The Malta Foundation programme : one year on : part I

The Malta Foundation programme was launched in July 2009, In July 2010 the first group of foundation doctors were awarded their Foundation Achievement of Competence Document allowing them to proceed to the next step of their career, basic specialist training. The programme was set p with two main objectives: A. t improve the first two years of postgraduate training of doctors and to ensure that doctors achieved a level of competence enabling provision of safe patient care; and B. to reverse the exodus of Maltese medical graduates and retain an adequate proportion of doctors to allow the local health service to provide a good quality service. we present the results of the introduction of the Foundation programme to Malta and ask whether the main objectives have been achievedpeer-reviewe

The Malta Foundation Programme : one year on : pt.II

Part 1 of this article can be found in this link : https://www.um.edu.mt/library/oar//handle/123456789/12739Part 2 of the article. The Malta Foundation programme was launched in July 2009, In July 2010 the first group of foundation doctors were awarded their Foundation Achievement of Competence Document allowing them to proceed to the next step of their career, basic specialist training. The programme was set p with two main objectives: A. to improve the first two years of postgraduate training of doctors and to ensure that doctors achieved a level of competence enabling provision of safe patient care; and B. to reverse the exodus of Maltese medical graduates and retain an adequate proportion of doctors to allow the local health service to provide a good quality service. we present the results of the introduction of the Foundation programme to Malta and ask whether the main objectives have been achieved.peer-reviewe

Adult immunisation : an overview

This year in particular saw the potential influenza pandemic fuel the uptake of immunisation against annual influenza. Judging from reports that both public and private sector vaccines ran out beforehand, the uptake must have been higher than usual, although no official reports are available to date. There were no significant reports of influenza illness in the community probably as a result of this.peer-reviewe

Clinical practice guidelines : the way ahead

A seminar entitled `Clinical Practice Guidelines - The Way Ahead' was organised jointly by the Office of the Director General and the Department of Medicine on 5th March 2005. The aim of the seminar was to introduce the concept of Clinical Practice Guidelines into the framework of the medical and paramedical professions in Malta. It was well attended by around 80 delegates from most of the healthcare professions. The seminar was co-chaired by Dr Alfred Caruana Galizia, Chairman Department of Medicine and Dr Mariella Borg Buontempo, Consultant in Public Health, Office of the Director General.peer-reviewe

Tetanus : forgiven, not forgotten

Tetanus is an illness that is still prevalent although the incidence has markedly decreased largely due to immunisation programmes. The latest four cases managed at St. Luke's hospital over 2001-2002 are presented. All of these patients survived. We give an overview of the illness and discuss the cases and management. The potential benefit of using dual antibiotic therapy is questioned.peer-reviewe

Crusted (Norwegian) scabies treated with oral ivermectin : a case report and overview

Crusted (Norwegian) scabies is a severe and highly contagious form of infestation caused by the mite Sarcoptes scabiei var. hominis. It occurs in a subgroup of patients who are either immunocompromised or physically or mentally debilitated. Due to its atypical clinical presentation as well as difficulties associated with its management it presents a number of challenges both from a therapeutic aspect as well as from public health perspective. Failure to diagnose this condition may give rise to a massive epidemic when the patient is in an institutional setting. We describe a case of crusted scabies which occurred in a nursing home leading to an institutional outbreak. She received a combination of oral ivermectin and topical scabicidal with good results. This case highlights the importance of being alert to the possible diagnosis of crusted scabies and gives an overview of the condition as well as management strategies.peer-reviewe

The Malta Foundation Programme : time to act

On the 27th November 2008, the Health Care Services Division announced that a Foundation Programme for Housephysicians will commence in July 2009. The same circular stated that “this two-year programme for Housephysicians essentially transforms the current housemanship into a structured learning experience.” For those of us who spent the main part of our two years of housemanship at St Luke’s Hospital, this sounds rather strange. For a start why do we need to “transform” the current housemanship? It worked well enough for us. And secondly what exactly is a “structured learning experience”?peer-reviewe

The first wave of COVID-19 in Malta; a national cross-sectional study

INTRODUCTION: The COVID-19 pandemic has posed major challenges to all aspects of healthcare. Malta’s population density, large proportion of elderly and high prevalence of diabetes and obesity put the country at risk of uncontrolled viral transmission and high mortality. Despite this, Malta achieved low mortality rates compared to figures overseas. The aim of this paper is to identify key factors that contributed to these favorable outcomes. METHODS: This is a retrospective, observational, nationwide study which evaluates outcomes of patients during the first wave of the pandemic in Malta, from the 7th of March to the 24th of April 2020. Data was collected on demographics and mode of transmission. Hospitalization rates to Malta’s main general hospital, Mater Dei Hospital, length of in-hospital stay, intensive care unit admissions and 30-day mortality were also analyzed. RESULTS: There were 447 confirmed cases in total; 19.5% imported, 74.2% related to community transmission and 6.3% nosocomially transmitted. Ninety-three patients (20.8%) were hospitalized, of which 4 were children. Patients with moderate-severe disease received hydroxychloroquine and azithromycin, in line with evidence available at the time. A total of 4 deaths were recorded, resulting in an all-cause mortality of 0.89%. Importantly, all admitted patients with moderate-severe disease survived to 30-day follow up. CONCLUSION: Effective public health interventions, widespread testing, remote surveillance of patients in the community and a low threshold for admission are likely to have contributed to these favorable outcomes. Hospital infection control measures were key in preventing significant nosocomial spread. These concepts can potentially be applied to stem future outbreaks of viral diseases. Patients with moderate-severe disease had excellent outcomes with no deaths reported at 30-day follow up