Night Float and the Struggle for Wellness in Medical Education

Dr James Agapoff and Dr Anandam Hilde discuss a quality improvement project to tackle the problem of sleep deprivation in trainees. The resident’s weary eyes said it all. He was finishing a 24-hour shift of a 30-day Q3 rotation (where a 24 to 30-hour shift starts every 3rd day). As a medical student waiting for […]

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Stay focused: watch out for myocardial infarction even at the time of Covid-19

By Massimo Mapelli MD, Antonio Frappampina MD, and Piergiuseppe Agostoni MD PhD   A 65-year old man presented to the emergency department with a 12-hour history of chest pain, dizziness, and nausea. ECG – as displayed by the cardiology fellow in the picture (Figure 1A) – showed an ST-elevation inferolateral myocardial infarction and the patient was […]

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In the land of the blind…

Leadership is one of those areas of medical training that is increasing in prevalence, and the number of schemes to ensure that medical leaders are available within the workforce is ever expanding. Some in our profession feel that the ‘leaders’ who are ‘trained’ seem to have few leadership qualities, and even less legitimacy to lead […]

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Look not for the fleck in your brother’s eye, but the gorilla in your own…

Teaching for medical graduates approaching clinical exams such as the MRCP PACES exam is an anxious time.  One is expected to ‘perform’ under pressure, wary of the need to elicit signs leading to potentially outlandish diagnoses.  The breadth of knowledge and skills required to confidently identify CMV retinitis at one station, followed by a complicated […]

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Aiming for ‘normal’

Normal ranges are papered to the door of almost every clinical medical student’s lavatory door or fridge, inside the cover of every notebook in the wards – accompanying every result on the EHR – everywhere we are told confidently what normal is. But as this paper studying the laboratory findings of several thousand inpatients at a […]

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Service, safety and training – a tricky trio.

The National Health Service is more than a health service, is is perhaps one of the biggest postgraduate universities in the world.  Within the corridors, operating theatres, and wards of the hospitals in the UK, healthcare professionals are learning. They are taught by example every day, and increasingly are allocated time out of the service […]

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Still only human

There is something different about medics.  We stand out at university – often forming into a clique that others find difficult to fathom, break into, or tolerate.  We strive to be different in many ways; we learn a huge range of facts and figures, along with new languages ( we are taught about everything from […]

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It’s good to talk…

When I think about my work on the acute medical unit, or my clinics, it is almost mind boggling, the number of interactions I have with other humans – trainees, consultant colleagues, radiographers, radiologists, professionals from other hospitals, biochemists, nurses, physios, therapists, and of course – patients.  As Atul Gawande points out in this splendid […]

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Are you safely socialised?

Changes in role within the medical profession are times of great upheaval.  One of the most challenging is the change from being a medical student to a fully qualified doctor.  A cohort of medical students qualifies every year around June/July time, and members of this cohort take their first steps on the wards and in […]

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