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Junior doctors

Martin Kaminski: How not to be a junior doctor

1 Aug, 14 | by BMJ

martin_KaminskiTo all the newly qualified doctors about to inaugurate their careers in junior house officer posts across the UK next week, I bestow upon you the secrets to a happy and fulfilling start as a junior doctor. Namely, do not do some of the things that my colleagues and I did (which is a way of hiding the fact that it was mostly me), and you will likely not only survive, but also avoid a few blunders along the way. Of course, this is contingent on having also memorised the entire Oxford Textbook of Medicine front to back. No pressure. more…

Kiran Varadharajan: A junior surgical trainee’s perspective on surgical simulation

13 Mar, 14 | by BMJ

kiran_varadharajanThe European Working Time Directive (EWTD) has reduced the number of hours that trainee doctors have to hone their skills. As a junior surgical trainee, I find that time in theatre is of the essence when it comes to improving my operative skills. “The Time for Training Report” highlighted these challenges with suggestions on how trainees can overcome the training barriers produced by EWTD. One of the key developments is simulation training. Simulation training forms an excellent way of developing skills in a controlled environment without causing potential harm to patients. These skills can then be transferred into real life operations. The upshot is that when operating on patients surgeons are honing their skills rather than learning from scratch. more…

Anna Allan on applying to core training

14 Feb, 14 | by BMJ

Alongside thousands of other trainees, over the past months I have been partaking in the core training application rigmarole. And it is exhausting. For example the process of compiling a portfolio of academic self worth for a 10 minute flick through, is simultaneously self assuring and depressing. The need for a quick and effective selection method nationally results in a nameless, faceless application process that may as well do away with the candidates entirely. Meeting face-to-face is a mere formality, and the questions asked seemingly as indiscriminate as the black folders clutched by hopeful applicants. more…

Keir Arran: A remote and rural foundation programme—a unique experience

1 Nov, 13 | by BMJ Group

keir_arranSeveral recent publications, including the BMA’s Healthcare in a rural setting suggest that there is a shortage of doctors working in rural areas.

I first heard about the N10 rural track foundation programme from a registrar working in A&E when I was a student. He talked about the programme with such enthusiasm that I looked it up and was sold on it instantly. There is some thought that junior doctors, under pressure from the European Working Time Directive and with shorter attachments, have lost the sense of being part of a team. When choosing my foundation posts, a good general medical training was obviously an important factor, but I wanted to achieve this in an environment where I would be recognised and valued as a member of the team, rather than feeling like “just another number.” A rural hospital sounded like it could provide this. more…

Jonny Martell: Surviving burnout

9 Aug, 13 | by BMJ Group

Jonny Martell Nothing much sprung to mind.  A friend had just asked me an odd question, paraphrasing the mystical scholar Andrew Harvey, “what breaks your heart the most?”  Was this an early showing of the carapace of cynicism to come? A day later it came back to me: the thought of my father’s final walk around the house and garden he couldn’t bear to leave.  The thought of his hands – devastated by rheumatoid arthritis – tying a knot in the rope to hang himself from the old oak tree.  Nearly a year ago and a few weeks into my first job as a doctor, my father took his own life.  more…

Nassim Parvizi on being a junior doctor on the Keogh Review

29 Jul, 13 | by BMJ

nassim_parviziAs junior doctors, we all see and hear things that work well or that could work better as we rotate between different departments across a number of hospital trusts. So we are in a privileged position to contribute to the safety of the healthcare we deliver to our patients. I previously found raising concerns a challenge, which was not helped by my lack of awareness of how a hospital’s organisation and management structure works beyond my ward. This improved as I was involved in visiting a hospital trust as part of Bruce Keogh’s Rapid Responsive Review. The trust I visited was one of the 14 hospital trusts in England with the highest mortality rates in the last two years (based on “standardised mortality rates”). more…

Sarah Welsh on health gadgets

14 May, 13 | by BMJ

Sarah WelshHardly 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…

Helen Jaques: Exposing junior doctors’ working hours

26 Mar, 13 | by BMJ

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…

Sam Fosker: The Francis report—applications for the leaders of tomorrow

11 Mar, 13 | by BMJ Group

sam_foskerThe 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…

Isobel Weinberg: The Foundation Programme Office giveth and it taketh away

4 Mar, 13 | by BMJ

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…

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