Archive for October, 2008
October 31st, 2008
The increasing politicisation of medicine continues this week with leading medical journals reporting on the proposed differences between the supporters of the 2 political parties and their leaders McCain and Obama. in the US election.
The New England Journal goes a step further than some in its coveage, publishing a “results style” table that looks more at home with in randomised control trial analysis than in a commentary on healthcare policy.
The essence is that healthcare is becoming more important priority for those in the US when ranked alongside other issues such as employment, war in Iraq, education, defence etc.
That said, its undeniable that healthcare is playing an incresing part of election strategy in the US. How long till we here in the UK actually see a tangible difference in healthcare policy from the leading political parties (Labour/ Conservative) on issues such as these.
Sound bites from a health savvy politician in any televised debate could potentially leave the oponent with egg on his face after any exchange.
Probably the most heavyweight stat is this
7% Republican Voters Surveyed said that expanding healthcare coverage across the US was important
in contrast to
94% of Democrats Voters Surveyed said that expanding healthcare coverage across the US was important
Who said that politics was boring. And we haven’t even mentioned stem cells…
We fully support the increasing awareness of clinicians to the wider issues in healthcare. Read the original article from the NEJM here.
J Bateman
October 27th, 2008
JAMA reports that medical schools may now be tempted to sell their names in an attempt to drum up much needed cash with the University of Minnesota being a prime target for those seeking to raise upwards of a reported $150 million.
JAMA. 2008;300(16):1937-1938.
In the UK I can see this catching on after the renaming of our famous football stadiums (The Reebok, Emirates et al). Surely someone will object to the University of Birmingham being renamed the Unibond University of Pot Noodle or something of that ilk?
We’ll have to wait and see.
Any suggestions for some sponsorship? A few tasteless ones come to mind….
October 25th, 2008
Published this week in the New England Journal of Medicine, promising trial data for the new monoclonal antibody Almetuzamab.The conclusions of the study were as follows:
“ In patients with early, relapsing–remitting multiple sclerosis, alemtuzumab was more effective than interferon beta-1a but was associated with autoimmunity, most seriously manifesting as immune thrombocytopenic purpura. The study was not powered to identify uncommon adverse events.”
NEJM abstract link here
There has been extensive media coverage of the drug on UK media sources including coverage of patients who have received the drug. Cambridge researchers showed a reduction in relapse rate and disability in 334 patients suffering from multiple sclerosis for less than 3 years.
October 25th, 2008
We have set up our own little page on facebook to let med students out there know about us. Its basically a combination of things that are on this site and the opportunity to get involved in the facebook communities out there.
http://www.facebook.com/pages/Medical-Educator/31527206607
Take a look over there, and if you want, add yourself as a fan!
October 24th, 2008
A 32 year old female presents with an expressive dysphasia to her GP. Her GP initially thinks it could be migraine as she recalls a mild headache. However, he explains to the patient that she needs to be seen in the hospital for a check up.
She has no visual symptoms, motor symptoms or other neurological symptoms or signs.
By the time she arrives in the Emergency department, her symptoms have entirely resolved.
O/E
Temp 36 o Celsius
BP 112/78
Sats 99% Air
GCS 15/15
Fingerprick Blood glucose 3.9mmol/l
On examination she has an entirely normal neurological examination. The rest of the general examination is unremarkable other than a soft systolic murmur.
Is there anything else to be done, or should she simply see her GP for a follow up and consideration of a referral to a headache clinic? If there is something to be done, what is it and why?
October 22nd, 2008
When applying for places at medical schools follow our 10 golden rules…
1.) Read an article form nature related to health prior to going to your interview.
2.)Have an aspect of your study/ SSM that you can specifically talk about in terms of interests
3.) Have a location specific reason why you want to that specific job
4.) Be able to list your strengths
5.) Have an answer to “what are your weaknesses”.
6.) Demonstrate areas outside of medicine where you can relax.
7.) Approach the topic of future speciality with sensible pro’s and cons about why you would like to work in that specific area
8.) Read about clinical governance (the 7 rules: google it or Clinical Governance).
9.) Read about the restructuring of medical careers (MMC, modernising medical careers/ MTAS) — google it or search http://www.nhsemployers.org/
10.) Thank the interviewers at the end for their time.
Preparation is key but some focus on areas to prepare for will really help!
See our PDF on applying for FY1 jobs, written by an F1 who successfully navigated through the process on the main site.
October 19th, 2008
Here’s a selection of what we’ve published in our links page to different sets of guidelines:
These are particularly helpful for referencing evidence based medicine.
AAN: American Academy of Neurology guidelines
AACE: American association of Clinical Endocrinologists with guidelines here
BAD: British association of dermatologists with guidelines here
BOA: British Association of Orthopaedics with guidelines here
British Society of Immunology
BSR: British Society of Rheumatology, clinical guidelines here
British Toxicological Society
BTS: British Thoracic Society, clinical guidelines here
EAU: European Association of Urology guidelines here
ESC European Society of Cardiology: nice source for cardiovascular guidelines list here
Fitness to Drive: British Driving and Vehicle Licensing Agency (DVLA) downloadable PDF ‘at a glance’ guide on fitness to drive
RCOG Royal College of obstetrics and gynaecology guidelines here
The Renal Association. source for chronic kidney disease and eGFR guidelines here
October 15th, 2008
Its clear that training schemes throughout the UK are oversubscribed with trainees where there are potentially not enough jobs.As the competition increases the need for ways to discriminate between the candidates becomes ever more important
The FY1 entry scheme is fixated on a scoring system in an attempt to homogenise all medical school graduates. But is this fair?
But what of a standard exam nationwide set for medical students? Is it on its way? You can be sure of a few things..
- There is a lot of money to be made from setting the questions…
- The potential for fraud increased exponentially as the stakes are raised
- Who will do what with the results. The worst performing medical school?
- The possibility of a medical school being in a position where a large proportion of students fail
Surely though its the only way to make the MTAS application process objective, and we here at medicaleducator broadly endorse a nationwide exam for medical students.
It seems like its still many miles away yet…
October 15th, 2008
Its a common story that we hear time and time again – that medical students have got no money, they are hard up, and struggling.
Reading this article today it seems the average cost of debt is almost £7,000, with some students in excess of £10,000. But in the grand scheme of things – does this pale into significance once you consider salary potential?
As a previous medical student i was part of a culture which was very much about living for the present and not worrying too much about the future in terms of debt. And i’m still paying it off!
We would be interested in hearing other peoples debt stories – is it a big factor for you, or is it one to stick your head in the sand about?
October 12th, 2008
A man has a CT scan of his abdomen booked after an attendance at one of his normal Hospital follow up clinic. Although the report largely gives him the ‘all clear’, what may the radiologist be commenting when he looks at the image below (if the request form was filled in with sparse clinical information!)
Axial CT abdomen, and courtesy of John S To, MD, with thanks, used under a Creative Commons licence
- What is the abnormality shown on the CT ?
- What is the likely underlying diagnosis?
