Turning over a new leaf

  The PMJ blog has been running for 2 and a half years, and in that time I have looked at many aspects of medical practice and education that have been thrown up by papers published in the PMJ. As time has gone on, we have had several submissions to the journal which seem to fit […]

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Hidden in plain sight.

  Patients do not come with diagnoses attached to their foreheads.  If only they did,  huge numbers of hospital visits and admissions could be avoided. To overcome the ever increasing number of potential diagnoses, and the rising tide of illness encountered by our ageing populations, we rely ever more heavily on investigations to guide us […]

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Look not for the fleck in your brother’s eye, but the gorilla in your own…

Teaching for medical graduates approaching clinical exams such as the MRCP PACES exam is an anxious time.  One is expected to ‘perform’ under pressure, wary of the need to elicit signs leading to potentially outlandish diagnoses.  The breadth of knowledge and skills required to confidently identify CMV retinitis at one station, followed by a complicated […]

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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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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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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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Still only human

There is something different about medics.  We stand out at university – often forming into a clique that others find difficult to fathom, break into, or tolerate.  We strive to be different in many ways; we learn a huge range of facts and figures, along with new languages ( we are taught about everything from […]

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What do all those numbers really mean doc?

  Go into hospital nowadays, and you will do well to escape without having a blood test of some sort.  Very often these are routine tests, which give doctors an overview of the state of play. There might be a few wayward figures here or there – but the doctors will ignore them, or explain […]

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