Clin Med
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As society changes, doctors must adapt. Despite remarkable advances in medicine, the pace of change--greater now than ever--is challenging doctors to define their role and relevance. Is medicine really facing a crisis? Are claims for a malaise in medicine overstated? Regardless, the profession has been called upon to respond collectively to change. ⋯ Approaches will vary but one constant should be a steadfast adherence to the scientific basis of medicine as a way of thinking. Engagement with the medical humanities will also help doctors stay fresh and deepen their understanding of what it feels like to be ill. In so doing, clinicians will find inspiration in the ordinary.
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Ward rounds (WRs) have been a valuable resource in medical education for both learners and teachers since first recorded in 1660. Previous studies have shown that over 50% of junior doctor learning occurs on WRs. However, postgraduate medical education in the UK has changed significantly over recent years with the adoption of the foundation programme and the application of the European Working Time Directive (EWTD). ⋯ Hindrances to learning and teaching include lack of time, increasing patient numbers and an absence of team consistency. The current study is the first to investigate the impact on the educational value of WRs following the introduction of the EWTD and the foundation programme. WRs continue to play a crucial role in postgraduate medical education but increasing pressure of service commitment and lack of teacher training continue to threaten this learning opportunity.
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Case Reports
Lesson of the month (1). Homonymous left hemianopia secondary to traumatic extracranial vertebral artery dissection.
This lesson reports the case of a 32-year-old female presenting with left-sided homonymous hemianopia after a road traffic accident. A diagnosis of vertebral artery dissection (VAD) was missed at presentation after an initial computed tomography head scan was normal. Later, VAD was confirmed on neck magnetic resonance imaging. VAD is an uncommon cause of stroke in the young and, to date, there are no current emergency guidelines available for the management of patients with the condition.
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Over the last few years, vitamin D deficiency has emerged as a risk factor for many diseases. Public awareness of the importance of the 'sunshine vitamin' is increasing, however deficiency remains an ongoing problem. Is an awareness of the importance of vitamin D enough to promote healthy people to take supplements or is a different approach required? In this article the importance of vitamin D is discussed and data showing that knowledge of this is not sufficient to encourage people to take supplements are presented.