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Wendy Reid: Postgraduate medical training in the NHS: complex and transforming

31 Aug, 16 | by BMJ

Wendy_Reid2Junior doctors’ anger and disillusionment during their recent dispute highlight the need for a new approach to ensure that they feel valued and able to work in supportive and accountable environments.

Rather than wait for the contractual dispute to be resolved, Health Education England (HEE) has been working with others, including postgraduate deans, the BMA’s Junior Doctors Committee, NHS Employers, and the Academy of Medical Royal Colleges (AoMRC), to address some of these challenges. more…

John Davies: Providing medical care in rural Brazil

26 Aug, 16 | by BMJ

Rio_Olympic_GamesThe Olympic Games are over, and what a wonderful two weeks they were. We finished the last events at the Olympic Stadium the day before the last day and there was a slight element of going mad. Hundreds of volunteers flooded onto the track. Shirts of different colours were swapped, and there were selfies and mass group photographs in all directions. No one was immune from the wonderful Brazilian enthusiasm for having good time. more…

Rammya Mathew on the national childhood obesity strategy—doctors need to champion public health

25 Aug, 16 | by BMJ

rammya_mathewI was left mortified after reading about the long awaited national childhood obesity strategy. “Underwhelming” would be the single best adjective to describe it. On reading the newspaper headlines, however, it is all too tempting to pass the buck to Public Health England and Dame Sally Davies et al. However, there is a sense of unease about this. I can’t fight the feeling of responsibility to demand more of our government. It seems incongruous to dedicate our working lives to treating disease and yet turn a blind eye to public health policy that is set to fail a generation. more…

Christopher Martyn: Research round-up

22 Aug, 16 | by BMJ

chris_martynAnnals of Internal Medicine

Mistreatment of residents in nursing homes

Conditioned by reports in the media about mistreatment of residents in nursing homes, one leaps to the conclusion that it must be the staff who are doing the mistreating. This study suggests that it’s more likely that the other residents are to blame. Two thousand elderly people living in nursing homes in New York state were observed and interviewed over a month. More than 20% reported experiencing at least one episode of abuse from their peers. Verbal aggression was the most common form, but invasion of privacy, menacing gestures, and physical attacks also occurred frequently. more…

Mary Higgins: The second victim in modern healthcare

22 Aug, 16 | by BMJ

IMG_0701

First do no harm. It’s one of the fundamental rules, but what experienced clinician has not, at least once, done some harm? Medicine is intricate, and imperfect, with increasing number of diseases and disease processes occurring in complex people within a multifaceted world. The tests we use are not perfect and the decisions we make every day are innumerable—and we can do harm. more…

Bayad Nozad: Rio, cupping, and public health risks

18 Aug, 16 | by BMJ

bayad_nozadThe Olympic Games are a major inspiration for people from all backgrounds and ages to participate in sport and lead more healthy lifestyles. We noticed great public engagement in all forms of sports following the London 2012 Olympics. This year, Public Health England and other organisations made use of the Rio Olympic Games to launch the Road to Rio Challenge.

Millions have watched as a number of athletes including Michael Phelps have been photographed with large red circles on their skin during Rio 2016. These are signs of “cupping” an ancient Chinese practice that is becoming popular amongst athletes and celebrities. more…

Colin Brewer: Assisted suicide and people with intractable psychiatric illness

18 Aug, 16 | by BMJ

When a former editor of The BMJ and respected health academic like Richard Smith even tentatively argues the case for medically assisted rational suicide (MARS) to avoid the slow and progressive personality annihilation that we call dementia, it can’t be dismissed as a fringe opinion. Dementia worries people more than cancer and that’s hardly surprising because while dying messily from cancer is distressing for families to watch and for patients to experience, the really awful stage usually lasts days or weeks rather than months. Of cancer patients who get the “green light” to go to Switzerland for MARS, fewer than 20% actually make the journey. [1] If palliative care proves adequate, they use it but they want to have the option for MARS if it doesn’t. more…

Michael L Millenson: Girls, queers, and patients

18 Aug, 16 | by BMJ Group

Millenson Formal PhotoIt’s not surprising that the word “patient” makes some activists uncomfortable. The Latin root patiens (“he who suffers”) suggests passivity, particularly when paired with doctore (“he who teaches”). ­Small wonder, then, that physicians have traditionally viewed patient-centeredness as their providing “caring custody” while acting as “rational agents” on patients’ behalf. (1) more…

John Davies: Looking after athletes in Rio

17 Aug, 16 | by BMJ

Rio_Olympic_Games

A few days ago I was in nominal charge of the second field of play team which is situated after the finishing line of the track. The finishing line is fixed as it has all the photo and electronic equipment on it, and starts are arranged variously according to the event’s length. I say I was in nominal charge, because I asked my Brazilian GP colleague to hold the leader’s radio, as my Portuguese would be inadequate if I needed to use it. We had all our kit and went through a rehearsal of using the spinal board, basket stretcher, and trolley for a collapsed person. We also went through the emergency bags we carry, the airway kit, folding splints, bandages and so on. I am reassured that my colleagues and I can work together through the international language of medicine.  more…

Peter Thomson: Would revoking the European Working Time Directive improve surgical training?

17 Aug, 16 | by BMJ

shift_workThe President of the Royal College of Surgeons of England suggested recently that leaving the EU will allow surgeons to undergo thousands of hours of extra training. Following the Brexit result, we are faced with the potential revoking of the European Working Time Directive (EWTD). The anti-EWTD-ers may now see their dreams come true, and this argument evokes significant similarities between the anti-EWTD debate and the mendacious EU referendum campaign. more…

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