Clin Med
-
Revalidation for doctors in the UK began in December 2012. Doctors in training need to revalidate every 5 years after obtaining their licence to practice and also at the point of achieving their certificate of completion of training. ⋯ Postgraduate deans are the responsible officers for trainees and there are new processes in place, including responsibilities for educational supervisors and ARCP panels to ensure that postgraduate deans can fulfil their General Medical Council obligations. In this article, I give examples of how this might work in practice.
-
It is becoming increasingly clear that genomics is beginning to have a major impact in guiding diagnoses and treatment of many disorders. As the cost of DNA sequencing continues to drop and more patient genomes are sequenced, the challenge is to deliver this knowledge to the clinic, particularly in cancer. ⋯ Genetic approaches, thought to be pipedreams five years ago for diseases such as Duchenne muscular dystrophy, are now showing promise in clinical trials and many of these methodologies are being applied more widely for other diseases. The era of genomic medicine has arrived.
-
Medical education is vital to the future of healthcare provision. It is also expensive. ⋯ Educational budgets should be transparent - so that their use and misuse are clear. We should develop a culture of lifelong learning and continually make explicit that future healthcare professionals need investment in their education to maintain the quality and safety of healthcare delivery.
-
We describe the case of a woman who presented with seemingly non-specific symptoms, including collapse, but through examination was eventually revealed to have an unusual, potentially fatal, but treatable neurological condition. We share some thoughts on the process of diagnosis, the difficulty of diagnosing a rare disease and the practice of neurology on the acute medical take. We also highlight the value of screening neurological examination in acute medical patients.
-
Acute colonic pseudo-obstruction (ACPO), or Ogilvie syndrome, is colonic bowel obstruction without a mechanical cause. Stroke is known to result in autonomic disturbance, which is one of the factors that can lead to ACPO, yet it has only rarely been described post stroke. There are several management options available, including conservative techniques, pharmacological therapies, endoscopic treatments and, finally, surgery. This case highlights effectively the refractory nature that this condition can take, and the different management options that can be used to help resolve it.