Thursday, 17 April 2014
who asked me to do this is one of a team who is organising this venture and is a retired Sheffield physician. He just happens to be my consultant when I did my first house job after qualification in 1983. He got in touch after reading a piece published in the Sunday Telegraph that highlighted the early attempts at surgery on cardiac injuries. I was closely involved in the story, which featured a soldier from Sheffield. One of the important sources of information for the story was a paper published in the Journal of the RAMC ( Royal Army Medical Corps) in 1918 by the surgeons involved. They describe the clinical course of the soldier in great detail from the moment he was admitted to hospital in Malta to the day he died of mediastinitis, a frequently fatal complication of a deep sternal wound infection. The findings at post mortem are also extensively described.The details in this published paper are quite extraordinary and made me think of how this soldier would have been managed in wars which have occurred since that great conflagration of 1914-
Coincidentally I watched a few episodes of MASH on a transatlantic flight recently - I had forgotten what a good programme it was, with servings in equal measure of pathos and feel good factor. What with all the wars British and American forces have been involved in since the Korean War, maybe a new MASH needs to be produced.
Wednesday, 16 April 2014
Thursday, 20 March 2014
Tuesday, 25 February 2014
This is fascinating stuff. In the United states, it is common practice to go and observe the surgeon you want to appoint, operate. In the UK, it is virtually unheard of - until recently that is. I was representing the Royal College of Surgeons at a appointments advisory committee to appoint a Consultant Heart Surgeon at a London Hospital. The medical director told me that it was common practice for him (the medical director - a non surgeon) and a senior surgeon to observe the potential appointee in their current workplace.
A formal assessment of surgical skills is made when trainees are interviewed for appointment to specialty training, both at ST3 level and at ST1 level. And yet, no formal assessment is made at the end of training when they are about to enter the scary real world or further on in their career as consultant when they are being assessed/appraised for revalidation. This paper suggests that there is value in doing so and I am sure the public would expect it.
Monday, 30 December 2013
BMJ Careers - Planning an “F3” year: opportunities and considerations for aspiring surgeons
I was interested to read about the increasing popularity of taking a year out between the F2 year, the second 'compulsory year' of British (and Maltese) medical graduates and the beginning of specialty training.
One should not be surprised by this - to be 'forced' to make such an important life lasting career decision barely 36 months after leaving med school is just too early.
In the past (or when I were a lad - said in the most Monty Pythonesque of Yorkshire accents), you could delay starting proper specialty training for as long (within reason) as you liked. It is strange, is it not, that doing extra things in your life like a Duke of Edinburgh award or taking a gap year before University, maybe working on a ward, is seen as an asset whilst after graduation there is an almighty mad rush to get you on the specialty register and working for the greater good of 'THE SERVICE' as soon as possible.
I don't think that is a good thing - medical graduates are not just NHS fodder - they need time to plan a fulfilling career for themselves and this may involve looking at different options. Young doctors are now increasingly saying so by voting with their feet.