page 79
Placements in Correctional Facilities
In the Republic of Korea, there are a total of 52 federal prisons and jails with an estimated
54,000 incarcerated inmates. Under the Republic of Korea’s Ministry of Justice, the
Correctional Service has estimated that a minimum of 116 correctional physicians (besides
PHDs) are needed to provide adequate correctional health services. To date, however, only
94 positions are filled, which are frequently aligned with urban prisons and jails. This human
resource gap for correctional facilities is currently covered by 37 PHDs across the nation
(1). Notably, PHDs are the only physicians within some rural prisons or jails (1).
As PHDs provide primary care services, their patient population differs from their
colleagues with placements in community placements. Many inmates have been diagnosed
with psychiatric disorders (e.g. substance abuse of illegal and prescribed drugs) and an
array of infectious diseases (e.g. tuberculosis). Geriatric inmates (older than 65 years)
constitute more than 10% of the total population, and hence have an increased risk of
chronic diseases including cancer and cardiovascular complications.
Challenges and Potential Solutions
National authorities state that fewer physicians seek employment in public health centers
and correctional facilities due to lower salaries and fewer incentives, when compared to
employment at hospitals and private health institutions. However, although financial
compensation cannot be overlooked, it is not the sole career motivator for the majority of
physicians. Based on their expertise and training, we believe that physicians seek the
opportunity to offer high-quality clinical services to patients, perform their daily clinical
duties in a respectful work environment, and receive medical-legal protections for their
clinical decision-making and management strategies.
First, national authorities can provide proper and continuous training and education
programs for physicians. For example, the Certified Correctional Health Professional
(CCHP) is a certification program that aims to help correctional physicians expand their
medical and public health expertise and skills. Second, they can facilitate a national
dialogue to strengthen medical curricula and motivate medical students to pursue primary
care specialties. Third, they can offer leadership incentives to PHDs who dedicate more
than three years to medically underserved communities.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
To encourage physicians to seek employment in primary care
services, national authorities should recognize these described
challenges and implement specific measures.
Page 80
During the ongoing coronavirus disease 2019 (COVID-19) pandemic, junior doctors’ roles
have expanded beyond primary healthcare services, especially since PHDs are now
serving across all levels of the national quarantine system (Figure 2). The majority of PHDs
work regular shifts at local COVID-19 screening centers and larger quarantine centers.
Other PHDs are assigned to the Korea Centers for Disease Control (KCDC) headquarters
as Epidemic Intelligence Service officers.
As the pandemic becomes controlled over time, we believe that national authorities will
observe the valuable role of junior doctors – including PHDs – and encourage their
continued contribution to the national health system.
Reference
1) Ministry of Justice (Republic of Korea). Korea Correctional Service Statistics 2020. 2020 [cited 2020 Oct
1]. Korean.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
Figure 2. New emblem of the Korean Association of
Public Health Doctors. [Translation: We are fighting at
the frontline of the pandemic]. Credit: KAPHD, 2020.
Moving forward, the national dialogue should highlight the essential
roles of all healthcare workers across public and private sectors, which
can enrich community health initiatives and public health advocacy.
These initial steps can empower physicians to explore work
experiences in primary care services where they can feel
rewarded and contribute positively to clinical care management.
Page 81
Junior Doctors Network Newsletter
Issue 20
October 2020
My JDN, My Passion
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
Dabota Yvonne Buowari, MD
Department of Accident and Emergency
University of Port Harcourt Teaching Hospital
Port Harcourt, Rivers State, Nigeria
A network of junior doctors
Creating professional relationships
A centre of research collaboration
A global scientific network
A platform for showcasing
Junior doctors’ leadership
Distributing informative newsletters
Producing wellness guidelines
A meeting of like minds
Linking colleagues together
On international scientific panels
A decade of existence
You have passed the teething stage
It is time to run
Run, run, run
You shall soar on eagles’ wings
Page 82
Junior Doctors Network Newsletter
Issue 20
October 2020
My Face Mask
JUNIOR DOCTORS’ COMMUNITY REFLECTIONS
Dabota Yvonne Buowari, MD
Department of Accident and Emergency
University of Port Harcourt Teaching Hospital
Port Harcourt, Rivers State, Nigeria
COVID-19 has changed the world
No more handshakes as greetings
No more hugs with close acquaintances
I am scared any day I go to work
I learn about colleagues who have contracted
COVID-19
Facemasks are key to our protection
Compulsory in public places
Made of vivid colours to match dresses
This accessory is now fashionable
It protects me
This difficult time marks history
Our global community will be resilient
Strengthening community support is key
Let’s fight this pandemic together
Wearing the face mask always
Photo 1. Face masks are protective
and fashionable with vivid colours.
Credit: Dr Dabota Yvonne Buowari.
Page 83
In February 2019, the Challenges of Residency Training and Early Career Doctors (ECDs)
in Nigeria (CHARTING) study was developed to explore demographic (e.g. migration,
placement), workplace (e.g. leadership challenges, career satisfaction, training and skills
acquisition, conflict resolution), and psychosocial health risks (e.g. burnout) among ECDs
in Nigeria (1-3). ECDs represent medical or dental graduates who are pursuing
postgraduate service, residency training or internship after their medical or dental
education. This large multi-centre and multi-disciplinary study was developed by the
Research Collaboration Network (RCN), a sub-structure of the Research and Statistics
Committee (RSC) of the Nigerian Association of Resident Doctors (NARD).
Junior Doctors Network Newsletter
Issue 20
October 2020
Challenges of Residency Training and Early Career
Doctors in Nigeria
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Ugo Enebeli, MB.BS
University of Port Harcourt Teaching Hospital
Port Harcourt, Nigeria
Oladimeji Adebayo, MB.BS
University College Hospital
Ibadan, Nigeria
Okhuaihesuyi Uyilawa, MB.BS
Delta State University Teaching Hospital
Ogharra, Nigeria
Aliyu Sokomba, MB.BS
Ahmadu Bello University Teaching Hospital
Zaria, Nigeria
Olusegun Olaopa, BChD
University College Hospital
Ibadan, Nigeria
Page 84
As a two-phased, two-year observational study, the CHARTING I study was conducted
between April and December 2019, with a total of 795 ECD participants from 10 centres.
The CHARTING II study was tentatively scheduled with ECD participants to be completed
between May and December 2020, but due to the coronavirus disease 2019 (COVID-19)
pandemic, data collection is currently ongoing. Data are stored in a NARD administrative
database and managed by study staff and investigators.
Key Findings and Implications
To date, CHARTING I study has been completed, and research findings have been
published in numerous peer-reviewed journals. The list is available on the RSC/RCN
website. In this article, we describe the relevant findings and implications related to ECDs
as they pursue postgraduate residency training in Nigeria (4).
Demographic Factors
Migration. Researchers reported that a high proportion of participants (51.6%), derived
from a population of mainly young males, had stated their intention to emigrate out of
Nigeria after their postgraduate residency training. These findings suggest that many ECDs
represent a migration-predisposed population.
Workplace Challenges
Skills Acquisition. Results showed a lack of up-to-date knowledge, small contingent
rewards, vast workload distribution, limited mentorship, and unequipped training facilities
during residency programs. Similarly, participants believed that residency programs
currently prioritize service delivery rather than postgraduate residency training. These
findings suggest that innovative organizational strategies – such as the revised policies on
job descriptions, increased remuneration and benefits, standardized curricula for medical
school and residency training programs, and increased funding for research laboratories
and grants – should be implemented to mitigate these observed challenges in postgraduate
residency training.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Health authorities should consider the implementation of concrete
policies and incentives to encourage the retention of the ECD
workforce in Nigeria.
Page 85
Leadership and Management Training. Although the majority of participants considered
leadership and management skills as essential skills in clinical practice, only 55.9% had
ever received training on management and leadership, and 38.1% received this training
during medical school.
Psychosocial Health Risks
Burnout. One systematic review demonstrated that the prevalence of burnout in Nigerian
physicians ranged from 23.6% to 51.7%, with the key predictor of young age. Other
predisposing factors included low doctor-patient ratio, extended work hours (over 80 hours
per week), limited availability of supportive services in the department, vague descriptions
of work responsibilities, and observed abuse of power by trainers. Since burnout is
recognized as a severe challenge among ECDs in Nigeria, strategies for mitigating their
risk of burnout should include the development of policies that protect ECDs’ health and
well-being, such as policies with appropriate work schedules, provision of gratuitous annual
medical physicals and mental health counseling, capacity development, and roundtable
discussions with stakeholders.
Future Directions
The CHARTING II study aims to further explore the described elements of demographic
factors, workplace challenges, and psychosocial health risks. Researchers intend to
examine the placement and distribution of ECDs across Nigeria and impacts on family life
(demographic factors); academic and professional performance, influence of social media
technology on training, workplace environment for learning, reasons for attrition, and
perceived satisfaction of training programs (workplace challenges); and psychological
health stressors on clinical performance and other mental health issues (psychosocial
health risks).
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
These findings imply that the integration of leadership training into
medical school curricula has the potential to improve leadership
and management skills among ECDs in Nigeria.
These findings identify the need for robust mental health programs
at clinical workplaces that can identify, manage, and reduce risk of
burnout and other stressors.
Page 86
References
1) Kanmodi K, Ekundayo O, Adebayo O, et al. Challenges of residency training and early career doctors in
Nigeria study (CHARTING STUDY): a protocol paper. Nigerian Journal of Medicine. 2019;28:198-205.
2) National Association of Resident Doctors of Nigeria. Initiating trainee research collaboration network: a
NARD initiative in Nigeria. Abuja, Nigeria: NARD; 2019.
3) Igbokwe M, Babalola I, Adebayo O. CHARTING Study: a trainee collaborative research study. JDN
Newsletter. 2019;16:23-24.
4) Adebayo O, Ogbonna V, Igbokwe MC, et al. Challenges of residency training and early career doctors in
Nigeria. Abuja, Nigeria: National Association of Resident Doctors of Nigeria; 2020.
5) Ogunsuji OO, Adebayo O, Olaopa O, et al. Burnout among Nigerian doctors: a systematic review.
Nigerian Medical Practitioner. 2019;76:24-29.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Continued scientific research can provide insight to health
authorities, stress the need to revise current policies to enhance
ECDs’ health and well-being in the workplace, and encourage the
regular evaluation of this essential health workforce for the
Nigerian health system.
Page 87
Medical training programs have been carefully crafted to meet the needs of medical
practice and health systems over time. Each residency training program is unique to its
specialty, including the academic curriculum, work environment, on-call schedules, and
clinical workload. Each specialty branch – Internal Medicine, General Surgery, Pediatrics,
and Obstetrics-Gynecology – has applied the latest technology to practice, aiming to
improve patient outcomes and provide high-quality health care.
Health care workers (HCWs) are on the frontline of this battle against this novel infection.
The limited availability of resources, such as personal protective equipment, has placed
HCWs at a higher risk of infection via direct and indirect exposure to infected patients. The
COVID-19 pandemic has forced health systems to consider the integration of telemedicine
and telehealth consultations in medical practice.
In the Philippines, the surge in clinical and surgical patient care services has not only
increased the workload, but it has also disrupted the residency training programs for
surgical specialties such as General Surgery (1,2). The academic curriculum that was
designed to enhance surgical skills has faced significant challenges in career mentorship
Junior Doctors Network Newsletter
Issue 20
October 2020
Transition to Telehealth and Telemedicine: The “New Normal”
in the Training of Surgical Residents in the Philippines
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Maymona Choudry, MD MPH
General Surgery Resident
Vicente Sotto Memorial Medical Center
Cebu City, Philippines
“Telemedicine is the natural evolution of healthcare”
– Andrew Watson, MD
With the emergence of the coronavirus disease 2019
(COVID-19) pandemic, significant disruptions were seen
across global health care systems.
Page 88
and physician-patient encounters. In efforts to ensure the health and safety of team
members, there are fewer team meetings and limited clinical and hands-on exposure (2,3).
The loss of normalcy and the added element of fear within their personal and professional
lives have led to physical, mental, and emotional exhaustion of HCWs (4).
As a resident, I have always been enthusiastic to attend national and international
conferences, learn about scientific updates on surgical techniques, and expand my
professional network. However, with limited financial support for these travel expenses, I
have been unable to strengthen my medical training with these professional development
opportunities. Hence, these virtual webinars have offered me the ability to participate in an
array of conferences and symposia, where I can enhance my understanding of surgical
concepts and clinical management focusing on holistic patient-centered care (Photos 2-3).
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Telehealth and telemedicine have opened a path for regional
and international collaborations across clinical disciplines.
This global health crisis has served as an eye-
opener to health systems, motivating the
integration of innovative technology into
medical practice. Instead of traditional face-to-
face consultations, a “new normal” has
emerged using the virtual platform. In our
hospital, our General Surgery department
integrated telemedicine as part of the normal
clinical routine. To continue our clinical and
theoretical learning, traditional large group
conferences and presentations are held on the
Zoom virtual platform (Photo 1). Currently, with
the decreasing incidence of COVID-19 cases in
Cebu City, we have returned to our traditional
workload within the “new normal” lifestyle.
Notably, we are now more adept in conducting
virtual daily endorsements, weekly
conferences, journal appraisals, tumor board or
clinical case presentations, and symposia.
Photo 1. Pre-operative and post-operative
weekly conference via Zoom. Credit: Dr Mopon.
Page 89
The “new normal” policies and workplace environments have shown the resilience and
resourcefulness of all HCWs – including surgical residents – when providing high-quality
health care and ensuring patient safety. This pandemic has provided surgical residents with
an outlet to explore more efficient methods of didactic learning and physician-patient
communication during their training, which may reduce health care expenditure and risk of
burnout (5).
References
1) Liang ZC, Wang W, Murphy D, Hui JH. Novel coronavirus and orthopaedic surgery: early experiences
from Singapore. J Bone Jt Surg Am. 2020;102:745-749.
2) Nassar AH, Zern NK, McIntyre LK. Emergency restructuring of a general surgery residency program
during the coronavirus disease 2019 pandemic: the University of Washington experience. JAMA Surg.
2020;155:624-627.
3) Potts JR, III. Residency and fellowship program accreditation: effects of the novel coronavirus (COVID-
19) pandemic. J Am Coll Surg. 2020;230:1094-1097.
4) Xiang YT, Jin Y, Cheung T. Joint international collaboration to combat mental health challenges during the
coronavirus disease 2019 pandemic. JAMA Psychiatry. 2020;77:989-990
5) Osama M, Zaheer F, Saeed H, Anees K, Jawed Q, SyedSH, Sheikh BA. Impact of COVID-19 on surgical
residency programs in Pakistan: a residents’ perspective. Do programs need formal restructuring to adjust
with the “new normal”? A cross-sectional survey study. International Journal of Surgery (London,
England). 2020;79:252-256.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Photo 3. Presentation of Dr Saldana in
an inter-hospital case conference.
Credit: Dr Mopon.
Photo 2. Presentation of Dr Saldana via Zoom in an inter-
hospital case conference among three participating hospitals
from three different regions in Philippines. Credit: Dr Maderazo.
Moving forward, evidence-based research should continue to
evaluate the efficiency of virtual versus traditional formats for
residency training and health care service delivery.
Page 90
After a distressing work shift, a medical registrar went to purchase a drink from the vending
machine. He noted that there was an inscription on the vending machine: “The light inside
me is off, but I am still working”. After reading this message, he shook his head and
thought, “So am I, vending machine!” (1).
Starting from medical school, doctors experience long work hours, passing through
different crucibles, burning the late-night candles to complete their medical training. When
they graduate from medical school, the clock restarts as their postgraduate training begins.
As their training is demanding, the bar is always too high, expectations are set on the
clouds, and there is zero tolerance for mistakes. However, these expectations cannot be
realistically met all the time. This perceived failure drastically affects the well-being of many
doctors (2).
As a doctor, there is need to pause and ignite the light inside the soul. For example, is the
light bright, is it becoming dim, or is it completely off? This answer is not binary, but rather
remains on a spectrum.
Junior Doctors Network Newsletter
Issue 20
October 2020
Doctors’ Well-being: Igniting the Light Inside You
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Uchechukwu Arum, MD
Education Director (2019−2020)
Junior Doctors Network
World Medical Association
Reflecting on this answer will allow doctors examine
their own well-being and seek appropriate supportive
services that can boost their satisfaction with personal
and professional accomplishments.
“Everything can be taken from a man but one thing: the last of
the human freedoms—to choose one’s attitude in any given
set of circumstances, to choose one’s own way”
− Viktor Frankl
Page 91
Doctors should regularly conduct the “light check” and gauge the brightness of the
lightbulb. Problematic mindsets serve as a significant driver to poor mental health
outcomes. Although doctors may experience feelings that affect their well-being during their
training, they should seek help early when they perceive that their light has dimmed. As
such, doctors should consider the following elements, which may lead to feelings of
inadequacy, embarrassment, or shame as well as lead to anxiety or depression.
❑ Self-criticism: When doctors perceive their performance as their identity, they may view
themselves as a “bad doctor”. However, missing questions during clinical rounds or
failing to follow-up on a laboratory result does not equate the definition of a “bad doctor”.
❑ Personalisation and Self-blame: Doctors may blame themselves if any unexpected
event happens in the workplace, rather than evaluating the event and learning from the
experience.
❑ Maladaptive Perfections: By the nature of the profession, most doctors are high
achievers. However, they may occasionally set high expectations and blame themselves
if their goals are not achieved.
❑ Impostor Phenomenon: Doctors may feel that they are an impostor or fraud, believing
that in a matter of time they will be discovered. This feeling might emanate because they
did not answer a question correctly during clinical rounds or they have not yet mastered
a clinical procedure.
❑ Negativity Bias and Pessimistic Explanatory: Doctors may experience negative
interactions and perceive their weight as greater than the positive events. Being filled
with pessimism and cynicism.
Additionally, many doctors may experience the Stanford duck syndrome (3). This syndrome
is described when trainees appear to be gliding effortlessly across this “Lake of Residency”,
but below the surface, their feet are actually paddling furiously. As doctors tend to hide this
struggle as not to be perceived as bad doctors, this experience can be self-isolating and
emotionally draining.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES Page 92
Way Forward
If doctors are experiencing any of the described feelings, they are not alone. There is hope,
but it starts with identifying the problem and understanding the experience. This
introspection can be achieved through five strategies.
❑ Cultivating Metacognitive Skills: Doctors should be able to reflect on their own
cognitive and emotional reactions to events and modify their reactions that would be
more appropriately served. After all, the final feeling is a result of the cognitive and
emotional reaction of an adverse event. This cognitive restructuring forms the basis for
cognitive behavioural therapy.
❑ Mindful Awareness: Doctors can practice mindful awareness and meditation of their
emotions. These techniques can include focusing on breathing patterns like taking deep
breaths and holding for five seconds before exhalation.
❑ Combating Negative Bias: Doctors can modify how they manage stressful situations
during their daily activities. The overall goal is to have a proportionate and functional
reaction when faced with adverse effects.
❑ Cultivating Optimism and Positive Emotions: Doctors can be active in creating
optimism by simple techniques like writing three actions that were performed well before
sleeping.
❑ Emotional Self-regulation: Doctors should try to remain positive and engage in positive
thinking. They should engage in the practice of saying positive words and being kind to
themselves.
Finally, the journey through medical career has always been a bumpy road. However, as
junior doctors, we should be kinder and allow ourselves to make mistakes along our
journey. We should always take care of ourselves by checking the “light inside us”.
References
1) Blaber M. Supporting trainee well-being. Academic lecture from Department of Palliative Medicine at the
Sandwell and West Birmingham NHS. 202 [cited 2020 Oct 8].
2) Accreditation Council for Graduate Medical Education. AWARE: well-being resources. 2020 [cited 2020
Oct 8].
3) Stanford University. Why does the duck stop here? n.d. [cited 2020 Oct 8].
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES Page 93
In Myanmar, positive cases of the coronavirus disease 2019 (COVID-19) are increasing
daily, and a total of 2,009 cases have been confirmed as of September 10, 2020 (1). The
return of migrant workers from foreign countries, coupled with local transmission initiated in
Rakhine State, increased the number of COVID-19 cases across the country. More than
80% of cases have been detected in the capital of Myanmar, Yangon.
As of mid-September 2020, the Myanmar Ministry of Health and Sports announced strict
stay-at-home policies, although a nationwide lockdown policy has not yet been
implemented. Restrictions on festivals and gatherings of more than five individuals have
remained have been prohibited since March 2020. Although these prohibitions have
impacted the daily lives of Myanmar citizens, frontline healthcare workers at public and
private hospitals continue to experience increased workload responsibilities.
Starting from April 2020, Yangon General Hospital reduced the number of in-patient
admissions, elective surgeries, and out-patient services. Fever clinics were opened in
different regions to provide screening and early detection services, and healthcare workers
were attentive for patients who may present fever, cough, and respiratory difficulties.
Junior Doctors Network Newsletter
Issue 20
October 2020
Telemedicine Applications during the COVID-19 Pandemic
in Myanmar
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Hsu Myat, MBBS
Founder, Youth Doctors Healthcare Group
Yangon, Myanmar
However, there are many patients with non-communicable
diseases – such as hypertension, diabetes, post-cancer
treatment, and ischemic heart disease – who require regular
follow-up through out-patient services.
Myanmar is now facing the second wave of COVID-19 cases,
and citizens are concerned about increased community
transmission and mortality rates.
Page 94
However, individuals with seasonal flu symptoms, acute viral infections, and asthmatic
attacks are reluctant to seek healthcare services at out-patient clinics or emergency
departments, since fever and cough are generalized symptoms. According to Ministry of
Health and Sports policy, they would have to visit the fever clinic first, take the COVID-19
swab test, and quarantine themselves as indicated.
From doctors’ perspectives, they also want to reduce the duration of contact with patients
as they can be asymptomatic spreaders of COVID-19. As a result, many primary
healthcare clinics have closed to avoid quarantine measures if in contact with positive
COVID-19 patients.
According to a report of the Myanmar health system, telecommunication facilities such as
internet and e-mail services were first introduced to government agencies including public
hospitals in 2002 (2). However, these services have not been widely used by doctors and
patients since face-to-face consultations have been preferred for healthcare service
delivery. Now, during the COVID-19 pandemic, telemedicine has been highlighted as a
solution for follow-up patient care. Platforms such as Z-waka, On Doctor, and MyanCare
have been introduced among physicians and patients for convenience. These online
platforms deliver healthcare services using virtual technology − such as direct instant
messaging (DIM) and video conferencing − that can facilitate direct interactions between
doctors and patients in virtual clinics. This is remarkably effective as smartphones are
becoming cheaper each day, and 4G internet data are more available, even in marginalized
communities across the country (3).
However, challenges still exist in the widespread use of telecommunication platforms.
Healthcare professionals need to be qualified in their professional skills to provide effective
healthcare services with the evolution of advanced medicine and technology. Some
physicians prefer certain telecommunication applications that are less useful as they cannot
instantaneously save patients’ medical records. However, language barriers, mobile data
unavailability, connection instability, and technical errors still prevent patients from using
telemedicine platforms. Therefore, we still need to advocate more for telemedicine
applications among doctors and patients, as we can advance the medical profession and
enhance how doctors can provide medical consultations to patients.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
To address this challenge, private healthcare sectors and
junior doctors have attempted to develop solutions using
innovative technology.
Page 95
As a junior doctor and freelance teleconsultation doctor, I believe that telemedicine
applications will result in improved outcomes on digitalization in healthcare across all urban
and rural communities in Myanmar. Doctors and patients should exert their efforts on
upcoming changes and try to transform healthcare services from paper to digital records.
Medical histories, including prescriptions and laboratory results, can be recorded on the
web-based technologies and can be easily sharable with other specialists for
multidisciplinary care. In remote areas, where secondary or tertiary care services are not
readily available, primary care doctors and other health professionals (e.g. trained nurses,
midwives) can record medical histories, conduct the medical examination, and contact
specialists through teleconsultation.
References
1) Ministry of Health and Sports (Myanmar). Coronavirus disease 2019 (COVID-19) situation reports. 2020
[cited 2020 Sep 10].
2) Hlaing PM, Nopparatjamjomras TR, Nopparatjamjomras S. Digital technology for preventative health care
in Myanmar. Digital Medicine. 2018;4:117-121.
3) Z-Waka. Welcome to Z-Waka. 2020 [cited 2020 Sep 10].
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
The use of teleconsultation will bring more effective and
convenient ways for conducting medical consultations and
maintain patients’ medical records during the COVID-19 pandemic
as well as increase access and availability in remote areas.
Page 96
Since November 2019, the coronavirus disease 2019 (COVID-19) pandemic has impacted
the daily activities, social interactions, and health and well-being of global citizens. Although
all age groups have been affected, scientists and clinicians are still learning about the
transmission dynamics and short- and long-term health effects of COVID-19 in children.
As the COVID-19 pandemic emerged, junior doctors were pursuing their residency training
or working in their respective specialty. Often, they were assigned to COVID-19 response
efforts in their institution or community, and hence provided clinical care for all age groups.
With limited information about the acute- and long-term effects of COVID-19 in children,
junior doctors initially sought guidance from specialist physicians in their department or
institution. Now, as clinical guidelines have been adapted to incorporate novel research
findings, junior doctors should remain up-to-date on the clinical management approaches,
especially as caring for COVID-19 patients is becoming more routine in clinical practice.
This article aims to present three topics – clinical presentation, disease severity and risk of
hospitalization, and immune response – that can encourage junior doctors to remain
abreast of the rapidly evolving scientific literature that influences clinical practice guidelines.
.
Junior Doctors Network Newsletter
Issue 20
October 2020
COVID-19 and Children: Global Dialogue for Junior Doctors
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Rujvee P. Patel, M.B.B.S
Medical Officer, COVID-19
Surat Municipal Corporation
Surat, India
As the scientific evidence continues to inform the rapidly
changing clinical guidelines, junior doctors are valuable
leaders during the COVID-19 pandemic response efforts in
their institutions and national health systems.
Page 97
Clinical Presentation. As the clinical presentation and prevalence of acute and chronic
illnesses can be different in children, when compared to other age groups, scientists have
studied the impact of COVID-19 on pediatric health and observed this same trend. To date,
children have presented with milder symptoms and have been less likely to be hospitalized,
when compared to adults. One national epidemiological study in China reported that fever
was a clinical presentation of 41-56% of pediatric patients, when compared with 88.7% of
adult patients (1). One systematic review of 18 studies (n=1,065 children with confirmed
COVID-19) concluded that children acquire severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) infection from family members and appear to experience mild symptoms
with rapid recovery with two weeks, when compared to adults (2).
Disease Severity and Risk of Hospitalization. The CDC COVID-19 Response Team
published an epidemiological report on a sample of COVID-19 cases (n=149,760 total
laboratory confirmed COVID-19; 146,510 adults and 2,572 children) in the United States.
When comparing adults (18-64 years) to children (<18 years), fever was reported in 56% of
children (vs 71% of adults), cough in 54% of children (vs 80% of adults), and shortness of
breath in 13% of children (vs 43% of adults) (3). Hospitalization occurred in 5.7-20% of
children (10-33% of adults) and admission to intensive care was reported in 0.58-2% of
children (vs 1.4-4.5% of adults) (3). Likewise, one national epidemiological study in China
concluded that the 728 children with laboratory confirmed COVID-19 were classified as
asymptomatic (12.9%), mild (43.1%) or moderate (41%) infection (1). Severe and critical
infections were reported in 2.5% and 0.6% of children, respectively, which was substantially
lower than statistics reported among adults with COVID-19 (1).
Immune Response. Although research to determine the specific mechanism for immune
response in children is ongoing, several hypotheses have been described to explore why
children infected with SARS-CoV-2 have reported less severe symptoms (4). First, children
may have a stronger innate immune response due to an elevated number of total
lymphocytes and absolute numbers of T and B cells. Second, the lower prevalence of
comorbidities may have offered protected immunity. Third, as fewer children have
experienced a previous beta coronavirus infection with potential for preexisting immunity,
they may have a lower risk of cross-reacting antibodies to SARS-CoV-2. Finally, children
may have fewer angiotensin-converting enzyme 2 (ACE2) receptors, and hence lower
affinity for SARS-CoV-2 entry.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES Page 98
To date, available scientific resources clearly and unanimously indicate that pediatric
patients tend to have a milder clinical presentation, rapid resolution of symptoms, and
better prognosis of COVID-19. This leads to the suggestion that children have a stronger
immune response against SARS-CoV-2, when compared to other age groups.
References:
1) Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics.
2020;145:e20200702.
2) Castagnoli R, Votto M, Licari A, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
infection in children and adolescents: a systematic review. JAMA Pediatr. 2020;174:882-889.
3) CDC COVID-19 Response Team. Coronavirus disease 2019 in children − United States, February 12 −
April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422-426.
4) Zimmermann P, Curtis N. COVID-19 in children, pregnancy and neonates: a review of epidemiologic and
clinical features. Pediatr Infect Dis J. 2020;39:469-477.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
By remaining up-to-date on the scientific literature – such as
clinical presentation and pharmaceutical regimen – junior doctors
on the frontline can utilize this information for their clinical
practice and management activities for COVID-19 patients.
Page 99
Over the past year, global response efforts to control community spread of the coronavirus
disease 2019 (COVID-19) have affected all sectors. National leaders have taken significant
actions by mandating stay-at-home restrictions, which have impacted the daily routine and
lifestyle of citizens. Local businesses have temporarily closed, unemployment rates have
increased, and nations have experienced economic crises. Citizens may be confused by
mixed messages on health and safety from national authorities, and hence decrease their
trust in federal actions.
After any public health event or outbreak, health professionals should reflect on their
response actions, identify limitations or unexpected events, and develop potential solutions
to strengthen future response efforts. According to the World Health Organization (WHO),
one such approach is the After Action Review (AAR), where health professionals
comprehensively review an event within three months of the incident and establish short-
and long-term action goals (Figure 1).
Junior Doctors Network Newsletter
Issue 20
October 2020
International Collaborations in the Post-Pandemic Era:
Focus on the After Action Review
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Chiang Kuan Yu, MD
Hospitalist, Taipei City Hospital
Deputy Chief Executive, Global Taiwan Medical Alliance
Taipei, Taiwan
Significant action is required to promptly address the challenges
faced during this pandemic and protect population health.
Figure 1. Timeline for Joint Operational and After Action Reviews. Credit: WHO, 2019 (1).
Page 100
To conduct an AAR, health authorities should follow the recommended five-step approach
by the WHO (Figure 2). First, in the pre-AAR phase, health professionals collaborate and
form the AAR team with appropriate scientific experts. Interdisciplinary discussions with
regional, national, and international authorities and stakeholders can guide the
Second, during the AAR, health professionals can identify key expertise, build group
consensus, and coordinate an appropriate timeframe with specific goals. These steps are
essential to foster teamwork and establish milestones to reach these established goals.
Finally, in the post-AAR phase, health professionals can summarize and document their
results and develop a database for follow-up learning. They can incorporate debriefing
sessions where team members can discuss the real-time positive and negative results from
the implemented actions.
During the COVID-19 pandemic, global dialogue has questioned the actions by the WHO to
promptly identify the source of the outbreak, establish the mode of transmission, and
develop prompt recommendations to curb community transmission (2). For this reason,
international platforms – like the International Hospital Federation – can offer key
information exchanges between national experts, where they can develop novel solutions
to complex public health challenges across countries. Regional alliances – like the Asia-
Pacific Academic Consortium for Public Health (APACPH) – can strengthen professional
networks across Japan, Malaysia, Republic of Korea, Singapore, and Taiwan (3).
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
Figure 2. After Action Reviews roadmap. Credit: WHO, 2019 (1).
development of potential solutions to
reduce the impact of identified
challenges. They can also develop a
checklist with essential questions:
❑ Are there limited resources,
confusion or institutional barriers that
have hindered the efficiency of
public health measures?
❑ Are there any socioeconomic factors
that have prevented regional or
national authorities from
implementing the established
response efforts?
The AAR may serve as an innovative framework for international
communication between medical and public health experts to connect
and coordinate future initiatives on emerging health topics.
Page 101
Future national studies can assess lessons learned, including the efficiency of resource
distribution at health institutions (e.g. availability of isolation units, sufficient supply of
appropriate personal protective equipment). Epidemiological studies and systematic
reviews can examine how citizens have perceived the societal changes due to the COVID-
19 pandemic – such as citizens’ knowledge, attitudes, and behaviors about COVID-19
transmission and citizens’ psychological stressors during the isolating stay-at-home
restrictions (3-6). Qualitative studies can further explore the psychological experiences and
challenges faced by health professionals who managed frontline efforts to curb disease
spread.
Moving forward, as global health authorities continue to evaluate the short- and long-term
effects of the COVID-19 pandemic on all sectors of society, they should consider the
implementation of innovative approaches – like the AAR – to evaluate current response
efforts. After a thorough review of implemented national action plans, they can evaluate the
strengths and limitations of these actions and collaborate with international colleagues, in
order to strengthen global initiatives that aim to effectively mitigate health risks to citizens
across the globe.
References
1) World Health Organization. Guidance for after action review (AAR). 2019 [cited 2020 Oct 1].
2) Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following
COVID-19 infection. Lancet Infect Dis. 2020;20:773.
3) Asia-Pacific Academic Consortium for Public Health. APACPH Education Webinar on Post-COVID-19, 11
Sept 2020. 2020 [cited 2020 Oct 1].
4) Delgado D, Wyss Quintana F, Perez G, et al. Personal safety during the COVID-19 pandemic: realities
and perspectives of healthcare workers in Latin America. Int J Environ Res Public Health. 2020;17:2798.
5) Kamate SK, Sharma S, Thakar S, et al. Assessing knowledge, attitudes and practices of dental
practitioners regarding the COVID-19 pandemic: a multinational study. Dent Med Probl. 2020;57:11-17.
6) Moccia L, Janiri D, Pepe M, et al. Affective temperament, attachment style, and the psychological impact
of the COVID-19 outbreak: an early report on the Italian general population. Brain Behav Immun.
2020;87:75-79.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ SCIENTIFIC PERSPECTIVES
During the COVID-19 pandemic, the global community has
enhanced professional networks, collaborated on essential
initiatives, and recommended appropriate prevention
strategies to safeguard the population.
Page 102
The Daegu province in the Republic of Korea experienced a great cluster outbreak of
coronavirus disease 2019 (COVID-19) in March 2020. Due to the robust epidemic
mitigation measures, there was a five-month period where the incidence of COVID-19
plateaued. However, as we approached August 2020, the incidence of COVID-19
skyrocketed, causing anxiety and fear across the country. On August 7, 2020, thousands of
junior doctors from over 100 hospitals marched out, raising their voices for the justice of
citizens’ health.
Junior Doctors Network Newsletter
Issue 20
October 2020
Junior Doctors Advocate for Justice: The 30-Day Record
JUNIOR DOCTORS’ ACTIVITIES
Jaehyeon Jang, MD Msc
Public Health Physician, Anseong Public Health Center
Director, Korean Intern and Resident Association
Anseong, Republic of Korea
Figure 1. Practicing doctors per 1,000 population
(2000 and 2017). Credit: ⓒHealth at a Glance
2019/CC-BY.
On August 23, 2020, national health
authorities abruptly announced a health
care workforce reform plan to expand
health care coverage through three efforts.
These efforts included increasing the
admission quotas at medical schools by
4,000 over the next 10 years, opening a
new public medical school, and modifying
the national health insurance to cover
Korean herbal medicine as an eligible
treatment. This plan appeared to utilize
data from the Organisation for Economic
Co-operation and Development (OECD),
reporting that the number of doctors
practicing in the Republic of Korea per
1,000 population was 2.3, which was lower
than the global average of 3.5, between
2000 and 2017 (1) (Figure 1).
A number of junior doctors in the Republic of Korea felt that they
had faced one of the most challenging moments in their career: the
COVID-19 pandemic and an unexpected government policy.
Page 103
It also did not consider the increase of medical expenses as a result of physician demand.
Second, there were concerns that the admission of new medical students would be based
on personal recommendations from government officials or civil organisations, rather than
based on the principles of merit, equity, and justice. Third, funding oriental potions under
the national health insurance, without any scientific evidence to verify their safety and
effectiveness, was believed to be unsafe for community health. Finally, the policy
formulation process did not include medical experts or associations.
Physicians have the right to consult about health policy and advocate for ethical policies
and practices. Therefore, they asked the government to re-examine this health plan. The
Korean Intern Resident Association (KIRA) expressed their disapproval of this health plan
to the government and planned to meet with health authorities on July 29, 2020 and August
6, 2020, to present critiques to policies and provide recommendations on future steps (2).
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ ACTIVITIES
Figure 2. Comparative price level for health (2000 and
2017). Credit: ⓒHealth at a Glance 2019/CC-BY.
Unfortunately, several elements to this
plan were unclear. First, the government
concluded that there was a shortage of
physicians without further exploring the
reported positive health indicators. For
example, according to the OECD data,
the number of doctor consultations per
person was 16.6 (OECD average: 6.8),
comparative price levels for health was 48
(OECD average: 72) (Figure 2), and
mortality from treatable cases per
100,000 population was 47 (OCED
average: 75), between 2000 and 2017.
Health plans should not be a sole authoritative decision from
government, but rather a multi-faceted approach that involves
all stakeholders to strategise on how best to achieve health
care service delivery.
Page 104
After this first strike, since authorities took no further action, junior doctors staged a walkout
on August 14, 2020. After this general strike, junior doctors planned another indefinite strike
starting on August 24, 2020. Negotiation meetings to resolve this conflict were scheduled
for August 23, 2020 and August 25, 2020, but every negotiation ended in a deadlock. The
law enforcement authorities (police and judicial officials) took a firm stand to crackdown on
doctors participating in the strike.
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ ACTIVITIES
Photo 2. Emergency committee president, Dr Jihyeon
Park, confirms the position of junior doctors at a press
conference on September 1, 2020.
Credit: ⓒ KMA/ CC-BY.
Photo 1. Junior doctors march to dispute the government
policy on August 7, 2020. Credit: ⓒ KIRA/ CC-BY.
Unfortunately, government authorities
unilaterally canceled the proposed meeting
prior to the first scheduled meeting, which
KIRA regarded as unacceptable and unjust.
Hence, KIRA set up an emergency
committee meeting on August 1, 2020, and
promptly mobilized all junior doctors to swing
to action. On August 7, 2020, the first protest
of junior doctors occurred (Photo 1).
On the third day of the strike (August 26,
2020), instead of proposing a means for
constructive communication and dialogue,
the government responded to junior doctors
with oppressive and violent measures
including on-site inspections in hospitals
nationwide. The government filed criminal
charges against junior doctors who
participated in the strike and did not comply
with back-to-work orders (3). As the
government increased their crackdown,
junior doctors strengthened their
determination to continue the strike (Photo
2).
Page 105
On September 4, 2020, the Korean Medical Association (KMA) and the government
reached a compromise. KIRA representatives were not invited to the negotiation, and the
contents of the agreement did not include the phrase, “withdrawal of plan”, which junior
doctors had requested. After all, both sides accepted the agreement that contained a
statement, “We shall hold every policy-making process until getting out of the pandemic.
We shall resume the discussion thereafter leaving the door open”. Through this procedure,
the tension was toned down, and all physicians returned to the hospitals.
At a time when the world was experiencing significant challenges during the COVID-19
pandemic and everyone needed to collaborate, this unwarranted health policy forced junior
doctors, who have always stood by their patients, to leave their duty post. Junior doctors
understood that any erroneous policy has the potential to cause as much damage as
observed during the COVID-19 pandemic. As such, junior doctors in the Republic of Korea
will continue to monitor the current situation and balance the ethical principles of
beneficence (acting in the best interest of the people) and non-maleficence (“do no harm”).
However, if junior doctors perceive any threat to the justice of citizens’ health and the
integrity of the health system, they remain dedicated to engage in negotiation and dialogue
to preserve the national health system. If these means fail, they are resolved to raise their
voices in unison to advocate for justice, equity, and ethical conduct.
References
1) Organisation for Economic Co-operation and Development. Health at a glance 2019: OECD indicators.
Paris: OECD Publishing, 2019.
2) Bahk E. Why do doctors oppose raising medical student quota? The Korea Times. 2020 [cited 2020 Sep
15].
3) Kim A. Government files criminal charges against striking junior doctors. The Korea Herald. 2020 [cited
2020 Sep 15].
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ ACTIVITIES Page 106
I vividly remember the start to my internship rotation at the Southern Nevada Health District
(SNHD) in January 2020. One day, an experienced Infectious Disease specialist
emphasized the importance of being alert about the novel respiratory virus infection
causing the coronavirus disease 2019 (COVID-19). As a public health professional working
in the prevention and control of infectious diseases, I have been following the world’s news
and official public health reports regarding this emerging virus.
As the number of cases in southern Nevada started increasing, the SNHD reached out to
the School of Public Health at the University of Nevada, Las Vegas (UNLV), for assistance
regarding disease investigation and contact tracing. I received an email about this public
health collaboration, and I was eager to help the Las Vegas community that unconditionally
welcomed me to their city two years ago. Along with six other UNLV public health students,
I was selected to complete the disease investigation and contact tracing training at the
SNHD. Immediately after the training, our team started making our first calls from the office
located at the UNLV campus.
As scientists were learning more about the virus each day, it was initially challenging to
interview patients who were infected with the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2). We observed that they were afraid of the short- and long-
term implications of their infection and potential transmission to family members.
Junior Doctors Network Newsletter
Issue 20
October 2020
Managing COVID-19 Contact Tracing Teams
in Las Vegas, Nevada
JUNIOR DOCTORS’ ACTIVITIES
Kristina Mihajlovski, MD MPHc
University of Nevada, Las Vegas
Las Vegas, Nevada, United States
The moment when Nevada’s patient zero of COVID-19
was detected in the state, public health professionals
were prepared to act promptly.
During our meetings, our team shared up-to-date scientific
findings and provided empathetic listening and support.
Page 107
For the next four months – March 31, 2020 until August 1, 2020 – our team conducted
more than 2,000 case investigations within the community and reached out to their contacts
to identify time and place of exposure. We shared additional resources with community
members, including isolation and quarantine guidance, testing site locations, food and
medication delivery options, mental health support services, and unemployment
assistance. Unfortunately, although we wanted to help all COVID-19 cases, time was the
limiting factor. Team members often consulted a community member who had lost a family
member or close friend, and we quickly responded to console them through expressed
empathy and support during these difficult times. Sometimes, we learned that they just
needed to speak to someone, and we were present to let them know that they were not
alone.
When scientists confirmed that contact tracing slowed the spread of COVID-19 (1) – and
our contract tracing activities were effective to date – our team received a grant from the
state of Nevada to expand our contact tracing activities. As such, we restructured our team
as there was a need for additional management positions. Along with my two co-workers, I
became a UNLV COVID-19 Contact Tracing Team Manager. After receiving more than
1,100 job applications, we hired six supervisors and 137 contact tracers. Our hardworking
contact tracing team played a key role in reducing community spread of COVID-19.
Reference
1) Centers for Disease Control and Prevention. Contact tracing. 2020 [cited 2020 Oct 11].
Junior Doctors Network Newsletter
Issue 20
October 2020
JUNIOR DOCTORS’ ACTIVITIES
As a junior doctor from Serbia, I am truly
honored to work along an amazing UNLV
team at the forefront of COVID-19 prevention
and control (Photo 1). This unique experience
has provided me the opportunity to gain
hands-on skills regarding disease
investigation and outbreak control. I am
humbled to represent junior doctors working in
COVID-19 response efforts and proud to
serve as a manager of this hardworking and
responsible public health team in one of the
most visited cities: Las Vegas. Photo 1. Dr Kristina Mihajlovski works as COVID-19
contact tracing team manager in Nevada.
Credit: Josh Hawkins/UNLV Photo Services.
Our team contributed individual expertise to strengthen our
contact tracing activities and make a significant impact in our
local community and state.
Page 108
The year 2020 marks the 75th anniversary of the United Nations (UN). Established in 1945,
the UN is an intergovernmental body with a mandate to uphold international peace, protect
human rights and international law, work towards sustainable development, and deliver
humanitarian aid. Every September, the UN convenes in New York City to hold their UN
General Assembly with delegations representing each nation, and they evaluate progress
made in established domains and commit to new interventions or funding. Unfortunately,
the celebration of a new decade with a recommitment to multilateral future engagements
has become a time of political turmoil and inconsistent action by health systems during the
coronavirus disease 2019 (COVID-19) pandemic.
On September 19, 2020, the Program in Global Surgery and Social Change (PGSSC) at
Harvard Medical School, InciSioN Global, and the Junior Doctor Network (JDN) of the
World Medical Association (WMA), co-hosted a virtual UN General Assembly side event.
Using the theme, The Future of the Operating Room (OR): Youth in Global Surgery, the
event hosted a panel of six experts and two moderators from diverse professional and
geographic backgrounds (Photo 1). In fact, 75% of these speakers were from low- and
middle-income countries (LMICs), which is a higher percentage of delegates who attend
UN General Assembly side events.
Junior Doctors Network Newsletter
Issue 20
October 2020
Inclusive Participation in Global Surgery at the UN General
Assembly during the COVID-19 Pandemic
INTERNATIONAL CONFERENCES
Manon Pigeolet, MD MSc
Université Libre de Bruxelles, Brussels, Belgium
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
Fabiola Ruth Castedo Camacho, MD
Neonatology Resident, Universidad de la República
Montevideo, Uruguay
Junior Country Lead for Uruguay, Global PaedSurg
Taking a silver lining perspective of these lockdown measures,
this unprecedented time can offer new opportunities, unavailable
before COVID-19, as innovative analyses will be required for
future actions across health systems.
Page 109
This same shift was observed in the registration and attendee list. Of the 800 individuals
who registered for this event, predominantly from LMICs, a total of 250 individuals actually
attended the virtual sessions. For the first time, when attending UN-related events, we
believe that we have expanded our global reach, where voices representing diverse
geographic, language, and socioeconomic areas were present to raise pertinent questions.
After all, we are the future of the OR, the UN, and our national health systems.
Listening to panelists’ experiences, it is clear that many factors contribute to unequal
access to surgical services. Although trauma and obstetric emergency care services are
considered basic surgical needs, they remain unavailable in many countries. Other chronic
conditions, often debilitating, are equally at risk of progressing due to a lack of safe surgery
and anesthesia services.
Other panel discussion points included the need for gender equality in surgery, the shared
responsibility with non-surgical specialties for surgery advocacy, and the need for surgical
care for the neonatal and pediatric populations. Affordable, accessible, and high-quality
basic health services for pediatric populations can permanently determine the quality of life
of the new generations. Neonates may require surgical interventions as their first need for
medical assistance in life, as observed in cases of congenital malformations and other
complications due to premature birth. Children and adolescents may need surgical
procedures for reconstructive purposes to prevent disability or minimize complications later
on in life. Many interventions are expensive, which further creates a high financial and
economic burden on families affected and national health systems.
Junior Doctors Network Newsletter
Issue 20
October 2020
INTERNATIONAL CONFERENCES
Albeit challenges, we must develop innovative ideas that
can increase availability and access to essential preventive
health care services to all global citizens.
Photo 1. “Youth in Global Surgery: The Future of the OR” panel,
hosted by the PGSSC, InciSioN, and WMA/JDN at the UN 75th
General Assembly. Credit: Dr Fabiola Castedo Camacho.
Page 110
Despite the challenges that global surgery still faces, health leaders have been able to turn
those difficulties into opportunities. Moving forward, future steps should include actions to:
❑ Advocate for improved surgical care with national health systems;
❑ Develop research solicitations that examine patient outcomes, barriers to care, specialty
training in global surgery, and cost-effective innovative technologies;
❑ Build an effective hospital surveillance system with regional and national data; and
❑ Support a regional and national registry system for patient outcomes related to surgical
care that can guide health policy initiatives.
As health professionals, we need to assure that surgery, obstetrics, and anesthesia care
receive the appropriate investment. In 2015, the Lancet Commission on Global Surgery
recommended one path forward in efforts to obtain accessible, affordable, and qualitative
surgery, obstetrics, and anesthesia care by 2030 for all individuals.
As junior doctors, we truly hope that COVID-19 will incite positive change and innovative
practices – like virtual conferences – in our global society. By organizing conferences and
community events, voices from youth and leading leaders from LMICs can be incorporated
to facilitate a wider discussion about new approaches and best practices to reduce
disparities in healthcare service delivery. The inclusion of these panels and discussions will
offer an insightful dialogue with the goal of accessible, affordable, and high-quality surgical,
obstetrics, and anesthesia care by 2030 for all global citizens.
Junior Doctors Network Newsletter
Issue 20
October 2020
INTERNATIONAL CONFERENCES
It is our responsibility to research and showcase relevant
information to multidisciplinary stakeholders in order to support
and facilitate this paradigm shift in global health.
Page 111