JDN_NEWSLETTER_NOVEMBER_2023_DONE

ISSN (print) 2415-1122
ISSN (online) 2312-220X
Junior Doctors Network Newsletter
Issue 27
December 2023
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
JDN inaugural participation at the 2023 World
Health Summit
Pages 19-21.
Health Festival – 3rd Panhellenic Congress of
Medical Students for Public Health
Page 23.
Emotional & Psychological Well-being in Cancer
Patients: The Role of Doctors & Society
Page 28.
Including Spanish articles and more…
Page 2
09 Words from the JDN Chairperson
Dr. Uchechukwu Arum (Nigeria/United Kingdom)
10 Words from the JDN Publications Director
Dr. Jeazul Ponce Hernandez (Mexico/Spain)
11 Words from the JDN Secretary
Dr. Marie-Claire Wangari (Kenya)
12 JDN Membership in a Snapshot
Dr. Pablo Estrella (Spain)
TEAM OF OFFICIALS’ CONTRIBUTIONS AND
STATEMENTS
Table of Contents
JDN WORKING GROUPS REPORTS
15 Medical Exchange, Education & International
Mobility
Dr. Balkiss Abdelmoula (Tunisia/Germany)
16 Medical Ethics
Dr. Jihoo Lee (Korea)
17 Pandemic Preparedness/COVID-19
Dr Wenzen (Jen) Zuo (Canada)
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 3
19 World Health Summit 2023, Berlin
Dr. Flora Wendel (Germany)
20 World Health Summit 2023, Berlin
Dr. Francisco Franco Pego (Portugal)
21 World Health Summit 2023, Berlin
Dr. Jeazul Ponce Hernandez (Mexico)
22 Organization of the European Health Summit
2023 in Murcia, Spain.
Dr. Pablo Estrella, Dr. Juan Pablo Carrasco, Dr. Alvaro
Cerame del Campo, Dr. Domingo Sanchez (Spain)
23 Health Festival – 3rd Panhellenic Congress of
Medical Students for Public Health, Greece
By Dr. Kostas Roditis (Greece)
CONFERENCES, MEETINGS, CONTRIBUTIONS,
TESTIMONIES AND EXPERIENCES
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 4
28 Emotional and Psychological Well-being in Cancer
Patients: The Role of Doctors and Society
Dr. Fatima Kur (Pakistan)
31 The GAPS of healthcare access for empty Spain, a new
challenge to overcome?
Dr. Jeazul Ponce Hernandez (Mexico)
35 The GAPS of healthcare access for empty Spain, a new
challenge to overcome? (Spanish version).
Dr. Jeazul Ponce Hernandez (Mexico)
39 Enhancing Clinical Research in Community Settings:
The Vital Role of Junior Doctors
Dr. Shiv Joshi (India)
42 Spanish Junior Doctors Leading the Way: Shaping the
Future of Medical Practice
Dr. Pablo Estrella, Dr. Juan Pablo Carrasco, Dr. Alvaro
Cerame del Campo, Dr. Domingo Sanchez (Spain)
45 Spanish Junior Doctors Leading the Way: Shaping the
Future of Medical Practice (Spanish version).
Dr. Pablo Estrella, Dr. Juan Pablo Carrasco, Dr. Alvaro
Cerame del Campo, Dr. Domingo Sanchez (Spain)
48 Addressing the intersection between Climate Change
and Health in Medical Education: The urgent need in India
Dr. Shiv Joshi (India)
ARTICLES BY JDN MEMBERS
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 5
CHAIRPERSON
DEPUTY
CHAIRPERSON
SECRETARY
SOCIO-MEDICAL
AFFAIRS OFFICER
EDUCATION
DIRECTOR
MEDICAL ETHICS
OFFICER
MEMBERSHIP
DIRECTOR
PUBLICATIONS
DIRECTOR
COMMUNICATIONS
DIRECTOR
IMMEDIATE PAST
CHAIRPERSON
Dr. Yassen Tcholakov
(Canada)
Dr. Marie-Claire Wangari
(Kenya)
Dr. Lekha Rathod
(India/Netherlands)
Dr. Pablo Estrella
(Spain)
Dr. Lwando Maki
(South Africa)
Dr. Uchechukwu Arum
(Nigeria/United Kingdom)
Dr. Sazi Nzama
(South Africa)
Dr. Balkiss
Abdelmoula
(Tunisia/Germany)
Dr. Jihoo Lee
(Korea)
Dr. Jeazul Ponce H.
(Mexico/Spain)
Junior Doctors Leadership 2022-2023
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 6
CHAIRPERSON
DEPUTY
CHAIRPERSON
SECRETARY
SOCIO-MEDICAL
AFFAIRS OFFICER
EDUCATION
DIRECTOR
MEDICAL ETHICS
OFFICER
MEMBERSHIP
DIRECTOR
PUBLICATIONS
DIRECTOR
COMMUNICATIONS
DIRECTOR
IMMEDIATE PAST
CHAIRPERSON
Dr. Marie-Claire
Wangari
(Kenya)
Dr. Francisco Prego
(Portugal)
Dr. Pablo Estrella
(Spain)
Dr. Uchechukwu Arum
(Nigeria/United Kingdom)
Dr. Sazi Nzama
(South Africa)
Dr. Balkiss
Abdelmoula
(Tunisia/Germany)
Dr. Shiv Joshi
(India))
Dr. Jeazul Ponce H.
(Mexico/Spain)
Junior Doctors Leadership 2023-2024
Dr. Deena Mariyam
(India/UAE)
Dr. Merlinda
Shazellenne
(Malaysia)
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 7
Dr. Ireju
(Nigeria)
Dr. Bonnke Arunga
(Kenya)
Dr. Carol Kangethe
(Kenya)
Dr. Fatma
(Tunisia)
Dr. Jamie Colloty
(South Africa)
Dr. Michael Johnson
(UK)
Dr. Po-Chin Li
(Taiwan)
Dr. Parth Patel
(Malawi)
Dr. Rebecca Enejo
(Nigeria)
Dr. Maymona Choudry
(Philippines)
Dr. Aqsa Shafique
(Pakistan)
Editorial Team 2022−2023
Junior Doctors Network Newsletter
Issue 27
December 2023
TEAM OF
OFFICIALS’
CONTRIBUTIONS,
AND
STATEMENTS.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 9
Words from
the JDN
Chairperson
Dr. Uchechukwu Arum, MD.
Chairperson
Term 2022-2023
Junior Doctors Network
World Medical Association
Dear Esteemed Colleagues,
It is with great pleasure that I introduce to you the 27th issue of our JDN newsletter. It is truly
remarkable to pause and contemplate the incredible journey we have shared. The Junior
Doctors Network not only endures but thrives, maintaining an unwavering commitment to
advocating for better healthcare on the global stage. This newsletter stands as a testament to
the tenacity and dedication of our network, which has seen substantial growth and flourishing
during this term. I have had the privilege of witnessing countless achievements, sharing in
both triumphs and challenges, and, most notably, being inspired by the collective spirit that
defines the Junior Doctors Network.
In this edition, we present a compendium of insightful articles, personal experiences, and
updates. Moreover, we continue our tradition of fostering linguistic diversity by featuring an
article in a language other than English (Spanish). As we navigate the ever-evolving
landscape of the medical world, our network remains a steadfast cornerstone for support,
networking, and the sharing of knowledge.
Together, we have achieved numerous milestones and cultivated a vibrant community where
knowledge, camaraderie, and mutual support flourish. As I transition from my role as the
Chairperson, I do so with unwavering confidence in the future of this network. The incoming
leadership will build upon the exceptional work we have initiated and steer us toward new
horizons.
I invite you to take a moment, relax, and delve into the content.
Warm regards,
Dr. Uchechukwu Arum
JDN-WMA Chairperson 2022-2023
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 10
Words from the
JDN Publications
Director
By Dr. Jeazul Ponce Hernandez, MD
MSc. MPH.
Publications Director
Term 2022−2023
Junior Doctors Network
World Medical Association
Dear JDN Colleagues,
It is my pleasure to present to you this new edition of the JDN newsletter, featuring a new look
and well-deserved updates. It is also an honor for me to share with you the events in which I
have been able to participate individually, but thanks to my membership in JDN/WMA, such
as the World Health Summit and the European Health Summit. This newsletter serves as a
platform for upcoming events led by young physicians.
We also have important material to share from the activities carried out by the working groups
and members of the management team. And, of course, we have our section of articles with a
scientific and research perspective, where the role of young physicians is crucial for the
advancement of science, technology, and the political inclusion of young physicians in global
health.
Please enjoy, and thank you very much to everyone for your participation in the making of this
issue—members of the publications team and those who took the time to submit their articles.
Thank you for your trust.
With affection,
Dr. Delta Jeazul Ponce Hernandez
Publication Team 2022-2023
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 11
2022-2023 JDN
Secretary
Remarks
Another JDN management team mandate has concluded since our last election in Berlin in
October 2022. Reflecting on this past term, I’m reminded of a quote by Martin Luther King, Jr.: ‘The
journey of a thousand miles begins with a single step. Watch your step. You don’t have to see the
whole staircase, just take the first step.’
Collaborating with the management team over the past year has been truly enlightening, and it’s
remarkable to see the positive strides we’ve made in our network. Our membership numbers have
nearly doubled, and we’ve introduced Spanish and French submissions in the JDN newsletter,
among other accomplishments.
From the Secretary’s perspective, we’ve consolidated all membership meeting minutes into one
document, making it easier to follow up on meeting proceedings. Additionally, we’ve continued our
monthly membership meetings in two time zones to accommodate our diverse membership. We’ve
also encouraged the use of our JDN calendar, including activities at the working group level. The
format of the management team strategy has been updated to include a summary of our working
groups’ plans, fostering greater cohesion between both parties.
It has been a pleasure to support various management team members, the 2023 Pre-WHA
Organizing Committee, and our general members with various tasks and inquiries on the JDN.
These engagements will be cherished.
In closing, I encourage everyone to ‘just take the first step.’ If you’re interested in engaging with the
JDN, take that leap. If you have ideas for what the network can achieve, share them with us. If you
want to establish a national JDN chapter, reach out. Remember, ‘Everything you’ve ever wanted is
sitting on the other side of fear.’ – George Adair.
By Dr. Marie-Claire Wangari,
MD.
JDN secretary
Term 2022-2023
Kenya
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 12
JDN’s
Membership
in a Snapshot
Understanding the membership data in a platform such as the Junior Doctors Network (JDN) is key to
monitoring changes over time and acting accordingly to adapt to continuous changes.
In the membership census of August 2023, the JDN had registered a total of 763 members (Table 1),
a significant increase from the 515 members registered in the 2022 census. This remarkable year-
over-year growth rate of 48.16% reflects the growing appeal and relevance of our network.
Dr. Pablo Estrella P. M.D. MPH.
Membership Director
Spain
Junior Doctors Network
World Medical Association
Region
Countries
Represented
Total Countries in
the Region
% Countries
Represented
Total members
(n)
Percentage of
members (%)
African Region 25 47 65% 144 18,9%
Eastern Mediterranean
Region
16 22 58% 101 13,2%
European Region 28 53 65% 106 13,9%
Region of the Americas 21 35 63% 132 17,3%
South-East Asia Region 7 12 63% 235 30,8%
Western Pacific Region 8 27 77% 45 5,9%
Total 105 196 65% 763 100,0%
Table 1. Junior Doctors Network Census 2023
Our network is not confined by
borders (Figure 1), and this is
reflected in our representation across
regions, with 65% of countries
represented in the JDN, and the
highest representation in the
Southeast Asia Region, with 77% of
countries represented. Among all the
regions, the South-East Asia and
Africa Regions have the highest
percentages of our total members
(31% and 19%, respectively) (Figure
2)
Figure 1. Membership Census 2023
Figure 2.
Percentage
of JDN
Members per
Region 2023
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 13
JDN’s Membership in a Snapshot
Membership data is the cornerstone of our understanding of the network’s evolution over time. It
enables us to assess our outreach and inclusivity, offering vital insights for informed decision-making.
As the Membership Director in both the past and the new term, I am responsible for managing this
data and ensuring its effective use. Moreover, the responsibilities of the position include coordinating
membership with the WMA Secretariat and maintaining an up-to-date membership database, as well
as engaging new and prospective members and supporting National JDNs.
Challenges were not absent in the past term (2022-2023), as is the case with any evolving
organization. These challenges include a high rate of incomplete applications, limited contact with
some National JDNs, and insufficient member engagement after joining. Furthermore, there is a need
for more institutional memory and continuity from previous terms.
To address these challenges, recommendations for the upcoming term include simplifying the JDN
application process, completing the Toolkit for Setting Up National JDNs, enhancing communication,
improving the Welcome Kit for increased member engagement, and collaborating with other
management team members to promote activities stimulating member participation.
Our membership data paints a compelling picture of growth and diversity within the JDN. As we move
forward, we invite all members to actively participate in JDN activities, whether through involvement
in working groups, representing us externally as part of JDN delegations, attending online events, or
contributing to member consultations. Your active engagement fuels our network’s strength and
dynamism. Together, we can ensure that the JDN remains a vibrant and inclusive platform for junior
doctors worldwide. Let’s collaborate to surpass the achievements of the previous term.
Original Picture. Junior Doctors Network Meeting in Nairobi,
Kenya, 2023.
Junior Doctors Network Newsletter
Issue 27
December 2023
REPORTS OF
JDN WORKING
GROUPS
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 15
Medical Exchange, Education and
International Mobility
By Dr. Balkiss Abdelmoula MD. MPH.
JDN Deputy Chair 2023-2024
JDN Medical Education Director 2022-2023
Tunisia/Germany
Junior Doctors Network
World Medical Association
With a focus on knowledge-sharing and fostering junior doctors’ engagement in the advancement
of medical education to drive positive change in their careers and in healthcare systems worldwide,
our Working Group has contributed to and coordinated the following activities during the past term:
• Revision of the WMA Resolution on Medical Workforce, adopted during the WMA general
assembly in October 2023
• Organizing the country presentation session around the thematic area of the “Medical
Workforce” during the JDN bi-annual meeting, in October 2023
• Special Edition on Medical Education and Medical Ethics, October 2023
• First joint webinar with the planetary health working group on integrating Planetary
Health in Medical Education, September 2023
• Junior Doctor’s representation during the JDN-IFMSA co-hosted WHA side event on
Youth Engagement, May 2023
• Junior Doctors representation at the WHO Youth Hub
• Organizing Webinars to guide Junior Doctors in their careers:
• Careers in Global Health (Junior Consultants Edition), February 2023
• Navigating career pathway in an international organization, November 2022
Report of the
JDN Working
Group on
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 16
Medical Ethics
Working Group
Update
The bedrock of the medical profession lies in the principles of Medical Ethics, constituting an
indispensable component of the worldwide healthcare landscape. Over the past decade,
physicians have been champions of and catalysts for dialogues concerning various facets of
Medical Ethics. These encompass clinical competencies and responsibilities, ethical
considerations in human and animal research, safeguarding patient confidentiality, and providing
compassionate end-of-life care. Consequently, junior doctors must assume proactive leadership
roles, fostering continued discourse among the global healthcare community on these diverse and
critical themes.
In June 2019, the Junior Doctors Network (JDN) established the Medical Ethics Working Group as
a global platform for junior doctors to exchange crucial information, and resources, and engage in
activities centred around Medical Ethics. This initiative strives to heighten awareness of Medical
Ethics within the junior doctor community by fostering creative and academic pursuits. The working
group has organized events focused on various aspects of Medical Ethics and actively encourages
junior doctors to participate in activities such as policy analysis, policy evaluation, and collaborative
research related to Medical Ethics. In 2023, the team has continued its efforts to represent and
support the cause
Key Achievements:
• Member Survey (Oct 2022): The survey identified that the field of most interest to members is
related to professional ethical dilemmas for physicians, including end-of-life care decisions,
access to clinical specialization, restrictions on prescription, as well as physicians’ working
conditions in terms of bullying or harassment.
• l Nairobi Thematic Session (Apr 2023): The working group successfully chaired its session,
introducing various activities and discussing relevant issues such as LGBTQ+ concerns and
collaboration with IPPNW.
• l JDN Newsletter Medical Ethics and Medical Education Collaborative Special Edition (Sep
2023): As one of the working group’s annual activities, the JDN newsletter special edition is
scheduled for publication in September. This year, the working group collaborated with the
medical education working group to expand the topics and encourage member participation.
Dr. Jihoo Lee, MD.
Medical Ethics Officer
Term 2022−2023
Korea
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 17
Pandemic
Preparedness/
COVID-19
Working Group
By Dr. Wenzen (Jen) Zuo
Pandemic Preparedness / COVID-
19 working group co-chair
Term 2022-2023
Canada
Junior Doctors Network
World Medical Association
The Pandemic Working Group is a re-activated working group from the ad-hoc “COVID-19 working
group” that was set up in January 2022. The current aim of the working group is to review
developments in the public health arena on matters about health emergencies of concern e.g.,
COVID-19 and monkeypox and appraise solutions being tabled to add the voice of junior doctors
worldwide in these efforts.
Since October 2022, our working group engagements have been as follows:
1. Publication of COVID-19 stories on the JDN social media handles
2. Observing and where applicable delivering interventions at the World Health Organization
(WHO) Intergovernmental Negotiating Body and the International Health Regulations as
representatives from the World Medical Association (WMA)
3. Hosting an open forum discussion on junior doctors’ understanding of the INB and IHR
processes and their impact on their work on the sidelines of the JDN Fall Meeting in Nairobi,
Kenya in April 2023
4. Coordinating a session at the 2023 Pre-WHA workshop dubbed, “WHO’s work on pandemic
prevention, preparedness and response (Focus on Global Health Law & Security)” facilitated by
Aush Lal, Commissioner from Chatham House Commission for Universal Health and Susan
Brown from Women in Global Health
5. Participating in the 152nd WHO Executive Board Meeting and 75th World Health Assembly and
drafting interventions related to the agenda of health emergencies
For the next steps in the coming term
1. The working group currently chairs the drafting group for the updates of the 2017 WMA
statement on epidemics and pandemics set for release in 2024.
2. We are currently exploring possible avenues of activities beyond those that focus on COVID-19
3. We are keen to welcome new members to join our working group. If you are interested in
joining us, please reach out to either.
• Wenzhen (Jen) Zuo: wenzhen.zuo@gmail.com
• Marie-Claire (MC) Wangari: mcwangari.wm@gmail.com
Junior Doctors Network Newsletter
Issue 27
December 2023
CONFERENCES,
MEETINGS,
CONTRIBUTIONS
& TESTIMONIES
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 19
The World Health Summit (WHS) is a yearly global health event that takes place in Berlin and
seeks to bring together stakeholders from national ministries, international organizations, civil
society, academia and the private sector.
World Health
Summit
2023, Berlin
Testimonies
Dr. Flora Wendel, MD.
Chair of JDN working group on
Comprehensive Primary Health Care
Term 2022-2023
Germany
Junior Doctors Network
World Medical Association
What I particularly liked about the WHS is
that all the sessions and side events took
place in one location which truly enabled
advocacy and networking. I further
appreciated the presence of many young
people and youth delegates at the event, as
well as the representation of research
institutions and networks. Policy must be
informed by research and youth must be
actively engaged in all stages of policy
making and included in high-level
discussions at global events.
At the WHS I focussed on sessions on
Universal Health Coverage including
prevention, health promotion, health literacy
and information and research collaborations.
As I am based in Germany, the perspectives
of many German organizations that were
present at the WHS and their representation
towards the international community were of
special interest to me.
While the rather small size of this international event provided a familiar atmosphere, unequal
representation of global health stakeholders (organization- and nationality-, SES-wise, etc) could
be criticized. Furthermore, the effectiveness of global health policy and interventions could be
questioned, as the WHS serves more as a platform for discussion, not a decision-making body or
adopting recommendations or declarations.
To conclude, WHS can offer various opportunities for JDN external representation and advocacy
and foster collaboration with diverse global health stakeholders and youth advocates. Ideally, a
representation of a diverse JDN delegation should be supported by WMA to improve youth
participation and the inclusion of junior doctors in the WHS. This would be a very interesting tool for
them to actively participate, learn and share their perspectives. The organizational goals and
collaborations would be a part of the preceding planning with the WMA secretariat and the
developing JDN advocacy strategy could be valuable work among JDN members through WMA.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 20
It was a pleasure to open up a JDN term in such a fashion
that two weeks after being elected we are already at the
World Health Summit, one of the most relevant events in
Global Health worldwide!
The objective of the group of three at the event was mostly to
make a diagnosis of what impact we can achieve with our
presence in Berlin in the years to come.
The assessment is certainly positive, and the potential
impact can happen everywhere: in the regular sessions, in
the side events or the numerous networking opportunities –
not only in the audience but also on stage.
When compared to a World Health Assembly (a format
known to many), the World Health Summit, has similar high-
level speakers and participants, with three major interesting
differences:
• Everything is happening within the same hotel hall
• Everyone among the organisers, speakers and
participants gets in touch
• All moments can be engaging, and participation is very
democratic
Again, in comparison with the WHA, the one great difference
is the fact that not all countries are present and it’s not WHO
official documents that are being approved. This is a
limitation in terms of formal power, but the establishment of
influence by other very effective means exists at the WHS!
I hope that future delegations to the WHS will benefit from
our assessment, with an action plan backed by the
Secretariat, as there is a lot to do in Berlin! For now, I can
only be proud of the people who thought this could be a good
place for JDN to start having a presence!
World Health
Summit
2023, Berlin
Testimonies
Dr. Francisco Franco Pêgo, MD.
Socio Medical Affairs Officer
Term 2023-2024
Portugal
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 21
World Health
Summit
2023, Berlin
Testimonies
Dr. Jeazul Ponce Hernandez, MD
MSc. MPH.
Publications Director
Mexico/Spain
Junior Doctors Network
World Medical Association
The WHS experience was quite interesting as
there was a huge participation of women, and
we discussed some important topics like the
digitalization of health and universal health
coverage as one of the essential global health
challenges, where the participation of various
actors, governments and civil society stands
out.
As for JDN, it is well known that the IFMSA has
been an essential part for many of us who are
now JDN members, seeing the representatives
of the voices of young people such as Dr.
Omnia El Omrani, Dr. Renzo Guinto, amongst
other former IFMSA or the alumni and to see
them being part of events of this magnitude was
very gratifying.
It is worth mentioning that the interesting
intervention of Dr. Tedros Adhanom
Ghebreyesus, Director of the WHO,
regarding the unfortunate situation in the
Middle East, where he condemns the
terrorist attacks but highlights the
humanitarian crisis in Palestine, does not
tip the balance on any side, but calls for
the respect of human rights and
international treaties.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 22
Organization of The
European Health
Summit (EJD AM-GA
2023 & UEMO GA)
This is the first time that the Spanish Medical Council
with an active Junior Doctors Chapter participation,
organised a European conference to discuss the main
challenges doctors will face in the coming years.
The EJD is a federation of junior doctors’ associations
from across Europe. It serves as a platform for
cooperation, communication, and exchange of
experiences among junior doctors from different
countries. EJD works on various issues, including the
quality of medical education and training, healthcare
systems, and mobility of doctors within the European
Union.
The Junior Doctors Chapter have continued to work
very actively in the organisation of the European
Health Summit together with the Standing Committee
of the CGCOM, where the Autumn Assembly of the
European Junior Doctors Association will take place.
In addition, an assembly of the European Union of
General Practitioners – UEMO was held
simultaneously with a day of debate on various current
issues in European health policy and an assembly of
the provincial members of young doctors in Spain.
Dr Pablo Estrella P. M.D.
MPH.
Membership Director
Spain
Junior Doctors Network
World Medical
Association
Dr Juan Pablo Carrasco
Picazo, MD. Representative
of Junior Doctors Valencia.
Psychiatrist (Valencia,
Spain)
Dr Alvaro Cerame del
Campo, MD. Medical
Workforce Chairperson
at the European Junior
Doctors EJD.
Psyquiatrist (Madrid,
Spain).
Dr Domingo Antonio
Sánchez Martínez
MD, MSc.
Spanish National
Representative of
Junior Doctors.
Medical Oncologist
(Murcia, Spain)
The European Health conference was on October 26th, and the EJD Autumn
Meeting – General Assembly 2023 was in Murcia, Spain on 27-28 October 2023.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 23
Health Festival – 3rd
Panhellenic Congress
of Medical Students for
Public Health
The “Health Festival – 3rd Panhellenic Congress of Medical Students for Public Health” is an
annual national conference organized by Hellenic Medical Students International Committee –
HelMSIC, a non-profit and non-governmental medical student organization founded in 1958,
representing Greek medical students worldwide. This year’s focus is on Mental Health, with the
event taking place from 8th to 10th December 2023, at the Centre for the Dissemination of
Research Results (KEDEA) of the Aristotle University of Thessaloniki in Greece (Figure 1). The
article explores the organization of the 3rd Health Festival, emphasizing on its goals, activities, and
opportunities for medical students and junior doctors to participate actively.
The “Health Festival – 3rd Panhellenic Congress of Medical Students for Public Health” is an
annual national conference organized by Hellenic Medical Students International Committee –
HelMSIC, a non-profit and non-governmental medical student organization founded in 1958,
representing Greek medical students worldwide. This year’s focus is on Mental Health, with the
event taking place from 8th to 10th December 2023, at the Centre for the Dissemination of
Research Results (KEDEA) of the Aristotle University of Thessaloniki in Greece (Figure 1). The
article explores the organization of the 3rd Health Festival, emphasizing on its goals, activities, and
opportunities for medical students and junior doctors to participate actively.
Dr. Kostas Roditis
Greece
Junior Doctors Network
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 24
Health Festival – 3rd Panhellenic Congress of Medical
Students for Public Health
Conference Goals:
The primary objective of the 3rd Health Festival is to foster a comprehensive understanding of
Mental Health among medical students and junior doctors. To achieve this, the conference
incorporates various activities and features, including roundtables, workshops, trainings, and a fair
from counselling organizations focused on mental health (Figure 2). The event also encourages
interactive methods such as debates and open space discussions to engage participants actively.
Key Components of the 3rd Health Festival:
• Roundtables by Leading Scientists: The conference features roundtables led by prominent
experts in the field of mental health. These discussions provide valuable insights and facilitate
in-depth conversations on critical topics.
• Workshops: Workshops are designed to offer participants hands-on learning experiences,
allowing them to develop practical skills related to mental health.
• Trainings by HelMSIC’s Peer Trainers: HelMSIC’s peer trainers will conduct specialized training
sessions, enhancing participants’ knowledge and understanding of mental health issues.
• Fair from Counselling Organizations: The fair showcases various counselling organizations
dedicated to supporting individuals with mental disorders. It provides attendees with the
opportunity to connect with these organizations and learn about available resources.
• Interactive Methods: The inclusion of interactive methods like debates and open space
discussions encourages active engagement and meaningful dialogue among participants.
• Active Involvement of Medical Students: The conference actively involves medical students in
various capacities, such as roundtable presenters, poster presenters, and oral announcers. This
inclusive approach ensures that students from all years and medical schools can participate.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 25
Health Festival – 3rd Panhellenic Congress of Medical
Students for Public Health
Participation Opportunities
For the first time, the Health Festival offers medical students and junior doctors the chance to
actively contribute to the conference:
• Roundtable Presenters: Six roundtables on mental disorders will feature five students each,
along with a responsible scientific supervisor. Each student/junior doctor will prepare a 20-minute
presentation on an assigned topic related to mental health.
• Poster Presentations: Medical students and junior doctors can present their research papers on
Mental Health in the form of posters. This allows them to share their findings with a diverse
audience from medical schools across Greece.
• Oral Announcements: In addition to posters, students and junior doctors can choose to present
their research as short announcements during the conference in an auditorium with attendees
from various medical schools.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 26
Health Festival – 3rd Panhellenic Congress of Medical
Students for Public Health
Junior Doctors Network Newsletter
Issue 27
December 2023
Conclusion:
The 3rd Health Festival – Panhellenic Congress of Medical Students on Public Health is a significant
event organized by HelMSIC to promote awareness and understanding of Mental Health among
medical students and junior doctors. With its diverse range of activities and opportunities for active
participation, the conference aims to equip future healthcare professionals with the knowledge and
skills needed to address mental health challenges effectively. As it continues to evolve, the Health
Festival plays a vital role in shaping the future of healthcare in Greece by nurturing informed and
compassionate medical professionals.
Conference Website: https://www.helmsic.gr/blog/2023/04/10/health-festival-2023
Contacting the organizing committee: hf-registration@helmsic.gr and registration@helmsic.gr
Facebook Page: https://www.facebook.com/events/6462395383772760
ARTICLES
BY
JDN
MEMBERS
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 28
Emotional and
Psychological Well-
being in Cancer
Patients: The Role of
Doctors and Society
Introduction:
Cancer patients frequently have emotional and psychological issues as a result of their diagnosis
and treatment. To improve the general well-being of cancer patients, doctors and society must
recognise and treat these requirements. The numerous methods that society and medical
professionals might use to assist cancer sufferers on their emotional and psychological journey are
examined in this essay.
1. The Role of Doctors:
Doctors bear a substantial amount of responsibility for providing holistic treatment to cancer
patients, which includes treating their emotional and psychological needs. Here are some major
parts of the doctor’s role in supporting cancer patients’ emotional well-being:
a) Communication and Empathy:
A healthy doctor-patient relationship requires effective communication. Doctors should take the
time to listen to their patients’ concerns, fears, and emotions about their diagnosis and treatment.
Doctors can relieve anxiety and encourage confidence by exhibiting empathy and understanding.
b) Education and Information:
Cancer patients frequently suffer anxiety and uncertainty because of the disease’s intricacy.
Doctors must present patients with clear and accurate information regarding their diagnosis,
treatment options, probable adverse effects, and prognosis. This makes patients feel more
informed and powerful, lowering anxiety and increasing control.
c) Psychosocial Support:
Doctors should be aware of the psychosocial support programmes offered to cancer patients.
Referring patients to support groups, counselling programmes, or mental health specialists might
provide them with additional emotional support. Collaboration with psychologists or psychiatrists
can aid in the treatment of certain mental health issues such as depression or anxiety disorders.
2. Society’s Role:
Aside from the direct involvement of doctors, society plays an important role in supporting the
emotional and psychological well-being of cancer patients. Here are some major components of
society’s role in fostering the emotional well-being of cancer patients:
a) Awareness and Education:
Cancer and its impact on emotional well-being should be aggressively promoted in society. By
educating the population about the difficulties cancer patients experience, society may develop
empathy, decrease stigma, and inspire support for patients’ experiences.
Dr. Fatima Khurshid
MBBS/ Registered Medical
Practitioner (PMDC) Medical
Doctor
Pakistan
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 29
Emotional and Psychological Well-being in Cancer
Patients: The Role of Doctors and Society
b) Supportive Networks:
Building supporting networks throughout communities is critical for cancer patients. Society can
enable the formation of support groups, both online and offline, where sufferers can connect with
others suffering similar issues. These networks provide a sense of belonging, emotional validation,
and the opportunity to share experiences and coping skills.
c) Workplace Support:
Employers can help cancer patients by assisting. Flexible work arrangements, compassionate
leave policies, and access to employee assistance programmes can help working cancer patients
reduce stress and anxiety. Society may help cancer sufferers by fostering a friendly work
environment.
d) Accessible Mental Health Services:
Society should make mental health therapies available and inexpensive to all cancer patients. This
involves proper funding for mental health programmes, minimising wait times for counselling or
therapy services, and integrating mental health support into the healthcare system.
e) Research and Policy Advocacy:
Society should fund research efforts focused on understanding the emotional and psychological
consequences of cancer and creating appropriate therapies. Advocating for policies that prioritise
mental health assistance for cancer patients can also contribute to increased access to care and
better overall results.
Conclusion:
A cancer patient’s overall quality of life both during and after treatment depends greatly on their
emotional and psychological health. To support these patients, both doctors and society have
significant roles to play. Maintaining open lines of communication, offering emotional support,
referring patients to mental health specialists, and educating and empowering patients are all ways
that doctors can help. In addition to providing accessible mental health care and financial support,
society may foster supportive communities and advance awareness and education. It’s crucial to
use techniques like active listening, reassurance, practical support, and self-care activities to help
patients re-engage with life. Other techniques include dealing with physical side effects, coping
with recurrence and fears of death, and managing patients’ concerns of side effects.
Collaboration with healthcare providers, promoting a happy environment, and providing resources
all contribute to patient well-being. Doctors and society can help cancer patients navigate their path
with strength and optimism by taking a holistic approach and adapting care to individual needs.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 30
Emotional and Psychological Well-being in Cancer
Patients: The Role of Doctors and Society
References:
1. Stanton AL, Luecken LJ, MacKinnon DP, Thompson EH. Mechanisms in psychosocial
interventions for adults living with cancer: Opportunity for integration of theory, research, and
practice. J Consult Clin Psychol.2013;81(2):318-335.
2. Holland JC, Breitbart WS, Jacobsen PB, Lederberg MS, Loscalzo MJ, McCorkle R, et
al.Psycho-oncology. 3rd ed. New York: Oxford University Press; 2015.
3. Carlson LE, Bultz BD. Benefits of psychosocial oncology care: Improved quality of life and
medical cost offset. Health Qual Life Outcomes.2003;1:8.
4. Barre PV, Padmaja G, Rana S, Tiamongla. Stress and Quality of Life in Cancer Patients:
Medical and Psychological Intervention. Indian J Psychol Med. 2018 May-Jun;40(3):232-238.
doi: 10.4103/IJPSYM.IJPSYM_512_17. PMID: 29875530; PMCID: PMC5968644.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 31
The GAPS of healthcare
access for empty Spain,
a new challenge to
overcome?
Spanish health system.
First, let’s talk about the achievements of the Spanish health system. The country has a successful
system of universal health coverage, which is committed to serving every person who resides in the
Spanish territory regardless of their condition, whether a regular or a non-regular migrant, access to
healthcare services is a right without conditions. Another success of the Spanish health system is
the population’s longevity. It is true that Spain, along with Japan, has one of the oldest populations
in the world, and this, of course, is due to its healthcare system, which focuses on preventive
medicine programs, and health promotion. However, above all, it is the country’s approach to
citizens and a significant investment of public funds in health. Nevertheless, before addressing the
problem described in this article’s title, we must understand how the Spanish public health system
works.
By Dr. Jeazul Ponce H. MD MSc.
MPH.
Ph.D. student at Complutense
University of Madrid
Mexico/Spain
Junior Doctors Network
World Medical Association
Picture 2. Examples of logos by each health institution of Catalonia, Andalusia and Castile and Leon.
A public system of universal coverage
combined with other types of coverage, work
together according to the type of job the
person has. For example, teachers or public
forces, MUFACE or ISFAS, respectively, both
are institutional bodies of the government that
work together with public health, but who also
have agreements with private health insurers.
On the other hand, we must mention that
Spain has particular geopolitics, being
governed through autonomous communities;
that is, each Spanish autonomous community
(picture 1) has its respective health institution.
For example, Salamanca city corresponds to
Sacyl, which is the acronym that means
“Sanidad Castilla y Leon” (Health Castile and
Leon), and thus respectively with the rest of
the cities into their autonomous communities,
Barcelona in “Servei Català de la Salut”
(Health of Catalonia), Seville in Andalusian
Health Service; (Health of Andalusia), etc.
Picture 1. Spanish Autonomous Communities
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 32
The GAPS of healthcare access for empty Spain, a new
challenge to overcome?
Picture 3. Evolution of population in Spain. Figure managed by the National Institute of Statistics (INE)
What is “empty Spain”?
The territories where depopulation is advancing incessantly suffer from the deterioration of public
healthcare provided by the autonomous communities. The lack of professionals and health
resources to cover the needs of dispersed, poorly connected, and ageing populations only
encourages relocation to places with more and better services. The cases of Soria, Jaén, Teruel,
and even my province, Salamanca, are very worrying.
Named “empty”, these depopulated regions of Spain are made up of provinces with a negative
demographic growth rate over a long period of time and a population density lower than the
national average.
The Spanish population has increased by around 38% from 1975 to 2021: it has gone from a
country with 34.2 million inhabitants to about 47.3 million, but this increase in population is only
noticeable in some areas. During these years, in which the country has suffered an economic
revolution, large regions have been affected by major migratory movements from rural areas to
large cities.
Thus, provinces such as Zamora have seen their population decrease by more than 31% in the
same period, according to population figures managed by the National Institute of Statistics (INE).
In contrast, others such as the Balearic Islands, have doubled their population (Picture 3).
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 33
The GAPS of healthcare access for empty Spain, a new
challenge to overcome?
Empty Spain: its impact on health services and its health system
The biopharmaceutical company Bristol Myers published a study about the challenge of empty
Spain and the relationship between inequality in access to health services in the most depopulated
areas. The population in Spain, as this study explains, is grouped around large cities that act with a
centripetal force that depopulates the rural regions and leaves them without services of any kind.
This deficit has repercussions on both primary and hospital care and emergency provision.
This translates into horrendous waiting lists, with some people waiting to be seen by a surgeon or
gastroenterologist since April 2022. Even patients living in cities have a long wait, so what happens
with the rural population? Sometimes, they must wait weeks or months to be seen by a family
doctor (primary healthcare practitioner) in their small town, otherwise patients are forced to move to
the nearest city for their basic clinical care needs.
Of course, there’s a lack of family
medicine specialists or general
physicians who cover rural areas, but
why? Perhaps because no doctors
interested in working there, far away,
likely due to limited resources, lack of
incentives, and uncompetitive
salaries.
Not only do the patients suffer from
these gaps of inequality and
deficiencies, but healthcare workers
find themselves with a tremendous
workload. Some doctors are required
to cover 24-hour night shifts, but who
can manage to perform well with 16
night shifts or more in a month,
working the equivalent of 3 doctors.
The low number of surgical interventions, for example, diminishes the professional capacity,
experience, and habit of specialists who prefer to go to other provinces to look for better job
opportunities to continue growing in their medical careers. The lack of doctors causes an overload
of work and causes great discomfort, harms the quality of work, and makes interactions difficult
among the few rural doctors.
This situation has been aggravated and increased, not only by retirements but by the impact of the
COVID-19 pandemic, the unfortunate death and loss of many fellow doctors, the fear of some
resident junior doctors of not performing the speciality of family medicine, for fear of being the first
line of intervention in a pandemic, or just because they don’t want to live far away from their homes
with poor salaries, and unfavourable conditions.
“Martillán”, is a village from Villar de Argañan a
town located in Salamanca province with 43
inhabitants. Original picture.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 34
The GAPS of healthcare access for empty Spain, a new
challenge to overcome?
What can be the solutions? What JDN can suggest or promote for the benefit of the youth
global healthcare workforce?
• The empowerment of a new generation of doctors as agents of change and direct health
promoters.
• Demand that political actors prioritize investment in public health, and do not encourage the
privatization of health, or force citizens to have to get rid of their resources to pay for private
insurance, which is optional and not mandatory.
• Promote the political participation/inclusion of young doctors through their schools, societies,
and different representations.
Spain’s public health system is one of the best in the world, it has survived many wars, has given
its best in the last pandemic and continues to give everything to provide quality medical care. It is
up to us to take care of it and demand that it not become extinct, since it is a global example that
must endure for many more years.
References
1. «BOE.es – Documento BOE-A-2002-15767». www.boe.es. Consultado el 30 de julio de 2018.
2. La España vacía: despoblación en España, datos y estadísticas, Instituto Nacional de
Esrtadistica. https://www.epdata.es/datos/despoblacion-espana-datos-estadisticas/282
3. El reto de reducir la desigualdad en el acceso a la salud en España, Bristol Meyers.
https://www.bms.com/assets/bms/spain/documents/moonshotbmshealthdisparities/MoonshotB
MSHealthDisparities.pdf
4. Fillat, Á. C., & González-Juanatey, J. R. (2020). COVID-19. Las consecuencias sociales,
sanitarias y cardiovasculares. Revista Española de Cardiología Suplementos, 20, 1.
https://doi.org/10.1016/S1131-3587(20)30027-3
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 35
Las brechas de
acceso a la sanidad
en la España vacía,
¿un nuevo reto a
superar?
El sistema sanitario español.
En primer lugar, hablemos de lo bueno del sistema sanitario español, y es su exitosa cobertura
sanitaria universal, que apuesta por atender a toda persona que se encuentre en territorio español
independientemente de su condición, ya sea inmigrante regular o no regular, da igual, el acceso al
servicio sanitario es un derecho sin condiciones. Otra de las bondades o resultados del sistema
sanitario español es la longevidad de su población. Es cierto que España, junto con Japón, tiene
una de las poblaciones más envejecidas del mundo, y esto, por supuesto, se debe a su sistema
sanitario, a los programas de medicina preventiva y a la promoción de la salud, pero, sobre todo, al
acercamiento a los ciudadanos y a una importante inversión de fondos públicos en sanidad. Sin
embargo, antes de abordar el problema descrito en el título de este artículo, debemos conocer
cómo funciona el sistema sanitario público español.
By Dr. Jeazul Ponce H. MD MSc. MPH.
Ph.D. student at Complutense
University of Madrid
Mexico
Junior Doctors Network
World Medical Association
Cobertura universal y un sistema público, con
otros que colaboran según el tipo de trabajo
que tenga la persona, maestros o fuerzas
públicas, MUFACE o ISFAS, respectivamente,
ambos son organismos institucionales del
gobierno que colaboran con la sanidad
pública, pero que también tiene convenios con
aseguradoras privadas de salud. Por otro lado,
debemos mencionar que, en España como
país, su geopolítica se rige a través de las
comunidades autónomas, es decir, cada
comunidad autónoma española (imagen 1)
tiene su respectiva institución sanitaria. Por
ejemplo, la ciudad de Salamanca corresponde
a Sacyl, que es el acrónimo que significa
“Sanidad Castilla y León”, y así
respectivamente con el resto de las ciudades
en sus comunidades autónomas, Barcelona en
“Servei Català de la Salut” (Sanidad de
Cataluña), Sevilla en Servicio Andaluz de
Salud; (Sanidad de Andalucía), etc.
Imagen 2. Ejemplos de logotipos de cada institución sanitaria de Cataluña, Andalucía y Castilla y León.
Imagen 1. Comunidades Autónomas de España
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 36
Las brechas de acceso a la sanidad en la España vacía,
¿un nuevo reto a superar?
Imagen 3. Evolución de la población en España. Figura realizada por el Instituto Nacional de Estadística
(INE)
¿Qué es “la España vacía”?
Los territorios donde la despoblación avanza sin cesar sufren el deterioro de la sanidad pública
que prestan las comunidades autónomas. La falta de profesionales y recursos sanitarios para
cubrir las necesidades de una población dispersa, mal comunicada y envejecida no hace sino
fomentar la huida a lugares con más y mejores servicios. Los casos de Soria, Jaén, Teruel, e
incluso mi provincia, Salamanca, son muy preocupantes.
La llamada España vacía, despoblada, está formada por provincias con una tasa de crecimiento
demográfico negativa durante un largo periodo y una densidad de población inferior a la media
nacional.
La población española ha aumentado en torno a un 38% desde 1975 hasta 2021: ha pasado de
ser un país con 34,2 millones de habitantes a otro con cerca de 47,3 millones, pero este aumento
de población sólo es perceptible en algunas zonas por igual. Durante estos años, en los que el
país ha sufrido una revolución económica, grandes regiones se han visto afectadas por
importantes movimientos migratorios desde las zonas rurales hacia las grandes ciudades.
Así, provincias como Zamora han visto disminuir su población en más de un 31% en este periodo,
según las cifras de población que maneja el Instituto Nacional de Estadística (INE). Por el
contrario, otras como Baleares, han duplicado su población (Imagen 3).
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 37
La España vacía: su impacto en los servicios sanitarios y su sistema de salud
La compañía biofarmacéutica Bristol Myers publicó un estudio sobre el reto de la España vacía y
la relación entre la desigualdad en el acceso a los servicios sanitarios en estas zonas más
despobladas. La población en España, según explica este estudio, se agrupa en torno a grandes
ciudades (Barcelona, Madrid, Bilbao, etc.), que actúan con una fuerza centrípeta que despuebla el
mundo rural y lo dejan sin servicios de ningún tipo. Este déficit repercute tanto en la atención
primaria como en la hospitalaria y las urgencias.
Esto se traduce en listas de espera “demoniacas”, gente esperando a ser atendida por el cirujano
o el gastroenterólogo desde abril de 2022, son incluso pacientes que viven en las ciudades
quienes deben esperar tanto tiempo. Pero ¿qué ocurre con la población rural?. En ocasiones,
deben esperar semanas o meses a que el médico de familia (atención primaria) les preste la
atención médica esencial en su pequeño pueblo, o los pacientes se ven obligados a trasladarse a
la ciudad más cercana para recibir atención clínica básica.
Por supuesto, faltan médicos
especialistas en medicina de familia o
médicos generales que cubran las
zonas rurales, pero ¿por qué? Quizá
porque no hay médicos interesados en
trabajar allí, lejos, probablemente por la
limitación de recursos, la falta de
incentivos y los salarios poco
competitivos.
No sólo los pacientes sufren estas
brechas de desigualdad y deficiencias,
sino que los trabajadores sanitarios se
encuentran con una sobrecarga
tremenda. Hay médicos que pueden
realizan guardias de 24 horas, pero que
llegan a realizar incluso 16 o más
guardias en un mes, es decir, trabajan
la jornada equivalente a 3 médicos.
El bajo número de intervenciones quirúrgicas, por ejemplo, merma la capacidad profesional, la
experiencia y el hábito de los especialistas que prefieren irse a otras provincias en busca de
mejores oportunidades laborales para seguir creciendo en su carrera médica. La falta de médicos
provoca una sobrecarga de trabajo que causa gran malestar, perjudica la calidad del trabajo y
dificulta la conciliación entre los pocos médicos rurales.
Esta situación se ha visto agravada y aumentada, no sólo por las jubilaciones, sino por el impacto
de la pandemia COVID-19, la desgraciada muerte y pérdida de muchos compañeros médicos, el
miedo de algunos médicos jóvenes a no realizar la especialidad de medicina de familia, por miedo
a ser la primera línea de intervención en una pandemia, o simplemente por no querer vivir lejos de
sus casas sin buenas condiciones laborales o salariales, etc.
“Martillán”, es un pueblo de Villar de Argañan una
localidad situada en la provincia de Salamanca
con 43 habitantes. Foto original.
Las brechas de acceso a la sanidad en la España vacía,
¿un nuevo reto a superar?
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 38
¿Cuáles pueden ser las soluciones? ¿Qué puede sugerir “Junior Doctors Network” en
beneficio del personal sanitario joven en todo el mundo?
• La capacitación de una nueva generación de médicos como agentes de cambio y promotores
directos de la salud.
• Exigir a los actores políticos que prioricen la inversión en salud pública y no fomenten la
privatización de la salud, ni obliguen a los ciudadanos a tener que desprenderse de sus
recursos para pagar seguros privados, que son opcionales y no obligatorios.
• Promover la participación/inclusión política de los médicos jóvenes a través de sus colegios,
sociedades y diferentes representaciones.
La sanidad pública española es una de las mejores del mundo, ha sobrevivido a muchas guerras,
ha dado lo mejor de sí en la última pandemia y sigue dándolo todo para ofrecer una asistencia
médica de calidad. De nosotros depende cuidarlo y exigir que no se extinga, ya que es un ejemplo
mundial que debe perdurar por muchos años más.
References
1. «BOE.es – Documento BOE-A-2002-15767». www.boe.es. Consultado el 30 de julio de 2018.
2. La España vacía: despoblación en España, datos y estadísticas, Instituto Nacional de
Esrtadistica. https://www.epdata.es/datos/despoblacion-espana-datos-estadisticas/282
3. El reto de reducir la desigualdad en el acceso a la salud en España, Bristol Meyers.
https://www.bms.com/assets/bms/spain/documents/moonshotbmshealthdisparities/MoonshotB
MSHealthDisparities.pdf
4. Fillat, Á. C., & González-Juanatey, J. R. (2020). COVID-19. Las consecuencias sociales,
sanitarias y cardiovasculares. Revista Española de Cardiología Suplementos, 20, 1.
https://doi.org/10.1016/S1131-3587(20)30027-3
Las brechas de acceso a la sanidad en la España vacía,
¿un nuevo reto a superar?
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 39
Enhancing Clinical
Research in Community
Settings: The Vital Role
of Junior Doctors
Introduction
Clinical research plays a pivotal role in advancing medical knowledge and improving patient care
[1]. Traditionally, clinical trials and studies have been conducted in controlled hospital settings.
However, there is a growing recognition of the importance of conducting research in community
settings to ensure the applicability of findings to a broader patient population [2]. A “community
setting” refers to a diverse array of non-hospital environments where individuals live, work, and
engage in daily activities. It encompasses neighbourhoods, primary care clinics, community health
centres, schools, workplaces, and other places where people naturally congregate. In the context
of clinical research, conducting studies in community settings involves investigating medical
interventions or health-related phenomena outside the controlled environment of a hospital. By
expanding research into community settings, the results are more likely to reflect the diverse
characteristics, behaviours, and needs of the general population, contributing to the development
of more effective and patient-centered healthcare interventions. In this scientific perspective, we
explore the significance of clinical research in community settings and shed light on the crucial role
that junior doctors play in advancing this field. This article draws upon scientifically sound
references to underscore the value of community-based clinical research and the contributions of
junior doctors in this endeavour.
The Significance of Clinical Research in Community Settings
Clinical research conducted in community settings offers several advantages that contribute to the
overall improvement of healthcare:
1. Diversity of Participants: Community-based research allows for the inclusion of a more diverse
and representative sample of patients compared to studies conducted solely in academic
medical centres [3]. This diversity enhances the external validity of study findings, ensuring that
interventions apply to a wider range of patients. As an example, consider that a clinical trial is
investigating a new diabetes medication. Instead of recruiting participants exclusively from a
single academic medical centre, the study collaborates with local community health clinics. This
approach allows for a more diverse participant pool, including individuals from various
socioeconomic backgrounds, ethnicities, and age groups. The study’s findings are therefore
more representative of the broader diabetic population, making it easier to generalize the
results to a wider range of patients.
2. Real-world Application: Community settings mirror the environments in which most patients
receive medical care. This is also the environment that they most likely live and work in, as a
contrast to inpatient hospital settings, where patients routinely do not live and work or spend
their daily lives. Therefore, research conducted in these settings provides insights into how
interventions will perform in the real world, beyond the controlled conditions of a hospital [4].
By Dr. Shiv Joshi
Medical Ethics Officer
Term 2023-2024
India
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 40
Enhancing Clinical Research in Community Settings: The
Vital Role of Junior Doctors
As an example, consider that a study is assessing the effectiveness of a new telemedicine
program for managing chronic illnesses. Rather than conducting the research solely within the
controlled environment of a hospital, researchers implement the program in local community
settings, such as rural clinics and urban health centres. By doing so, they can observe how
patients interact with the technology and receive care in their everyday lives. This approach
ensures that the findings are more applicable to the real-world scenarios in which patients typically
manage their health.
3. Patient-Centeredness: However, what sets community-based research apart is its intrinsic
ability to embed these patient-centric outcomes within the fabric of everyday life. This approach
fosters a deeper understanding of how healthcare interventions truly impact individuals in their
natural environments, allowing for a more comprehensive assessment of the holistic patient
experience. In contrast to the controlled setting of inpatient care, community-based research
captures the real-world nuances and challenges patients face, offering a more nuanced
perspective on the effectiveness of medical interventions and a stronger alignment with
patients’ needs and preferences [5]. As an example, consider that researchers are conducting a
study on the impact of a specific exercise regimen for individuals with chronic pain. Instead of
monitoring patients in a hospital gym, they collaborate with local fitness centres and community
organizations. By integrating the exercise program into the daily routines of participants,
researchers gain a deeper understanding of how the intervention affects patients in their natural
environments. This patient-centred approach enables them to consider factors like motivation,
social support, and lifestyle, providing a more comprehensive assessment of the patient
experience.
4. Cost-Efficiency: Conducting research in community settings can be more cost-effective than in
academic medical centres, making it possible to investigate a wider range of interventions and
health conditions within limited budgets [6]. As an example, consider that a research project
aims to investigate the effectiveness of various community-based interventions for reducing the
incidence of childhood obesity. By conducting the study in collaboration with local schools,
after-school programs, and community centres, researchers can reduce costs associated with
renting and operating hospital facilities. This cost-efficient approach allows them to explore a
wider range of interventions and gather data from a larger sample of children, making the study
more comprehensive and budget-friendly.
The Role of Junior Doctors in Community-Based Clinical Research
• Junior doctors, often in the early stages of their medical careers, play a vital role in advancing
clinical research in community settings. Their involvement can be multifaceted:
• Patient Recruitment and Informed Consent: Junior doctors can actively engage in recruiting
patients for research studies and obtaining informed consent. Their close interaction with
patients allows for effective communication of study details and the importance of participation.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 41
Enhancing Clinical Research in Community Settings: The
Vital Role of Junior Doctors
• Data Collection and Monitoring: Collecting data in community settings is crucial for the success
of research projects. Junior doctors can take on responsibilities such as administering
questionnaires, conducting physical exams, and monitoring participants’ progress throughout
the study; therefore, aiding in accurate, and robust data collection.
• Data Analysis and Interpretation: Junior doctors are well-versed in statistical methods and data
analysis techniques. They can contribute to the rigorous analysis of research data, helping to
draw meaningful conclusions and insights from the collected information.
• Participant Education: Educating study participants about their conditions and the research
being conducted is essential. Junior doctors can explain complex medical concepts in a
comprehensible manner, ensuring that participants have a clear understanding of their role in
the research.
• Advocacy for Research: Junior doctors can serve as advocates for clinical research within their
communities and healthcare institutions. Their enthusiasm for research can inspire colleagues
and patients alike to become involved in research activities.
• Interdisciplinary Collaboration: Junior doctors often work closely with other healthcare
professionals, such as nurses, pharmacists, and social workers. This interdisciplinary
collaboration is crucial for the success of research in community settings, where comprehensive
care is provided.
References
1. Vickers AJ, Scardino PT. “The clinically-integrated randomized trial: proposed novel method for
conducting large trials at low cost.” Trials. 2009;10(1):14.
2. Tunis SR, Stryer DB, Clancy CM. “Practical clinical trials: increasing the value of clinical
research for decision making in clinical and health policy.” JAMA. 2003;290(12):1624-1632.
3. Zwarenstein M, Treweek S, Gagnier JJ, et al. “Improving the reporting of pragmatic trials: an
extension of the CONSORT statement.” BMJ. 2008;337:a2390.
4. Weijer C, Grimshaw JM, Eccles MP, et al. “The Ottawa Statement on the Ethical Design and
Conduct of Cluster Randomized Trials.” PLoS Med. 2012;9(11):e1001346.
5. Foy R, Eccles MP, Jamtvedt G, et al. “What do we know about how to do audit and feedback?
Pitfalls in applying evidence from a systematic review.” BMC Health Serv Res. 2005;5(1):50.
6. Klassen TP, Hartling L, Craig JC, et al. “Barriers to and facilitators of clinical practice guideline
use in nursing homes.” J Am Geriatr Soc. 2010;58(11):1-7.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 42
Spanish Junior
Doctors Leading the
Way: Shaping the
Future of Medical
Practice
The Spanish General Council of Official Medical Colleges (CGCOM), member of the WMA, has its
Junior Doctors Chapter, focusing on internal national collaboration with Autonomous Communities’
representatives and maintaining a regional and international perspective through external
representatives. Over the past year, this Spanish Junior Doctors Chapter has spearheaded
numerous initiatives to enhance the working conditions of medical residents in Spain. Additionally,
it has drawn attention to the emerging issue of medical deserts in both the country and the region.
Furthermore, as part of Spain’s Presidency of the European Commission, the chapter has played a
pivotal role in organizing a European Junior Doctors event in Murcia.
Study on Working Conditions of Medical Residents (MIR) in Spain
The study on the working conditions of medical residents (MIR) in Spain, published in August 2023
in the Q1 Impact Factor magazine, has ignited discussions surrounding the well-being of resident
doctors. This study shed light on the pressing issues within the MIR program, with some residents
enduring extended working hours that exceed European regulations. Such demanding schedules
result in fatigue and stress, ultimately jeopardizing both their well-being and the quality of care
delivered to patients. Furthermore, the study reveals that a substantial proportion of MIRs fail to
take the required daily and weekly rest periods, exacerbating these challenges. Moreover, the
research underscores the significant disparities in working conditions between various locations
and specialities, emphasizing the need for a comprehensive approach to address these concerns
(picture 1).
Dr Pablo Estrella P. M.D. MPH.
Public Health Resident
Membership Director
Spain
Junior Doctors Network
World Medical Association
Dr Juan Pablo Carrasco P., MD.
Representative of Junior Doctors
Valencia. Psychiatrist (Valencia, Spain)
Junior Doctors Network
World Medical Association
Dr Alvaro Cerame del Campo, MD.
Medical Workforce Chairperson at the
European Junior Doctors EJD.
Psyquiatrist (Madrid, Spain).
Junior Doctors Network
World Medical Association
Dr Domingo A. Sánchez M. MD, MSc.
Spanish National Representative of
Junior Doctors. Medical Oncologist
(Murcia, Spain)
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 43
Spanish Junior Doctors Leading the Way: Shaping the
Future of Medical Practice
The General Council of Official Medical Colleges (CGCOM) president presented the case to the
European Parliament’s Petitions Committee, advocating for uninterrupted rest periods for
resident doctors. It was followed by the European Commission’s response, that this study
highlights EU Directive 2003/88/CE and its relevance to working time regulations. This directive
emphasizes the importance of daily and weekly rest periods, raising crucial questions about
implementing these regulations in Spain.
Spain’s proposal to extend this research to other European Junior Doctors (EJD) members is a
significant step toward improving working conditions for junior doctors across the European
Region. The formation of a Working Group for a multicentre study under the Medical Workforce
Pillar is explored, offering a promising baseline for regional advocacy.
Medical Deserts Report and Impact
The Juniors Doctors Chapter presented a report on “medical
deserts” in Spain examining areas with limited healthcare
coverage and their impact on healthcare access. Junior
doctors’ perspectives shed light on underlying factors
contributing to this issue, including job dissatisfaction,
infrastructure, and rural living conditions. The report presents
findings from a study conducted on the different regional
representatives in Spain, revealing the perception of junior
doctors regarding medical deserts and the utilization of
medical residents to address these challenges.
This report highlighted the best practices and emphasised the
need to avoid certain measures that can hinder healthcare
provision in rural areas. The report’s significant media
coverage underscores the growing concern about healthcare
access in various regions of Spain (Picture 2).
Picture 2. Medical Deserts Report
and Impact
Picture 1. of the Research Paper on Spanish residents’ duty hours and resting times
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 44
Spanish Junior Doctors Leading the Way: Shaping the
Future of Medical Practice
References
1. Sanchez Martinez, D.A., Carrasco Picazo, J.P., Estrella Porter, P.D. et al. Resident physician
duty hours, resting times and European Working Time Directive compliance in Spain: a
cross-sectional study. Hum Resour Health 21, 70 (2023). https://doi.org/10.1186/s12960-023-
00857-x
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 45
Jóvenes médicos
españoles liderando
el camino: dando
forma al futuro de la
práctica médica
El Consejo General de Colegios Oficiales de Médicos de España (CGCOM), miembro de la AMM,
tiene su Capítulo de Médicos Jóvenes, centrándose en la colaboración nacional interna con
representantes de las Comunidades Autónomas y manteniendo una perspectiva regional e
internacional a través de representantes externos. Durante el año pasado, este Capítulo Español
de Médicos Jóvenes ha liderado numerosas iniciativas para mejorar las condiciones laborales de
los médicos residentes en España. Además, ha manifestado su preocupación sobre el problema
emergente de los desiertos médicos tanto en el país como en la región. Además, como parte de la
Presidencia española de la Comisión Europea, el capítulo ha desempeñado un papel fundamental
en la organización de un evento europeo de jóvenes médicos en Murcia.
Estudio sobre las Condiciones Laborales de los Médicos Residentes (MIR) en España.
El estudio sobre las condiciones laborales de los médicos residentes (MIR) en España, publicado
en agosto de 2023 en la revista Q1 Impact Factor, ha encendido el debate en torno al bienestar de
los médicos residentes. Este estudio arrojó luz sobre los problemas apremiantes dentro del
programa MIR, donde algunos residentes soportan jornadas laborales prolongadas que exceden
las regulaciones europeas. Horarios tan exigentes provocan fatiga y estrés, lo que en última
instancia pone en peligro tanto su bienestar como la calidad de la atención brindada a los
pacientes. Además, el estudio revela que una proporción sustancial de MIR no toma los períodos
de descanso diarios y semanales requeridos, lo que agrava estos desafíos. Además, la
investigación subraya las importantes disparidades en las condiciones laborales entre diversos
lugares y especialidades, enfatizando la necesidad de un enfoque integral para abordar estas
problematicas (imagen 1).
Dr Pablo Estrella P. M.D. MPH.
Residente de Salud Pública
Director de Membresía
España
Junior Doctors Network
Asociación Médica Mundial
Dr Juan Pablo Carrasco Picazo, MD.
Representante de Junior Doctors Valencia.
Psiquiatra (Valencia, España)
Junior Doctors Network
Asociación Médica Mundial
Dr Alvaro Cerame del Campo, MD.
Presidente del personal médico del
European Junior Doctors EJD. Psiquiatra
(Madrid, España).
Junior Doctors Network
Asociación Médica Mundial
Dr Domingo A. Sánchez M. MD, MSc.
Representante Nacional de Junior Doctors España
Médico Oncólogo (Murcia, España)
Junior Doctors Network
Asociación Médica Mundial
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 46
Médicos jóvenes españoles liderando el camino: dando
forma al futuro de la práctica médica
El presidente del Consejo General de Colegios Oficiales de Médicos (CGCOM) presentó el caso
ante la Comisión de Peticiones del Parlamento Europeo, abogando por periodos de descanso
ininterrumpidos para los médicos residentes. A esto le siguió la respuesta de la Comisión
Europea: este estudio destaca la Directiva de la UE 2003/88/CE y su relevancia para las
regulaciones sobre el tiempo de trabajo. Esta directiva enfatiza la importancia de los períodos de
descanso diarios y semanales, planteando interrogantes cruciales sobre la implementación de
estas regulaciones en España.
La propuesta de España de ampliar esta investigación a otros miembros de los médicos jóvenes
europeos (EJD) es un paso significativo hacia la mejora de las condiciones laborales de los
médicos jóvenes en toda la Región de Europa. Se explora la formación de un grupo de trabajo
para un estudio multicéntrico en el marco del pilar de fuerza laboral médica, lo que ofrece una
base prometedora para la promoción regional.
Perspectivas de los médicos jóvenes sobre los desiertos
médicos.
El Capítulo de Médicos Jóvenes presentó un informe sobre los
“desiertos médicos” en España analizando las zonas con
cobertura sanitaria limitada y su impacto en el acceso a la
asistencia sanitaria. Las perspectivas de los médicos jóvenes
arrojan datos sobre los factores subyacentes que contribuyen a
este problema, incluida la insatisfacción laboral, la
infraestructura y las condiciones de vida rurales. El informe
presenta los resultados de un estudio realizado entre los
diferentes representantes regionales en España, que revela la
percepción de los médicos jóvenes sobre los desiertos médicos
y la utilización de médicos residentes para abordar estos
desafíos.
Este informe destacó las mejores prácticas y enfatizó la
necesidad de evitar ciertas medidas que puedan obstaculizar la
prestación de atención médica en las zonas rurales. La
importante cobertura mediática del informe subraya la creciente
preocupación por el acceso a la asistencia sanitaria en varias
regiones de España (Imagen 2).
Imagen 2. Informe e impacto de
los desiertos médicos
Imagen 1.
Trabajo de
Investigación sobre
los horarios de
guardia y descanso
de los residentes
españoles
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 47
Médicos jóvenes españoles liderando el camino:
dando forma al futuro de la práctica médica
References
1. Sanchez Martinez, D.A., Carrasco Picazo, J.P., Estrella Porter, P.D. et al.
Resident physician duty hours, resting times and European Working
Time Directive compliance in Spain: a cross-sectional study. Hum Resour
Health 21, 70 (2023). https://doi.org/10.1186/s12960-023-00857-x
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 48
Addressing the
intersection between
Climate Change and Health
in Medical Education: The
urgent need in India
Introduction
Climate change is a significant threat to humanity, with direct and indirect effects on human health.
In India, the impact of climate change on health is severe, making it a major public health concern
(1). For instance, in May 2015, India experienced one of its deadliest heat waves, with
temperatures soaring above 45°C (113°F). This extreme heat resulted in over 2,500 deaths, mainly
among the elderly, children, and outdoor labourers. These events demonstrate how climate change
can have a quantifiable and severe impact on health in India. This article advocates that medical
education in India must address the intersection between climate change and health to prepare
healthcare professionals to respond to the challenges posed by climate change.
Impact of Climate Change on Health in India
Climate change has various effects on human health, including extreme heat, air pollution,
waterborne diseases, and vector-borne diseases. In India, these health impacts are severe and
urgent, with the country being among the most affected by climate change (2). For instance, air
pollution contributes to 1.7 million deaths in India annually, making it the leading risk factor for
premature mortality and disease burden in the country (3).
Why is now a critical time for India to address this intersection?
Several factors make now the right time to address the intersection between climate change and
health in medical education in India. First, the increasing severity and frequency of climate-related
disasters, such as floods and heat waves, are highlighting the urgency of addressing climate
change and health (4). India’s rapid urbanization, with over 30% of the population now residing in
cities and a projected increase to 40% by 2030, has led to a tripling of the built environment,
accommodating an additional 200 million urban residents (5). This urban expansion has generated
increased demand for energy and water, raised emissions and waste levels, reduced air quality,
and resulted in various health consequences. Notably, nearly 44% of India’s carbon emissions
originate in urban areas (5). Urban centres, especially megacities and metro cities, are major
contributors to greenhouse gas emissions and face heightened risks such as water stress, heat
island effects, and the frequency and intensity of urban floods and droughts. Instances of urban
flooding in major Indian cities have resulted in loss of life, property damage, and disease
outbreaks, with climate change-related rainfall pattern shifts playing a significant role. Rising
temperatures, particularly in cities like Bengaluru, Chennai, Delhi, Jaipur, and Kolkata, have further
compounded health risks. Additionally, a substantial population is at risk from sea-level rise and
coastal flooding in cities such as Chennai and Mumbai (5).
Second, the COVID-19 pandemic has demonstrated the critical role of healthcare professionals in
managing public health crises, making it even more crucial to equip them with the necessary skills
and knowledge to manage the health impacts of climate change. Finally, the Indian government’s
focus on promoting sustainable development and reducing greenhouse gas emissions through
initiatives such as the National Action Plan on Climate Change provides an excellent opportunity to
integrate climate change and health into medical education (6).
By Dr. Shiv Joshi
Medical Ethics Officer
Term 2023-2024
India
Junior Doctors Network
World Medical Association
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 49
Addressing the intersection between Climate Change and
Health in Medical Education: The urgent need in India
Importance of Including Climate Change and Health in Medical Education
Medical education in India must incorporate the intersection between climate change and health to
equip medical students with the knowledge and skills necessary to mitigate the impacts of climate
change on health and promote sustainable healthcare practices. The traditional medical training
has not emphasized the impacts of climate change on health in the past. Medical curricula should
cover topics such as the health impacts of climate change, adaptation and mitigation strategies,
and strategies to promote sustainable healthcare practices (7).
Collaboration and Coordination for Effective Implementation
The integration of climate change and health into medical education in India requires collaboration
and coordination between academic institutions, public health officials, and policymakers. Medical
schools and public health institutions should work together to develop and implement curricula that
address the intersection between climate change and health. Additionally, policymakers should
prioritize climate change and health in their policy decisions, including the development of
healthcare infrastructure and public health programs (8).
Benefits of Including Climate Change and Health in Medical Education
The inclusion of climate change and health in medical education in India is essential for several
reasons. It will enable healthcare professionals to identify and manage the health impacts of
climate change, promote the adoption of sustainable healthcare practices, and create awareness
among healthcare professionals of the need to take action on climate change and health, inspiring
them to become advocates for sustainable healthcare practices (9).
Conclusion
The intersection between climate change and health is a critical issue in India, and medical
education must address this issue to prepare healthcare professionals to respond to the challenges
posed by climate change. Integrating climate change and health into medical curricula will equip
medical students with the knowledge and skills necessary to mitigate the impacts of climate
change on health and promote sustainable healthcare practices. The urgent need to address the
intersection between climate change and health in medical education in India cannot be
overstated.
Junior Doctors Network Newsletter
Issue 27
December 2023
Page 50
Addressing the intersection between Climate Change and
Health in Medical Education: The urgent need in India
References:
1. Dube RK, Gupta A. Climate Change and Health: A Framework for Medical Education and
Training. Indian Journal of Community Medicine. 2017;42(4):183-186. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748152/
2. Government of India. India’s Second Biennial Update Report to the United Nations Framework
Convention on Climate Change. Ministry of Environment, Forest and Climate Change,
Government of India; 2018. Available from:
https://www4.unfccc.int/sites/ndcstaging/PublishedDocuments/India%20First/Second%20Bienn
ial%20Update%20Report%20of%20India.pdf
3. India State-Level Disease Burden Initiative Air Pollution Collaborators. The impact of air
pollution on deaths, disease burden, and life expectancy across the states of India: the Global
Burden of Disease Study 2017. Lancet Planetary Health. 2019;3(1):e26-e39. Available from:
https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30261-4/fulltext
4. Djalante R, Shaw R, DeWit A. Building resilience against biological hazards and pandemics:
COVID-19 and its implications for the Sendai Framework. Progress in Disaster Science.
2020;6:100080. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226104/
5. National Institute of Disaster Management. (2021). REPORT SUMMARY OF WEBINAR
CLIMATE CHANGE AND DISASTERS.Available from: Report_29October2021sk2.pdf
(nidm.gov.in)
6. Ministry of Environment, Forest and Climate Change. National Action Plan on Climate Change.
Government of India; 2008. Available from: http://www.moef.gov.in/wp-
content/uploads/2016/01/napcc_eng-1.pdf
7. Patwardhan B, Ravi Kumar K, Kulkarni P, et al. Climate Change and Health: Training Public
Health Professionals to Address the Health Impacts of Climate Change. Indian Journal of
Public Health. 2017;61(2):71-76. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461173/
8. Patz JA, Frumkin H, Holloway T, Vimont DJ, Haines A. Climate Change: Challenges and
Opportunities for Global Health. JAMA. 2014;312(15):1565-1580. Available from:
https://jamanetwork.com/journals/jama/fullarticle/1914174
9. Costello A, Abbas M, Allen A, et al. Managing the health effects of climate change: Lancet and
University College London Institute for Global Health Commission. Lancet.
2009;373(9676):1693-1733. Available from:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60935-1/fulltext
Junior Doctors Network Newsletter
Issue 27
December 2023
Junior Doctors
Network
Newsletter
Issue 27
December 2023