Thursday 24 May 2012

C-section

According to this from the BBC News website if your child is born by  Normal Vagina Delivery there less likely to become fat. Problem is that a risk factor for needing a C section is a big baby, diabetic mother etc, which are also risk factors for having an obese child.

The only true way to find out if having a C section would be a risk of causing obesity in itself would be to conduct a randomised controlled trial. Get one thousand pregnant women and randomly allocate them to NVD or to C section. Then follow up the kids in ten years time and see if they are fat or not.

Wednesday 23 May 2012

Rhymes with "Clucking Bell."

Thank you JD for highlighting this. This idea is the most stupid one I have seen.

"The announcement has been broadly welcomed by doctors leaders and NHS managers."


What the hell! Who would be idiotic enough to support this proposal? Or is it simply "support" in the same way professionals supported the health care bill?


All this will do is make GPs in middle class areas look good and GPs who work in deprived areas  look bad.


This simply isn't feasible to do. 



Wednesday 16 May 2012

Orchestra and Epilepsy

The brain is like an orchestra, with everything running smoothly and in harmony with one another. An orchestra is usually playing together to play something nice. However every now and again a Lady Gaga appears and disrupts the whole bloody thing.

That is how you explain epilepsy to an eight year old

Sunday 13 May 2012

Ward 401

Not a very enticing name for a medical documentary about life on the geriatric wards. We have plenty of programs dealing with sick kids who people can very easy feel sorry for and go "oh, isn't she sweet," or "what a brave little soldier he is," etc etc.

How about a program about life on the stroke unit or the geriatric ward?

 (SHIT! I MEAN HEALTH CARE OF THE ELDERLY WARD - WHAT? THATS POLITICALLY INCORRECT TO NOW? SORRY - HEALTH CARE OF THE OLDER PERSON WARD).

Ahh, I see. Talking about Mrs Jones who has dementia, cant wipe her own bottom and has come in because she has had a fall doesn't make very good television.


Saturday 5 May 2012

OSCE or SSCE?

Is it an Objective Structured Clinical Examination or a  Subjective Structured Clinical Examination?

On paper is should be objective but in real life its down to whether or not the examiner takes an instant like or dislike to you.

The FM passed a resit OSCE yesterday. On her first sitting she got 31/32 for the head and neck station. Second time round she failed this station, despite her examination being exactly the same, a neck lump in exactly the same place and her suggested differentials being the same.

This time round she got full marks in the lower Peripheral NS and Breast station, despite failing them first time round. Her examinations were exactly the same, down to the same way she introduced herself and held the tendon hammer. This time round the OSCE gods were smiling.

There is also the fact that OSCEs are a game. First time round she passed the critical care station but dropped a couple of marks. After getting feedback she realised there was a mark for commenting on the values of observations given to her in the station. Second time round she scored much highly for saying things like this...

"This blood pressure of 80/40 is low, I am concerned by it."

Repeat above statement but for pulse rate, respiratory rate, oxygen saturation etc.

A similar example is in the radiology station. Two bloody marks for simply stating that this is a "PA chest radiograph."

Is this really the best way we have to decide who is suitable to be a doctor or not?

On another note she got 29/30 for her abdomen examination (on both times), saying to the examiner that she would admit this patient who had an ileostomy two months and was in an incredible amount of pain, was probably the right thing to say.

Friday 4 May 2012

IS THERE

The Fuddled Medic is now DR FUDDLED MEDIC. You heard me - A DOCTOR!

Assuming she does not have any outstanding library fines that could prevent graduation!