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Mashup Score: 33The case for reform of rotational training - 2 hour(s) ago
Supporters argue that it broadens trainee experience—while detractors say the burden of moving to a new placement every few months is too high. The clamour for change is growing, reports Jo Best Calls for reform of rotational training have been growing. Grassroots movements, junior doctors’ committees, and others have been calling for updates to a system that they say brings little benefit and much disadvantage to doctors in training. Under the current system (see box 1) trainees rotate to new jobs—often spread over a wide geographical area—every few months for anything up to a decade (or longer if working less than full time) before achieving their certificate of completion of training. Supporters of the system argue that doctors are thus exposed to different hospitals, patient populations, and ways of working, bringing a breadth of knowledge to their practice. Box 1 ### How does rotational training work? The current rotational training system requires doctors to move between jobs reg
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Mashup Score: 6Assessment of diplopia in adults - 4 hour(s) ago
### What you need to know Double vision, or diplopia, may be the first sign of sight or life threatening pathology. A thorough, accurate first assessment is important for determining the clinical urgency of related pathology and ensuring timely management. Whether diplopia is monocular or binocular will help identify aetiology and determine the urgency of management. Ensure double vision is distinguished from blurred vision (when a patient sees a single image that appears unclear), which has many other distinct causes. In diplopia, the second image may appear fainter as a “ghost” image. Monocular diplopia refers to double vision originating solely from one eye. This will persist when the patient is asked to cover the other, unaffected eye and suggests an intraocular pathology. Differentials for monocular diplopia include refractive error, dry eye syndrome, corneal pathology, cataract, and non-urgent retinal pathology. In such cases, a routine optometrist or ophthalmology referral is ap
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Mashup Score: 6When will the world get cancer vaccines? - 6 hour(s) ago
Vaccines against cancer have been a dream for decades, but the mRNA revolution has sparked new hope. Chris Baraniuk looks at what’s in the pipeline—and the challenges that remain On 6 January 2023 the UK government announced that it was partnering with BioNTech, the company that created the first covid-19 mRNA vaccine, to enrol as many as 10 000 patients in trials of a new mRNA cancer vaccine.1 Iain Foulkes, speaking for Cancer Research UK, told BBC News that “mRNA vaccines are one of the most exciting research developments to come out of the pandemic, and there are strong hints that they could become powerful treatment options for cancer.” For BioNTech, it’s a huge step forward considering the company was founded nearly 15 years ago to develop mRNA therapies for cancer. Cancer kills considerably more people worldwide each year than covid-19 does, according to World Health Organization figures. Countless companies and research institutions around the world have long targeted cancer vac
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Mashup Score: 34Medicine is designed for righthanded people - 8 hour(s) ago
Chloe Milton describes the challenges of being left handed in clinical environments that are designed for righthanded use The surgeon glared at me. When I asked what I’d done wrong they replied that they found it “scary” that I’d used the “wrong” hand to cut sutures when assisting in theatre. What’s scary to me is how easily the challenges faced by lefthanded trainees are dismissed—an experience I’ve had not only in surgery but across all medical specialties. Medicine needs to move away from the idea of “right” and “wrong” hands, so that lefthanded students learning examination and surgical skills are properly supported in caring for patients. From the beginning of my first year of medical school I noticed that the whole clinical environment was designed for righthanded use. Tradition dictates that you should stand on the right side of a patient when examining them, making it difficult—if not impossible—to use your left hand to do so. Moreover, the equipment used in clinical skills ses
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Mashup Score: 8Action demanded on alcohol as deaths hit record levels - 9 hour(s) ago
With a record number of UK deaths from alcohol and drinking rates high among children, Bryan Christie examines the data and what is being done to reverse the trends Campaigners are calling for action to tackle a worsening public health crisis after new data showed that the death toll from alcohol related causes has reached record levels in the UK. At a time when 27 people in the UK are dying a day as a result of alcohol misuse, drinks companies are spending some £6bn promoting their products in major markets around the world.1 The latest figures from the Office for National Statistics (ONS)2 show that in 2022 there were 10 048 deaths (16.6 per 100 000 people) from alcohol specific causes registered in the UK, the highest number on record. This was 32.8% higher than in 2019, before the covid pandemic. Death rates stabilised in the period from 2012 to 2019. Meanwhile, a report published on 25 April by the World Health Organization on substance misuse among children in 44 countries has fo
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Mashup Score: 37
Why do politicians have such a low opinion of British people’s compassion to think this policy is a vote winner, asks Martin McKee Late on 22 April 2024 the Safety of Rwanda (Asylum and Immigration) Bill cleared its final stages in the UK parliament.1 Its stated purpose is to enable the government to send migrants who have reached the UK to Rwanda. The bill was deemed necessary because the government’s previous attempts to send migrants to Rwanda were thwarted, firstly by a series of temporary blocks (Rule 39 orders) imposed by the European Court of Human Rights, and then by the UK Supreme Court.2 The Supreme Court ruled that the government had failed to show that refugees sent to Rwanda would be safe and would not be sent on to another country and that its plans were incompatible with the UK’s obligations under international agreements, in particular, the 1951 Refugee Convention. These decisions created two problems. Firstly, should the government want to proceed, it had to show that
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Mashup Score: 3Total anomalous pulmonary venous connection in an adult - 11 hour(s) ago
This chest radiograph (fig 1, left panel) and reconstructed cardiac computed tomography angiography scan (fig 1, right panel) show a rare example of unobstructed supracardiac total anomalous pulmonary venous connection (TAPVC).1 The patient, a woman in her 30s, presented with worsening dyspnoea, cyanosis, …
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Mashup Score: 6Medscape caves in on courses funded by tobacco giant Philip Morris, while medics fear global push into medical education - 21 hour(s) ago
Clinic demonstrations, podcasts, and TV shows: Hristio Boytchev reveals how an ambitious deal between a leading medical education provider and the tobacco industry collapsed this week The medical education provider Medscape has bowed to pressure and agreed to permanently remove a series of accredited medical education courses on smoking cessation funded by the tobacco industry giant Philip Morris International (PMI), The BMJ and The Examination have found. Medscape has acknowledged its “misjudgment” in a letter to complainants and says that it will not accept funding from any organisation affiliated with the tobacco industry in the future. The move comes after a BMJ investigation revealed the PMI deal and widespread protests among doctors and academics in reaction to the partnership. Critics had said that the content tended to portray non-cigarette nicotine products as relatively harmless, therefore aligning with the commercial interests of PMI, which also sells e-cigarettes, nicotine
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Mashup Score: 4US Supreme Court hears arguments on whether states can regulate emergency abortions - 22 hour(s) ago
The US Supreme Court heard oral arguments on 24 April that emergency abortions should be allowed in states with strict abortion bans. An emergency abortion is a rare procedure carried out to save a woman’s life or to protect her health. Questions by conservative justices suggested the court might rule against permitting such abortions when it gives its ruling in June or early July.1 In 2022 the Supreme Court overturned the constitutional right to abortion and returned regulation to the 50 states, about half of which ban or severely restrict abortions.2 Idaho’s strict abortion ban shows the continuing conflict between federal law and state law. The US Constitution says that federal law overrides state law. The …
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Mashup Score: 3Doctors can’t fix the alcohol problem by themselves - 23 hour(s) ago
A decade ago the jurisdiction of England and Wales was on the brink of introducing a policy that would have led to substantial reductions in the harms done by alcohol (doi:10.1136/bmj.f7646).1 Instead, politicians U turned, ignoring strong health advice in favour of protecting industry interests. Other, braver territories, including Ireland and Australian states, brought in minimum unit pricing, and today the policy saves lives and reduces consumption and hospital admissions (doi:10.1136/bmj-2023-077550).2 After Scotland introduced a minimum unit price, the biggest reduction in alcohol related deaths was seen among the most deprived groups. As evidence mounts for the effect of minimum pricing on reducing alcohol consumption, those …
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“Rotational training injects a vast amount of stress, anxiety, and worry into the lives of people who already have far too much strain on their mental health.” The clamour for change to rotational training is growing. @forthebest reports https://t.co/Pm1wDs42lp