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Desmond O’Neill: Elective Dreams

19 Aug, 14 | by BMJ

desmond_oneillWith every elective student that joins our unit, I get a vivid flashback of my own electives. No matter how much water has flowed under the bridge since then, something particularly special endures about these less structured educational episodes. Even if undertaken in a local hospital, the elements of summer holiday, change of routine, and freshness suffuse the experience for both student and clinician.

My “formal” electives were a blast. Hamburg in the summer is green, leafy, and sunny—with water a constant presence from the huge harbour to the Alster lakes in the centre of the city. The first summer was spent in a large hospital there, St Georg, whose Wilhelmine ward blocks radiated the spirit of the great German pioneers of 19th century medicine. The second elective was in the racier setting of the small Harbour Hospital beside the red light district of the Reeperbahn, transvestites and sailors prominent among the clientele. more…

Julie Browne: Word counts, words count—how do we want things to be in medical education?

15 Aug, 14 | by BMJ

Julie BrowneI have just come across a neat little web tool from the New York Times. You can type in any word, and see a line graph showing how frequently it’s been used in the New York Times by year right back to 1860. You can also compare several words simultaneously. It’s a fascinating insight into the degree of public debate surrounding news stories in the United States over the last 150 years.

Take, for example, “influenza.” The graph shows a huge rise in mentions during the Spanish influenza pandemic of 1918, and more peaks mark the outbreaks of 1957, 1968, and the H5N1 bird flu scare of 2005. Some medical words make a dramatic appearance—like “antibiotic” in the 1940s or “anorexia” in the 1970s—while others disappear entirely, such as “scrofula,” which last showed up in 1899, and “phthisis,” which faded away in 1917. more…

Lavanya Malhotra: Tackling obesity with gold

24 Jul, 14 | by BMJ

Lavanya MalhotraThe Dubai municipality has come up with a novel way to promote a balanced diet and exercise in the city: slim down, and the reward will be worth your weight in gold. Or rather, you will receive 1 g of gold for every kg shed. Earlier this week it was estimated that more than 15 000 people had signed up, with the final numbers expected to be more since registration closed yesterday. Already this is more than the 9666 people who took part in a similar scheme last year.

An initiative like this is especially important in Dubai. The United Arab Emirates (UAE) has been ranked as the fifth most obese nation in the world, according to a 2012 report published in the BMC Public Health journal. More than 66% of men and 60% of women in the UAE are overweight or obese, according to the Lancet‘s Global Burden of Disease Study 2013. more…

Jack Johnson: My week as a medical journalist

14 Jul, 14 | by BMJ

jack_johnsonI arrived at the offices of The BMJ on Monday 7 July, expecting to spend the day at a desk reading scholarly articles, which I had little chance of making sense of. I am a sixth form student and spent a week at The BMJ on work experience. My previous encounter with work experience was at Dunn’s Bakery in Crouch End, north London, so I was already impressed as I walked through the reception area of BMA House, and through the courtyard with its fountain and gargoyles. The BMJ’s offices are pretty standard, but it was the world of medical journalism that I was plunged into that really surprised and engaged me. more…

Lavanya Malhotra: Sex education in India

9 Jul, 14 | by BMJ

Lavanya MalhotraThe website of India’s health minister, Harsh Vardhan, currently states: “So called ‘sex education’ to be banned. Yoga to be made compulsory.” The media has not been impressed, and controversy rages as health professionals and educators debate the merits of age appropriate sex education in schools.

Vardhan has since retracted his original statement, saying: “Crudity and graphic representation of culturally objectionable symbols as manifested in the UPA’s [United Progressive Alliance, a coalition of political parties which governed India for the past 10 years] so called sex education programme cannot be called sex education. Every education system must strive to have an ideal curriculum, and to that extent my stand is valid. Sex education builds societies free of gender discrimination, teenage pregnancy, HIV-AIDS proliferation, pornography addiction.” more…

Rhys Davies: Ode to a stethoscope

11 Jun, 14 | by BMJ

A recent article in The BMJ wondered whether portable ultrasound scanners might soon replace the trusty stethoscope. These ultrasounds are easy to use, sexy, cheap at only £5000(!), and lead to greater confidence at the examination couch. But forgive me if I’m not ready to swap my stethoscope for a tricorder just yet.

The invention of the stethoscope is credited to René Laennec, a particularly tuberculous Frenchman in the early 19th century. Worried by his own infectiousness, and the sensitivities of his patients, he created a stiff hollow tube to convey auscultated sounds from the patient’s chest to his ear. The bi-auricular rubber piping incarnation, to be worn with pride around the necks of generations of doctors and medical students, came later. more…

Hemal Kanzaria et al: How can we reduce medical waste in US hospitals?

4 Apr, 14 | by BMJ

hemal_kanzariaUS hospitals annually discard millions of dollars of clean, unused medical equipment due to procedural excess or federal regulations. [1,2] Many health professional students do not recognise the magnitude of this waste or the extent of worldwide inequities in access to such supplies. In an era of value driven care, it is critical to engage students in cost conscious care and waste reduction efforts.

Remedy at University of California San Francisco (R@UCSF) is a student implemented, service learning initiative for the responsible redistribution of medical supplies to underserved communities. [3] Through an experiential curriculum, the program objectives are a) to reduce disparities in access to healthcare supplies by providing clean and needed equipment to under resourced communities and b) to expose students to the magnitude of medical waste in US hospitals. more…

Richard Smith: Teaching medical students online consultation with patients

14 Feb, 14 | by BMJ

Richard SmithA first year medical student of today may well still be practising in 2070. We can’t know how medicine will look then, but we can see some clear trends. The relationship between doctors and patients will surely be much more equal; indeed, health will be the business primarily of patients, with doctors as advisers, guides, and facilitators. Much of medical practice will be conducted online, with online consultations routine. Indeed, in some parts of medicine online consultations are routine now, reminding us that the future is already here but not evenly distributed. Recognising these trends, Leicester Medical School has introduced medical students to online interaction with patients at the very beginning of their course. I went to Leicester to meet with patients, students, and teachers who are participating in the programme. more…

Alice James: Tackling tobacco temptation—why we need to target children

28 Nov, 13 | by BMJ

alice_jamesThe most effective way we can reduce the global burden of smoking is to target young people. During the debate on standardised packaging of tobacco products, an initiative which has for now been stalled by the government, MP Bob Blackman stressed that, “Two thirds of current smokers began under the age of 18″ and that once “hooked” it becomes “very difficult to give up.”

Governments need to take extra measures to make tobacco products more difficult for children to purchase. It appears some are making a start: New York City councillors recently voted to increase the legal age for buying cigarettes from 18 to 21 as well as backing the introduction of a $10.50 minimum price for a pack of cigarettes. Making the legal smoking age equal to the legal drinking age might accentuate the effect of this tobacco control measure, as previously teenagers might have taken up smoking because of the ease of buying cigarettes compared with the ease of purchasing alcohol. The more governments can do to prevent smoking becoming habitual during adolescence, the less likely the individual is to embark on a lifetime trajectory of smoking-related ill health. 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…

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