Clinical medicine (London, England)
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Typically lasting 7-9 years, medical-scientist training programmes (MSTPs) allow students a unique opportunity to simultaneously intercalate medical (MBBS, MBChB or MD) and research (PhD) degrees. The nature of both degrees means that the combined programme is arduous, and selection is often restricted to a few highly motivated students. Despite the many successes of MSTPs, enthusiasm about MSTPs and the number of intercalating students, at least in some countries, appear to be diminishing. In this review, I shed light on MSTPs around the world, highlight the plethora of successes such programmes have had and provide insights on the setbacks experienced and solutions offered, with the aim of reigniting interest in these programmes.
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Atrial fibrillation is driven by spontaneous electrical activation emerging from the pulmonary veins. Catheter ablation using either radiofrequency or cryothermal energy electrically isolates these veins from the left atrium, both reducing the burden of atrial fibrillation episodes and improving the patient's symptoms. ⋯ Underlying medical problems - including obesity, hypertension and obstructive sleep apnoea - should be optimally treated before considering ablation. Although this treatment has the potential to cure patients of their symptoms, they should be aware of the important associated procedural complications.