Editorial

2006 ◽  
Vol 5 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Medical Training ◽  
Case Reports ◽  
Junior Doctors ◽  
Acute Medicine ◽  
The Past ◽  
Acute Medical Unit ◽  
Application Service ◽  
Public House ◽  
The Uk

They say time flies when you’re having fun – and the 5 years since Paul Jenkins convinced me to take over as editor of this journal have certainly flown by. This period has seen a dramatic expansion in the numbers of physicians specialising in Acute Medicine, the confirmation of subspeciality status and development of a training curriculum. Addressing over 300 delegates at the recent Society for Acute Medicine meeting at the Royal College of Physicians, President Mike Jones reminded us that only seven years earlier the Society’s entire membership had sat around a small table in a public house just a few hundred yards from that spot. At that time many were predicting that recruitment to the speciality would be a major challenge. ‘Why would anyone choose to specialise in acute medicine?’ was a question, sometimes whispered in the corridors of St Andrew’s Place. And yet many have made this choice, and many more continue to do so. The Society for Acute Medicine now has upwards of 400 members, a figure which has doubled in the past 12 months. Even more encouraging was the large number of trainees who visited the Acute Medicine stand at the recent BMJ careers fair. Many junior doctors clearly view Acute Medicine as a positive career choice, not the ‘last resort’ which some predicted it may become. However, challenges remain. By the time this edition hits the press the Medical Training Application Service (MTAS) will be swinging into action to produce the first applicants for ‘post MMC’ training positions across the UK. For those of us who are involved in the shortlisting and interview process, the enormity of the task is rapidly becoming apparent. In Wessex, the Deanery has suggested that Acute Medicine shortlisting may take as much as a week, with a further week set aside for interviews of the hopeful candidates. Then comes ‘round two’, later in the year, when potentially we do it all over again. Suddenly the prospect of annual leave in the months of March or April looks like a forlorn hope. But before I break this news to my wife and family, I should spare a thought for those readers who find themselves on the opposite side of the process. To be part of the first cohort of trainees to be involved in this must be a daunting prospect. Many of those enthusiastic potential recruits to the speciality are clearly struggling to know where to turn to for advice on the process, confused by often contradictory messages and unanswered questions. Hopefully all will become clearer as the deadlines approach. A smaller ‘Reviews’ section in this edition reflects a dramatic increase in the number of articles submitted for consideration of publication in this journal over the past 6 months. As a result we have accommodated more case reports than normal, along with two papers in our new section for research and audit. I would encourage similar submissions in the future; case reports need not be rare or esoteric, provided they contain a clear teaching message clinicians involved in the acute ‘take’. Completed audits will be considered if they demonstrate clear evidence of how to improve practice in an acute medical unit. Owing to some software problems, Rila has temporarily suspended their submissions website which, until recently, had been the mechanism for submission of articles to this journal. Until these problems are resolved, I would be grateful if any articles could be e-mailed directly to me at the address shown on this page, so that I can arrange for peer review. Finally, a reminder that this edition concludes the cycle of reviews which started in 2002 and has now covered the majority of conditions presenting as emergencies on the acute medical ‘take’. The new cycle, starting in 2007 with volume 6 issue 1 will follow a modified pattern, with different authors hopefully providing a fresh perspective in their updated reviews. My thanks go to all of the authors who have produced material over the past 5 years as well as to the editorial board for their ongoing hard work in commissioning articles for the past and future cycles.

How do junior doctors spend their time in an Acute Medical Unit?

2015 ◽  
Vol 14 (2) ◽  
pp. 57-60
Author(s):  
Eirini V Kasfiki ◽  
◽  
Mamoon Yusaf ◽  
Jivendra Gosai ◽  
Makani Purva ◽  
...  
Keyword(s):  
General Practice ◽  
Hospital Admission ◽  
Postgraduate Training ◽  
Junior Doctors ◽  
Bed Occupancy ◽  
Medical Unit ◽  
Admission Rates ◽  
The Past ◽  
Acute Medical Unit ◽  
The Uk

In the UK, postgraduate training for doctors has undergone significant changes over the past decade general practice, etc. During this period, hospital admission rates and bed occupancy have also increased.

Editorial Volume 1 Issue 1

2002 ◽  
Vol 1 (1) ◽  
Author(s):  
Paul F Jenkins ◽  
Keyword(s):  
Case Reports ◽  
General Medicine ◽  
Work Load ◽  
Original Research ◽  
Acute Medicine ◽  
The Past ◽  
Review Articles ◽  
Medical Emergencies

As you can see, the title of the Journal has changed and this is intended to emphasize its educational direction. It will continue to commission articles covering general medical topics with a particular emphasis on the management of acute medical emergencies, aiming to reflect the challenges that face those physicians responsible for supporting the acute medical intake. The CME component will continue,so helping to facilitate the accumulation of CPD points in General Medicine. As always we welcome submissions for publication and these can take the form of original research in areas of relevance to Acute Medicine or case-reports. We will continue to commission review articles as otherwise it proves impossible to maintain the cycle and the combination of articles we have planned. I am particularly enthused by the combination of topics covered in this Edition and I do hope that you enjoy reading them as much as I have enjoyed my editing duties. Profound thanks as always to those who have so kindly contributed;we do appreciate the extra commitment, especially in these days of inexorably heavier work-load for clinicians. This is my last Journal as Editor and I must extend my gratitude to those who have written articles over the past four years, to the member of the Editorial Board and of course to the Staff at RILA who have self lessly supported the Editor’s task. Unfailingly efficient they have been a complete pleasure to work with and very under tanding of the occasional memory lapse of this particular Editor! Chris Roseveare, Consultant in Acute Medicine in Southampton, takes over and the new editorial board will be announced in the next issue. Chris has some brilliant ideas and will lead this Journal to renewed success I am sure. I wish him the best of luck.

Editorial Volume 16 Issue 4

2017 ◽  
Vol 16 (4) ◽  
pp. 155-155
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Internal Medicine ◽  
Case Reports ◽  
Editorial Team ◽  
Research Committee ◽  
Acute Medicine ◽  
The Future ◽  
New Vision ◽  
The Uk

My time has come. After 15 years and over 50 editions it is time for me to hang up my metaphorical red biro, and hand over the role of Editor. It has been an interesting job, and I am extremely grateful to everyone who has contributed and supported the journal over this period. When I took on the position in 2002, this journal was very different to how it is today. Some readers may recall its original incarnation as the CPD journal of Internal Medicine, part of a series of publications produced at that time by Rila. Initially this was comprised predominantly of commissioned review articles, running over a 5 year cycle which was designed to cover the common conditions managed by ‘general’ physicians. As time progressed, the number of unsolicited submissions grew steadily – initially (and continually) dominated by case reports, but with a slowly increasing number of research-based articles as the readership expanded. The quality of these submissions improved further when we finally attained indexing in PubMed, which also attracted more international submissions. I am delighted that the current edition features research papers from the Netherlands and Singapore, both of which have a growing community of Acute Physicians. I remain hopeful that the number of acute medicine-related research submissions from the UK will rise as the speciality grows. The number of high quality abstracts presented at the Society for Acute Medicine (SAM) meetings is indicative of the amount of work that is going on, but it is disappointing that so few of these turn into publications in peerreviewed journals. Acute Physicians are busy people with constant and year-round operational pressures, which may mean that writing up research is continually pushed down the list of priorities. Perhaps also the fact that the number of consultant posts across the continues to exceed the number of Acute Internal Medicine trainees removes some of the ‘pressure to publish’ which is felt by trainees in other hospital specialities. My hopes for the future of this journal have been boosted by the appointment of Tim Cooksley as my replacement ‘Editor in Chief’, who will take over from the Spring 2018 edition onwards. Tim has been a hard working member of the editorial team over recent years, and prior to this was a regular contributor to the journal. He has a strong research background and is a leading member of the SAMBA academy and SAM research committee. I would also like to thank the other members of the editorial board without whose support and contributions this job would have been completely untenable. I understand that Tim plans to keep many of these colleagues in post, as well as bringing in some ‘new blood’ to create a fresh new vision for the future. I wish them all well, and will look forward to reading (as opposed to writing) these editorials. Thanks, finally, to all of the loyal readers who have stuck with the journal over the past 2 decades. I hope that we have managed to keep you entertained and educated on those occasional moments of respite during the acute medical on-call. I wish you all well for the future.

Editorial

2016 ◽  
Vol 15 (1) ◽  
pp. 2-2
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
The Netherlands ◽  
Editorial Team ◽  
Patient Specific ◽  
Service Improvement ◽  
Single Individual ◽  
National Goal ◽  
Acute Medicine ◽  
North West ◽  
The Past

Clinicians working in acute medicine will be familiar with change. The speciality and the environment we work in has changed continually over the past 15 years – I often reflect that no two years have been the same since I started working in the field back in 1999. Change is important, in order to achieve best practice, but sustaining such improvements can be an enormous challenge. The regular turnover of medical staff, local management restructuring and the constantly shifting National goal posts often conspire against us. It is easy for ‘changefatigue’ to set in. Submissions to this journal often describe local audits and service improvement projects which have raised standards: a low baseline may result in a statistically significant improvement from a relatively small intervention – often an education programme or poster campaign to raise awareness of the problem. However, what happens next is far more important: can the improvement be sustained when the key driver behind the project – the enthusiast – moves on, after their 4 month block of acute medicine comes to an end? One year on, we are often back where we started. Two articles in this edition appear to have achieved the Holy Grail of sustainability. In the paper by Joanne Botten from Musgrove Park, door to antibiotic time was improved for patients with neutopaenic sepsis by introducing a system whereby the antibiotics could be administered without waiting for a prescription to be written. The combination of a neutropaenic sepsis alert card and a patient-specific direction empowered the nurses and patients to ensure administration within an hour of arrival in over 90% of cases, a figure which has been sustained for over a year. Sustainable change is often facilitated by modifications in paperwork, but crucially the project’s success was not reliant on a single individual. The value of engaging with the wider team is also shown in Gary Misselbook’s paper describing sustained improvement in the layout and utility of an AMU procedure room. The authors describe how repeated attempts by different registrars had failed to achieve more than temporary reorganisation; the change was only sustained when nursing, infection control and administrative staff became involved in the process. The multiprofessional nature of the AMU is one of its greatest assets – we would all do well to remember this when instigating change. On a similar note, observant readers may have noticed some changes to the editorial board of this journal – I am delighted to welcome Dr Tim Cooksley, acute physician from Manchester and Dr Prabath Nanayakkara from the VUMC in the Netherlands. Tim came through the acute medicine training programme in the North West and his role in the acute oncology service at the Christie Hospital as well as his active involvement in the SAMBA project over recent years brings an important perspective to the editorial team. Prabath has been heavily involved with the development of acute medicine in the Netherlands and co-hosted the successful SAMSTERDAM meeting in 2014. His international perspective will be welcome as we attempt to extend the reach of Acute Medicine to our European neighbours over the coming years. I am very grateful to Nik Patel, Mark Jackson and Ashwin Pinto for their help and support during the past decade and wish them well for the future.

Editorial

2005 ◽  
Vol 4 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Night Shift ◽  
Hospital Medicine ◽  
Phone Call ◽  
Junior Doctors ◽  
Exact Nature ◽  
Text Book ◽  
Acute Medicine ◽  
Junior Staff ◽  
Training Programmes ◽  
The Uk

The challenges and uncertainties of working in the developing field of Acute Medicine have been a regular theme for editorial comment in this journal since I took the helm in 2002. Almost four years on, with sub-specialty status confirmed, over 200 consultants and many SpRs enrolled in higher specialist training programmes throughout the UK, Acute Medicine finds itself in a much stronger position than any could have predicted at that time. Enthusiasm for the field is clear from the numbers of applicants for training programmes at SpR level, as well as the dramatic rise in attendances at acute medicine meetings across the country in the last year. However, on-going challenges remain. Eighteen months from now, Modernising Medical Careers will send shockwaves throughout hospital medicine. The exact nature of the change to our training programmes remains unclear, and will probably have changed again between my writing this and its publication. However it is essential that Acute Medicine is ready for whatever comes our way. We must work closely with our colleagues in Emergency Medicine and Critical Care to develop common stem training schemes which allow doctors to choose the area of ‘front door’ medicine which suits them best. Where possible we should seek to encourage dual accreditation in two or more of these areas. But most of all we need to maintain the momentum which has carried us so far in such a short space of time, and which has the potential to make Acute Medicine one of the largest hospital specialties. This edition’s review articles cover a varied mix of common and less common conditions on the acute medical ‘take’. Most medical admission units will be faced with at least one patient presenting with a seizure in each 24 hour period. Dr Kinton emphasises the importance of a good history in the management of this problem, but also provides some useful tips to help distinguish seizures from other causes of blackout. Distinction from syncope can be a particular challenge, not least because of the differing implications for driving, the loss of which can have devastating consequences. Acute ischaemic stroke is another common problem, the management of which is comprehensively reviewed by David Jarrett and Hemang Dave. As well as summarising some of the major trial data for thrombolytic and antiplatelet therapy, this review includes some advice on some of the common clinical challenges which don’t usually feature in text book descriptions of this condition. Less common, but no less important, Acute liver failure must be distinguished from decompensated chronic liver disease – the former often requiring discussion with a regional liver unit. Phil Berry has included a useful checklist to have to hand before making this phone call. Headache, palpitations and sweating is a common problem on the post-take ward round – particularly amongst the junior staff completing a night shift. Fortunately most junior doctors do not have a phaeochromocytoma – in common with every patient for whom I have ever requested 24 hour urinary catecholamine measurement. Having read Dr Solomon’s thorough review of the acute management of this condition I will now feel equipped to manage this condition when I finally get a positive result back from the laboratory! Apologies that this edition has been a little delayed – I hope you consider it to have been worth waiting for….

Editorial

2003 ◽  
Vol 2 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Emergency Services ◽  
Case Reports ◽  
Community Acquired Pneumonia ◽  
Rapid Expansion ◽  
Medical Specialties ◽  
Acute Medicine ◽  
General Internal ◽  
Competency Based ◽  
Exciting Time ◽  
The Uk

It could be said that the past 12 months have been an exciting time in the field of acute medicine. In addition to the high profile afforded by the publication of Reforming Emergency Care and the ongoing Emergency Services Collaborative, the significance of the recent acquisition of subspecialty status for Acute Medicine cannot be understated. This, in turn has enabled approval of a new competency-based training curriculum by the JCHMT. Hopefully within the next few months, specialist registrars in General Internal Medicine with Acute Medicine will be appointed to the first few numbered posts in this discipline. Clearly a rapid expansion in posts of this nature will be required in the next few years in order to meet the enormous demand for consultants in Acute Medicine. Recently, in common with other medical specialties, hospitals have experienced difficulties in recruiting suitable applicants for such posts resulting in many vacancies across the UK. One challenge for those of us already working in the field is to maintain enthusiasm for the concept, while we are waiting for the trainees to mature into competent consultants. This edition includes another varied selection of reviews. Community acquired pneumonia may be of particular relevance over the remaining winter months, although hopefully the brief mention of SARS in this paper will now only be of historical significance. Patients with hypercalcaemia, dysphagia and Guillan Barre syndrome may be less frequent attenders, but nonetheless often create management dilemmas with which the admitting physician needs to be familiar. In a departure from our previous format, we have included two case reports this time, both highlighting an important clinical scenario. Power kite flying may not be a familiar activity for many readers, but the outcome described by Merrison and colleagues justifies its inclusion as ‘a case to remember’. Mark Mallett, on the other hand, reminds us that syncope can, on occasions, reflect significant underlying pathology, even in an apparently healthy member of the hospital portering staff. Once again we would like to encourage similar submissions for future editions of the journal. After several years of association with CPD Acute Medicine and its predecessor, it is with great sadness that this edition is Paul Jenkins ’last as sub-editor. We wish him well as he moves on to new challenges in his role as President of the Society for Acute Medicine, and gratefully acknowledge all of his hard work in establishing the journal.

Editorial

2004 ◽  
Vol 3 (2) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Bacterial Meningitis ◽  
Medical Staff ◽  
Case Reports ◽  
Rapid Development ◽  
Working Party ◽  
Significant Shift ◽  
Multiple Choice Questions ◽  
Acute Medicine ◽  
Junior Staff ◽  
The Uk

Over the past three years it has become apparent to me that referring to ‘current affairs’ in these columns can be a mistake, serving only to highlight inevitable printing delays. By the time this edition arrives on your doormat Euro 2004, ‘Big Brother’ and the early summer heat wave will be nothing but a distant memory. However the ‘recent’ publication of the Royal College of Physicians document ‘Acute Medicine – making it work for patients’ cannot be allowed to pass without a mention. This report represents a significant shift in the position of the College in relation to Acute Medicine since the previous working party reported its findings in 2000. The value of consultants specialising in Acute Medicine is now clearly recognised and supported – every trust should now have one, with the minimum figure of three per hospital being proposed by 2008. Whether this is achievable will depend on the rapid development of training schemes across the UK, as well as the generation of enthusiasm for the specialty amongst junior staff. The number of applicants for our Wessex programme indicates no shortage of the latter. Although developing a training scheme takes a lot of hard work, it is vital that those already working in the specialty make this a high priority. We have already seen benefits from the appointment of high quality middle grade staff and are looking forward to a ‘flood’ of future applicants for local consultant posts, 4 years from now. This edition comprises four more important review papers on aspects of acute medicine, along with the first in our ‘Controversies in acute medicine’ series. The latter was designed to try to stir up some correspondence, for future publication. The confusion over oxygen delivery in the acute setting seems to reign fairly widely amongst junior, and indeed some more senior medical staff. Hopefully Dr Cooper’s well-written paper will serve to dismiss some of the misconceptions in this area. Our reviews cover relatively uncommon, but nonetheless important aspects of acute medicine. Tuberculosis and HIV are both on the increase in the UK. The success of anti-retroviral therapy will undoubtedly lead HIVrelated illness to be a significant part of our practice over the next decade. An understanding of the range of conditions specific to this group of immunocompromised patients is therefore crucial for physicians involved in the acute take. Hypoglycaemia and suspected bacterial meningitis are both conditions which require immediate action by medical staff. Both of these reviews comprehensively cover their respective topics with a combination of well written text, illustrations tables and algorithms. Dr Hartman highlights recent evidence supporting the use of dexamethosone in bacterial meningitis and re-iterates some of the points made in an earlier edition regarding the use (and abuse) of CT scanning prior to lumbar puncture. For a change we have no case reports this time, although Dr Macdonald’s audit of the innovative review clinic in the Emergency Assessment Area of Heartlands hospital provides a worthy substitute. Submission of similar articles in future would be most welcome. Once again, a reminder that multiple choice questions are for self assessment and ‘personal’ CPD only; I hope you will find this edition helpful in your clinical practice.

Does UK medical education provide doctors with sufficient skills and knowledge to manage patients with eating disorders safely?

2018 ◽  
Vol 94 (1113) ◽  
pp. 374-380 ◽  
Author(s):  
Agnes Ayton ◽  
Ali Ibrahim
Keyword(s):  
Eating Disorders ◽  
Patient Safety ◽  
Eating Disorder ◽  
Postgraduate Training ◽  
Medical Training ◽  
Improve Patient Safety ◽  
Medical Schools ◽  
Junior Doctors ◽  
The Uk ◽  
Improve Patient

BackgroundEating disorders affect 1%–4% of the population and they are associated with an increased rate of mortality and multimorbidity. Following the avoidable deaths of three people the parliamentary ombudsman called for a review of training for all junior doctors to improve patient safety.ObjectiveTo review the teaching and assessment relating to eating disorders at all levels of medical training in the UK.MethodWe surveyed all the UK medical schools about their curricula, teaching and examinations related to eating disorders in 2017. Furthermore, we reviewed curricula and requirements for annual progression (Annual Review of Competence Progression (ARCP)) for all relevant postgraduate training programmes, including foundation training, general practice and 33 specialties.Main outcome measuresInclusion of eating disorders in curricula, time dedicated to teaching, assessment methods and ARCP requirements.ResultsThe medical school response rate was 93%. The total number of hours spent on eating disorder teaching in medical schools is <2 hours. Postgraduate training adds little more, with the exception of child and adolescent psychiatry. The majority of doctors are never assessed on their knowledge of eating disorders during their entire training, and only a few medical students and trainees have the opportunity to choose a specialist placement to develop their clinical skills.ConclusionsEating disorder teaching is minimal during the 10–16 years of undergraduate and postgraduate medical training in the UK. Given the risk of mortality and multimorbidity associated with these disorders, this needs to be urgently reviewed to improve patient safety.

scholarly journals EDITORIAL NOTE

1997 ◽  
Vol 134 (3) ◽  
pp. 285-285
Author(s):  
Nigel Woodcock ◽  
Nick McCave ◽  
Mike Bickle ◽  
Jane Holland
Keyword(s):  
Editorial Note ◽  
Geographical Proximity ◽  
Face To Face ◽  
The Past ◽  
Editorial Practice ◽  
On Line ◽  
The Uk ◽  
Geological Magazine

This issue marks the departure of the longest-serving of the current editors of Geological Magazine, Dr Chris Hughes, and his replacement by Dr Tim Palmer (University of Wales, Aberystwyth). The Geological Magazine has always had a strong content of palaeontology and biostratigraphy, and Chris Hughes has efficiently maintained the quality of these contributions since 1973. He is moving on from his lectureship in the Cambridge Earth Sciences Department to head the Associated Examining Board, based in Guildford. The other editors thank him warmly for his experienced guidance over the past 24 years and wish him success in his new post.The editors welcome Tim Palmer, whose appointment from outside the Cambridge department represents a significant and deliberate departure from custom. Some 13 years ago, the Magazine broadened its editorial advice in a major way by appointing an Editorial Board, most of whose members have come not just from outside Cambridge, but from beyond the UK. Our new editorial appointment signals an extension of this same policy.An important advantage of having all the Magazine's editors under one roof has been the efficiency and speed of communicating with each other. However, with the Cambridge editors now talking to each other as much by Email as face-to-face, geographical proximity has become a less crucial asset. The spread of Email is changing many other aspects of the editorial practice and the Geological Magazine office, run by Jane Holland, is now on-line at [email protected]. The editors now encourage the use of Email for all business except for submission of manuscripts, and in particular for contributors' queries and for referees' reports.

scholarly journals Trainees Update

2007 ◽  
Vol 6 (2) ◽  
pp. 89-89
Author(s):  
Hannah Skene ◽  
Keyword(s):  
Acute Care ◽  
Medical Training ◽  
Acute Medicine ◽  
Strong Position ◽  
The Uk

It has certainly been a huge year of change for all of us in training posts, and in acute medicine particularly. There are now trainees in Acute Care Common Stem (ACCS) and Core Medical Training (CMT) programmes as well as new posts at ST3 level and above. Across the UK we have doubled the number of specialty trainees in Acute Medicine, and the specialty is in a very strong position.

Sign in / Sign up

Export Citation Format

Share Document