Guilt, shame and negative emotion in undergraduate medical education: is there a role for Balint groups?

Balint groups are a structured discussion which explores non-clinical aspects of the doctor-patient relationship. In this commentary piece we describe our experience of a Balint group for final-year medical students in a large regional hospital. We discuss that our participants reported a significant burden of negative emotion, primarily guilt and shame, in attempting to navigate the hospital environment as learners. We note how our participants perceived they would acquire the ability to manage these negative emotions simply by becoming doctors, despite being only a few months from qualification. A cultural shift in undergraduate training, combined with a challenging period for the medical profession in general, may leave new doctors isolated in the face of the emotional strain of medicine. We therefore encourage educators to consider using Balint groups as an adjunct to more traditional clinical training.

Penetration of the Heart by an Airgun Pellet: A Case Without Significant Effusion or Valvular Injury.

Cardiac gunshot injuries are rare in the United Kingdom, but they are associated with significant morbidity and mortality. We present the case of a young male who was shot at close range with a low-caliber air rifle. The projectile entered the thorax through the right axilla, but it was identified at the cardiac apex on initial imaging. Subsequent investigations demonstrated the pellet at the apex of the left ventricle. The potential for embolization was considered, and the pellet was retrieved after surgical exploration. No significant valvular injury was sustained despite the pellet's trajectory, and the patient made an uncomplicated recovery.