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Www.bmj
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15

Surgical team in India calls for mandatory enforcement of WHO safety checklist

A team of gastrointestinal surgeons in India has called for mandatory enforcement of the World Health Organization’s surgical safety checklist across the country, after implementing it in their own department and observing lower postoperative complications and mortality.  
bmj.com
over 6 years ago
Www.bmj
1
15

Surgical team in India calls for mandatory enforcement of WHO safety checklist

A team of gastrointestinal surgeons in India has called for mandatory enforcement of the World Health Organization’s surgical safety checklist across the country, after implementing it in their own department and observing lower postoperative complications and mortality.  
bmj.com
over 6 years ago
Static.www.bmj
1
30

Response from Hepatitis C Trust, BASL, BIA, BVHG, BSG, and BHIVA to article asking whether widespread screening for hepatitis C is justified

Koretz and colleagues argue that hepatitis C virus (HCV) screening should be delayed.1 We disagree. HCV transmission was common in the 1960s-80s, and because mortality occurs 30-40 years after infection deaths will rise exponentially over the next decade.2 Delaying effective intervention will have a massive impact. The authors argue that because a community study showed an increase in liver and non-liver mortality most infected people will not die from HCV. Infection can cause or exacerbate renal disease, diabetes, and dyslipidaemia and treatment reduces all cause mortality,3 indicating that both liver and non-liver related deaths are caused by …  
bmj.com
over 6 years ago
Preview
1
7

British Social Attitudes 2014

The King's Fund report on the British Social Attitudes 2014 survey of the public's satisfaction with the NHS and health care issues. By John Appleby and Ruth Robertson Since 1983, the National Centre for Social Research’s British Social Attitudes survey has asked the public – rather than simply patients – about their views on and feelings towards the NHS and health care issues generally.  
The King's Fund
over 6 years ago
Www.bmj
1
25

Surgical team in India calls for mandatory enforcement of WHO safety checklist

A team of gastrointestinal surgeons in India has called for mandatory enforcement of the World Health Organization’s surgical safety checklist across the country, after implementing it in their own department and observing lower postoperative complications and mortality.  
bmj.com
over 6 years ago
Static.www.bmj
1
2

People’s willingness to accept overdetection in cancer screening: population survey

Objectives To describe the level of overdetection people would find acceptable in screening for breast, prostate, and bowel cancer and whether acceptability is influenced by the magnitude of the benefit from screening and the cancer specific harms from overdetection.  
bmj.com
over 6 years ago
Preview
1
9

February 2015's primary survey

Stream February 2015's primary survey by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 6 years ago
Preview
1
33

The Sports Injury Registry

Stream The Sports Injury Registry by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 6 years ago
%3fr=0
8
516

Video Animation In Medical Education

Introduction This post describe the creation of a Stroke Summary video. The aim of this project was to assess the attitudes of medical students towards the use of video animation in medical education. An educational tutorial was produced outlining the basic principles of stroke. This aimed to provide a summary of different aspects relating to stroke, outlined in the Bristol University curriculum. This intended to be a short, concise animation covering stroke presentation, definition and recognition, with an overview of the blood supply to the brain and the classification of stroke presentation used in clinical practice. This was followed by some key facts and a summary of different management stages. After the video animation was produced an assessment of student’s attitudes using an online questionnaire was undertaken. This consisted of ten short questions and an open text feedback for additional comments. The video was then edited with reference to feedback given by students and the results analysed. This report will outline relevant research and project work that lead to this assignment being undertaken. A description of the method followed to generate the video animation and to collect feedback on students will be outlined followed by analysis of results. This will then be discussed in relation to previous work and research. Background There are a number of reasons this project has been undertaken. On a personal level, I have a long-standing interest in teaching and medical education. As part of a previous project I created a series of audio tutorials in cardiovascular medicine and assessed student attitudes to audio learning. The findings of this report showed that a large number of students found these audio tutorials useful and would like more of these available to supplement their learning. One of the questions given to students at this time assessed how useful they found different types of educational material. This project showed students reporting audio tutorials more useful than previously thought, while also reporting that they were not readily available. Although a video tutorial was not provided to them at this time, feedback questions assessed attitudes to video tutorials as a learning resource. Students reported low availability and felt they would be more useful than audio tutorials. Some results from this project are shown in figure 1. Figure 1. Results from previous research by Buick (2007), showing attitudes of students towards different learning tutorials. The majority of students report audio tutorials to be ‘quite useful’ or ‘very useful’. Video tutorials are thought by students to be more useful that audio tutorials, however there is a large proportion that do not have access to these learning resources. As a number of students reported an inability to access to video tutorials, it was thought that creating a video animation tutorial followed by assessing students attitudes would be a useful follow up project. If this is found to be a useful resource, other students may generate video tutorials in the future. Therefore student feedback also assessed attitudes towards authenticity, relating to who generates the tutorial and whether they find the ability to feedback a useful tool. Medical education is widely researched globally, although it is not often a consideration for those studying medicine. Those involved in teaching and educating future doctors have looked at different methods of passing on knowledge. A high quality medical education given to future healthcare professionals is important. It is widely accepted that a better knowledge results in better care for patients and education is at the centre of any healthcare system. This is reflected in the cost of educating medical students and training doctors in the UK. In the 1997 it was reported by the Department of Health that estimates of 200 million pounds would be spent per year for an increase in 1000 medical students being trained in the UK. This suggests that the cost of training a medical student is in the region of £200,0001. Medical education in the UK is split in two halves, with undergraduate and postgraduate training. The Department of Health has recently invested millions of pounds into the development of online tutorials for postgraduate training posts in a number of different specialities. Justification for is given by reducing the cost of training through the use of standardised online tutorials. This will be a more cost effective method than the standard in hospital teaching. This approach has not been undertaken for undergraduate medical education. Universities are seen as primarily responsible for undergraduate training. Many of these institutions have used the Internet to aid teaching and have produced video tutorials. However, as reflected in the previous project (Buick, 2007), resources are often limited and students do not feel they have ready access to these educational tutorials. The benefits of different types of learning resource have been researched. These include online audio downloads (Spickard et al, 2004), practice exam questions and interactive tutorials (Hudsen, 2004). Research showing the benefit of video was shown by Balslev et al (2005) comparing video and written text while teaching a patient case. Balsley et al (2005) found those who learnt using a video presentation rather than those given written text showed a significant increase in data exploration, theory evaluation and exploration. However, there is little research looking specifically at video animation for explaining conditions. Animation software is now available on personal computers and is also possible using Microsoft PowerPointTM, which is the most widely used presentation software. It is clear that recent trends show training can benefit from this type of learning resource. Generation of high quality video tutorials can help students learn while reducing the cost of training. It is for this reason that more material is likely to become available, either from funded production supported by external organisations or by the trainers and trainees themselves who have technology able to produce material such as this on their home computer. Ethical and Legal Issues During the development of this video some ethical and legal issues arose that had to be addressed before a final video could be made. When considering what imagery would be used in the video, I wanted to include pictures of clinical signs relevant to the audio narration. However, taking images from the Internet without prior consent was not thought to be ethical and therefore clinical signs were displayed graphically through drawings and diagrams. Plagiarism and copyright were some of the legal issues surrounding the presentation of medical information. Narrated information was generated using a number of information sources, none of which were exclusively quoted. Therefore an end reference list was generated showing all supporting information sources. Images used in the animation were either self generated or taken from sources such as Wikipedia.org. This resource supplies images under a free software license such as GNU general public license2. This allows anyone to freely use and edit images while referencing the original source. Skills Needed To Develop This Video Animation To generate the video a number I had to develop a number of new skills. Unlike previous work that had been undertaken this media was generated using animation software. To use this effectively I had to research the different functions that were available. To do this I combined reading books aimed to teach beginners such as Macromedia Flash 8 for Dummies (Ellen Finkelstein and Gurdy Leete, 2006) and online sources such as www.learnflash.com . To generate voice narration, another program was used that allowed editing and splicing of audio tracks. This was then split up into a number of narrated sections and added to the animation. Method Script To produce the tutorial the first stage was to construct a script for narration. This involved outlining the areas to be covered. The main headings used were: Stroke definition This gave a clinical definition and a lay person recognition mnemonic called FAST which is used to help members of the general public recognise stroke. Pathophysiology This covered blood supply to the brain. This combined diagrams of the circle of Willis, with images of the brain. Arterial blood supply were then displayed over the brain images while relating this to the arterial vessels leaving the circle of Willis Classification Students at Bristol university are asked to understand the Oxford / Bamford classification. This was covered in detail with explanations of clinical signs that may be seen and graphical representation of these. Prevalence This section covered prevalence, national impact and cost of stroke in the UK. Management In this section management was split up it to immediate management, medical management, in hospital care and some of the procedures considered for different cases. Risk factors for stroke and research into this was also written up and narrated. However at a later stage this was not included due to time constraints and video length. Narration An audio narration was generated using software called ‘Garage Band’ which allows audio tracks to be recorded and edited. The narration was exported in 45 sections so that this could then be added to the animation at relevant points. Animation The animation was made using Adobe Flash. This software is used for making websites and animations used for Internet adverts. It has the facility to export as a ‘flash video format’, which can then be played using a media player online. This software generates animation by allowing objects to be drawn on a stage and moved around using command lines and tools. This was used as it has the ability to animate objects and add audio narration. It also is designed for exporting animations to the Internet allowing the material to be accessed by a large number of people. Feedback A short questionnaire was generated which consisted of ten questions and placed online using a survey collection website (www.surveymonkey.com). Students were directed to the feedback questionnaire and allowed to submit this anonymously. Adapting the tutorial Some feedback constructively suggested changes that could be made. The video was updated after some concern about the speed of narration and that some of the narrative sections seemed to overlap. Analysis and Report The results of the feedback were then collected and displayed in a table. This was then added to the report and discussed with reference to research and previous project work. Results Students were allowed to access to the video animation through the Internet. After uploading the video an email was sent to students studying COMP2 at Bristol University. These students are required to know about aspects of stroke covered in this tutorial to pass this section of the course. The email notified them of the options to view the tutorial and how to give feedback. In total 30 students completed the feedback questionnaire and out of these 4 students provided optional written feedback. The results to the questions given were generally very positive. The majority of students showed a strong preference to video animations as a useful tool in medical education. The results are displayed in Table 1 below. TABLE 1 shows the ten question asked of the students and to what extent they agreed with each statement. Results are given in the percentage of students who chose the relevant category. Written Feedback Four written comments were made: "Really useful presentation!! Would be much better if someone proof read the whole thing as there are some spelling mistakes; also if the pauses between facts were longer it would be more easier to take in some facts. Overall, really nicely done!!" "Some of speech went too quickly, but good overall" "Very clearly written with excellent use of images to match the text and commentary!" "The Video was excellent." Discussion Student attitudes to this video tutorial were very positive. This was in contrast to the attitudes previously shown in the audio tutorial project (Buick, 2007) where video tutorials were not thought to be a useful resource. These results support recent developments in the generation of online video training for doctors by the Department of Health and previous research by Balsley et al (2005). Question one showed that the majority of students strongly agreed that the stroke video would be a useful resource. Questions two, three and four aimed to establish what aspects of a disease were best outlined using a video animation. Results showed that students agree or strongly agreed that defining the condition, pathophysiology and management were all well explained in this format. Interestingly, a large majority of students (70%) felt pathophysiology was best represented kinaesthetically. This may be due to the visual aspect that can be associated with pathophysiology. Disease processes are often represented using diagrams in textbooks with text explaining the disease process. Using computer technology it is possible to turn the text into audio narration and allow the user to view dynamic diagrams. In this way, students can better conceptualise the disease process, facilitating a more complete understanding of disease and its clinical manifestations. Question five aimed to highlight the benefit of visual stimulation as well as audio narration as a positive learning method. All students agreed or strongly agreed that the combination of these two aspects was beneficial. Question six showed a very strong response from students wanting access to more video tutorials, with 70% of students strongly agreeing to this statement. It is often the case that students take part in generating teaching material, and some students may be concerned that this material is inaccurate. However, many students do not think that this is a significant problem. This is reflected by the spread of student’s opinion seen in question 7, where there was no clear consensus of opinion. It may be that as students learn from a number of different resources, that any inaccuracies will be revealed and perhaps stimulate a better understanding through the process of verifying correct answers and practicing evidence based medicine. Question nine and ten show that most students value resources that allow sharing of educational material and feel they could help others learn. They would also value the option to feedback on this material. The written feedback showed positive responses from students. However there was feedback on some aspects of the video that they felt could be changed. The narration was delivered quickly with few gaps between statements to keep the tutorial short and concise, however this was thought to be distracting and made it less easy to follow. Following this feedback the narration was changed and placed back on the Internet for others to review. Further research and investigation could include the generation of a larger resource of video animations. My research has suggested that using animation to cover pathophysiology may be most beneficial. The software used to make this video also allows for the incorporation of interactive elements. The video produced in this project or other videos could have online menus, allowing users to select which part of the tutorial they wish to view rather than having to watch the whole animation, or they include interactive questions. Reflections Strength and weaknesses Strengths of this project include its unique approach to medical education. There have been few animated videos produced for undergraduate medical students that use this advanced software. This software is used by professional web developers but can be used effectively by students and doctors for educational purposes to produce video animation and interactive tutorials. For these reasons, I passionately believe that this technology could be used to revolutionise the way students learn medicine. If done effectively this could provide a more cost effective and engaging learning experience. This will ultimately benefit patients and doctors alike. This material can be place online allowing remote access. This is increasingly important for medical students studying on placements who are often learning away from the university setting. Weaknesses of this project include that of the work intensity of generating animated video. It is estimated that it takes around 6 to 9 hours to produce a minute of animated video. This does not include the research and recording of narration. The total sum of time to generate material and the additional skills needed to use the software makes generation of larger numbers of videos not possible by a small community of learners such as a university. Although it was done in this case, it is difficult to edit the material after it has been created. This may mean that material will become inaccurate when new advances occur. The feedback sample collected was opportunistic and the response rate was low. These factors may bias the results as only a subsection of opinions may have been obtained. These opinions may not be representative of the population studied or generalisable to them. It was difficult obtaining a professional medical opinion about the video in the time that I was allocated. However this has been organised for a later time. Knowledge and skills gained During this project I was able to learn about stroke its presentation, classification, management and risk factors. I read texts, which summarised stroke and research into risk factors and management of stroke. The challenge of usefully condensing a subject into a short educational tutorial was a challenging one. I feel I improved my skills of summarising information effectively. I gained knowledge of some of the challenges of undertaking a project such as this. One of the largest challenges included how long it took to produce the animation. In the future I will be aware of these difficulties and allow for time to gather information and generate the material. I also learnt the benefit of gaining feedback and allowing for adaption to this. It took more time to respond to feedback but this resulted in a better product that other students can use. I also reflected on the impact of stroke itself. Stroke has a major impact on patients, health care and carers. Much can be done in the recognition classification and management. A better understanding benefits all areas and I have gained a better knowledge and the importance of helping others gain a good understanding of stroke. I learned how to generate a video animation for the use of teaching in medicine and combine this with audio presentation. I learned how long it can take to generate material like this and the skill of organising my time effectively to manage a project. I can use this skill in the future to produce more educational material to help teach during my medical career. I also gained skills in learning how to place material on the Internet for others to access and will also use this in the future. Conclusions Previously evidence has shown the use of videos in medical education to be beneficial. It has normally been used to demonstrate clinical examination and procedures this study suggest there is a place for explanation of pathophysiology and disease summaries. However, there has been little research in to its use for graphically representing condition summaries. Computer technology now allows people to generate animation on their personal computer. It is possible that over time more students and doctors will start producing innovative visual and audio teaching material. This project indicates that this would be well received by students. References Planning the Medical Workforce: Medical Workforce Standing Advisory Committee: Third Report December. 1997 Page 40. The GNU project launched in 1984. Balslev T, de Grave W S, Muijtjens A M and Scherpbier A J (2005) Comparison of text and video cases in a postgraduate problem-based learning format Medical Education; 39: 1086–1092 Buick (2007) Year 3 External SSC. Bristol University Medical School. Spickard A, Smithers J, Cordray D, Gigante J, Wofford J L. (2004) A randomised trial of an online lecture with and without audio; Medical Education 38 (7), 787–790. Hudson J. N., (2004) Computer-aided learning in the real world of medical education: does the quality of interaction with the computer affect student learning? Medical Education 38 (8), 887–895. Ellen Finkelstein and Gurdy Leete, (2006) Macromedia Flash 8 for Dummies. Wiley publishing Inc. ISBN 0764596918  
Dr Alastair Buick
almost 12 years ago
Foo20151013 2023 jvnsb0?1444773955
3
95

Difficulties In Trying To Access Medical Courses

I'm a GP registrar in East Anglia with an interest in continuing medical education. Alex Gordon-Weeks - academic surgical registrar at Oxford - and I are undertaking a project that explores some of the difficulties that doctors face when trying to access medical courses. Doctors complete a number of compulsory and non-compulsory educational courses during and after their medical training. Now that revalidation is compulsory doctors must provide evidence of continuing medical education. Attending courses are an ideal way of maintaining knowledge but they can be expensive and time consuming so it is important that adequate information regarding the course undertaken is provided by the course organisers. To identify areas in which these features could be improved we wish to understand more about the courses that you attend. We have put together a short survey to obtain anonymised information that we can use to improve course provision. We would love for Meducation members to fill it in and would really appreciate your participation. You can take the survey at http://www.surveymonkey.com/s/SSL7286. Thanks!  
craig Sheridan
over 8 years ago
Foo20151013 2023 159552n?1444774079
3
111

Current Social Media Guidance

Hello & Welcome! You may have already read my blog on 'My Top 5 Tips to use Social Media to Improve your Medical Education' and if so you will have an idea of what 'Social Media' is and how it can be harnessed to improve medical education. There are also features that could improve health promotion and communication but today I would like to focus on where we have to be careful with these resources. In my last blog I circumnavigated the drawbacks of social media in medicine so that I could give them the full attention they deserve in their own blog today. But its not all doom and gloom! I also hope to give you a brief overview of the current social media guidance that is available to doctors and medical students and how we can minimise the risks associated with representing ourselves online. But firstly, what actually is social media and why do i keep blogging about it? If you are new here I recommend giving 'Social Media' a quick google, but the phrase basically includes any website where the user (i.e. you) can upload information and interact with other users. Thats a definition of the top of my head, so don't hold me to it, but most people would agree that this definition includes the classic examples of Facebook, Twitter, YouTube, Linkedin etc, but there are many many more. These sites are important to us as (future) health professionals because they can be both used and unfortunately abused. However, several medical bodies including the General Medical Council and the Royal College of General Practitioners agree that these resources are here to stay and they shouldn't (and probably couldn't) be excommunicated. With this in mind, there has been much guidance on the topic, but as you are about to find out a lot of it is common sense and your own personal discretion. Before you read on, I'd like to forewarn you that I try and keep things lighthearted with this topic. I'll hope you can excuse my levity of the situation, especially if any of the original authors of these guidelines end up reading this post. But as I am sure you are aware, this is a dry topic and hard to digest without the odd joke or two... British Medical Association - Using Social Media: practical and ethical guidance for doctors and medical 2011 The BMA guidance is the earliest guidance originating from a major medical body that i've come across. That said, I have not done a proper literature review of the subject. This is a blog, not a dissertation. But still, the BMA gives an early and brief summary of the problems facing health professionals using social media. Key points such as patient confidentiality, personal privacy, defamation, copyright and online professionalism are covered and therefore it is a nice starting point. It is also quite a short document, which may appeal to those who are less feverent on the subject. On the other hand, I personally feel that the BMA guidance does social media an injustice by not going into the great benefits these resources can yield. There are also no really practical tips or solutions for the drawbacks they've highlighted to students. Read it for yourself here or just google 'BMA Guidance Social Media' Royal College of General Practitioners - Social Media Highway Code Feb 2013 The RCGP guidelines are my favourite. After a cheesy introduction likening the social media surge with the dawn of the automobile they then take a turn for the worse by trying to continue the metaphor further by sharing a 'Social Media Highway Code'. Their Top 10 Tips that form the majority of the code don't look to be much more than common sense. However, each chapter there after dissects each of their recommendations in great detail and provides practical tips on how to make the most from social media whilst protecting yourself from the issues raised above. As I mentioned earlier, the RCGP recognise the inevitability of social media and they acknowledge this in the better part of their introduction. They make a great point that older doctors have a responsibility to become technologically savvy, whereas younger doctors who have grown up engrossed in social networking probably have to develop their professionalism skills more than their older colleagues (I'm aware this is a generalising statement). Either way, the RCGP highlight that everyone has something to take away from this set of guidelines. Read it for yourself here or google; 'RCGP Social Media Guidance,' but be warned, this is one of the more lengthy documents available on the topic. General Medical Council - Doctor's Use of Social Media April 2013 The GMC guidance kicks off with a little summary of the relevant bits of 'Good Medical Practice.' Again, nothing much that isn't common sense. That being said, they then go on to write that 'Serious or persistent failure to follow this guidance will put your registration at risk,' which sounds ominous and probably warrants a quick flick through (do it now! - the PDF is at the bottom of their page). Reassuringly, the GMC does not try and place a blanket ban on social media. They give a 'tip of the hat' to the benefits of social media and then go on to outline all the drawbacks as many of the guidance already has. Asides from the issue of anonymity there is really nothing new covered and the GMC actually gives a lot of autonomy to doctors and medical students. However, the GMC are, in many ways, who we ultimately answer to and so you would be a fool not to revisit the issues they cover in their version of the guidance. As I mentioned, the GMC brought online anonymity to the forefront of our minds. Should we, shouldn't we? A lot of health professionals believe that the human right to a private life extends to the right to have anonymity online. However, before we go into this any further lets take a closer look at what the GMC actually says... If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the view of the profession more widely. As you can see, the use of the phrase 'Should also identify yourself by name' gives some room for manoeuvre and is a world apart from what could have been written (i.e. you must). To those who believe their human rights are being infringed, perhaps a solution is to stop identifying yourself as a doctor online, although I appreciate this can be difficult if you are tagged in certain things. There are a number of good points why doctors shouldn't be anonymous online and it is certainly a must if you are in the trade of offering health promotion via the world wide web. However, I can see the point of those who want to remain anonymous for comical or satirical purposes. A quick google of the topic will reveal that the GMC has said that they do not envisage fitness to practice issues arising from doctors remaining anonymous online, but from the temptations that arise from running an anonymous profile such as cyber-bullying and misinformation. Read the GMC guidance yourself here. National Health Service (Health Education) - Social Media in Education May 2013 The NHS-HE guidelines are high quality and cover the entire scope of what social media means to medicine. There are several key issues that I haven't encountered elsewhere. This set of guidance is written from a managerial, technical perspective. It doesn't really feel aimed at doctors or medical students but it gives such an overview of the subject that I thought it was worth including. If you feel brave enough, read it for yourself here. Conclusion To my knowledge, these are the current key guidelines for the use of social media in medicine. I hope you have found this blog useful in providing a quick summary of a topic that is becoming increasingly swamped with lengthy guidelines. In the future we need to see material produced or delivered that educates health professionals in how to use social media, rather than regurgitating the pros and cons every couple of months. I think webicina is a good example of a social media 'training course,' . There should be more material like this. Perhaps this is where I'm headed with my next project... As always, if you have anything to add to this blog, please feel free to add to the comments below. I will be able to take difficult queries forwards with me to the Doctors 2.0 conference next week! If you are a student and interested in coming to the conference in Paris next week you should get in contact with me directly (@LFarmery on twitter). Also, it would be a great help if you could fill out my very quick pilot survey to help me understand how doctors and medical students currently use social media. Also see my website Occipital Designs LARF Disclaimer The thoughts and feelings expressed here are those produced by my own being and are not representative in part or whole of any organisation or company. Occipital Designs is a rather clunky, thinly veiled, pseudonym. If you would like to contact me please do so on Twitter...  
Dr. Luke Farmery
over 8 years ago
Foo20151013 2023 a5gegv?1444774173
5
192

Commitment Issues

I recently read a question on meducation posted around a year ago, the jist of which was “as a medical student, is it too early to start developing commitment to a specialty?” I.e. “even though I haven’t graduated yet, should I start building a portfolio of experience and evidence to show that specialty X is what I really want to do?” MMC revolutionised (for better or worse) the medical career structure forcing new graduates to decide on a career path much earlier. Many have appreciated the clear delineation of their career pathway. Others have found the 15 month period between leaving university and applying for specialty training too short to make an informed decision (just ask the 10% of FY2s that took a career break last year (i)). Whether right or wrong, there is now less time to rotate round ‘SHO’ jobs, decide on a career and build a CV capable of winning over an interview panel. You’ll probably find you’re in one of 2 camps at university: Those who are absolutely 110% certain there is nothing they want to do, ever, other than specialty X, or Those who really like specialty X, but also like specialties W, Y and Z and haven't made up their minds (A few people find themselves feeling they don’t want to be part of any medical career, but that’s for another post.) Students identifying with the first statement are usually concerned they will not get enough general experience, or that they will be stuck with their decision if they change their minds later on. Those who are leaning more towards statement 2 may not build as strong a body of evidence for any one specialty; however it’s possible to get involved in activities either relevant to a few career options, or several specialty-specific activities and subsequently edit the CV for a specific interview. The key message is that whether you think you have your career mapped out or not, medical school is the perfect time to start collecting evidence that you’re interested in a career in a particular specialty: time for extra-curricular activities only becomes scarcer when you have a full time job complete with working long days, nights and weekends. Your experiences at medical school can then be supplemented with taster weeks, teaching and judicious use of your study budget for training days and conferences; bear in mind that all specialties allow at least 3 years* following FY2 before starting specialty training which can be used for gaining further experience (but be prepared to justify and defend your actions). It’s also important to consider the manner in which individual specialties require such a commitment to be demonstrated: In general terms, the more niche and/or competitive the specialty, the more they will want you to demonstrate that you a) really know what the job entails and b) have made a concerted effort to further your knowledge of the subject. To get a job in neurosurgery for example, which is not only niche but had a completion ratio of 4.9 in 2013(ii) you’ll need to have gone to courses relevant to neurosurgery and have achievements related to the specialty such as a neurosurgical elective, attachment or taster experience(iii). Some specialties assess commitment in a variety of situations e.g. the radiology interview this year had stations on the general overview and future of radiology as a career, a CV based demonstration of commitment to specialty as well as a station requiring the interpretation of images. General Practice on the other hand which in its very nature is very broad, at no point allocates marks specifically for commitment to specialty (or anything else on a CV for that matter) as it is entirely dependent on an exam (SJTs and clinical questions) and skill-based stations at a selection centre. The person specification* details what is expected and desirable as demonstration of commitment in each specialty. So, how do you actually show you’re committed to a specialty? It may be pretty obvious but try to get a consistent and well-rounded CV. Consider: • Joining a student committee or group for your specialty. If there isn't one at your university, find some like-minded people and start one • Asking the firms you work for if you can help with an audit/research even if data collection doesn’t sound very interesting • Finding a research project (e.g. as part of a related intercalated or higher degree) • Prizes and examinations relevant to the specialty • Developing a relevant teaching programme • Selecting your selected study modules/components, elective and dissertation with your chosen specialty in mind • Going to teaching or study days aimed at students at the relevant Royal College Remember it’s not just what you’ve done but also what you’ve learnt from it; get into a habit of reflecting on what each activity has helped you achieve or understand. This is where most people who appear to have the perfect CV come unstuck: There will always be someone who has more presentations and publications etc. etc. but don’t be put off that it means they are a dead cert for the job. Whatever you do, make sure you have EVIDENCE that you’ve done it. Become a bit obsessive. Trust me, you forget a lot and nothing counts if you can’t prove it. Assessing commitment to specialty aims to highlight who really understands and wants a career in that specialty. From my own recent experience however, just identifying experiences explicitly related to a specific specialty ignores the transferable and clinically/professionally/personally important skills one has that would make them a successful trainee. I’d be very interested in your views on ‘commitment to specialty’: for example do you think the fact someone has 20 papers in a given specialty means they are necessarily the best for the job? Or are you planning to take a year out post-FY2 to build on your CV to gain more experience? Let us know! References *See person specifications for specialty-specific details at http://specialtytraining.hee.nhs.uk/specialty-recruitment/person-specifications-2013/ i. http://www.foundationprogramme.nhs.uk/download.asp?file=F2_career_destination_report_November_2013.pdf ii. http://specialtytraining.hee.nhs.uk/wp-content/uploads/sites/475/2013/03/Specialty-Training-2013.pdf iii. http://specialtytraining.hee.nhs.uk/wp-content/uploads/sites/475/2013/03/2014-PS-NEUROSURGERY-ST1-1.02.pdf  
Dr Lydia Spurr
over 7 years ago
Foo20151013 2023 ybwd01?1444774304
1
267

The NHS should care … for it's staff

The NHS is one of the largest employers in the world. It is one of the largest healthcare providers in the world and it is one of the most loved and needed institutions in this country. The downsides to the NHS is that it is constantly ‘in crisis’ and it is expected to provide better care and newer treatments with less money and not enough staff. Recently, this has caused a significant drop in staff morale and the beginnings of an exodus of trained staff out of the NHS. This needs to be addressed. If you read almost any management textbook, journal article or magazine, they will tell you that happy staff perform better. This ethos is easy to theorise but less easy to practice. Companies like Google and Apple have taken this to heart but so did some of the old Victorian companies like Cadbury’s and Roundtree. These companies aimed to make a profit but also to invest and look after their staff because of moral and economic principles… and it worked. I believe the NHS needs to embrace this old fashioned paternalistic concept, if it wishes to continue to be a world leader in excellent, affordable healthcare and professional training. If the NHS invests in its staff now, it will increase staff morale, encourage people to stay working in the NHS and ensure top quality patient care. The reforms Staff canteens open 24/7 (or near enough), that serve good quality, healthy and affordable food. If staff have to work unsociable shifts, it seems unfair not to provide them with the chance to eat a healthy meal at 2am rather than a Domino's. Staff canteens also allow the staff to unwind and socialise away from the wards and the public, they can be unofficial hubs of productivity where the 'real business' takes place away from the meetings. Staff rooms with free tea and coffee - it doesn't cost much and every appreciates a 'cuppa'. A** crèche** for the children of staff, on site or nearby. Reduces the stress of having to take children to carers and pick them up, allows greater flexibility for the staff. Free staff car parking (if they car share). Staff have to get to work and cars are the most practical way for most people, so why punish them by charging car parking? An onsite gym that is free/reduced price for staff and open 24/7 so that staff can pop in around their various shifts. The physio gym could just be expanded so patients and staff use the same facilities. Providing healthcare is stressful, takes long hours and is antisocial. All these factors make it easy to put on weight, especially with most hospitals only providing unhealthy meals, Costa and Gregs. So, an onsite gym would make it a lot more convenient for the staff to get the exercise they need to burn off all that stress and calories. Healthier, happier staff! A hospital/ centre social society like a student ‘MedSoc’ to organise staff socials and sports teams etc. This organisation could even organise special events for the staff like a summer ball or sports day. Anything fun that would bring the staff together and let them blow off steam. It could easily incorporate, elected officials from the professional bodies and elected representatives of the different employees and act as an unofficial staff voice. Regular staff forums that allow each group of employees to raise concerns or solutions to problems with the organisations management and senior staff. Staff rota’s should not just be imposed by management but should be organised in a flexible manner that allows staff input. The NHS management should encourage and provide extra learning opportunities for the staff. By investing in staff education they provide people with opportunities to develop them selves which will benefit the organisation and increase their sense of satisfaction with what they are doing. Team based points systems for good performance and regular rewards for excellent care. These points systems can then be used to promote competition between teams which should raise the level of care. Have a monthly leader board and reward the best team with a day at a spa or something. These changes may hark back to ideas that are out of favour now with the increased desires for measured ‘efficiency’, but I believe that these suggestions would hugely increase staff well being, which would hopefully improve their attitudes towards the organisation they work for and would hence make them happier and less stressed when they are caring for patients. If you have any other suggestions for improving staff wellbeing please do leave comments. The NHS is enormous and has a huge variety. It would be fascinating to survey as many parts of it as possible and see how many places have these services available for the staff already. Please feel free to contact me if you know of any study like this or if you are keen of setting up a study like this with me.  
jacob matthews
about 7 years ago
Www.bmj
1
16

A third of GPs are considering retirement, BMA survey finds

A third of GPs in the United Kingdom are considering retiring from general practice in the next five years, a survey of the profession has found.  
bmj.com
over 6 years ago
Preview
1
9

Physician Salaries, Job Satisfaction Detailed in New Survey

Compensation is still a sore issue for many physicians, according to Medscape's 2015 Physician Compensation Report.  
medscape.com
over 6 years ago
Www.bmj
0
26

Short term exposure to air pollution and stroke: systematic review and meta-analysis

Data sources Medline, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science searched to January 2014 with no language restrictions.  
feeds.bmj.com
over 6 years ago
Www.bmj
0
9

A third of GPs are considering retirement, BMA survey finds

A third of GPs in the United Kingdom are considering retiring from general practice in the next five years, a survey of the profession has found.  
feeds.bmj.com
over 6 years ago
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0
8

Red Checklist

UMEM Red Checklist  
youtube.com
over 6 years ago