Clin Med
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Workforce planning in medicine is at best an inexact science and at worst a dark art. Over the past year it has become clear that several forces influencing the consultant physician workforce are coming into play at the same time. Many of these forces cannot be easily controlled, but their effects are predictable and thus can be prepared for. Recommendations are made as to how the issues raised should be addressed.
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It is now clear that women doctors will soon make up the majority of the medical workforce. Research shows that women often prefer part time and flexible working, and are inclined to favour some specialist fields over others. Although these facts are widely known, as yet it appears that little account has been taken of their economic and organisational consequences. ⋯ Women's preference for flexible working at certain stages of their careers could be a major advantage in health service planning; models need to be developed that recognise women's willingness to work in new ways. Although women are under-represented in positions of national leadership, there is no evidence to suggest that they are disadvantaged in their endeavours, or unwilling to deliver the commitment necessary. However, they may need timely advice and encouragement to reach their full potential.
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Cardiovascular disease is predicted to be a leading cause of death and disability worldwide for the foreseeable future. Observational studies link a variety of prevalent early life experiences (for example, smoking in pregnancy, child poverty) to increased risk of adult cardiovascular disease. Experimental animal studies suggest plausible causal relationships. ⋯ This has led to a general policy emphasis on prevention and early intervention. To date, there are few examples of the evidence base being useful in shaping specific policies, despite potential to do so, and some examples of policy misunderstanding of science. Minor changes to the perspectives of epidemiological research in this area might greatly increase the potential for evidence-based policy.
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Comparative Study
Competency mapping in quality management of foundation training.
Competency-based curricula focus on outcomes in terms of application of knowledge and acquisition of competencies. The aim of this exercise was to analyse posts and programmes for potential training outcomes. A mapping process against the UK foundation curriculum was designed. ⋯ Widespread difficulty in achieving these competencies raises the question of whether they should be included within the national curricula. Development of competency-based training is a complex, multistep process. However, it is possible to analyse it in a large programme of trainees in the setting of the modern, busy NHS.