Many years ago I worked with a doctor who would disappear for a few moments at important decision points in clinical care. Sometimes this was during ward rounds and sometimes on call. He was an excellent doctor—the momentary absences never made a difference to the care of patients. Still I used to wonder where he […]
A 60 year old woman goes to her doctor with dizziness and poor balance. Her doctor is not sure what is wrong but thinks about postural hypotension, Meniere’s disease, and benign positional paroxysmal vertigo. He examines her and orders tests with these differentials in mind. But he cannot find anything on physical examination and all […]
There is a lot to remember when you are leading a ward round. There’s the patient, the relatives, the junior doctors, the nurses, the physiotherapist, the occupational therapist, the pharmacist, the social worker, and the discharge coordinator. There are also the case notes, the drug charts, the observation sheets, the blood tests, the radiology films, […]
A 40 year old man has a cough—but his GP cannot find out the cause. Eventually the patient is referred to the local hospital where he is diagnosed with asthma. The doctor who sees him starts inhalers. But the inhalers don’t work and so he goes back for another appointment. The next doctor that he […]
Do you believe in interprofessional education? Do you believe in problem based learning? Do you believe in objective structured clinical examinations? Do you believe in reflection in action? Or reflection on action? Do you believe in the NHS? Do you believe in NICE? What do you believe in? When I first moved to the UK […]
“You teach a child to read, and he or her will be able to pass a literacy test.” One of the most enjoyable things about listening to George W Bush torturing the English language is that no matter how confused his sentences get you can still understand almost exactly what he means. Widely derided as […]
Putting the horse before the cart always seems like a sensible idea. And so it is with funding initiatives—it seems sensible to invest in starting up sustainable projects that will have long term positive outcomes. This is largely the received wisdom in investing in healthcare professionals’ education—invest in the undergraduate education of healthcare professionals in […]
One of the latest thoughts to emanate from authorities in medical education is that investments in education will produce a tangible return on investment. The theory goes a bit like this: you invest in educational provision, healthcare professionals learn and put their learning into action, and this results in a return on investment. This return […]
A running joke about revalidation is that its roll out is and always will be 12 to 18 months away. What will mandarins in Whitehall and the colleges chuckle about now that revalidation has finally started? Almost as important, will revalidation work and what impact will it have on the working lives of doctors, standards […]
In the nineteenth century there were few standards in medical education. Students would often do an apprenticeship with a general practitioner and gradually gain experience in the trade. They had to pay for their education—which barred all but those from the privileged classes from becoming a doctor. For those who did persevere with their education […]