Clin Med
-
It is recognised that physicians can face difficulty in identifying the aetiology of an episode of loss of consciousness. This lesson reports the case of a patient who was diagnosed with epilepsy in 2008 after presenting with ‘funny turns’ and had more than 100 further blackouts before a correct diagnosis of sinus node disease was made in 2010. ⋯ Diagnostic and management strategies are discussed for patients presenting with loss of consciousness. Physicians are reminded of the difficulty in distinguishing cardiovascular syncope from epilepsy in such patients and the broader principle of questioning a diagnosis in those who do not appear to respond to treatment.
-
The UK has recognised the important role its health professionals play in achieving the Millennium Development Goals. For doctors to contribute to these efforts without detracting from domestic service and training commitments presents a challenge. ⋯ Furthermore, the knowledge and skills required to make contributions to global health are not sufficiently served by existing training. A model for a national curriculum and tiered qualifications in global health is proposed, based on rigorous appraisal and mentoring to complement the training pathways for UK specialisation, allowing doctors to add global health skills at a level appropriate for their career plans.
-
Significant changes to the structure and entry into specialist training continue to be implemented. This is likely to have had a long-term impact on rheumatology service provision and the proportion of trainees undertaking academic medicine. An online questionnaire was sent to all trainees on the Joint Royal Colleges Postgraduate Training Board (JRCPTB) database. ⋯ Of these, 33 (23%) were registered for, or had been awarded, an MD or PhD with a wide variety of funding sources. Mainstream funding sources included Arthritis Research UK, the Medical Research Council, the National Institute for Health Research and the Wellcome Trust, but a substantial number of trainees (n = 17, 51.5%) also utilised other sources of funding. The data from this study will be valuable in the planning of future rheumatology training and academic career pathways and provide useful comparative data for other medical specialties.