I am in the recruitment stage between interviews and offers. At this moment in time, when I look to August I can see myself as both in training and not in training. I can see myself as employed and as unemployed. Perhaps it is the task of ranking potential future jobs, or the desire to […]
Carolyn Thomas: Yet another cardiac risk calculator?
To see for myself how reliable the new NHS heart disease risk calculator is, I completed all required fields exactly as I would have answered seven years ago. That was just before I survived what physicians still call “the widowmaker heart attack,” caused by a fully occluded left anterior descending coronary artery. (By the way, […]
Samir Dawlatly: Do I obsess too much about the NHS?
When I was a teenager, I was obsessed with playing guitar. I taught myself to play on my sister’s guitar, taking it off her when she came back from lessons. For my GCSE music performance I sang and played an Eric Clapton song. While I was at medical school, I became obsessed with climbing after […]
Pallavi Bradshaw: Innovation doesn’t need a new law
At the end of last week, common sense prevailed. The decision was made that the Medical Innovation Bill would not get a second reading in the House of Commons, and therefore, would not progress any further in this parliament. Rather, there appears to be growing recognition of the need to take a step back and […]
The BMJ Today: Prescribing on sparse evidence, homeopathy, and research methodology
How to prescribe when the evidence is lacking • Several observational studies have shown associations between using drugs with anticholinergic side effects—such as loperamide, loratadine, baclofen, amitriptyline, oxybutynin, or chlorphenamine—and cognitive decline. Links have also been shown with earlier death, falls, and admission to hospital with confusion and dementia. “But is this cause, or is […]
Richard Lehman’s journal review—16 March 2015
NEJM 12 March 2015 Vol 372 1009 Stroke is a wonderfully straightforward word. When used in a medical context, everybody thinks of a sudden blow. It is something that needs swift action. But actually “stroke” isn’t a straightforward word: ask the cat that has just jumped on to my lap. Now it means a slow […]
The BMJ Today: Treatments for inflammatory diseases
A combination of old drugs is not inferior to biologics for rheumatoid arthritis • Tumor necrosis factor inhibitors are safe and effective therapies for patients with rheumatoid arthritis resistant to methotrexate and other disease modifying drugs, but they are very expensive. The BMJ Today reports the results of an open label pragmatic trial—the TACIT trial—that […]
Neel Sharma: Those who can teach, those who can’t don’t
Recently I was left dumbfounded by a senior colleague who stated that the sign of a good medical educator is one who can do two things well: publish and deliver conference presentations. I questioned him on the aspect of teaching. Surely this is relevant in the field of medical education— a field designed to enhance […]
Billy Boland: Psychiatry is full of story
I had a minor revelation at the weekend whilst talking about why I became a psychiatrist. It’s one of the careers that never fails to excite further questions when you’re getting to know people. I feel like I’ve told my story a thousand times. That’s why it felt so strange to get a new personal […]
BMJ Today: Reassurance on varenicline, caring (or not) for NHS staff, and more holiday for emergency doctors
Good news for quitters A research paper in The BMJ today “is the most comprehensive published review to date of the neuropsychiatric safety of varenicline.” It was necessary, say the authors from Bristol University, because while several studies have found no evidence of an increased risk of neuropsychiatric side effects with varenicline, these studies have […]