• The BMJ‘s investigation looking at why UK doctors have had difficulty prescribing the drug Avastin to treat wet age related macular degeneration rather than the more expensive Lucentis has provoked some interesting responses, including ones from Niall Dickson, chief executive of the General Medical Council, and Stephen JW Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine.

• In research news, a large multi-centre, prospective study published in the New England Journal of Medicine has found that taking a blood sample from women at 10 to 14 weeks of pregnancy and analysing cell-free foetal DNA for an extra chromosome is more effective than standard non-invasive screening tests in diagnosing Down’s syndrome.

• In his 10 minute consultation, Adam D Jakes explains how “back pain in teenagers is common,” and that “characterising the pain and identifying the presence of red flags are vital to ensuring that potentially serious conditions are identified.”

• And finally, take a look at Jeffrey Aronson’s blog. An interaction with a patient—”That specialist registrar you referred me to was totally useless,” said Pat. “What an insolent shmuck. Doc, don’t ever become a registrar”—caused him to look closely at the “sh” phoneme. I learnt a lot and had a good giggle.

Sally Carter is lead technical editor for the education section.