Three pipe chest pain…

Medicine is no longer quite so full of time to ponder as it once seems to have been.  Rumination and consideration have taken a back seat to efficiency.  Protocols and pathways seem to be the order of the day, and once a patient is on a pathway, it can be very difficult to get them […]

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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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Wait – did I just hear a zebra going past?

There is an often quoted medical witticism, that originated in 1940’s Maryland: ‘When you hear hoofbeats behind you, don’t expect to see a zebra’   Suffice to say, there aren’t many zebras in Maryland… In the rough and tumble of acute medical admissions, there are an increasing number of horses in the herd to contend […]

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Fashionable inequality?

Modern life in developed societies is a world away from the lives our recent ancestors lived. Better sanitation, advances in farming and food supply, the cumulative effects of public health interventions over the years, and huge advances in medical knowledge and technology have also shifted the landscape of disease. As a society, our preoccupation is […]

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A disease by any other name…

  As a UK medical graduate, working in a London Hospital, it is fair to say that my CV doesn’t contain a huge diversity of workplaces, or populations served.  However, it is striking how many different levels of health literacy I encounter within the working week. I have had conversations with patients to correct the […]

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If a job’s worth doing…

Image via WM Jas on Flickr Competency based curricula have largely replaced purely knowledge-based curricula in medical education.  As assessment of competency has become a seemingly endless task, the participants in medical education have often complained that learning and development has been reduced to a series of hoops to jump through or, even worse, a […]

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I am conflicted…are you?

  I am conflicted… and it is down to a couple of papers in this May’s PMJ that look at the development of a new tool for assessing the performance of trainees in a key medical task. Most nights – or at least 2 a week – I spend a portion of my evening logging […]

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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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The beauty of the written word?

Of the essential skills for doctors, writing has to be up there as one of the most important.  Doctors writing has been the butt of many jokes ove the years – justifiably, and written prescriptions remain a significant source of error in hospitals up and down the land. The medical notes are another area where […]

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Observe, record, tabulate, communicate…

When I was knee high to a grasshopper, I had a teacher that used to be incredibly irritating.  Instead of getting away with a lucky guess, or a grasp at a faded memory, we had to be able to ‘show our workings.’  This meant we had to understand where our answers came from, from first […]

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