Author: BJGP Life

The CSA examination: learning to be a fox again

Khalil Hassanally is a First5 GP and student of bioethics. Twitter: @asuitabledoctor Coming from an immigrant community there has always been huge pressure on not losing one’s roots. Many apocryphal tales, anecdotes and fables are told in this regard, and one in particular that sticks in my mind is that of the fox who lost his walk. The story, as it goes, was of fox who used to be the envy of the other animals for his unique walk. One day, fox saw man who rather than walk on four legs walked on just two. Keen to maintain his reputation of being the best walker, fox attempted to walk on two legs, though try as he might fox could not replicate the walk of man.  Defeated, the fox tried to return to his own walk only to realise he had forgotten what it looked like and that is why fox today has the funniest walk of all the animals. Many of us whose neighbourhoods are plagued with vulpes vulpes see nothing funny about how fleet of foot the fox is, or how deftly he empties poultry from the garden; nevertheless the story of the fox’s walk rang particularly resonant having finally completed the Clinical Skills Assessment (CSA). When we started off practising as trainees, we were individuals with our many voices and ways of consultation but by the end...

Read More

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...

Read More

“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...

Read More

Welcome to BJGP Life!

The British Journal of General Practice and BJGP Open are bringing research to clinical practice. This is where we add the debate and opinion to help ensure everyone benefits from that research.

BJGP Current Issue

BJGP October 2018 cover

Sign up!

Enter your email address to subscribe to BJGP Life and receive notifications of new posts by email.