Near peer integrated teaching for final year medical students.

INTRODUCTION: Medical students preparing for final exams need practical and theoretical knowledge. We evaluated a junior doctor led integrated programme delivering theoretical and practical teaching. METHODS: An 8-week junior-doctor led teaching programme was set up for final year medical students. Theory, OSCE and bedside teaching on selected weekly clinical themes were run. Satisfaction was evaluated using a questionnaire survey. RESULTS: Almost all agreed that the programme was useful and that an integrated approach to teaching was more beneficial than separate and unrelated lectures and practical teaching. The majority agreed that theory sessions and practical sessions had improved their confidence for finals and agreed they felt more prepared for work as a doctor. Most agreed that the Facebook® group provided an easily accessible platform for communication and sharing learning resources. Some comments, however, highlighted limitations particularly in the ability to answer difficult questions. CONCLUSION: Integrated teaching by junior doctors in small groups appeared to be an efficient teaching method (for theoretical and clinical skills) for medical students, improving their confidence for finals and life as a doctor and provided useful opportunities for junior doctors to develop as clinical teachers. This can be a useful blueprint for other hospitals.

Dengue fever in Pakistan: a paradigm shift; changing epidemiology and clinical patterns.

Dengue fever has huge public health implications and affects over 100 million people worldwide. This review pictures the current situation of Dengue in Pakistan and presents a review of published literature. Pakistan has seen recurrent epidemics of Dengue Fever recently. Unfortunately, these epidemics are becoming more severe in their clinical manifestation. Pakistan experienced large epidemics of dengue fever during 2008, 2010 and 2011 affecting thousands of people and claiming hundreds of deaths. A comparison of data during these epidemics indicates a shift from mild to a more severe disease, which could be interpreted as an epidemiologic transition pattern in the country. Expansion of Dengue in Pakistan seems to be multifactorial, including the climate change, frequent natural disasters, vector resistance to insecticides and lack of resources. This highlights the need for rigorous vector control. Continuing education of primary care physicians is crucial for early appropriate management to reduce mortality.

An unusual cause of stroke in a young female.

Takayasu arteritis is a granulomatous vasculitis of medium- to large-sized arteries. Initial presentation is usually with nonspecific constitutional symptoms, but unusually, it can present with acute ischemic features in the advanced disease. We present a case of a young Asian female who presented with acute stroke due to Takayasu arteritis. Involvement of proximal arteries was a source of embolism, which was the most likely cause of stroke in this patient. Patient made a good clinical recovery with a combination of medical treatment and rehabilitation. Takayasu arteritis should be considered as a possibility in all young patients presenting with stroke, as this is fairly responsive to medical management and associated with good clinical outcomes.

Developing a 'buddy scheme' for foundation doctors.

BACKGROUND: Changes in working practices have resulted in disruption of the traditional team structure and work patterns. The need for support for juniors during the transition from medical school led to a buddying programme for foundation trainees at the Royal Bournemouth Hospital (RBH). METHODS: In phase 1, a programme was evaluated using a questionnaire consisting of 12 questions, some of which took the format of a five-point Likert scale. Areas for improvement were identified and implemented in phase 2. Outcomes were re-evaluated using the same questionnaire format. RESULTS: Compared with phase 1, more foundation year-1 doctors (FY1s) felt that they benefited from an FY2 buddy (68 versus 17%; p = 0.0025), and that the buddy had helped to smooth the transition from student to doctor (39 versus 17%; p = 0.20), in phase 2. First contact was initiated by the FY2 (90 versus 43%, p = 0.02), and occurred as a face-to-face meeting (68 versus 29%, p = 0.09). FY1s felt that buddies were more accessible (89 versus 24%, p = 0.0001), developed a better rapport (84 versus 31%, p = 0.002) and felt more likely to get involved in buddying in the future (55 versus 22%, p = 0.05). DISCUSSION: Our buddy scheme improved on previous models, and was effective and well received. The committee responsible for organising and overseeing the scheme is thought to have contributed to this improvement. In order for any such scheme to be successful it is important to constantly evaluate and adapt the scheme.

A consultant physician in acute medicine: the Bournemouth Model for managing increasing numbers of medical emergency admissions.

Consultant-led medical admission units have been developed as one method of managing the increasing number of acute medical emergencies. The need to document such innovations and to evaluate and analyse the role of an acute care physician in meeting the problems of acute care has been emphasised. We therefore report our experience of an acute admissions unit led by a consultant physician in acute medicine in a district general hospital.