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Wilson Cheng: Misguided messages on safe male circumcisions

25 Feb, 14 | by BMJ

wilson_chengThree large randomised clinical trials that took place in Kenya, Uganda, and South Africa were published in 2007, and showed that medically performed circumcision is safe and can reduce men’s risk of HIV infection by 60%. The World Health Organization (WHO) and UNAIDS therefore recommend safe male circumcision (SMC) as an essential part of HIV prevention programming. In 2010, the Ugandan Ministry of Health adopted the national safe male circumcision policy, which recommends voluntary safe male circumcision for all men, and makes it available through the public health system. more…

Colin Brewer: Is addiction a disease?

24 Feb, 14 | by BMJ

colin_brewerLast November, The Spectator held a debate on the proposition that drug addiction is not a disease. Former BMJ columnist Theodore Dalrymple was one of the proposers (I was invited to join him but couldn’t be there), and the motion was carried by a substantial majority. Apart from telling us what many ordinary people think about addicts and addiction, the debate also has important implications for Alcoholics Anonymous (AA) and its sister organisation Narcotics Anonymous. more…

Kevin Murray: The future of high secure services over the next 50 years

20 Feb, 14 | by BMJ

In the past 50 years mental healthcare has been transformed in ways few could imagine in 1964. Fifty years ago Broadmoor Hospital had nearly 1000 patients who stayed an average of 20 years each at what is arguably the world’s most famous high secure hospital for mentally disordered offenders. Today it has some 195 patients who stay an average of five years. more…

James Partridge responds to the government’s review of cosmetic surgery

18 Feb, 14 | by BMJ

James Partridge

There was more than a little bit of déja vu about the government’s response to the Keogh review of cosmetic surgery when it finally saw the light of day, early last Thursday.[1]
A bunch of us were led into a Department of Health underground room and given the embargoed report … I can recall receiving just such an embargo in the spring of 2005 before the Cayton report emerging on precisely the same issues (now buried deep in the government archives).[2] more…

William Cayley: We have met the enemy

17 Feb, 14 | by BMJ

bill_cayley“We have met the enemy and he is us.” (Pogo)
Manica Balasegaram makes a number of excellent points in his recent post, but his conclusion that “the system is broken” only addresses part of the problem. I read the piece at the MSF website on “Looking for alternative models” with interest, but I do not think that alternative business models alone will solve a fundamental conflict that is built into the very nature of who we are in the medical profession. more…

Martin Carroll: Thinking of working in the NHS?

17 Feb, 14 | by BMJ

martin_carrollIn 2013, the National Health Service (NHS) celebrated 65 years of providing comprehensive healthcare, free at the point of delivery to UK citizens. There are a number of factors contributing to the success and longevity of the NHS, including the dedication of its workforce. The role of doctors and nurses from overseas should not be underestimated. In a recent poll by the think tank British Future 75% of respondents believed that the NHS would not have survived without the work of doctors and nurses coming from abroad. more…

John Appleby:—your bits in their hands

13 Feb, 14 | by BMJ

Over the past few months there has been considerable debate and argument about plans by the NHS to collect and centrally collate details of individual patient records from general practice for the first time. Many have expressed worries about the initiative and how potentially sensitive patient information will be used, who will have access to it (and for what reasons), and not least its security. Such fears are perhaps not just hypothetical given past examples of lost patient notes and what appear to be the misuse of sensitive patient information (even for the best of intentions). more…

Kate Granger: Why compassionate care is so important

6 Feb, 14 | by BMJ

kate_grangerHaving terminal cancer is rubbish. There is no way of getting around that fact. I’ve just spent nearly a week in hospital feeling exceptionally unwell and at times wondering whether I was actually going to recover from this episode of febrile neutropenia. But I did and lived to see another day. Cancer has completely changed my life, but it’s not all bad, and the powerful voice I seem to have developed as a result is being heard far and wide and is something that astonishes me. more…

Ahmet Ozdemir Aktan: Criminalising doctors in Turkey—an update

6 Feb, 14 | by BMJ

a_ozdemir_aktan Professor Aktan has written an update to his previous blog about a new Turkish law which forbids medical treatment of injured protesters without state permission.

The law is now signed by the President and is in action. The threat of imprisonment and a fine is real for Turkish medical staff. The Turkish Medical Association will try further actions to stop the law. The law can be stopped by the Constitutional Court. However, an application to the Constitutional Court must be made by the main opposition party. The main opposition party has agreed to take the law to the Constitutional Court, but the procedure may take a year.

See also:

Competing interests: I declare that I have read and understood BMJ Group policy on declaration of interests and I have no relevant interest to declare.

Ahmet Ozdemir Aktan is professor of surgery, Marmara University School of Medicine, Istanbul, Turkey and the president of the Turkish Medical Association.

Kieran Walsh: Medical education—high value but high cost?

6 Feb, 14 | by BMJ

Medical education has undergone many reforms over the past thirty years. Medical students of the past spent much time learning things they didn’t need to know—today medical education is curriculum driven. In the past medical education was “one size fits all”—today it is learner centric. In the past students practised on patients—today increasingly they practise in simulations or online. What can be said in defence of medical education of the past? Perhaps there is one thing—it was low cost. Medical education has undergone a process of reform in recent years. I think that most of the reforms have been worthwhile although I know that not everyone would agree with me. However surely most would agree that the reforms have cost money. Small group teaching, high fidelity simulations, high technology e-learning programmes, problem based learning tutorials, train the trainer programmes—they all require funding. So if the direction of travel of medical education has been moving from low cost low value to high cost high value, the obvious question is—where next? I would argue that we must look for models and methods of medical education that are high value, but low cost. more…

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