Month: August 2015

Going back to the start – influencing prospective medical students

James Pearson is an ST3 trainee in Bath and the education scholar for the year. Suddenly you are sitting there alongside all these very intelligent people and the familiar world of sixth form seems so far away. I still remember my first day at medical school when the year group were told in our welcoming lecture that the majority of us would become GPs. I distinctly remember my reaction and that of all my peers was one of surprise and shock! How could they suggest something as absurd as that? At that point, our exposure to medicine had mostly...

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“For One Week Only” – Diagnosing high blood pressure in primary care

David Nunan is a Departmental Lecturer and Senior Researcher based in the Nuffield Department of Primary Care Health Sciences and the Centre for Evidence Based Medicine at the University of Oxford. His research interests include evidence-based medicine, cardiovascular and non-communicable disease and lifestyle medicine in primary care. At the 44th Annual Conference of the Society for Academic Primary Care I presented results from our study to assess the diagnostic accuracy of self-monitoring blood pressure (BP) for diagnosing hypertension in primary care. Here is a synopsis of that presentation. High blood pressure is one of the biggest underlying risk factor for cardiovascular disease (CVD) and that CVD itself is the biggest cause of premature death globally. Therefore, accurate diagnosis of high blood pressure is pretty crucial. Current NICE guidance advocates suspecting hypertension if clinic blood pressure is 140/90 mmHg or greater on 2-3 occasions over a period of weeks to months. If there is a suspicion then the patient should be offered ambulatory blood pressure monitoring which collects the average blood pressure taken over 24 hours using a special electronic monitor that automatically takes measurements 2 to 3 times an hour (1 per hour at night – more than this would be unkind). This is currently considered the “gold” or reference standard for diagnosing high blood pressure. However, not everybody can tolerate this intense level of monitoring.  In these cases...

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The Locum: Assassin of Independent Contractor Status

Adam Staten is a GP trainee in Surrey and is on Twitter @adamstaten. In the June issue of the BJGP there was a debate as to whether GPs should maintain their status as independent contractors. To me this seemed like a macrocosm of the decision that all newly qualified GPs have to make when it comes to finding a job. Since the new contract for general practice it seems to have become the norm for a new GP to take a salaried job which provides stable employment and predictable pay without the burden of extra responsibilities born by partners....

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