Hardly a new breakthrough, but gadgets relating to health, fitness, and wellbeing are on the increase. Pedometers, sleep monitors, diet apps, and so on, all remain very much in vogue. But, are medical gadgets really the way forward in healthcare? Do we want to be strung up to some monitoring gadget whilst we get on with daily living? Or are they merely a fascination that will pass?

Smartphones are cashing in on the publics want for a “quick fix” with regards to health, targeting its audience with the likes of weight loss apps. The health service may also be wise to embrace these advances. more…

Back when Christian Jessen of Embarrassing Bodies fame was training as a junior doctor, he regularly worked dangerously long hours. But then in August 2009 the European Working Time Directive (EWTD) was introduced to limit the working hours of doctors to 48 hours a week. Problem solved.

But of course nothing is ever that simple, as Jessen discovered in his Channel 4 Dispatches investigation on junior doctors’ hours. Despite the regulations, doctors up and down the country are still working in excess of 100 hours a week. more…

The main focus of the recent Francis report has been on the implications it has on the clinical and economic management of the NHS, but there are many lessons that can be applied to all levels of hospital hierarchy.

Patient centred care is championed across healthcare, and nowhere as much as in complex care wards for older people, such as the one I’m currently placed on. The increasing number of admissions for older people with complex comorbidities and backgrounds means protocols and standardised treatments, although useful, are continuously being adapted for patients’ needs. more…

On Monday, a friend posted a picture of an enormous, triple layered chocolate cake on Facebook. It was, she wrote, a present for her boyfriend—a final year medical student—to celebrate his being awarded his top choice of location for his first job next year. Getting the first choice has meaning beyond simple preference: it enables the couple to spend the next two years living in the same part of the country.

But the elation and the chocolate cake were soon followed by sadness and anger. As you will have heard by now, the job allocation process is to be rerun, and, like thousands of other final year medical students, my friend’s boyfriend has no idea whether he will achieve the tantalisingly glimpsed first choice job again. more…

The junior doctor’s applications process has metamorphosed from an individual interview process, to modernising medical careers (MMC), to the foundation programme application system. There has been a big push towards centralising services for the majority of NHS training applications. This year has also seen a change with regards to the application itself. A two hour “situational judgement test” (SJT) now forms the basis of the application as opposed to the previous “white space” questions. Whilst this was previously heralded as a fairer and more accurate reflection of the abilities of each individual to manage complex scenarios, and therefore a better way of discriminating between medical students, there have been problems. The two key ones include a lack of foundation programme training positions for medical students to apply for, and the latest news that there has been an error with the marking of final year student SJT papers. This means that the thousands of medical students who received their deanery information yesterday may have been given incorrect scores and information about their futures. more…

Tomorrow I’ll go to work and among other things, prescribe drugs. I’ve been told that they work and that they’re mostly safe. There’s plenty to encourage me in believing this: whether enshrined in official guidelines or treatment protocols (or not), lots of other doctors prescribe these drugs in the same or similar patients, for the same or similar conditions. As Ben Goldacre points out in his latest book, Bad Pharma, this is an “ad hoc oral tradition.”

At medical school we learned the physiology underpinning which drugs to give for what condition. There was an elegant simplicity in the study of pharmacology—this molecule acts at this receptor, and via these signalling pathways, brings about this change. Then we were told that given classes of drugs worked for certain conditions, with the occasional reference, by a clinician or lecturer, to a particular trial to align our faith to a particular named drug. more…

It is a sign of the times that one of the best ways for information from outside of hospital to come to my attention is via my Facebook newsfeed. This is indeed true, with links to various newspaper articles plastered all over my homepage announcing the recent death of Joseph E Murray, a pioneer of transplant surgery and Nobel prize winner. Long fascinated by the Nobel prize, I have always thought it inspiring that they were originally founded to reward those who “conferred the greatest benefit to mankind.”

Reading about Murray, one cannot help but feel in awe. Not only did he perform the first successful kidney transplant, but in so doing he inspired countless others in the field, resulting in the huge advances in transplant surgery that we are able to take for granted today. A true testament to this impressive feat is the fact that the endeavours of his team in 1954 helped to propel specialty breakthroughs of such a magnitude that today a (basic) understanding of organ transplantation pervades the general populace and is considered matter of fact. Incredible that the work of one individual helped to achieve so much. more…

My fellow FY1s and I have been flying solo for over three months now. It has been filled with “firsts.” First day of work, first night shift… first pay cheque. All exciting milestones in their own right, and each followed, perhaps naïvely, by a sense of achievement having surmounted such momentous obstacles. Time has sprinted by, as demonstrated by my radio silence on the BMJ blogs front. What little spare time I have seems to be spent on my new favourite pastimes: eating and sleeping. However at time of writing I have foregone these two pleasures as I find myself in an almost heavenly lull during my night shift. more…

In my opinion a recent Panorama programme, “Britain’s Secret Health Tourists,” didn’t do justice to a complex issue. With a Department of Health consultation looming on the issue, it’s important doctors understand why. I’ve attempted to summarise the evidence on this issue elsewhere, so here I’ll stick to the key points that I think Panorama got wrong, conflated, or forgot to mention.

The key scoop presented by the Panorama team was that middle men were, for a fee, arranging GP registrations for foreign nationals. The problems with presenting this as a scoop are, firstly, that GPs are entitled to register whoever they wish so long as they don’t discriminate and, secondly, that the exploitation of vulnerable migrants is sadly not news. more…

Shadowing began over a week ago. As around 7000 of my newly qualified peers entered our new homes (read: hospital trusts) for the first time, I couldn’t help but feel a sense of adventure. In some ways it felt like the first day of school—new rules, new faces, new friends. In others it was also like the first day of medical school—new responsibilities and new jargon. Everything familiar and yet somehow uniquely different. Who knew that within a few short hours, our minds would be spinning with more acronyms than we’d know what to do with: from DOPS to CBDs to PDPs. And that’s just our online portfolios! more…