The Keio journal of medicine
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The medical curriculum at King's College London School of Medicine is a 5 year course; an extended program (6 years) and a graduate entry program (4 years) are also available. The first 2 years of the curriculum comprise phases 1 and 2. The curriculum consists of core material that is common to all students and student-selected components (students undertake three such components in the first 2 years). ⋯ Assessment consists of in-course assessment (e.g., presentations, tests and essays) and end-of-year examinations which consist of written papers and an objective structured clinical examination at the end of year 2. The main strengths of the program include the scenario format of learning and the practice of medicine early on. The difficulties arise mainly from the large numbers of students (420 per year).
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Historical Article
Imatinib (Gleevec) as a paradigm of targeted cancer therapies.
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Review
What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base.
The advent of endoscopic technologies and techniques has expanded the limits of conventional endoscopic sinus surgery. The expanded endonasal approach describes a series of surgical modules in the sagittal and coronal planes that allow surgical access to the entire ventral skull base. The sagittal plane extends from the frontal sinus to the second cervical vertebra. ⋯ The introduction of the septal mucosal flap for dural reconstruction has decreased the incidence of postoperative cerebrospinal fluid leaks to less than 5%. Early data suggests that oncological outcomes for malignant sinonasal tumors with skull base involvement are comparable to conventional techniques. Proper training in endonasal surgical techniques is essential to prevent unnecessary morbidity and achieve good outcomes.
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Professionalism is a core competency of physicians. In this article, the statements of professional societies (e.g., the Charter on Medical Professionalism), the expectations of patients and society regarding professionalism, and a framework for defining medical professionalism are described. The framework's foundation consists of clinical competence, communication skills, and a sound understanding of the ethical and legal aspects of medicine. ⋯ Professionalism assessments can be used for formative and summative feedback, evaluation of professionalism education programs, and generating hypotheses for professionalism research. Finally, the rich history and culture of clinical excellence and professionalism and specific programs for teaching and assessing professionalism at Mayo Clinic are described throughout this article. Indeed, the Mayo Clinic experience validates professionalism a s a core physician competency.
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According to a paper published by the International Work Group on Death, Dying and Bereavement, "Each person has a spiritual dimension." That means each person has spiritual energy and spiritual needs. In facing death, a patient suffers spiritual pain and needs spiritual care. This paper describes what spirituality and spiritual pain mean. ⋯ Death education; 2. Presence at the bedside; 3. Humor as an expression of love.