Physicians pursue the interest that during the hospital stay the best patient care needs to be provided; and achieving that in a short time - as a result the patient is expected to recover from illness and return to normal life.
The ability to prevent possible complications that the patients are exposed to, has always generated ambiguity in the current medical practice, since it is assumed, that the relief of the patients once the treatment is established, should always be the same1. However, it is the awareness and proper care of comorbidities and the baseline condition of the patients that determine the success rate of the treatment, without requiring additional interventions beyond the ones proposed at the beginning of the treatment 2, 3.
This important factor has generated in practitioners the need to be able to monitor the clinical evolution of the patients. Laboratory tests are an important basis of medical diagnosis, and are frequently used to monitor the clinical progress of the hospitalised patient. The patient clinical state sometimes changes suddenly or continuously; requiring the surveillance of the basic variables such as vital signs. Vital signs monitoring activate a warning signal for the immediate reassessment of the patient and reorient the medical decisions at any moment during the hospitalisation, with the goal of avoiding further deterioration or adequately treating any new disease state that the patient may develop 3, 4.
From that point of view and long time ago the medical community has observed the need to generate a code that could be universal and that could be used as an early warning of the patient worsening. As a result of this situation, in different countries around the world, researchers and clinicians have developed scales, scores, algorithms and others tools to identify early patients in risks to be in critical conditions. Those tools are based on the ability of easy data collection and simple clinical interpretations allowing the clinical personnel to make objective and early assessment of the overall clinical state of the patients 4.
These scales or scores are not ideal, since there is no perfect scale, and all have statistical weaknesses either in their sensitivity or specificity. The clinical judgment and the physician experience, added to a score from any of these scales, may guide the path to follow according to the particular scenario to treat the patient illness 5.
Selecting the ideal scale to be adopted is one of the controversial topics in which a practitioners and institutions can be involved in. Occasionally other services in the hospital such as clinical laboratory and clinical imaging values play an important role in the process of diagnosis of the disease and are counted in the risk scales making easier to have good standard of care. Scientific studies assess the statistical performance of these scales yield controversial results that sometimes distort or endorse these results 5. This is why the decision of the ideal scale is based first on the target population that physicians in charge will care of and select the appropriate scale or score that will be applied, to know the implications of the most representative age group of patients that will be attended and to use scales which data acquisition be a simple and quick task to perform6.
Based on that, the Royal College of Physicians of the United Kingdom headed by Bryan Williams and collaborators, and many other researchers worldwide have analysed a significant number of scales on the basis that the scale should use systems (track and trigger warning systems protocol) divided into three types. Single parameter systems, multi-parameter systems, total weighted scoring systems and combined systems 6.
The researchers came to the conclusion that the performance of these scales was better than those that conserve the third type of system, since not only the parameters are categorized but also those who develop the scale proposed management to be carried out in an easy, orderly scheme and logical within a framework of independent work or in addition to more robust strategies that involve management schemes within a hospital institutions - the so-called (Rapid Response Systems RRS) 7.
For Williams et al, the MEWS changed its name after being accepted by the Royal College of Physicians of the United Kingdom as the NEWS scale with its variables defined as (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, consciousness or new confusion and temperature). This score has been recognized and quickly adopted worldwide. The NEWS has an immediate applicability as a parameter of high sensitivity in the detection of clinical deterioration, despite its known low specificity. Thus inviting the attending physician to approach and reassess the state of the patient. The score makes changes in medical decisions according to the new conditions found during the patient’s assessment7.
This kind of scales must be endorsed internationally and be easily replicable by all practitioners who wish to adopt them. This allows other physicians to obtain results when implementing actions, reaching better clinical outcomes similar to clinical studies previously published. In the daily practice and clinical application we find different scenarios to use the scales, where the main problem of its application represent extra costs in lab test or clinical images and the time invested by the practitioners and medical personnel 7.
For this reason, the scales for clinical assessment should be easy and flexible to be implemented by any person, ideally for any member of the healthcare team to avoid barriers during the process of data acquisition. From this perspective, the scales that are based on easily collected parameters are the most appropriate, but they are often the scales that suffer the rigors of the biases when they are undervalued or overvalued, just the operability can be affected by personnel knowledge and skill.
The interesting thing about this exercise is to see that the people who have the most continuous contact with the patient, such as the nursing staff, physicians with the practice have the ability to use them in their practice and this would make the scales a valuable resource to perform clinical assessments and achieve the goal proposed.
In this new era where the reincorporation of a patient into daily life in a short time is ideal scenario, the medical and nurse staffs and also service providers seek to alleviate the patient's health breakdown. It is here from the hospital point of view where the proper care not only in the quality of care but also in the prevention of complications plays an important role in the applicability of these early detection scales. This is an invitation to success from its inception and to tend to patients being hospitalized for the minimum time required.
Like doctors in other specialties, general medical practitioners (GPs) are exposed daily to human suffering which most of society try to avoid.1 The World Health Organisation (WHO) predicts that by 2030 depression will be ‘the leading cause of disease burden globally.’ And that 1 in 4 individuals seeking health care are ‘troubled by mental or behavioural disorders, not often correctly diagnosed and/or treated.’2, 3 Doctors suffer from stress, anxiety and depression (as well as vascular disease, cirrhosis of the liver and road traffic accidents) more than the general population.4-10 Help for doctors is inadequate and doctors are reluctant to seek help.1, 4, 11 Where improvement is suggested, it is usually as counselling and general support.11 Instead of ‘more of the same’, we suggest a radically different approach: Adaptation Practice, which Clive Sherlock pioneered and has taught since 1975. It is pragmatic and safe. This study tests its acceptability to a group of working doctors.
Doctors bear the responsibility for fellow human beings’ health, well-being and, often, for their very survival. Added to this, GPs are under increasing pressure from more patients who want more cures and from health service managers who demand clinical excellence and more administration and more managerial skills of them. GPs’ stress is related to increasing workloads, changes to meet requirements of external bodies, insufficient time to do the job justice, paperwork, long hours, dealing with problem patients, budget restraints, eroding of clinical autonomy, and interpersonal problems.6, 10, 12 The recent rise in the GMC’s Fitness to Practice complaints related to patients’ expectations of doctors is yet another stress making them feel threatened.13
Job satisfaction for GPs is at its lowest level since a major survey started ten years ago, while levels of stress are at their highest. In 2015 there had been a year on year increase in the number of GPs reporting a slight to strong likelihood of their leaving ‘direct patient care’ within five years, with 53% of those under 50 and 87% of those over 50.6
By nature and vocation, GPs want to help but too much pressure is unbearable and takes its toll. They work, not with numbers, data or profits, but with human suffering, which, inevitably, is an emotional burden because of compassion and because it makes them aware of their own vulnerabilities and mortality. 3, 14 When combined with heavy workloads and low morale, doctors themselves inevitably suffer emotionally and psychologically.7, 10, 14 At the same time they and others feel they should be invincible.1, 15-17 What professional help is available for them is inadequate.3, 4, 18, 19 Existing support services in the UK are underfunded and sporadic.4 Some are outsourced to counselling services, and some of these are by telephone. Doctors do not like to be counselled and are reluctant to use these services.4, 15, 17
Doctors themselves are the mainstay for diagnosis and treatment of mental illnesses but are not adequately trained.3, 20 Mental illness is not well understood and conventional treatments are insufficient and often harmful. 15, 20-23 Consequently, doctors do not have the wherewithal to deal with the emotional and psychological problems they face every day in their patients and often in themselves, their colleagues and their families.4, 12, 18
There is significant prejudice, stigmatisation and intolerance of mental ill health within the medical profession due to lack of understanding and fear.3, 4, 9, 15, 17, 20, 21, 22, 24 This not only affects how doctors treat their patients, it also exacerbates their own difficulties when they suffer with emotional and psychological problems themselves, and dissuades them from self-disclosure and from seeking professional help.3, 4, 8, 10, 18, 20, 25, 26 To succumb to stress, anxiety and depression is seen as being weak and inadequate as a person and in particular as a doctor. 3, 4, 15 Doctors think they should know the answers and should be able to cope.1, 4
However, doctors are willing to learn work-related skills as this present study set out to show.11 Adaptation Practice is training; not treatment or therapy. The course in this study was presented as a postgraduate programme for doctors to learn how to cope with stress, anxiety and depression.
METHOD
Recruitment
We asked by letter all 314 GPs registered in one UK urban and semi-rural Health Authority Area if they would be interested in a course of twelve fortnightly seminars to learn the basics of Adaptation Practice: a programme of self-discipline to cope with stress, anxiety and depression. Included, was the Hospital Anxiety and Depression Scale (HADS). Those who responded and whose HADS scores were ≥ 8 (the threshold for anxiety and depression) were invited to the course.
Stress, anxiety and depression
Anxiety and depression were assessed by the HADS and stress by a simple stress scale (SSS – see Table 1) one month before training started, immediately prior to training, at three months (mid-way through the training) and at six months (at the end of training).
Table 1: The Simple Stress Scaledeveloped by Clive Sherlock and used to assess the level of stress in a subject. A total score ≥ 8, out of a maximum of 24 is suggestive of a disturbing level of stress or burnout.
I feel I am under too much stress: 0 hardly ever 1 occasionally 2 most of the time 3 all the time
I feel exhausted: 0 seldom 1 some of the time 2 much of the time 3 most of the time
I care about other people: 0 as much as I ever did 1 rather less than I used to 2 definitely less than I used to 3 hardly at all
I have lost my appetite: 0 not at all 1 a little 2 moderately 3 significantly
I sleep well: 0 most of the time 1 quite often 2 occasionally 3 not at all
I am irritable: 0 not at all 1 occasionally 2 quite often 3 very often indeed
I feel dissatisfied: 0 never 1 occasionally 2 quite often 3 most of the time
I feel run down: 0 not at all 1 occasionally 2 quite often 3 most of the time
Evaluation of Adaptation Practice
Half of those GPs who applied for the course were unable to attend because of prior commitments on the days planned for the course. These acted as a control group. Those who attended the course were the study group. All those who attended were also assessed in private by the authors immediately before and throughout the course. At the end of the course the doctors wrote anonymous self-assessments.
Training in Adaptation Practice
Those attending the course were taught not to express and suppress upsetting and disturbing emotion, not to distract their attention from it (including not to think about it and not to analyse it) and not to numb themselves to it with chemicals (alcohol, recreational drugs or prescribed medication). Instead, they learned how to engage with their moods and feelings physically, not cognitively, and how not to engage with thoughts about them. They were instructed to practise this six days a week with whatever they were doing, wherever they were. They were all offered unrestricted confidential telephone and e-mail support from the authors between training sessions and after the course had finished.
Statistical Analyses
The results are reported as means ± standard errors of the means. The scores were normally distributed and the data were analysed by analysis of variance with additional paired comparisons within periods, using the LSD method. Correlations were determined using Pearson’s correlation. The analyses were carried out using the statistical software programme SPSS 17.0 for Windows.
RESULTS
Recruitment
Of 314 registered GPs, 225 (72%) responded to our initial contact, and of these 152 (68%) said they would be interested in participating in the training course. Recruitment was restricted to those with HADS scores ≥ 8. Of the 225 who responded there were 71 (32%) for anxiety, 35 (16%) for depression, and 79 (35%) for both. 29 (13%) applied to attend the course. All were experienced GPs. 15 of these attended and 14 were not able to attend because of pre-existing commitments on the course dates. They asked for alternative dates but these were not available.
At the initial assessment (one month before the course started) there were significant correlations between the scores for anxiety and depression (P < 0.001), anxiety and stress (P < 0.001) and depression and stress (P < 0.001). At the second assessment immediately before the course started these correlations remained highly significant.
Effects of Adaptation Practice
All those who attended the course reported a subjective improvement in their abilities to cope with their own stress, anxiety and depression, and in their sense of well-being.
Anxiety
There were no significant differences between the control and study groups either one month before the start (P=0.949) or immediately before the first session (P=0.914). The anxiety scores in both groups remained greater than 8 at both assessments (Figure 1). At the mid-point of the course the mean score had fallen slightly in the study group (Figure 1) but the difference was not significant (P=0.652) By the end of the course the mean anxiety score in the study group was significantly lower (P=0.008) than that of the control group (Figure 1). The mean scores for anxiety decreased over the 4 assessments. This tendency was significant in the study group (P=0.002) but not in the control group (P=0.567).
Figure 1: The mean anxiety scores and standard errors of the means (SEM) for a control group and a study group of doctors with pre-existing signs of anxiety, assessed twice before, once during and once at the end of a six-month course in Adaptation Practice.
Depression
There were no significant differences between the control and the study groups either one month before the start (P=0.310) or immediately before the first session (P=0.880). The mean HADS scores for depression before training were all greater than 8 (Figure 2). At three months (the mid-point of the course) the difference between the mean scores in the two groups was not significant (P=0.631). At the end of the course the mean depression score in the study group was significantly lower (P=0.046) than the control group (Figure 2). The mean scores for depression decreased over the 4 assessments. This tendency was significant in the assessment group (P=0.003) but not in control group (P=0.689).
Figure 2: The mean depression scores and standard errors of the means (SEM) for a control group and a study group of doctors with pre-existing signs of depression, assessed twice before, once during and once at the end of a six-month course in Adaptation Practice.
Stress
There were no significant differences between the control group and the study group either one month before the course started (P=0.234) or immediately before it started (P=0.505). The stress scores were all greater than 8 (Figure 3). At three months (the mid-point of the course) the difference between the mean scores between the two groups was not significant (P=0.621). At the end of the course the mean stress score in the study group was lower (P=0.077) than that of the control group (Figure 3). The mean assessment scores for stress decreased over the 4 assessments. This decrease was significant for the assessment group (P=0.001) but not for the control group (P=0.425).
Figure 3: The mean stress scores and standard errors of the means (SEM) for a control group and a study group of doctors with pre-existing signs of stress, assessed twice before, once during and once at the end of a six-month course in Adaptation Practice.
Correlations
At all four assessments there were correlations among all three psychological parameters. At the initial assessment the correlation between anxiety and depression (r2= 0.405; P = 0.029) and between depression and stress (r2= 0.800; P < 0.0001) were significant but the correlation between anxiety and stress was not (r2= 0.253; P = 0.185). At the commencement of the course the correlation between anxiety and depression (r2= 0.479; P = 0.009), between depression and stress (r2= 0.765; P < 0.0001) and between anxiety and stress (r2= 0.486; P = 0.007) were all significant.
At three months (the mid-point) the correlation between anxiety and depression (r2= 0.526; P = 0.003), between depression and stress (r2= 0.622; P < 0.0001) and between anxiety and stress (r2= 0.790; P < 0.0001) were all significant and similarly at the and of the course: the correlation between anxiety and depression (r2= 0.604; P = 0.001), between depression and stress (r2= 0.577; P =0.001) and between anxiety and stress (r2= 0.740; P < 0.0001) were also all significant.
Assessments of the doctors’ psychological states and methods of coping
The doctors attending the course were assessed individually in private. They variously complained of stress, anxiety and depression. Notable findings included suicidal thoughts, plans for suicide, self-medication, excessive consumption of alcohol and an intention to leave the medical profession because of the unbearable pressures involved.
By the end of the course all these signs and symptoms had improved and the doctors felt confident in their ability to cope not only with pressures from outside but also with emotion, moods and feelings inside. One doctor still wanted to leave the profession but less adamantly than before, and stayed.
There was no qualitative assessment of the control group.
Qualitative Self-assessments
The anonymous self-assessment reports give meaningful, subjective accounts of what the doctors experienced individually. They fall into four main themes. There were no negative comments.
Connecting with emotion physically in the body
The following comments indicate contact with emotion:
‘I am more aware of my feelings.’
‘It is difficult to say “Yes” to unpleasant or upsetting feelings and situations. I have always preferred to avoid them and I have had a lifetime of suppressing emotions, so it is very difficult to say “Yes” to them, but this is what I am now doing.’
‘Since I’ve been more aware of my feelings there has been an enormous improvement in concentration.’
Developing inner emotional strength and coping.
A number of comments indicate the need to develop the strength to contain emotion physically in the body:
‘I am more accepting of daily stresses at work.’
‘I try to deal with problems instead of feeling so desperate and so wronged by them.’
‘I am calmer, and I lose my temper less often and less dramatically.’
‘The Practice was difficult initially because of my own resistances to it.’
‘I’ve always avoided seeking help for myself. I often feel worse than the patients I prescribe antidepressants for. I can now cope and I feel stronger but I don’t feel I’ve been treated and I now realise I didn’t need treatment: I needed to learn what to do and how to do it.’
Dealing with unpleasant, unwanted thoughts.
These comments illustrate the doctors’ new reactions to thoughts as they started to address the underlying emotion that normally drives worrying thoughts:
‘I now have less ruminations.’
‘As a long-standing ruminator I now realise these thoughts are the source of many anxieties. Thoughts were the main problem for me.’
‘I have learned to deal with obsessional thoughts by not giving time to them.’
General well-being.
The doctors commented on their sense of general well-being and ability to cope:
‘I am less tense and less anxious.’
‘I am now coping with episodes of work overload much better.’
‘I am feeling better generally.’
‘This has given me confidence to pursue the course of action I knew was correct.’
‘There are all-round improvements because of adapting myself to work and other people.’
‘I am happier and more content, optimistic and much less negative.’
DISCUSSION
Varying degrees of stress, anxiety or depression are universal.16, 26 Only about half of those thought to be clinically affected by these conditions seek help for them.26 If put into practice, sound medical knowledge and training can be beneficial to doctors’ own health.1, 11, 15 This does not seem to be true for stress, anxiety and depression.22 Too little is known about emotional and psychological problems, and treatment for them is inadequate.2, 9, 15, 17, 19, 21, 23, 28, 29
In this study, there was a high level of interest in how to deal with stress, anxiety and depression. Almost one third of respondents had scores on the HADS and SSS that suggested worrying levels of emotional and psychological problems amongst these working GPs. The fact that 152 doctors (68% of respondents) declared an interest in a six-month evening course (90 minute sessions after work on Thursday evenings) to learn how to deal with these conditions, suggests that:
stress, anxiety and depression are significant problems either amongst their patients or for the GPs themselves, or both
GPs are not confident in their ability to deal with them and want to learn more
although they have a strong tendency not to admit that they cannot cope and not to seek help, doctors are willing to attend a course to train and to learn.11
Most doctors tell their patients to seek professional help and to talk about their feelings but do not do so themselves.3, 5 They prescribe drugs for their patients that either the doctors will not take themselves or that they take but find ineffective. Of the 15 GPs on the course only one had mentioned psychological difficulties to a colleague and one to a partner and both only reticently. 16
ADAPTATION PRACTICE
Adaptation Practice strongly discourages self-disclosure, except in private to the Adaptation Practice teacher, which is necessary in order to assess the nature and severity of any problems and to lay the foundations for a rapport. Adaptation Practice sessions involve detailed discussion of moods and feelings as physical sensations and powerful forces that affect behaviour in all human beings. The ethos in Adaptation Practice is for participants to learn from their own experience how they are affected by emotion and how they can change this by containing themselves and not letting the emotion control them. It is not to criticise, judge, blame or condemn. Consequently, without the causes of stigmatisation, there is no prejudice and no stigma; instead there is respect and dignity and a pragmatic attitude to change.16
Adaptation Practice trains individuals to bear and endure upsetting, disturbing emotion by not expressing it, not suppressing it, not distracting themselves from it and not numbing themselves to it with drugs (alcohol, recreational drugs or prescribed medication). Bearing it this way develops emotional strength and resilience.
The high level of interest, the willingness to attend in groups and the positive results from this study indicate that Adaptation Practice is an acceptable way of teaching doctors how to cope with their own stress, anxiety and depression, that makes sense intellectually and emotionally. This, as well as the pragmatic approach mentioned above, makes Adaptation Practice radically different from other approaches.
GENERAL COMMENTS
Given that those who could not attend asked for an alternative day to attend, gave us reason to assume that the manner in which the study group and the control group were selected – individual availability on a given week night – would not have biased the sampling procedures and it seems reasonable to assume that the two groups did not differ in any meaningful way that would have biased the outcome.
Not surprisingly, there were strong positive correlations between anxiety and depression and between depression and stress on all assessments and between anxiety and stress on all but the first assessment, suggesting a strong association among these parameters of psychological states.
The mean scores for anxiety, depression and stress fell significantly in the participating GPs compared with the control group. The subjective reports from both the medical assessments and the self-assessments support these changes in the study group.
This study begs a number of important questions:
if doctors are prejudiced and stigmatise mental illness amongst themselves then what are their conscious, or unconscious, attitudes to mental illness in their patients? 3, 5, 9, 24
if doctors cannot cope with emotional problems themselves then whom are they and their patients to turn to for help? This is not the same as doctors suffering from physical conditions requiring surgery, or medications such as insulin or antibiotics.3, 5 Doctors expect, and are expected, to be able to cope with their emotions and, if necessary, that the treatment they give their patients will also work effectively for themselves
what are doctors to do and what are their patients to do, when doctors succumb to their own moods and feelings?
Adaptation Practice could be integrated in the medical curriculum at undergraduate and postgraduate levels, including Continuing Professional Development (CPD). Not only GPs but all doctors and other healthcare staff (nurses, physiotherapists, occupational therapists, social workers, etc.) could develop emotional resilience – which the GMC have proposed in recent years – and a better understanding of emotional and psychological problems and mental illnesses.
It is hoped that this preliminary study will stimulate and encourage a new way of looking at and investigating emotional and psychological problems and lead to further evaluation of Adaptation Practice.29, 30
With adequate training doctors and psychologists could teach Adaptation Practice.
Poetry is a way of expressing the subjective experiences that spill over the rational mind and it permits spontaneous overflow of subjective feelings. The ability to express oneself through poetry, and share that experience, is one of the unique human experiences that distinguish us from lower biological forms. The strife and struggle of modern men have made them miserable wretches on the face of this beautiful cosmos, and the technological revolution has taken the poetic sense from them; a time old coping mechanism. Those not capable of expressing their own sorrows and joys of everyday life in poetic words could find a surrogate writer in The Gushing Fountain.
In his collection of poetry, Dr Latoo (who is currently working as a Consultant Psychiatrist in United Kingdom) has catered poems for every mood and occasion: love, parting and sorrow, inspiration, rapture, memory, nature, solitude, and contemplation. Some of them are deeply personal and the author is trying to unearth a time capsule he had left in his native country of Kashmir. Dr Latoo appears to be searching for inner truths and making a self exploratory pilgrimage in his collection of poetry. Poetry has the power to describe and dramatize one’s own life, and Dr Latoo has done it well. The themes generally move from childhood to old age, love to grief, sorrow to joyfulness, aggressive nationalism to corrupted politicians, and depression to psychosis. There are pearls of mystical wisdom embedded in the poetry:
“Be choreographed by a great master for our sustenance Rather than just be a part of random unplanned accident?”
There are wise statements in “Divine Justice”:
“Anything like fatalism shall be a contradiction Of the Divine justice, free will and Lord’s will.”
All poetries have some hidden messages, and the book as a whole stands for immense moral values. “Woman” stands for women’s rights and dignity. The thoughts about the forgotten orphans are heart touching. “Behold a Man - Judging others” points towards the fallacy of judging other people without correcting oneself. Mental health professionals are particularly prone to this error because they are often professionally bound to assess their clients; we are only supposed to assess others and not judge others. We should not even judge ourselves, but only do self-assessment - God is the only Judge. The author writes about very ordinary humble human beings like the barber, Rupa, Ayesha, Ahmed, Puja etc. “Marriage” highlights the sanctity of wedlock. These poetries reflect the world view of the author. “Hold fast to thy dreams” may be inspired by Langston Hughes (1902 - 1967) and reminded me of my father who liked the verses of Hughes on dreams. “A raven who wants to be a dove” refers to people who pretend to be what they are not - wearing borrowed garments.
There are also poems about the author’s travelling experiences. A century ago, if a poet wrote about airport, he would have been frowned upon by the peer group, but in the 21st century it is appropriate to write such poetry. “Noisy airport and my mind” illustrates the hustle and bustle of contemporary life and gives the book a modern flavour. “By the Dal Lake” is nostalgic and the author is trying to recapture and share his lost Kashmiri literary Empire with the readers. Born in Kashmir, there is no surprise that the author renders beautiful nature in his poems. One wonders, if William Wordsworth were born in Kashmir, what would have been the content of his writings. Dr Latoo’s dual identity is evident when he writes about Kashmir and London.
In these days of global union through mere technology, poetry may have a serious role in the “international soul-union.” The days of regional poetry are over. Poets like Dr Latoo may be able to contribute to the formation of a healthier global village; poetry penetrates beyond the psychic realm into the spiritual dimension. There is a mission of peace and love in the Gushing Fountain, and the author is not enforcing any strong convictions on the readers. There is a poet-philosopher in the author of the Gushing Fountain.
The author has used rhyming and free verse styles of poetry. Metaphors and similes are appropriately embedded in various situations:
“A smile on our face blooms the gardens of her innocent soul A tear in our eyes arises from the blood of her bruised heart.” (From the poem, “Mother”)
Lyrical poetries are ravishingly harmonious and there are no repetitions. The thoughts are clear and there is an exotic element in all the poetry. On the whole, all the poems are cerebral and riveting. The works are relevant to the present century and can be appreciated by scholar and casual readers alike. Every poem is an experience to be savoured and memorised. Let these pieces of poetry echo and reverberate not only in the conflict-ridden valleys of Kashmir, but all around the world until they find rest in the minds of the waiting millions.
Psychiatry is going through an identity crisis because the newer medications are not as effective as expected to be and clinicians are turning to different forms of psychotherapy. Poetry/lyric therapy could be another form of psychotherapy that needs attention in the field of soft psychiatry. Dr Latoo’s book could be an inspiration and encouragement in this line of treatment. Hypnotherapists readily recognize that words are like loaded bullets and are highly potent. To an extent, poetry therapy involves the principles of both hetero- and self- hypnotherapy. Primitive and modern religions take advantage of the potentials of different forms of poetry in religious rituals for healing and promoting health.
A study of the mechanism of poetry writing is helpful in developing better conceptual models of creativity and deeper understanding of mental process. Sudden flashes of creative insight and other intuitive leaps, which arise from states of mind through intermediate steps that remain hidden beneath consciousness, and such ultrafast processing involving a concealed intermediate step, is consistent with quantum computations. A poet who enjoys superior mental health is capable of swinging from the unconscious quantum logic to the classical logic of consensus consciousness with an ultrafast speed. In psychotic states, “the quantum gates” do not shut swiftly as in normal mental states and the sufferers get trapped in the quantum logic. The usefulness of poetry therapy in psychotic patients, who get stuck in the quantum logic of the unconscious mind back to the classical logic of ordinary consciousness, needs further analytical studies. The primary aetiology of psychotic disorders may be biological, but secondary symptoms are quantum-linked and the new generation of psychotherapists have to learn the quantum meta-languages to communicate with psychotic and depressed patients. Poetry is such a source of quantum meta-language.
Poetry therapy promotes abstract thinking and develops imaginative powers. It is also a means of relieving and revealing innermost sentiments; it helps to ventilate overpowering emotions and hidden tensions. It is a form of self-expression and aids to build greater self-esteem; useful in strengthening interpersonal skills and communication skills. It would be valuable in repairing the assault of psychosis on the personalities of the sufferers. Quoting from my own memory lane, I became interested in poetry therapy when I comprehended the core problem of a patient who wrote:
“Moon, you shine at the centre of the sky, Catching attention from all over the world, Don’t you know that I am lonely?”
Poetry is of the heart and imagination whereas science is about reason and logic and may be grounded on contradictory principles. If science is about objectivity, poetry is essentially about subjectivity and to blend those human experiences harmoniously is a hard task; Dr Latoo has successfully achieved this goal. A man of science, when he writes poetry, has to liberate himself from the shackles of rationalism so that he can be a wholly free human: to be a poet one has to be a natural human being. To quote from Jean-Jacques Rousseau: “Man is born free and everywhere he is in chains.” Let us hope that the Gushing Fountain will have a part two and even more!
Once upon a time there lived a quite wealthy young man - in the sense that he was quite smug and comfortable, never really wanting for anything. ‘Wealthy people don’t have to concern themselves about others or indeed material matters, he used to say to himself, blissfully unaware of the dramatic irony in his statement. He had tons of clothes (which made it difficult to decide what to wear each day), lived on his own in a big house almost the size of a mansion, went on lots of holidays to exotic places, ate in the best restaurants, and by all accounts had no worries whatsoever. He was a man of modest intelligence, quite tall and stout with an arrogant (or should I say confident) manner. He could quite easily win an argument because he would literally wear his opponent down with the ferocity of his delivery, even though it bore little substance. 'I could be a politician because I am so good at debating sensitive issues which affect ordinary people, he would reflect when on his own, which was frequent.
His parents had so much money (from their banking business) to fritter away and therefore had no trouble finding him a suitably big house (almost as large as a mansion as stated) in a fashionable area of London. He also owned a house in Richleymanor, a wealthy, prosperous suburb of Richleyshire. ‘Because I have no worries and am in perfect health', he said when he was only 16, 'I am going to become a doctor and heal people who are not rich enough to see me privately and who are a million times less fortunate than me.' Such was his altruistic spirit. And so he studied as hard as he could because he had to (he was not the brightest card in the pack). With the help of his parents' influential circle of friends in the whole of Richleyshire who knew people in high places, he managed to secure a place in an elite medical school where only top doctors were trained - even though he did not possess any outstanding qualifications on leaving school. But that sort of thing doesn’t really matter if you possess an altruistic spirit. 'I mean', he reasoned, – 'Lots of famous people (including entrepreneurs) did not pass their final school year exams with Honours and I am just like them in that respect - really down-to-earth, a man of the people.'
On the first day of entry to the Royal Breedington University Medical School he was already planning his future career. Not for him the humdrum life of a family doctor. No - he was aiming for prestige and acclaim. He did not need the money though extra money would help 'because you can never have enough, especially if you want to help others less fortunate than yourself', he would say to himself. Such was his determination. 'Should I become a great brain surgeon', he pondered one evening. Should I become an eminent cardiologist or a revered obstetrician? You see, for him it was not enough to be an ordinary doctor - one had to be special in some way. These careers and others (the field of Medicine is huge) he considered. Then one day he decided: 'I know now what to do'; I will get my basic qualifications out of the way and then embark on a career in Mentalology - a subject which was gaining great interest in the popular press. Even students at the University were talking about it. It was a higher degree than Neurodevelopmental Psychobabble (another much sought-after career, normally the reserve of doctors studying cerebrotherapy). So after lots and lots of postgraduate courses in Mentalology he finally passed the higher degree, becoming a member of the Royal College of Mentalologists (MRCM), spent 5 more years in training and became a Consultant Mentalologist at a very prestigious hospital, one which had links to a university, as it happened. His ultimate ambition was to become a Doctor in Medical Politics because he wanted to be in charge of doctors and patients but without the encumbrance of having to care for patients per se or to actually meet doctors. Not for him the drudgery of life in a hospital or general practice – no - one needs to earn as much as possible by doing the least work, rather like Business Executives, he would ruminate.
Initially he enjoyed seeing a few patients here and there as par for the course, but because he felt he was a very important doctor, he needed to move up the ladder to the higher echelons, managing other doctors who might in turn benefit from his great wisdom and enormous insight, accrued in just 8 years training! He decided that he was too important to be seen hanging around hospital wards or in the outpatient department and so spent nearly all his time in the library and at meetings, apart from breakfast and lunch. He always had breakfast in the hospital canteen to show he had the common touch, and sometimes he would make a point of staying on longer after lunch in order to mix with other not-so-important doctors, who would laugh and grovel obsequiously at his every spoken word. Then suddenly he was off, and would be seen bustling and rushing through the canteen doors on his way to a very important event at the prestigious headquarters of the Organization, where he would sit three seats away from the Lord High Superexecutive Chief of the Organization (LHSCO), a very long title indeed but when one is important one usually has imposing if not long titles. Such was the circle the very important doctor was mixing, it explained why he was hardly ever seen in the hospital outside lunch hours or breakfast. Because, you see, in his estimation or rather esteemed opinion, if one is not around much then one must be a very important person indeed.
Sometimes he was seen rushing off to other very important meetings at a top-class hotel where there would be a special Conference Room; sometimes he was at meetings all day. However, often it was difficult to find out exactly what he was doing or where he was because many of the meetings were high level top-secret meetings; for example, a Superexecutive meeting lasting a whole hour might have on the agenda a motion to close down the hospital outpatient department because patients were costing the Organisation too much money. That superfluous-to-requirements money could be better spent on holidays and pay rises for other but not-so-important medical chums as well as serious-minded managers who in turn might do him a favour later on. 'You never know what's around the corner', he always used to say in one of his contemplative moments. The Organization often talked about very big issues such as Doctor Management Downcasting (how to keep those grasping medics in line) and Patient Empowerment, even though patients were never included in any discussions about where they would go when their hospital closed down. Sometimes meetings would extend until the early hours of the morning, which suited the very important doctor because he had no family to worry about or other personal commitments and could come and go as he pleased. Others had to stay on at the very important meetings regardless of their personal circumstances. Sometimes he was so exhausted attending meetings he would spend the following afternoon on the golf course relaxing before attending another evening conference. 'I don't know how he does it', his reverential colleagues would mutter, in hushed tones. 'He deserves another award for taking time off to recharge his batteries for the next meeting'. 'It is quite astonishing how much energy some people have', he would say contentedly to himself.' 'What would the Organisation do without someone of my great leadership skills’?, he asked himself many times in a semi-congratulatory tone.
Nothing would deter the very important doctor from achieving his goals and pleasing the Organisation. After all, this was the way to the top of the medical hierarchy – Doctor of Medical Politics (DMP) and Chief Scientist and Supervisor of the Faculty of Mentalology (CSSFM for short) was his goal. First he set out some decrees or edicts. These would all come under the rubric 'Management Directives', or put in another way, informing his colleagues in a polite but firm manner how he would delegate them to do ‘this and that', and therefore no one would blame the very important doctor for say, dismantling any part of the service; besides, his sheer tenacity and doggedness (character traits which he had cultivated from his seniors) gained him further admiration from the legions of subdoctors (doctors who were under his control) who had to yield to his commands. He would sometimes act very humble when questioned about his ruthless tactics and would feign innocence (or was it impotence) in the face of criticism. No, it was the Organization 'calling the shots', as he used to describe it, callously ignoring the plight of his colleagues and patients.
It was strange that he could never recall or at least did not seem to know any of the names of people in the Organization who were responsible for the targets to be achieved. 'Anyway, most patients are not really ill, they just complain and they can jolly well go back to their own general practitioner if they want to bother someone', he would argue in one of his rare insights into the human condition, particularly when colleagues challenged him. His doctor 'associates' (he could never really truthfully call them friends) were stupefied by his perspicacity and visionary zeal and were in no doubt that in order to achieve a change in their practice it was better they were paid less and worked more intensely between 9am and 5pm. They could come in earlier or stay later if they wanted to of course, but no extra money was available for overtime because it was costing the Organization thousands of pounds annually. Best to give the bonuses to those who really deserved them - those Manager Doctors who were extremely busy writing protocols about Best Practice and Risk Assessments - real life-and - death issues, and spending at least 4 hours every six months at very special high-powered meetings drafting 'outcome protocols'. So many emails to send out. This agenda was 'all in a day's work' for the very important doctor who needed to supervise this superhuman task in between meals.
But even the very important doctor himself needed resources and time to carry out all this work. 'I know what', he said to himself one bright sunny Sunday morning on the golf course, - 'I will reduce the amount of time doctors spend seeing patients and cut costs further in this way for all those dedicated doctors because dedication is costing too much'. One hospital in-patient could cost the Organization £1000 a week, even more. 'The doctors can still attend meetings in the hospital (no costs incurred) and do extra administrative work.' 'The bonuses will only go to those who have achieved a special distinction in doing the work of Managers and follow the party line'. 'Yes, that's the way forward', he thought to himself, in one of his rare flashes of brilliance. 'From now on doctors will only have to work 9-5pm'. 'The on-call commitments can be covered by NHS Indirect', the latter being a new company set up to replace doctors and nurses at night-time and weekends, usually manned by staff from one of the local supermarkets. Surgeons would be then free to down tools at 5pm instead of wasting time (and the Organization's money) battling through endless hours of unnecessary exhaustive operations such as cardiac bypasses or hip replacements, which could easily be carried out in the patients' homes anyway. Psychobabble experts could use tick-box rating scales or instruments to assess new referrals (no need to see patients, too costly).
There is no way to describe the tumultuous reception these ideas received at the Managers Annual Conference in Bristol, and the very important doctor received even more accolades. In fact, he was considered for a Rhodium Medal, the highest award in the land given to any doctor. Before being conferred with this precious and prestigious medal (because it can only be worn around your neck, or else it lies on the mantelpiece where nobody really notices it) he was given two lots of pay rises - one for services to the Organisation, the other for keeping the common grasping subdoctors in line by forcing them to sign in and out of work every day and by reducing their salaries. After all, there were rumours that the grasping, greedy subdoctors were beginning to think that perhaps the very important doctor was becoming too very very important. But they kept quiet in any event.
His great achievement was the setting up of SCRAP (Strategic Commission for Rapid Abolition Programme) which set out a one-year plan of how to prevent any patient being seen by a doctor. The patient could be seen by any number of people, from the tea lady to the hospital porter, who were already working flat out on the minimum wage. At least they were not so expensive to keep on the pay roll. The next brilliant idea he concocted was to replace the word 'patient' with 'customer'. 'Patient', he did not like. It gave the impression that someone was ill and needed to see a doctor. But with the New Opinion About Hospital Patients (NOAHPS in short) charter, the word 'patient' did not fit the profile of an enterprising Organisation and so NOAHCS (New Opinion About Hospital Customers) sounded much better. All staff were thence ordered to use this terminology or face the consequences. It was rumoured that it was a sacking offence to use the word patient. He even sent an email to the same effect around the whole Organisation. No one spoke out for fear of reprisal and possible instant dismissal. He was applauded at every Organization meeting from that time on and was rewarded by being given Freedom of the Hospital. This meant he did not have to do anything really - just walk around shaking hands with everybody, telling them what a great job they were doing, and so forth. He used the phrase 'Congratulations on a job well done' as many as four times a day to different staff in the hospital. In private he would be irritated because he had to praise other people for what he truly believed were his achievements.
By the end of each week he was so exhausted from sitting on comfortable chairs (some were so comfortable it was a real effort to get out of them) at the many meetings he attended that he would fly off to some far away country for a rest, though of course would endeavour to find out how that country dismantled its health service. Because of his enterprising attitude on behalf of the Organization these trips would be paid for and the very important doctor would not have to spend a penny. 'I deserve it because of all the hard work I am putting in', he used to say, to justify his huge salary and the enormous expenses paid for by the Organization. 'They obviously think very highly of me.' Besides, they know I would get a better salary elsewhere if they did not pay me such gigantic sums of money here', he would rationalise. But this suits me for the time. I have a big house in London near the University and an even bigger house in Richleyshire where I can play golf on the weekends and charge all my expenses to the Organization, even the Golf Club fees. 'Why not? Politicians were doing it', he would argue, in a rare utterance of cognitive dissonance (or pangs of conscience others might think) a term he had picked at one of the many important half-hour psychology conferences he attended (he was much too busy to stay to the end of any conference.
As time passed he was beginning to think he needed a higher salary because time off and holidays were costing him money (domestic shopping, clothes, food, heating bills) despite the freebies. During his days off he would spend lots of time going to museums, visiting the theatre, eating in expensive restaurants and staying in luxury hotels not too far from home, say 10 miles or less. However, for him a real holiday was travelling abroad in a first class seat on a prestigious airline to faraway places. This gave him an edge over his less wealthy colleagues and he would often spend hours on his return recounting his great adventures and experiences abroad in exotic lands. 'He is so broadminded and well-travelled', his managerial associates would say with a feeling of unrequited envy. It is quite remarkable how he manages to be in so many places at the same time - if only he could do the same at this hospital, we would be top of the League Tables for Hospital Risk (LTHR) and gain the recognition we deserve'. 'For all his hard work spent travelling abroad researching better ways of closing down wards and hospitals he now deserves a huge rise in salary'.
And so it came to be. The very important doctor was given an extra allowance (EA for short) worth half his salary and a Credit for Working Hard Allowance (CWHA), both linked to his pension. He was also given a bonus allowance (BA) for sitting twice yearly on a Doctors Work Review Panel (DWRP) set up to deal with those doctors who were not pulling their weight or taking more than one day sick leave or 2 days annual leave at a time. Study leave had already been dropped because the very important doctor argued that if he did not need study leave then no one else did. Besides, ‘Who needs study leave when you can look things up on the internet – even how to carry out open heart surgery’. He would argue. Commitment to the Organization was his raison d'être.
And so it continued. After 10 years nearly all the patients had been discharged from the hospital and family doctors were sending them elsewhere into more luxurious, expensive, private hospitals for 'reviews, assessments, and second, third, even fourth opinions'. The Organization would pay for all this from the money it saved closing down the local hospital. This was the very important doctor's finest hour and for his services to the Organization he was awarded the Rhodium Medal at the Annual Convention of Supermanagers Conference. This award was inevitable, given all the time both home and abroad he had invested in this venture. Now the entire hospital could be closed down thereby saving the Organization millions of pounds.
However, there was a problem with this way of operating, he began to think: ‘If the hospital were to close down there would be no need for an Organization to run it. There would be no management posts and my post as MDP and CSSFM might be superfluous to requirements. 'I know what I will do' - he decided - 'When that happens I will apply for another post in a different Organisation and I am sure I will be successful given all the accolades I have received, and when that Organisation closes down with my help I will get an even bigger salary and move on to the next post' - maybe Minister for Health?
Doris-Eva Bamiou is a Department of Health HEFCE funded Senior Lecturer at the UCL Ear Institute, and Consultant in Audiovestibular Medicine at the National Hospital for Neurology and Neurosurgery. She is also Honorary Consultant at the RNTNE Hospital and Great Ormond Street Hospital. She sees both adults, with vertigo, hearing problems or auditory processing disorders, and children with auditory processing disorders and complex communication needs in her clinics. She works in an academic, multidisciplinary environment.
After completing specialty training in ENT in Greece, Ms Bamiou trained in Audiological Medicine in the UK. During her training, she spent a three-month fellowship in Professor Musiek’s department in the States (on a stipendium from Professor Musiek and a grant from the TWJ foundation), where she trained in the diagnosis and management of patients with auditory processing disorders. Her PhD degree is onauditory processing in patients with structural brain lesions.
She is Director of the MSc in Audiovestibular Medicine at UCL. In addition, she has been Director and Organiser of the Current Trends in Auditory Processing Disorders instructional courses for the past several years. She is immediate past Secretaryof the British Society of Audiology (BSA), and Chair of the Auditory Processing Disorders Special Interest Group of the same Society. She is adviser in Audiology to the JLO, and in the Editorial Board of the Audiological Medicine journal.
She has a keen interest in research. Interests include the aetiology of hearing loss, auditory processing disorders in the presence of other neurological conditions as well as in the normal population, auditory neuropathy, vestibular rehabilitation and overlap between psychiatric and vestibular disorders.
How long have you been working in your speciality?
I first became interested as an ENT trainee in Greece, in 1993. At the time I was at a paediatric hospital, and we did a lot of paediatric testing (distraction and ABR). In 1994 I moved to an adult hospital, where I came across and learned to test and manage adult patients with vertigo and hearing loss.
Which aspect of your work do you find most satisfying?
Solving clinical problems, teaching postgraduate students, designing research projects and interpreting research results give me equal satisfaction – I enjoy equally the patient/doctor or student/teacher interaction and the intellectual challenges.
What achievements are you most proud of in your medical career?
I set up the first adult clinic for patients with auditory processing disorders at the National Hospital for Neurology, and the first multidisciplinary clinic in this field, again at the same hospital.
Which part of your job do you enjoy the least?
Administration and form filling exercises.
What are your views about the current status of medical training in your country and what do you think needs to change?
I wonder whether trainees get enough proper training in their very early days on and whether the length of the training is sufficient for them to be able to function independently by the end of their training.
How would you encourage more medical students into entering your speciality?
We do Audiovestibular Medicine Taster days, and we encourage them to come and “shadow” us to see what it is really like.
What qualities do you think a good trainee should possess?
He/she should be kind, hard working, highly motivated to learn and able to develop independent thinking.
What is the most important advice you could offer to a new trainee?
It may be hard work training as a Doctor, but it’s all worth it!
What qualities do you think a good trainer should possess?
Amongst many other things, empathy, and the ability to teach each trainee at their own level.
Do you think doctors are over-regulated compared with other professions?
Not more than is required.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what shouldbe done to counter this trend?
I think it is difficult to reconcile managerial activities with a doctor’s role.
Which scientific paper/publication has influenced you the most?
Several. I tend to read a lot of papers for lectures etc so this changes every few weeks!
What single area of medical research in your speciality should be given priority?
I could not separate one more than others.
What is the most challenging area in your speciality that needs further development?
Rehabilitation (auditory and vestibular) of the patient with complex needs.
Which changes would substantially improve the quality of healthcare in your country?
More funding and more rationalized use of free NHS services, depending on the patient’s income.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
Yes, by working closely and by educating managers.
How has the political environment affected your work?
Not at all.
What are your interests outside of work?
I read a lot of books of every kind, I go to the theatre and to art exhibitions.
If you were not a doctor, what would you do?
This will sound very boring. I would still like to be a doctor!
Robert Moots is Professor of Rheumatology at the University of Liverpool and Director for Research and Development at the University Hospital, Aintree. He is also a Consultant Rheumatologist at the hospital.
He graduated from St Mary’s Hospital, London University in 1985 and also worked at Harvard Medical School. He became a Consultant Rheumatologist at University Hospital Aintree in 1997 and the youngest full-time professor of Rheumatology and Head of Department in 2003.
Professor Moots has published extensively in rheumatology, winning the prestigious Michael Mason prize for rheumatology research. He advises the UK Department of Health and NICE. His research interests are inflammatory rheumatic diseases, in particular innate cellular immunity in rheumatoid arthritis, immunotherapy, new therapeutic targets and clinical trials.
How long have you been working in your speciality?
I’ve been working as a consultant in rheumatology since1997, when I returned to the UK from the USA. Of course I was a trainee in rheumatology for a few years before then.
Which aspect of your work do you find most satisfying?
Its hard to single out any one thing. The great fun of being Professor is that no two days are the same. My job varies so much from looking after patients, to teaching, running research and also communicating and sharing research findings with other clinicians and scientists throughout the world – giving me the opportunity to visit countries, where I would not normally have visited.
What achievements are you most proud of in your medical career?
Clinically, I often deal with rare rheumatic diseases, or situations where normal treatments have failed and other doctors have said there is “no more that can be done”. Each patient that I see in this situation, who then goes on to recover and have a normal happy life, gives me a great satisfaction. Academically, building up a successful research team of talented individuals in Liverpool, the first academic rheumatology unit in that city, has been a great privilege.
Which part of your job do you enjoy the least?
Trying to balance the demands of patient care with the many other calls on my time can be rather wearing. But nothing is worse than the ever expanding administration tasks and bureaucracy!
What are your views about the current status of medical training in your country and what do you think needs to change?
When I visit other countries to lecture, I always try to see how medicine runs there. I attend clinics and hospitals, see patients and learn how practice compares to the UK. I am pleased to note that the standard in the UK remains amongst the highest of all countries.
How would you encourage more medical students into entering your speciality?
Its hard to image why students and doctors could consider any specialty other than Rheumatology! Rheumatology provides the opportunity to see patients of all ages, develop a close rapport with patients as the diseases tend to be chronic and prevalent, perform cutting edge research to understand pathophysiological process underlying the diseases and access drugs that can make a revolution to lives with great outcomes.
What qualities do you think a good trainee should possess?
Be keen to learn, open, honest and bright. I also like trainees to challenge accepted wisdom – a considered critical approach is needed to move things forward and to keep us on our toes.
What is the most important advice you could offer to a new trainee?
Don’t accept non-evidence based dogma. Don’t learn bad habits. Be critical and try to improve things. Try to spend some time away from your unit and ideally out of your country – seeing how medicine works in other environments to get life and work in a better perspective.
What qualities do you think a good trainer should possess?
Good trainers should be excellent clinicians, inspirational leaders and listeners with patience. If you know someone like this, you should really treasure them!
Do you think doctors are over-regulated compared with other professions?
No – but I fear that we are getting there in the UK.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what shouldbe done to counter this trend?
With a recent change in government in the UK and major changes to the Health Service planned, it’s a little too early to tell. We have to be vigilant though.
Which scientific paper/publication has influenced you the most?
For much of my working life, I was focused on the T cell as the major driver for diseases such as rheumatoid arthritis. The paper that changed that was: Edwards SW, Hallett MB. Seeing the wood for the trees: the forgotten role of neutrophils in rheumatoid arthritis. Immunol Today.1997 Jul;18(7):320-4. This crucial paper from Steve Edwards, the world leader in neutrophil biology opened my eyes to a whole new field of work. I didn’t know at the time that I would eventually have the privilege of working with Steve.
What single area of medical research in your specialty should be given priority?
That’s an easy one – it should be whatever my group are working on at the time.(I just wish that were the case!)
What is the most challenging area in your specialty that needs further development?
Many rheumatic diseases such as rheumatoid arthritis can be treated extremely successfully (with patients enjoying a full remission) if they can access the right drugs at the right time. There is still much variability in time to diagnosis and in provision of appropriate medications – the challenge is to ensure that best practice can be rolled out more effectively.
Which changes would substantially improve the quality of healthcare in your country?
There needs to be a greater understanding of the importance of rheumatic diseases in the UK. These conditions are prevalent, may cause significant morbidity (and indeed mortality), cost the nation considerably in reduced productivity and in disability payments – yet many of these conditions can be treated most effectively.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
Its crucial that doctors are fully engaged in management. We are in the best position to be advocates for our patients but cannot do this effectively without understanding the health care system and take the lead in ensuring this works for the best.
How has the political environment affected your work?
The consequences of the recent change in Government in the UK are likely to be considerable for the National Health Service. This will involve major changes to the work of staff at all levels. It is too early to know the full extent of this – but we all wait with trepidation
What are your interests outside of work?
With so much to do, its hard to find the time for much else apart from relaxing with my family. I travel a lot and especially enjoy taking my children with me. My 10 year old has heard me lecture so much that I suspect she can give my talk for me (and do it better). She has also taken to asking questions at the end of my lecture, which always scares the chairperson of the meeting!
If you were not a doctor, what would you do?
I’m not sure that I would be fit for anything else!
Dr James Moon is a Senior Lecturer and Consultant Cardiologist at UCL and the Heart Hospital. He set up and runs the cardiac MRI department dividing his time between clinical practice and research.
He is part of a team of 5 research fellows in the new Heart Hospital Imaging department. He is interested in understanding the structure and function of the heart, particularly the heart muscle, and in detecting abnormalities of the heart to better target treatment.
How long have you been working in your speciality?
12 years (3 as consultant)
Which aspect of your work do you find most satisfying?
The creative aspects of research - joining the dots on information that does not fit and constructing a coherent body of work.
What achievements are you most proud of in your medical career?
Changing statin prescribing in England – as a registrar, I did not having access to cardiac MRI for 2 years and I worked relentlessly at all levels of the healthcare system –including up to Commons Health Select Committee - on this with the result that £1billion was saved or diverted to treat more individuals with statins – the UK now has the highest uptake of statins for primary prevention in the world.
Developing new ways of detecting different types of disease with MRI or CT scanners – in its latest iteration, we may be onto a technique that can measure a fundamental process common to most diseases and organs – not just the heart, and with CT as well as MRI: the volume of cells, fibrosis and their ratio.
Which part of your job do you enjoy the least?
New bureaucracy which we did without just a few years ago..
What are your views about the current status of medical training in your country and what do you think needs to change?
I worry about a tickbox ‘learning portfolio’ culture which dumbs down initiative and personal responsibility leaving a misplaced sense of entitlement.
How would you encourage more medical students into entering your speciality?
I’ve not seen the need to – cardiology is a fantastic, over-subscribed specialty with something for everyone so its pretty competitive.
What qualities do you think a good trainee should possess?
The same as those of a doctor. I have never seen this trainee:consultant divide; there is a continuum of learning and responsibility development.
What is the most important advice you could offer to a new trainee?
My advice is about learning rather than being a trainee. Medicine does not have that many raw facts to learn. What it does have is interconnected systems. Rarely consciously try and learn information – rather, try and link everything you have ever learned together, preventing isolated islands of knowledge. It takes longer to create the story, but you will never forget it and it’s far more rewarding. If you encounter something new - a tricky JVP waveform, an ECG repolarisation abnormality or some esoteric MRCP clinical sign, invoke your know of the physical world and apply it to explain the new phenomena – write the essay, deconvolute the phenomena and build it back up, perhaps with subtle changes to see where that gets you. You have spent decades learning about the Krebb’s cycle, anatomy, electron transport, fractals, Newtonian dynamics, Brownian motion, fluid dynamics, conservation of energy, entropy, cell structure, evolutionary biology, statistics etc etc – use them.
What qualities do you think a good trainer should possess?
I am not sure I know, but generating enthusiasm in people, and then rewarding and promoting it - that’s a good starting point.
Do you think doctors are over-regulated compared with other professions?
No.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what shouldbe done to counter this trend?
It’s the effects on individuals that concern me. I fully understand the need for process, protocol teamwork and hierarchy, but these remove individual responsibility
Which scientific paper/publication has influenced you the most?
The non-medical maths/science/philosophy books and magazines I read at school and university. I particularly remember Martin Gardner recreational maths books. Recently I have used fractals and the concepts behind trapdoor ciphers in my understanding of cardiology.
What single area of medical research in your speciality should be given priority?
Prioritize individual researchers/teams rather than topics to create progress through their enthusiasm and own perceptions of priorities.
What is the most challenging area in your speciality that needs further development?
Managing our increasing technical capability which comes with ever reducing incremental benefit.
Which changes would substantially improve the quality of healthcare in your country?
I would overhaul the way society pays for and develops drugs. I would focus on increasing drug company reward for the risk associated with genuine innovation whilst reducing reward for expensive ‘me too’ drugs with no added value. My group estimated that about 10% of the NHS drug budget could immediately be reallocated improving societal value for money in prescribing, paying for all those much needed NICE decision cancer type drugs and concurrently turbocharging rather empty pharmaceutical drug development pipelines.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
Absolutely. If you have transparently good and altruistic ideas, are selfless about who gets he credit for them, and sufficiently driven to achieve results, the NHS is a wonderful place - its like a demagnetized iron – apply a sufficiently persuasive external field, and the domains line up, generating far more force and direction than expected.
How has the political environment affected your work?
The UK has been great for my field –new techniques are adopted early and the international bane of my field - cardiology-radiology turf wars are less acrimonious here as socialized medicine does not reimburse on a pay per procedure basis..
What are your interests outside of work?
My young family, recreational science, cooking.
If you were not a doctor, what would you do?
Who knows. Perhaps an economist or maybe evolutionary biologist.
Prof Griffiths is a Professor of Medicine (Intensive Care), Dept of Musculoskeletal Biology, Institute of Ageing & Chronic Disease, Faculty of Health & Life Sciences University of Liverpool, and Honorary Consultant Physician in Intensive Care Medicine, Whiston Hospital, UK.
He obtained a BSc in Physiology during undergraduate training in medicine (MBBS) at University College London during the ‘70s. During the early ‘80s in London obtained a research MD studying muscle energetics in the early days of human Magnetic Resonance Spectroscopy. Became a consultant in adult Intensive Care Medicine in 1985 following a move to Liverpool in 1984 and continued research interests in muscle and expanded these into nutrition (glutamine) and the critically ill. Since then has been a pioneer of the rehabilitation of the post-ICU patient. He extensively involved over the last two decades in undergraduate curriculum reform and as the Director of the Final Year has pioneered a fully portfolio based professional learning programme.
How long have you been working in your speciality?
I have been a consultant intensive care physician for more than 25 years.
Which aspect of your work do you find most satisfying?
To be able to improve patient care through clinical research and the training of medical students.
What achievements are you most proud of in your medical career?
Raising the awareness of the physical, psychological and cognitive challenges ICU patients and relatives face during recovery and contributing to the evidence base guiding rehabilitation.Clinical nutrition research on glutamine and identifying the need to use six month mortality outcomes in the critically ill. Creating a final year of undergraduate medical training that fosters professionalism and critical self awareness based upon a clinical portfolio and appraisal process that produces graduates fit for practice.
Which part of your job do you enjoy the least?
Very little, but perhaps the ever increasing bureaucracy of regulation in practice and research.
What are your views about the current status of medical training in your country and what do you think needs to change?
In the UK most medical schools have radically reformed their curriculum to meet the needs of modern medicine and life- long learning. In Liverpool our students are recognized to be well prepared with the skills to ensure patient safety and start foundation training following a course commended by clinicians, hospitals, examiners and GMC alike. Post-graduate changes have paralleled these developments and while the training structures and closer observations are to be commended the restrictions on working time remains a concern for the acquisition of real “shop floor” experience. Our trainees simply don’t get enough “flying hours” as in the past.
How would you encourage more medical students into entering your speciality?
Intensive care medicine is popular. The problem for students is to understand how to get there. The new Faculty of Intensive Care medicine, that has just starte, brings an independent speciality out from under the umbrella of its various parent specialities and hopefully will provide the focus to make the career pathway clearer in the future.
What qualities do you think a good trainee should possess?
All those attributes that the GMC expect of a practitioner! In particular I like to see enthusiasm, self awareness and measured confidence, an enquiring and questioning mind and a degree of professional flexibility mixed with the ability to ask for help and advice. I need to trust them just as their patients need to as well.
What is the most important advice you could offer to a new trainee?
Stay calm, be professional and follow the basic principles of good medical practice doing the simple things well, and don’t be afraid to ask for help.
What qualities do you think a good trainer should possess?
Maintain professionalism and be a role model at all times with the ability to listen, support and recognize the strengths as well as being firm with those things that need developing.
Do you think doctors are over-regulated compared with other professions?
No, while regulation does not itself prevent bad medicine it does prevent it being ignored.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what should be done to counter this trend?
De-professionalising only occurs when doctors avoid taking leadership roles. I think this was a fear in the recent past but in the last 10 years in the UK there has been a strong drive to redefine professionalism and the role of the doctor for the 21st century and it is central now to modern undergraduate and post graduate training with the importance of Consultants and GPs taking leadership roles in planning health care delivery.
Which scientific paper/publication has influenced you the most?
Huxley AF 1957 A theory of muscular contraction” Prog. In Biophys. And Biophys. Chem; 7:255.
Professor Sir Andrew Huxley was awarded the Nobel prize in medicine in 1963 with AL Hodgkin for nerve conduction but my personal memory is in muscle physiology (as one of my tutors) for his work on the theory of muscle contraction and the role of cross bridges. His clarity of thought was demonstrated in his ability to always ask the question everyone else wished they had asked! He was a kind and gentle teacher that gave time even for a simple medical student.
What single area of medical research in your speciality should be given priority?
The brain is the forgotten organ in multiple organ failure. We now recognize that acute brain dysfunction is a serious problem but we know little about its pathology, how to prevent it or recover from it.
What is the most challenging area in your speciality that needs further development?
There has been a rush towards ill conceived large scale pragmatic clinical effectiveness studies of various therapies few of which have shown much to change practice. Rather there is a need for more detailed scientific research to better define efficacy of therapies by exploring the pathological processes and the genetic and environmental influences of common disorders that result in multiple organ failure.
Which changes would substantially improve the quality of healthcare in your country?
Addressing the challenge of an ageing population and in particular the community medical and non-medical support of the aged infirm so that modern medicine does not grind to a halt.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
By showing leadership and making the changes happen and not leaving it to others perhaps less informed to direct change.
How has the political environment affected your work?
I have tried to ignore it as much as possible. Politics is a business best left to politicians while the rest of the world gets on with life.
What are your interests outside of work?
I treasure my family, a marriage of 28 years, with two undergraduates in medicine and one in architecture and doing all the jobs they ask of a father. When not escaping to the south of France or walking I become a generalist handyman so it can be a gardener, electrician, plumber, decorator, carpenter, car mechanic………and the Sunday Roast!
If you were not a doctor, what would you do?
With the exception of playing a musical instrument anything that combines academia, teaching and its practical application, but with preference in the natural world.
Dr David Fearnley, aged 41, is a Consultant Forensic Psychiatrist at Ashworth Hospital, a high secure psychiatric hospital in Merseyside, UK. He is also the Medical Director of Mersey Care NHS Trust, which is a large mental health and learning disability trust and one of three in England that have a high secure service. As Medical Director he is responsible for the performance of over 175 doctors, 50 pharmacists and has the lead responsibility for R&D and information governance. He is the College Special Advisor on Appraisal at the Royal College of Psychiatrists and has an interest in the development of management and leadership skills in doctors.
How long have you been working in your specialty?
I started training in psychiatry in 1994, and undertook specialist registrar training between 1998 and 2001. I became a consultant forensic psychiatrist in a high secure hospital in 2001 and medical director for the wider trust in 2005.
Which aspect of your work do you find most satisfying?
I have always found clinical work satisfying, and particularly when it becomes linked to wider service changes. I think this is why I decided to take on management responsibilities in addition to my clinical work so that I could continue to work at this interface.
What achievements are you most proud of in your medical career?
I have been particularly pleased whenever I have passed my exams and I have been able to make progress in my career. Also, in 2009 I won the inaugural Royal College of Psychiatrists Psychiatrist of the Year award, largely because of my innovative approach to involving service users and carers in their treatment.
Which part of your job do you enjoy the least?
I find that I dislike having to read poorly written reports because of the limited time available to do other things!
What are your views about the current status of medical training in your country and what do you think needs to change?
In my view, medical training in England is of an exceptionally high standard although more emphasis will need to be brought into training around management and leadership.
How would you encourage more medical students into entering your speciality?
I think medical students should be exposed to mental health services as soon as possible, to see not only the clinical aspects but appreciate the organisational structures.
What qualities do you think a good trainee should possess?
I think trainees should develop a sense of respect for everybody they work with including the service users and carers, particularly when they feel under pressure. This is, in my opinion, the hallmark of somebody who will make a great clinician.
What is the most important advice you could offer to a new trainee?
I think new trainees should create habits in terms of acquiring new knowledge (particularly evidence based knowledge) so that they build up a sense of lifelong learning that extends beyond clinical examinations.
What qualities do you think a good trainer should possess?
A good trainer should be approachable and accessible, with a willingness to challenge the status quo but also show interest in the life of the trainee.
Do you think doctors are over-regulated compared with other professions?
The medical profession is entering the phase of increased regulation through revalidation. I think this is an acceptable position in view of the enormous privilege that practicing medicine offers and the need to assure the public that doctors are fit to practise.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what should be done to counter this trend?
I think doctors are becoming better at identifying certain tasks that others are equally capable of undertaking. I think doctors should be continually seeking out areas of healthcare that they alone have the skills, knowledge and attitude to be responsible for.
Which scientific paper/publication has influenced you the most?
I have found the work of the Cochrane Collaboration (rather than a single publication) to influence me considerably because it made me aware, through the work of the Archie Cochrane, the importance of standing back and comparing more than one study whenever possible.
What single area of medical research in your speciality should be given priority?
I think the overlap between mental illness and personality disorder is not understood well enough and yet is a major reason for patients remaining in secure care longer than perhaps they might need to in the future.
What is the most challenging area in your speciality that needs further development?
As a medical manager, I think that more needs to be done to encourage doctors to see management and leadership as part of their role as a professional and to gain competencies and confidence in these areas during their undergraduate and postgraduate training.
Which changes would substantially improve the quality of healthcare in your country?
Healthcare delivery in the UK is undergoing change following the publication of the coalition government’s White Paper in health, and it is encouraging clinicians, particularly GPs, to take part in commissioning. I think this, alongside a focus on better outcome measures is likely to improve the quality of healthcare.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
I think doctors are in a unique position following years of clinical training to make decisions in terms of management and leadership. They should be able to transfer their ability to manage particular cases over time to managing projects and resources both in operational and strategic terms.
How has the political environment affected your work?
The NHS has an element of political oversight that does influence the work, particularly in the high secure service where public protection is a key factor.
What are your interests outside of work?
My time outside work is spent almost exclusively with my family.
If you were not a doctor, what would you do?
I would like to be a writer (although I doubt I have the skills to do so successfully!)
David Kingdom is a Professor of Mental Health Care Delivery at University of Southampton and Honorary Consultant Psychiatrist to Hampshire Partnership Foundation Trust.
How long have you been working in your speciality?
30 years
Which aspect of your work do you find most satisfying?
Clinical work can be very stimulating but so can research particularly when you feel, rightly or wrongly, that you have contributed something original which can benefit patients.
What achievements are you most proud of in your medical career?
Developing cognitive behaviour therapy for people with psychosis and then seeing it gradually becoming part of accepted practice in many parts of the world.
Which part of your job do you enjoy the least?
Doing reports and filling in forms.
What are your views about the current status of medical training in your country and what do you think needs to change?
Generally I think there have been many positive developments of it especially in improving the interaction between patients, health care staff and doctors but there is still a real problem with conveying the importance of psychological aspects.
How would you encourage more medical students into entering your speciality?
I would like to see psychology being increasingly accepted as a relevant qualification on a par with other sciences.
What qualities do you think a good trainee should possess?
Intelligence and warmth.
What is the most important advice you could offer to a new trainee?
Spend as much time learning from patients and their carers as you can.
What qualities do you think a good trainer should possess?
Intelligence and warmth.
Do you think doctors are over-regulated compared with other professions?
No, although revalidation may be going that way.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what should be done to counter this trend?
No – we need to maximise the efficiency of our work and this will mean gradual change in roles of ourselves and others.
Which scientific paper/publication has influenced you the most?
‘Not made of wood’ by Jan Foudraine, a Dutch psychiatrist who spent time listening to patients in long-stay hospitals and drawing out the extraordinary stories of their lives.
What single area of medical research in your speciality should be given priority?
Psychological treatments for currently treatment resistant conditions.
What is the most challenging area in your speciality that needs further development?
Classification of mental disorders.
Which changes would substantially improve the quality of healthcare in your country?
Introduction of effective care pathways which are linked directly to outcome measurement and funding contingent on these.
Do you think doctors can make a valuable contribution to healthcare management? If so how?
Yes – by seeing that clinically effective interventions are made available to those who can benefit from them.
How has the political environment affected your work?
Funding has improved over the past decade but is now looking much more uncertain.
What are your interests outside of work?
Family, sailing & watching Southampton FC.
If you were not a doctor, what would you do?
Law probably as it also involves work with people and is a steady job.
Professor Elisabeth Paice is currently on secondment to NHS London having been appointed to the new post of Acting Director of Medical and Dental Education from her role as Dean Director at London Deanery. The new role will ensure that the right number of doctors and dentists have the right training to deliver the service ambitions outlined in Healthcare for London. Elisabeth will be leading on the Medical and Dental Education Commissioning System (MDECS). This is the name of the programme of work that will manage the changes to postgraduate medical and dental training.
She was born in Washington DC, brought up in Canada, and studied medicine first at Trinity College Dublin and later at Westminster Medical School. She was the originator of the 'Hospital at Night' concept; developed the 'Point of View Surveys'; chaired PMETB working parties on Generic Standards and the National Trainee Survey and has published variously including on doctors in difficulty; workplace bullying; women in medicine. She was Chair of COPMeD, Conference of Postgraduate Medical Deans, from July 2006 to July 2008.
How long have you been working in your speciality?
I have been a full-time postgraduate dean since 1995. Before that I was a consultant rheumatologist for 13 years.
Which aspect of your work do you find most satisfying?
I get great satisfaction out of developing and implementing new ideas, especially when they work well enough to be taken up by others. I think most doctors have a creative streak and sometimes bureaucracy can damp this down. One of the reasons why medical education and training is so enjoyable is that it has to keep changing because of changes in the way the service is developing. There are standards to be met, of course, and regulators to satisfy, but within those constraints there is plenty of room for innovation. The better the quality of education and training, the better and safer the care of patients.
What achievements are you most proud of in your medical career?
As Dean Director of London, I have been very proud to lead postgraduate medical and dental education in one of the world’s great cities, with its five world-renowned medical schools, numerous centres of clinical excellence, and over 10,000 trainees. In order to understand trainees’ views, I introduced a regular survey through which they could voice their views about the quality of training they were receiving. I was very pleased when this formed the basis of the very successful National Trainee Doctor Survey, now embarking on its fourth iteration. This survey has enabled postgraduate deans across the UK to identify departments where training is not meeting the minimum standards for training and to take appropriate action.
Other achievements of which I am proud include the development of a multiprofessional team-based approach to out of hours services, known as the Hospital at Night initiative, which has improved patient safety while providing a solution for reducing the hours of junior doctors. Most recently I am delighted with the success of London’s Simulation and Technology-enhanced Learning Initiative (STeLI) which recently won the prestigious Health Service Journal Award for Patient Safety.
Which part of your job do you enjoy the least?
I least enjoy dealing with performance issues, whether internal to my staff or among trainees or their trainers.
What are your views about the current status of medical training in your country and what do you think needs to change?
Medical education is recognized in the UK as being a vital factor in providing the high quality doctors necessary for a high quality health service. It needs to be better resourced, and in particular every doctor with responsibility for educational supervision needs to have the training, the time, and the tools to do a good job. The way in which training has traditionally taken place, known as the ‘apprenticeship model’, is no longer suitable because of restrictions on the hours of work. I am all in favour of these restrictions, because long hours have a negative impact on learning and pose a risk to the health and safety of both doctors and patients. But we need radical change in the way we depend on doctors in training to provide out of hours cover and we need to find robust ways to ensure they gain the practical experience they need.
How would you encourage more medical students into entering your speciality?
I would strongly encourage any medical student to consider taking an interest in medical education from the start. Whatever the field of medicine that they enter, there will inevitably be an expectation that they will teach the next generation of doctors and of other healthcare professionals. Teaching is increasingly being recognized as one of the duties of a doctor, and like anything else, the more effort you put in, the more rewarding the outcomes.
What qualities do you think a good trainee should possess?
Trainees need to have a solid grounding in the basic sciences, because it is the foundation on which their postgraduate training will build. They need to be both conscientious and curious, doing what is required of them, but also going the extra mile in the search for knowledge. They should be motivated by the desire to make a positive difference to the lives of others, because I believe that is the only motivation that stands the test of time.
What is the most important advice you could offer to a new trainee?
Read the curriculum, establish what is expected of you and what you can expect from your seniors and your team, and engage with the educational programme.
What qualities do you think a good trainer should possess?
Kindness, honesty, expertise - and a passion for developing these qualities in their juniors.
Do you think doctors are over-regulated compared with other professions?
No, it is a profession in which we can potentially harm others, regulation is a necessity.
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what should be done to counter this trend? The responsibility for the professionalism of a doctor lies with the doctor. There are no policies in the UK that de-professionalise doctors.
Which scientific paper/publication has influenced you the most? I have been heavily influenced by the body of work by Charles Czeisler in the USA and Philippa Gander in New Zealand about the impact of long hours and sleep deprivation on health, safety, errors and retention of learning of doctors in training.
What single area of medical research in your speciality should be given priority? Simulation technology.
What is the most challenging area in your speciality that needs further development? Fitting adequate training into a 48 hour week without lengthening the duration of training
Which changes would substantially improve the quality of healthcare in your country?
Improving the training of general practitioners
Do you think doctors can make a valuable contribution to healthcare management? If so how?
All doctors need to learn to look after the system of care as well as the patient in front of them. Medical leadership is crucial to modernizing services. During training all doctors should be involved in quality improvement initiatives and all should learn how to champion change effectively.
How has the political environment affected your work?
The most recent impact has come from the national policy to introduce a separation between the commissioning of education and its provision. This has meant a reorganization of the way we work, with much of the work we did being commissioned from lead providers. While change is always disconcerting, there are real benefits to be realized from this one, in particular a better alignment between service and education planning.
What are your interests outside of work?
Looking after our four delightful grandchildren
If you were not a doctor, what would you do?
When I was at school I planned to write plays, but a medical career has sated my appetite for drama.
He'd try to sit, couldn't hold on for long,
Fidgety, restless, frustration would only prolong
Tried hard to listen to parents and teacher,
Distracted, voices sounding like a background clutter
Kept working on sitting listening and learning
Realized wasn't at par with kids and his sibling
This sentence would redundantly echo in his head
"Sit, listen, learn" you dumb head!!!
"How come life can't be better than what I feel?"
Why is it so hard for me to deal
My head hurts after constant listening,
Nothing I do is gratifying
They say, am not in same learning standard curve as other kids
My parents are worried for me, not understanding my needs
Have tried all avenues, anger, love , comfort, compassion,
Yet everyday is a challenge for them to find a solution
They interpreted his "not sitting still as restlessness",
Not listening and disruptive behaviour as impulsiveness
His attention level considered as poor learning skills
parents embarrassed, trying to overcome his hills
"Trust me”, He'd say, “you don’t understand, I'm trying my best"
Parents instead kept echoing sit, listen and learn, and accept it as a test
All this felt repetitive and redundant in his head,
Until someone said "maybe something is wrong with his brain instead"
Suggested see a doctor who might help clear the clutter away
Who observed his behaviour without decision to change him right away,
That's when he told the parents "Your child has had attention deficit disorder"
They felt was a mental taboo, and asked not to speak about it louder
The doctor insisted on strict compliance and periodic follow-up
Meds, mental stimulation exercises worked, felt no more like empty cup
Before he knew, he was sitting longer, nothing felt like clutter
Realized the deficit had prevented him from thinking better
Parents and doctors worked together, we salute them for the joint effort,
helped him evolve into the person altogether different
He listens to his inner and external suggestions alone and in group discussions,
Has learned realities of life, applying them in every day decisions
Sits down for hours working on his research projects
Sit, listen, learn, now all sound real, not mystical acts
BJMP 2009: 2(3) 57-58
A case of accidental carotid artery cannulation in a patient for Hemofilter: complication and management
Sanil Nair , Harshal Wagh , Kavita Mordani and Salim Bhuiyan
In the 'Author Details' block of the left column on page 58, the correct details of SALIM BHUIYAN should be
Kenneth Brummel-Smith, MD is the Charlotte Edwards Maguire Professor of Geriatrics and the chair of the Department of Geriatrics at the FSU College of Medicine. He is editor of five textbooks, Geriatric Rehabilitation, Practical Ambulatory Geriatrics, Interviewing and Patient Care, Geriatric Assessment, and Reichel’s Care of the Elderly. His research has addressed the effect of a support group on caregivers of patients with Alzheimer’s disease, methods of assessing pain in persons with Alzheimer’s disease, and advance care planning. He serves on the National Advisory Council on Aging for the National Institute on Aging.
How long have you been working in your speciality?
I started in geriatrics in 1983. I completed a residency in family medicine, then a fellowship in faculty development. While teaching in a family medicine residency 3 years after that, I was sent to a Society of Teachers in Family Medicine conference on integrating geriatrics into family practice teaching. I feel in love with the concept of the “functional approach” and dedicated myself to learning more geriatrics. After taking a 1-year certificate course in geriatrics at UCLA I was offered the position of Co-Chief of the Clinical Gerontology service at Rancho Los Amigos Hospital, the largest rehabilitation hospital in the US. And that was the start of it all!
Which aspect of your work do you find most satisfying?
Although my work now is primarily academic, I still get the most satisfaction is working closely with a elder in guiding them through difficult medical decision-making situations. I never cease to be amazed how well people can think through difficult medical decisions, if they are fully engaged in the process and educated about their options. We rarely give patients enough credit to do this.
What achievements are you most proud of in your medical career?
Being selected by the American Geriatrics Society for the Dennis W Jahnigen Memorial Award for outstanding contributions to geriatric education in 2006, and by the students of the Florida State University College of Medicine (FSUCOM) for the Hippocratic Award in 2008 for best representing professionalism, compassionate care, and inspirational teaching.
Which part of your job do you enjoy the least?
Dealing with personnel issues in my department
What are your views about the current status of medical training in your country and what do you think needs to change?
I think we need to make some fundamental changes. The future of medicine is in managing chronic conditions in a team environment. Much of the ways we teach medicine today is just like we did 30 years ago when I was in school. First, I would rethink the role of basic science teaching. Not every student needs the same thing. I see the best value of basic science is to teach critical thinking, but most of it today focuses on memorizing and regurgitating minute details. Second, I would provide most clinical teaching in teams of providers – especially medicine, social work, nursing and pharmacy. Third, I would equip students with real skills for helping patients to manage chronic conditions – patient-centered compassionate care, using motivational interviewing. Finally, I would adopt what most other advanced countries do – require a service commitment after graduation in rural and underserved areas, in exchange for more subsidies of educational costs.
How would you encourage more medical students into entering your speciality?
Start with positive role models – we use a senior mentor program where each student is assigned a mentor in the community in the 1st year of med school. The senior mentors are relatively healthy, very active and engaged in their communities and a real hoot to be around! We train every student in geriatric issues as a normal part of clinical care, not something special or different. And we have required integration of geriatrics into all other classes and a required 4th year rotation. Perhaps that’s why we have the highest rating by our graduates of their geriatric skills in the country.
What qualities do you think a good trainee should possess?
Compassion for others, an inquisitive mind, the recognition that authority is often wrong, and a commitment to evidence.
What is the most important advice you could offer to a new trainee?
Relax and remember you (and all of us) are not that important in the large scheme of things
What qualities do you think a good trainer should possess?
Relax and remember you (and all of us) are not that important in the large scheme of things
Do you think doctors are over-regulated compared with other professions?
No – we under-regulated. Nobody should let us do all the things we get away with. What other business can kill tens of thousands clients a year and get away with it? If you doubt this, you have not read the Institute of Medicine’s report “To Err is Human.” But you should!
Is there any aspect of current health policies in your country that are de-professionalising doctors? If yes what should be done to counter this trend?
Yes. Calling patients “consumers.” Allowing doctors to advertise – especially plastic surgeons. And the growing influence of money on medicine – unnecessary surgeries and diagnostic tests, and unthinking acceptance of pharmaceutical companies information.
Which scientific paper/publication has influenced you the most?
Donald Berwick, “What patient-centered should mean: Confessions of an extremist,” Health Affairs 28, no. 4 (2009): w555–w565 (published online 19 May 2009; 10.1377/hlthaff.28.4.w555)
What single area of medical research in your speciality should be given priority?
Non-pharmaceutical management of behavioral disturbance in dementia
What is the most challenging area in your speciality that needs further development?
Developing a reasonable reimbursement system that recognizes the role of cognitive work and support of families in the patient’s care
Which changes would substantially improve the quality of healthcare in your country?
A single-payer national health insurance program, dissolution of the fee-for-service model of reimbursement, cost-effectiveness research, regulation of pharmaceutical costs
Do you think doctors can make a valuable contribution to healthcare management? If so how?
Absolutely – if they put the patient first in all considerations.
How has the political environment affected your work?
Mostly through frustration. Washington seems to be in the lobbyist’s pocket and while I had great hopes of health care reform, I think we will be worse off if the present plans go through.
BJMP 2009:2(2) 4-5
Obesity and Pulmonary Hypertension. What’s the Link?
Roop Kaw.
In the second paragraph of the left column on page 5, the second sentence must have read
"The most direct evidence comes from observations that treatment of OSA with continious positive airway pressure (CPAP) may lower daytime PAP"
BJMP 2009:2(1) 38 - 40
The ‘Lost’ Mirena: What Investigations Are Required ? An Intraperitoneal Levonorgestrel-Releasing Intrauterine System Following Uterine Perforation: Case Report
Shambhu S and Pappas M
The correct name of the author must have read Pappas A on pages 4,39, 41
REFRESHER DAY ON OBSTETRIC ANAESTHESIA AND ANALGESIA
Contact: Obstetric Anaesthetists' Association Secretariat Tel: 011-44-20-8741-1311 Fax: 011-44-20-8741-0611 Email: available through webpage Website: www.oaa-anaes.ac.uk
Anesthesiology
October 07, 2009 United Kingdom / London
UPPER & LOWER LIMB PERIPHERAL NERVE BLOCK WORKSHOP
Contact: Aynsley Pix, B. Braun Medical Limited Email: aynsley.pix@bbraun.com Website: www.aesculap-academy.com
Anesthesiology / Pain Management
October 08, 2009 United Kingdom / Sheffield
2009 DIFFICULT AIRWAY SOCIETY ANNUAL MEETING
Contact: Anne Griffin, Abbey Conference & Corporate Tel: 011-353-1-648-6130 Fax: 011-353-1-648-6197 Email: das2009@abbey.ie Website: www.das2009.co.uk/cms/
Anesthesiology
November 04-06, 2009 United Kingdom / Perth
ASSOCIATION OF CARDIOTHORACIC ANAESTHETISTS AUTUMN MEETING 2009
Contact: Mrs. Andrea Reid, Secretary to Cardiac Anaesthetists Tel: 011-44-125-365-7789 Fax: 011-44-125-365-7134 Email: andrea.reid@bfwhospitals.nhs.uk Website: www.actablackpool2009.nhs.uk
Anesthesiology
November 05-06, 2009 United Kingdom / Blackpool
2009 THREE-DAY COURSE ON OBSTETRIC ANAESTHESIA AND ANALGESIA
Contact: Obstetric Anaesthetists' Association Secretariat Tel: 011-44-20-8741-1311 Fax: 011-44-20-8741-0611 Email: available through webpage Website: www.oaa-anaes.ac.uk
Anesthesiology
November 09-11, 2009 United Kingdom / London
GENERAL MEDICINE
DIABETES & ENDOCRINOLOGY: CLINICAL CHALLENGES & EXPERT ADVICE
Contact: Christine Berwick Tel: 011-44-131-247-3634 Fax: 011-44-131-220-4393 Email: c.berwick@rcpe.ac.uk Website: www.rcpe.ac.uk
Endocrinology / Family Medicine / General Medicine / Geriatrics / Internal Medicine
October 01, 2009 United Kingdom / Edinburgh
2ND NATIONAL CONFERENCE: ANXIETY & DEPRESSION
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Family Medicine / General Medicine / Psychiatry
October 01-02, 2009 United Kingdom / London
3RD ROYAL COLLEGE OF GENERAL PRACTITIONERS (RCGP) ANNUAL NATIONAL PRIMARY CARE CONFERENCE
Contact: Terri Myers, RCGP Tel: 011-44-20-7581-3232 Fax: 011-44-20-7225-3047 Email: courses@rcgp.org.uk Website: www.rcgpannualconference.org.uk
Family Medicine / General Medicine
November 05-07, 2009 United Kingdom / Glasgow
NEW CLINICAL SOLUTIONS IN DIABETES CARE CONFERENCE: OPPORTUNITIES & CHALLENGES
Contact: Alison Bone, Diabetes UK Tel: 011-44-1325-488-606 Email: alison.bone@diabetes.org.uk Website: www.diabetes.org.uk
Family Medicine / General Medicine
November 05, 2009 United Kingdom / York
INNOVATIONS AND PROGRESS IN HEALTHCARE FOR WOMEN
Contact: Confab Consulting, Conference Organisers Tel: 011-44-20-8906-7778 Fax: 011-44-20-8906-7790 Email: IPHW09@confab-consulting.co.uk Website: www.womenshealth.uk.com
Family Medicine / General Medicine / Obstetrics/Gynecology / Oncology
November 09-11, 2009 United Kingdom / London
GYNAE & OBSTETRICS
TRAINING THE TRAINERS
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
October 01-02, 2009 United Kingdom / London
POSTMENOPAUSAL HEALTH
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
October 12-13, 2009 United Kingdom / London
ADVANCED TECHNIQUES IN VAGINAL HYSTERECTOMY
Contact: Therese Eleftheriou, Course Secretary Tel: 011-44-20-7795-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com/dates.htm
Obstetrics/Gynecology / Surgery
October 15, 2009 United Kingdom / London
BASIC PRACTICAL SKILLS IN OBSTETRICS AND GYNAECOLOGY
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
October 26-28, 2009 United Kingdom / London
ADVANCE LABOUR WARD PRACTICE
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
November 02-04, 2009 United Kingdom / London
BRITISH SOCIETY OF UROGYNAECOLOGY / ROYAL COLLEGE OF OBSTETRICIANS & GYNAECOLOGISTS JOINT MEETING
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
November 05-06, 2009 United Kingdom / London
MEDICAL COMPLICATIONS IN PREGNANCY
Contact: Symposium Office, Imperial College London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp
Obstetrics/Gynecology
November 11-13, 2009 United Kingdom / London
PROMPT (PRACTICAL OBSTETRICS MULTI-PROFESSIONAL TRAINING) COURSE: TRAINING THE TRAINERS
Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings
Obstetrics/Gynecology
November 12, 2009 United Kingdom / London
PROMPT (PRACTICAL OBSTETRICS MULTI-PROFESSIONAL TRAINING) COURSE: TRAINING THE TRAINERS
Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings
Obstetrics/Gynecology
November 13, 2009 United Kingdom / London
NEONATAL UPDATE 2009
Contact: Symposium Office, Imperial College London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp
Obstetrics/Gynecology
November 16-20, 2009 United Kingdom / London
QUALITY MANAGEMENT OF A FERTILITY SERVICE STUDY DAY 2009
Contact: British Fertility Society Tel: 011-44-14-5464-2217 Fax: 011-44-14-5464-2222 Email: bfs@bioscientifica.com Website: www.britishfertilitysociety.org.uk
Obstetrics/Gynecology / Other Specialties / Urology
November 17, 2009 United Kingdom / London
REPRODUCTIVE GENETICS
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
November 19, 2009 United Kingdom / London
LAPAROSCOPIC SURGERY
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk/events Website: www.rcog.org.uk/events
Obstetrics/Gynecology / Surgery
December 02, 2009 United Kingdom / London
RECENT ADVANCES IN GYNAECOLOGICAL SURGERY
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology / Surgery
December 03-04, 2009 United Kingdom / London
HANDS ON LAPAROSCOPIC HYSTERECTOMY WORKSHOP
Contact: Therese Eleftheriou, Course Secretary Tel: 011-44-20-7795-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com/dates.htm
Obstetrics/Gynecology / Surgery
December 03, 2009 United Kingdom / London
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
December 07-09, 2009 United Kingdom / London
PAEDIATRICS
EUROPEAN SYMPOSIUM ON LATE COMPLICATIONS AFTER CHILDHOOD CANCER
Contact: Margaret Falconer, Event Co-ordinator Tel: 011-44-131-226-0821 Fax: 011-44-131-226-0801 Email: eslccc2009@colpitts.co.uk Website: www.eslccc2009.com
Oncology / Pediatrics
October 29-30, 2009 United Kingdom / Edinburgh
3RD NATIONAL CONFERENCE: PAEDIATRICS ASTHMA & ALLERGY
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Immunology/Allergy / Pediatrics
November 09-10, 2009 United Kingdom / London
PSYCHIATRY
2ND NATIONAL CONFERENCE: ANXIETY & DEPRESSION
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Family Medicine / General Medicine / Psychiatry
October 01-02, 2009 United Kingdom / London
DRUG TREATMENTS IN AFFECTIVE DISORDERS
Contact: Mrs. Susan Chandler, British Association for Psychopharmacology Tel: 011-44-1223-358-428 Email: susan@bap.org.uk Website: www.bap.org.uk
Psychiatry
October 08-09, 2009 United Kingdom / Manchester
DRUG TREATMENTS IN OLD AGE PSYCHIATRY
Contact: Mrs. Susan Chandler, British Association for Psychopharmacology Tel: 011-44-1223-358-428 Email: susan@bap.org.uk Website: www.bap.org.uk
Psychiatry
November 11-13, 2009 United Kingdom / London
BRITISH ASSOCIATION FOR PSYCHOPHARMACOLOGY (BAP) MASTERCLASSES IN CLINICAL PSYCHOPHARMACOLOGY
Contact: Lynne Harmer, BAP Tel: 011-44-1223-358-421 Email: lynne@bap.org.uk Website: www.bap.org.uk
Clinical Pharmacology / Psychiatry
November 11, 2009 United Kingdom / London
CAREIF 2009 INTERNATIONAL CONFERENCE*
Contact: Hampton Medical Conferences Tel: 011-44-20-8979-8300 Fax: 011-44-20-8979-6700 Email: careif@hmconline.co.uk Website: www.careif.ukevents.org
Other Specialties / Psychiatry
December 04, 2009 United Kingdom / London
7TH NATIONAL CONFERENCE: BIPOLAR DISORDERS
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Psychiatry
December 10, 2009 United Kingdom / London
SLEEP DISORDERS
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Psychiatry / Respirology
RADIOLOGY
ECHOCARDIOGRAPHY
Contact: Robina, Intensive Care Society Tel: 011-44-20-7280-4350 Email: events@ics.ac.uk Website: www.ics.ac.uk
Internal Medicine / Radiology/Imaging
September 04, 2009 United Kingdom / London
PET / CT COURSE
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
October 01, 2009 United Kingdom / Glasgow
WELSH BRANCH, BRITISH INSTITUTE OF RADIOLOGY, AUTUMN MEETING
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
October 16-17, 2009 United Kingdom / Llantrisant
OBESITY: THE CHALLENGES & SOLUTIONS IN IMAGING
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
October 19, 2009 United Kingdom / London
ROYAL COLLEGE OF RADIOLOGISTS BREAST GROUP MEETING*
Contact: Hampton Medical Conferences, Conference Manager Tel: 011-44-20-8979-8300 Fax: 011-44-20-8979-6700 Email: hmc@hamptonmedical.com Website: www.hamptonmedical.com
Radiology/Imaging
November 02, 2009 United Kingdom / Belfast
CONTROLLING RADIATION RISKS IN DIAGNOSTIC RADIOLOGY
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
November 24, 2009 United Kingdom / London
RPS UPDATE TRAINING SESSION
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
November 25, 2009 United Kingdom / London
BRITISH SOCIETY OF THORACIC IMAGING AUTUMN MEETING
Contact: British Institute of Radiology Tel: 011-44-20-7307-1400 Email: available through website Website: www.bir.org.uk
Radiology/Imaging
November 27, 2009 United Kingdom / London
7TH ANNUAL CONFERENCE OF UK & IRELAND NEUROENDOCRINE TUMOUR SOCIETY (UKI NETS)
Contact: UKI NETS Secretariat Tel: 011-44-145-464-2277 Fax: 011-44-145-464-2222 Email: enquiries@ukinets.org Website: www.ukinets.org
Endocrinology / Gastroenterology / Oncology / Other Specialties / Pathology / Radiology/Imaging / Surgery
November 30, 2009 United Kingdom / London
SURGERY
2ND ANNUAL ROYAL MARSDEN BREAST CANCER MEETING: HOT TOPICS IN BREAST CANCER
Contact: The Royal Marsden Tel: 011-44-20-7808-2921 Fax: 011-44-20-7808-2334 Email: conferencecentre@rmh.nhs.uk Website: www.royalmarsden.nhs.uk
Oncology / Pathology / Radiology/Imaging / Surgery
October 02, 2009 United Kingdom / London
CURRENT CONCEPTS IN EXTERNAL FIXATION IN TRAUMA
Contact: Jean Fretwell Tel: 011-44-113-392-3819 Email: jean.fretwell@leedsth.nhs.uk Website: www.rcseng.ac.uk
Orthopedics / Surgery
October 05, 2009 United Kingdom / Leeds
ADVANCED TECHNIQUES IN VAGINAL HYSTERECTOMY
Contact: Therese Eleftheriou, Course Secretary Tel: 011-44-20-7795-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com/dates.htm
Obstetrics/Gynecology / Surgery
October 15, 2009 United Kingdom / London
CARE OF THE CRITICALLY ILL SURGICAL PATIENT INSTRUCTOR COURSE
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6311 Email: ccrisp@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Other Specialties / Surgery
October 26-27, 2009 United Kingdom / London
21ST CENTURY DECONTAMINATION: SHARING EXPERTISE
Contact: Aynsley Pix, B. Braun Medical Limited Email: aynsley.pix@bbraun.com Website: www.aesculap-academy.com
Surgery
November 03-04, 2009 United Kingdom / Sheffield
CORE SKILLS IN OPERATIVE ORTHOPAEDIC SURGERY
Contact: Mrs. Kelly Westlake Tel: 011-44-29-2068-2129 Email: westlakekm@cardiff.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
November 04-06, 2009 United Kingdom / Cardiff
CORE SKILLS IN OPERATIVE ORTHOPAEDIC SURGERY
Contact: Lesley Izzard Tel: 011-44-114-271-4027 Email: Lesley.izzrd@sth.nhs.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
November 04-06, 2009 United Kingdom / Sheffield
HANDS ON GYNAECOLOGICAL ENDOSCOPY SKILLS WORKSHOP
Contact: Therese Eleftheriou, Course Secretary Tel: 011-44-20-7795-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com/dates.htm
Obstetrics/Gynecology / Surgery
November 11-13, 2009 United Kingdom / London
ONEHEALTH STUDY DAY
Contact: Aynsley Pix, B. Braun Medical Limited Email: aynsley.pix@bbraun.com Website: www.aesculap-academy.com
Surgery
November 11, 2009 United Kingdom / Tankersley
Contact: Mrs. Kelly Westlake Tel: 011-44-29-2068-2131 Email: westlakekm@cf.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
June 15-17, 2009 United Kingdom / Cardiff
BASIC SKILLS IN HAND SURGERY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: plastic@rcseng.ac.uk Website: www.rcseng.ac.uk
Plastic Surgery
June 15-17, 2009 United Kingdom / London
BRITISH FERTILITY SOCIETY PELVIC ULTRASOUND STUDY DAY
Contact: British Fertility Society Secretariat Tel: 011-44-454-642-217 Fax: 011-44-454-642-222 Email: bfs@bioscientifica.com Website: www.britishfertilitysociety.org.uk
Obstetrics/Gynecology / Radiology/Imaging
June 15-16, 2009 United Kingdom / London
REPRODUCTIVE AGEING IN OLDER MOTHERS
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Family Medicine / Obstetrics/Gynecology / Other Specialties
June 15, 2009 United Kingdom / London
BASIC TECHNIQUES IN ARTHROSCOPIC SURGERY BASK/RCS
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6337 Email: orthopaedic@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Orthopedics / Surgery
June 16, 2009 United Kingdom / London
SPECIALTY SKILLS IN EMERGENCY SURGERY & TRAUMA
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6328 Email: trauma@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Emergency Medicine / General Medicine
June 16-17, 2009 United Kingdom / Nottingham
CARE OF THE CRITICALLY ILL SURGICAL PATIENT
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6311 Email: ccrisp@rcseng.ac Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
June 17-19, 2009 United Kingdom / London
HOW TO PRACTICE EVIDENCE-BASED HEALTH CARE
Contact: Dr. Jane Ilsley, Western General Hospital Tel: 011-44-131-537-3355 Email: wtcrf.education@ed.ac.uk Website: www.rcpe.ac.uk
Other Specialties
June 18-19, 2009 United Kingdom / Edinburgh
BRITISH MATERNAL & FETAL MEDICINE SOCIETY 2009 ANNUAL CONFERENCE
Contact: Hampton Medical Conferences Tel: 011-44-20-8979-8300 Email: fetal@hamptonmedical.com Website: www.bmfms.org.uk
Obstetrics/Gynecology
June 18-19, 2009 United Kingdom / Liverpool
WRIST & HAND ARTHROPLASTY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: plastic@rcseng.ac.uk Website: www.rcseng.ac.uk
Plastic Surgery
June 18, 2009 United Kingdom / London
HOW DOES RHEUMATOID ARTHRITIS NEED TO BE MANAGED?
Contact: Meetings & Events Office, Royal College of Physicians Tel: 011-44-20-7034-4900 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event
General Medicine / Orthopedics / Rheumatology
June 18, 2009 United Kingdom / London
3RD SYMPOSIUM ON ACETABULAR RECONSTRUCTION
Contact: Furlong Research Charitable Foundation Tel: 011-44-207-436-1919 Email: furlong@frcf.org.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Orthopedics / Surgery
June 19, 2009 United Kingdom / London
ROAD TRAFFIC FATALITIES, PASSENGERS, PEDESTRIANS, PATHOLOGISTS & POLICE
Contact: Conference Department, Royal College of Pathologists Tel: 011-44-20-7451-6715 Email: meetings@rcpath.org Website: www.rcpath.org
Pathology
June 19, 2009 United Kingdom / London
MANAGEMENT OF COMMON PROBLEMS IN OLDER PEOPLE
Contact: Joyce Achampong, Senior Regional Events Co-ordinator, Royal Society of Medicine Tel: 011-44-20-7290-2980 Fax: 011-44-20-7290-2989 Email: joyce.achampong@rsm.ac.uk Website: www.rsm.ac.uk/academ/condiary.php
Family Medicine / General Medicine / Internal Medicine
June 19, 2009 United Kingdom / York
UK THALASSAEMIA SOCIETY CONFERENCE
Contact: UK Thalassaemia Society Tel: 011-44-20-8882-0011 Fax: 011-44-20-8882-8618 Email: office@ukts.org Website: www.rsm.ac.uk/academ/condiary.php
Hematology
June 20, 2009 United Kingdom / Wilmslow
2009 ANNUAL MEETING OF BRITISH ASSOCIATION OF UROLOGICAL SURGEONS (BAUS)
Contact: BAUS Tel: 011-44-20-7869-6950 Fax: 011-44-20-7404-5048 Email: admin@baus.org.uk Website: baus.meeting.org.uk
Surgery / Urology
June 22-25, 2009 United Kingdom / Glasgow
GASTROENTEROLOGY FOR THE PCP BRITISH ISLES/NORWEGIAN FJORDS CRUISE
Contact: Continuing Education, Inc. Tel: 800-422-0711 (US) or 727-526-1571 Email: contactus@continuingeducation.net Website: www.continuingeducation.net
Family Medicine / Internal Medicine
June 22-July 04, 2009 United Kingdom / Harwich
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY
Contact: Conference Office, Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings
Obstetrics/Gynecology
June 22-24, 2009 United Kingdom / London
BYPASS, BALLOON PUMPS & CIRCULATORY SUPPORT
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: cardiothoracics@rcseng.ac.uk Website: www.rcseng.ac.uk
Surgery
June 22, 2009 United Kingdom / London
WORKSHOP IN PELVIC SURGERY
Contact: TMB Marketing and Communications, Conference Desk Tel: 011-44-1306-877-000 Fax: 011-44-1306-877-777 Email: info@wips-intl.com Website: www.wips-intl.com
Obstetrics/Gynecology
June 22-26, 2009 United Kingdom / London
SPECIALTY SKILLS IN VASCULAR SURGERY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: vascular@rcseng.ac.uk Website: www.rcseng.ac.uk
Surgery
June 22-23, 2009 United Kingdom / London
5TH INTERNATIONAL CONFERENCE ON CHILDREN'S BONE HEALTH
Contact: Clare Moloney, Oxford International Tel: 011-44-1865-511-550 Fax: 011-44-1865-511-570 Email: clare.moloney@oxfordint.co.uk Website: www.iccbh5.org
Endocrinology / Orthopedics / Pediatrics
June 23-26, 2009 United Kingdom / Cambridge
9TH ANNUAL INTERNATIONAL ASSOCIATION OF FORENSIC MENTAL HEALTH SERVICES (IAFMHS)
Contact: IAFMHS Tel: 604-924-5026 Fax: 604-924-5027 Email: tmoropito@iafmhs.org Website: www.iafmhs.org
Psychiatry
June 24-26, 2009 United Kingdom / Edinburgh
ADVANCED SKILLS IN VASCULAR SURGERY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: vascular@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
June 24-26, 2009 United Kingdom / London
INTERMEDIATE THORACIC SURGERY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: Cardiothoracics@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
June 24-25, 2009 United Kingdom / London
ASSOCIATION OF BREAST SURGERY AT BASO TRAINEES MEETING 2009
Contact: Krysia Cruickshank Tel: 011-44-141-211-6248 Email: krysia.cruickshank@northglasgow.scot.nhs.uk Website: www.baso.org
Oncology / Surgery
June 25-26, 2009 United Kingdom / Glasgow
RECENT ADVANCES IN MEDICINE
Contact: Sue Dent, University Hospital of North Tees Tel: 011-44-164-262-4791 Fax: 011-44-164-226-4918 Email: sue.dent@nth.nhs.uk Website: www.rcpe.ac.uk
Family Medicine / General Medicine / Internal Medicine
June 26, 2009 United Kingdom / Stockton-on-Tees
SYSTEMATIC TRAINING IN ACUTE ILLNESS RECOGNITION & TREATMENT FOR SURGERY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6311 Email: ccrisp@rcseng.ac.uk Website: www.rcseng.ac.uk
Surgery
June 27, 2009 United Kingdom / London
13TH CONFERENCE OF NATIONAL OSTEOPOROSIS SOCIETY
Contact: Sarah Phillips or Kelly Hall, Events Dep’t., National Osteoporosis Society Tel: 011-44-1761-473-106 or 011-44-1761-473-123 Fax: 011-44-1761-471-104 Email: s.phillips@nos.org.uk or k.hall@nos.org.uk Website: www.nos.org.uk
Other Specialties
June 29-July 01, 2009 United Kingdom / Manchester
2009 ANNUAL MEETING OF BRITISH SOCIETY FOR ALLERGY & CLINICAL IMMUNOLOGY (BSACI)
Contact: BSACI Tel: 011-44-207-340-9614 Email: info@bsaci.org Website: www.bsaci.org
Immunology/Allergy
June 29-July 01, 2009 United Kingdom / Nottingham
PATHOLOGICAL SOCIETY OF GREAT BRITAIN & IRELAND SUMMER MEETING 2009
Contact: Pathological Society of Great Britain & Ireland Tel: 011-44-20-7976-1260 Fax: 011-44-20-7930-2981 Email: admin@pathsoc.org Website: www.pathsoc.org
Pathology
June 30-July 03, 2009 United Kingdom / Cardiff
UPDATE IN MANAGEMENT OF DETRUSOR OVERACTIVITY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: urology@rcseng.ac.uk Website: www.rcseng.ac.uk
Surgery / Urology
June 30, 2009 United Kingdom / London
CARDIOTHORACICS FOR SURGICAL ASSISTANTS
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: Cardiothoracics@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
June 30, 2009 United Kingdom / London
RECONSTRUCTIVE TECHNIQUES IN UROLOGY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: urology@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery / Urology
June 30, 2009 United Kingdom / London
CARE HOME MEDICINE
Contact: Meetings & Events Office, Royal College of Physicians of Edinburgh Tel: 011-44-20-7034-4900 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event
General Medicine / Geriatrics / Other Specialties / Pain Management
June 30, 2009 United Kingdom / London
SOUTH ASIA DAY: JOINT RCOG/AICC RCOG/SAFOG MEETING
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
July 03, 2009 United Kingdom / London
CANCER IN WOMEN BALTIC SEA CRUISE
Contact: Continuing Education, Inc. Tel: 800-422-0711 (US) or 727-526-1571 Email: available through web page Website: www.continuingeducation.net
Family Medicine / Internal Medicine / Obstetrics/Gynecology
July 04-16, 2009 United Kingdom / Harwich
6TH INTERNATIONAL ASSOCIATION FOR BIOLOGICALS SYMPOSIUM ON ADVANCES IN TRANSFUSION SAFETY
Contact: Department of Haematology, Cambridge Institute for Medical Research Tel: 011-44-122-354-8044 Email: jpa1000@cam.ac.uk Website: www.iabs.org
Hematology / Other Specialties
July 06-07, 2009 United Kingdom / Cambridge
4TH NATIONAL AUTISM TODAY
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Family Medicine / General Medicine / Neurology / Pediatrics / Psychiatry
July 06-07, 2009 United Kingdom / London
MRCOG PART 1 REVISION COURSE
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
July 06-10, 2009 United Kingdom / London
CURRENT CONCEPTS IN EXTERNAL FIXATION IN TRAUMA
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6337 Email: orthopaedics@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Orthopedics / Surgery
July 06, 2009 United Kingdom / London
WORKSHOP ON THE MOLECULAR PHARMACOLOGY & THERAPEUTICS OF BONE DISEASE
Contact: National Association for the Relief of Paget's Disease Tel: 011-44-161-799-4646 Fax: 011-44-161-799-6511 Email: director@paget.org.uk Website: www.paget.org.uk
Endocrinology / Other Specialties
July 06-09, 2009 United Kingdom / Oxford
89TH ANNUAL MEETING OF BRITISH ASSOCIATION OF DERMATOLOGISTS
Contact: Conference & Events Services, British Association of Dermatologists Tel: 011-44-20-7391-6358 Fax: 011-44-20-7388-0487 Email: conference@bad.org.uk Website: www.bad.org.uk
Dermatology
July 07-10, 2009 United Kingdom / Glasgow
13TH BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY AND ENT EXPO
Contact: ENT UK Tel: 011-44-20-7404-8373 Fax: 011-44-20-7420-4200 Email: conferences@entuk.org Website: www.bacouk.org
Otolaryngology
July 08-10, 2009 United Kingdom / Liverpool
HANDS ON GYNAECOLOGICAL ENDOSCOPY SKILLS WORKSHOP
Contact: Therese Eleftheriou, Course Secretary Tel: 011-44-20-7795-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com/dates.htm
Obstetrics/Gynecology / Surgery
July 08-10, 2009 United Kingdom / London
INTERNATIONAL SYMPOSIUM ON PAGET’S DISEASE
Contact: National Association for the Relief of Paget's Disease Tel: 011-44-161-799-4646 Fax: 011-44-161-799-6511 Email: director@paget.org.uk Website: www.paget.org.uk
Endocrinology / Other Specialties
July 08-09, 2009 United Kingdom / Oxford
11TH NATIONAL CONFERENCE: THE DIABETES EPIDEMIC
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Endocrinology
July 13-14, 2009 United Kingdom / London
DEFINITIVE SURGICAL TRAUMA SKILLS FOR THE GENERAL SURGEON
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: trauma@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
July 14-15, 2009 United Kingdom / London
3RD NATIONAL CRITICAL CARE SYMPOSIA
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Internal Medicine
July 15-17, 2009 United Kingdom / London
BRITAIN PACIFIC MEDICAL AND LEGAL CONFERENCE
Contact: Lorenzo Boccalbella Tel: 011-61-07-3254-3331 Fax: 011-61-07-3254-3332 Email: info@educationcpe.com Website: www.conferences21.com
Legal/Ethics
July 17-24, 2009 United Kingdom / Oxford
BRITAIN PACIFIC MEDICAL & LEGAL CONFERENCE
Contact: Continuing Professional Education Pty Ltd. Tel: 011-61-7-3254-3331 Fax: 011-61-7-3254-3332 Email: info@conferences21.com Website: www.conferences21.com
Legal/Ethics
July 17-24, 2009 United Kingdom / Stratford-upon-Avon
BASIC SCIENCE: CELL SIGNALLING AND THE GUT
Contact: United European Gastroenterology Federation Secretariat Tel: 011-43-1-997-1639 Fax: 011-43-1-997-1639 ext. 10 Email: office@uegf.org Website: www.uegf.org
Gastroenterology
July 19-21, 2009 United Kingdom / Cambridge
MRCOG PART 2 REVISION COURSE
Contact: Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
July 20-22, 2009 United Kingdom / London
FRCS (PLAST) AESTHETIC STUDY DAY
Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: aesthetic@rcseng.ac.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Plastic Surgery
July 21, 2009 United Kingdom / London
2009 BRITISH ASSOCIATION FOR PSYCHOPHARMACOLOGY (BAP) SUMMER MEETING
Contact: Lynne Harmer, BAP Tel: 011-44-1223-358-421 Email: lynne@bap.org.uk Website: www.bap.org.uk
Clinical Pharmacology / Psychiatry
July 26-29, 2009 United Kingdom / Oxford
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY
Contact: Royal College of Obstetricians & Gynecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/events
Obstetrics/Gynecology
July 27-29, 2009 United Kingdom / London
CORE SKILLS IN LAPAROSCOPIC SURGERY
Contact: Julie Bradley Tel: 011-44-121-424-1488 Email: julie.bradley@heartofengland.nhs.uk Website: www.rcseng.ac.uk/education/courses/course_list.html
Surgery
August 19-21, 2009 United Kingdom / Birmingham
11TH NATIONAL CONFERENCE: PARKINSONS DISEASE
Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk
Neurology
August 25, 2009 United Kingdom / London
CAMBRIDGE CONFERENCE ON BREAST CANCER IMAGING March 23-24, 2009 Contact: Hampton Medical Conferences, Secretariat Tel: 011-44-20-8979-8300 Fax: 011-44-20-8979-6700 Email: hmc@hamptonmedical.com Website: www.cambridgeconferencebci.ukevents.org Radiology/Imaging, United Kingdom / Cambridge
2009 ANNUAL MEETING OF THE BRITISH SOCIETY OF GASTROENTEROLOGY March 23-26, 2009 Contact: British Society of Gastroenterology Tel: 011-44-207-387-3534 Fax: 011-44-207-487-3734 Email: bsg@mailbox.ulcc.ac.uk Website: www.bsg.org.uk/meet_calendar/calendar.htm Gastroenterology United Kingdom / Glasgow
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY March 23-25, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
OESOPHAGO-GASTRIC CANCER SURGERY March 23-25, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6328 Email: general@rcseg.ac.uk Website: www.rcseng.ac.uk Oncology / Surgery United Kingdom / London
SPECIALTY SKILLS IN BREAST DISEASE MANAGEMENT (ADVANCED) March 23-26, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: breast@rcseng.ac.uk Website: www.rcseng.ac.uk Plastic Surgery / Surgery United Kingdom / London
CHILD HEALTH PROMOTION & SURVEILLANCE March 23-25, 2009 Contact: Symposium Office, Imperial College of London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp Pediatrics United Kingdom / London
2009 EUROPEAN ASSOCIATION FOR THE STUDY OF DIABETES (EASD) ROBERT TURNER CLINICAL RESEARCH COURSE March 23-27, 2009 Contact: EASD Secretariat Tel: 011-49-211-758-4690 Fax: 011-49-211-758-46929 Email: secretariat@easd.org Website: www.easd.org Endocrinology United Kingdom / Oxford
ROYAL COLLEGE OF PHYSICIANS - RESPIRATORY FAILURE March 24, 2009 Contact: Royal College of Physicians Tel: 011-44-20-7935-1174 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event Respirology, United Kingdom / London
5TH ANNUAL BRITISH COSMETIC DERMATOLOGY GROUP COURSE March 26-27, 2009 Contact: Rebecca Bennett Email: Rebecca_L_Bennett@btopenworld.com Website: www.bad.org.uk Dermatology United Kingdom / London
IDENTIFYING T CELL SUBSET PHENOTYPE AND FUNCTION IN PARASITE INFECTIONS. March 27, 2009 Contact: EuroSciCon Email: enquiries@euroscicon.com Website: www.euroscicon.com Infectious Disease / Other Specialties United Kingdom / Welwyn Garden City United Kingdom / London
ANNUAL SCIENTIFIC MEETING OF BRITISH SOCIETY FOR INVESTIGATIVE DERMATOLOGY (BSID March 30-April 01, 2009 Contact: Dr. Graham Ogg, BSID Chairman Tel: 011-44-1865-222-334 Fax: 011-44-1865-222-502 Email: graham.ogg@ndm.ox.ac.uk Website: www.bsid.org.uk Dermatology United Kingdom / Cirencester
164TH MEETING OF THE SOCIETY FOR GENERAL MICROBIOLOGY March 30-April 03, 2009 Contact: Josiane Dunn, Meetings Administrator Tel: 011-44-118-988-1805 Fax: 011-44-118-988-5656 Email: meetings@sgm.ac.uk Website: www.sgm.ac.uk/meetings Hematology / Infectious Disease / Other Specialties United Kingdom / Harrogate
2009 ANNUAL MEETING OF THE BRITISH PAIN SOCIETY March 31-April 03, 2009 . Contact: The British Pain Society Tel: 011-44-207-269-7840 Fax: 011-44-207-831-0859 Email: info@britishpainsociety.org Website: www.britishpainsociety.org Pain Management United Kingdom / London
9TH LONDON INTERNATIONAL EATING DISORDERS CONFERENCE March 31-April 02, 2009 Contact: MA Healthcare Events Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Website: www.mahealthcareevents.co.uk Family Medicine / General Medicine / Pediatrics / Psychiatry United Kingdom / London
ROYAL COLLEGE OF PHYSICIANS - ACUTE MEDICINE April 01, 2009 Contact: Royal College of Physicians Tel: 011-44-20-7935-1174 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event General Medicine / Internal Medicine United Kingdom / London
UROLOGICAL ANATOMY FOR SURGERY April 03, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: urology@rcseng.ac.uk Website: www.rcseng.ac.uk Surgery / Urology United Kingdom / London
UK RADIATION ONCOLOGY CONFERENCE (UKRO) April 06-08, 2009 Contact: UKRO Secretariat Tel: 011-44-1904-610-821 Fax: 011-44-1904-612-279 Email: ukro@ipem.ac.ukWebsite: www.ukro.org.uk Oncology / Radiology/Imaging United Kingdom / Cardiff
OTOLARYNGOLOGY FOR GENERAL PRACTITIONERS April 07, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: ent@rcseng.ac.uk Website: www.rcsengac.uk General Medicine United Kingdom / London
EUROPEAN PSYCHIATRIC ASSOCIATION SECTION OF NEUROIMAGING 5TH ANNUAL MEETING: GENES, BRAIN, BEHAVIOUR April 09-10, 2009 Contact: Institute of Psychiatry, King's College London Tel: 011-44-20-7836-5454 Email: epaneuroimaging2009@iop.kcl.ac.uk Website: www.iop.kcl.ac.uk Psychiatry United Kingdom / Edinburgh
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY April 15-17, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
PROMPT (PRACTICAL OBSTETRICS MULTI-PROFESSIONAL TRAINING) COURSE: TRAINING THE TRAINERS April 16, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
DRAWING FOR SURGEONS April 16-17, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6337 Email: drawingforsurgeons@rcseng.ac.uk Website: www.rcseng.ac.uk Surgery United Kingdom / London
PROMPT (PRACTICAL OBSTETRICS MULTI-PROFESSIONAL TRAINING) COURSE: TRAINING THE TRAINERS April 17, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
2009 ANNUAL MEETING OF THE RENAL ASSOCIATION April 20-24, 2009 Contact: The British Pain Society Tel: 011-44-207-269-7840 Fax: 011-44-207-831-0859 Email: info@britishpainsociety.org Website: www.britishpainsociety.org Nephrology United Kingdom / Liverpool
3RD NATIONAL CONFERENCE: TREATING SCHIZOPHRENIA April 27-28, 2009 Contact: MA Healthcare Events Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Website: www.mahealthcareevents.co.uk Psychiatry United Kingdom / London
RHEUMATOLOGY 2009 April 28-May 01, 2009 Contact: Louis Bellintani, Education and Events Officer Tel: 011-44-20-7842-0913 Fax: 011-44-20-7842-0914 Email: conferences@rheumatology.org.uk Website: www.bsrconference.org.uk Rheumatology United Kingdom / Glasgow
OPERATIVE SKILLS IN NEUROSURGERY April 28-30, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: neurosurgery@rcseng.ac.uk Website: www.rcseng.ac.uk Neurology / Surgery United Kingdom / London
2009 PATIENT SAFETY CONGRESS April 30-May 01, 2009 Contact: Customer Service Team Tel: 011-44-207-554-5800 Email: psc2009@emap.com Website: www.patientsafetycongress.co.uk Other Specialties United Kingdom / Birmingham
ROYAL COLLEGE OF PHYSICIANS - DEVICE THERAPY FOR HEART FAILURE April 30, 2009 Contact: Royal College of Physicians Tel: 011-44-20-7935-1174 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event Cardiology United Kingdom / London
RISK MANAGEMENT AND MEDICO-LEGAL ISSUES IN WOMEN'S HEALTH May 06-07, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Legal/Ethics / Obstetrics/Gynecology United Kingdom / London
SPECIALTY SKILLS IN ONCOPLASTIC & BREAST RECONSTRUCTION SURGERY (ST 5-7) May 06-07, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6332 Email: breast@rcseng.ac.uk Website: www.rcseng.ac.uk Plastic Surgery / Surgery United Kingdom / London
ROYAL COLLEGE OF PHYSICIANS - NEUROLOGY ON ACUTE TAKE May 07, 2009 Contact: Royal College of Physicians Tel: 011-44-20-7935-1174 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event Neurology United Kingdom / London
THEORETICAL ATSM COURSE IN LAPAROSCOPY SURGERY May 08, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
URODYNAMICS ATSM COURSE May 11-12, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772- 6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetingsObstetrics/Gynecology / Urology United Kingdom / London
EMERGENCY SKILLS IN MAXILLOFACIAL SURGERY May 11-12, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6340 Email: maxfac@rcseng.ac.uk Website: www.rcseng.ac.uk Emergency Medicine / Surgery United Kingdom / London
OPERATIVE SKILLS IN EAR, NOSE & THROAT SURGERY May 13-14, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6336 Email: ent@rcseng.ac.uk Website: www.rcseng.ac.uk Otolaryngology / Surgery United Kingdom / London
GP REFRESHER COURSE May 13-15, 2009 Contact: Symposium Office, Imperial College London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp Family Medicine / General Medicine United Kingdom / London
BIOLOGICAL & PHARMACOLOGICAL ASPECTS OF PERINATAL PSYCHIATRY May 14, 2009 Contact: Institute of Psychiatry, King's College London Tel: 011-44-20-7836-5454 Email: available through website Website: www.iop.kcl.ac.uk Psychiatry United Kingdom / London
ROYAL COLLEGE OF PHYSICIANS - ACUTE AND GENERAL MEDICINE FOR THE PHYSICIAN May 20-21, 2009 Contact: Royal College of Physicians Tel: 011-44-20-7935-1174 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk/event General Medicine United Kingdom / Birmingham
OBSTETRIC ANAESTHESIA 2009 May 20-22, 2009 . Contact: Meeting Secretariat Tel: 011-44-2-087-411-311 Fax: 011-44-2-087-410-611 Website: www.oaa-anaes.ac.uk Anesthesiology / Obstetrics/Gynecology United Kingdom / Jersey
FORENSIC GYNAECOLOGY May 21-22, 2009 Contact: Conference Office, Royal College of Obstetricians and Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Legal/Ethics / Obstetrics/Gynecology United Kingdom / London
INFECTIOUS DISEASES: ADULT ISSUES IN THE OUTPATIENT AND INPATIENT SETTING LONDON TO IRELAND CRUISE May 24-29, 2009 Contact: MCE Conferences Tel: 888-533-9031 Fax: 858-777-5588 Email: info@mceconferences.com Website: www.mceconferences.com Family Medicine / Internal Medicine United Kingdom / London
BASIC PRACTICAL SKILLS IN OBSTETRICS & GYNAECOLOGY May 26-28, 2009 Contact: Conference Office, Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6245 Fax: 011-44-20-7772-6388 Email: conference@rcog.org.uk Website: www.rcog.org.uk/meetings Obstetrics/Gynecology United Kingdom / London
ENDOSCOPIC SUTURING TECHNIQUES May 27-28, 2009 Contact: Royal College of Surgeons of England Tel: 011-44-20-7869-6337 Email: MIS@rcseng.ac.uk Website: www.rcseng.ac.uk Surgery United Kingdom / London
CURRENT ISSUES IN SEXUAL HEALTH May 28-29, 2009 Contact: Mark Allen Group Tel: 011-44-20-7501-6762 Fax: 011-44-20-7733-8174 Email: conferences@markallengroup.co.uk Website: www.mahealthcareevents.co.uk Infectious Disease United Kingdom / London
PROGRESS IN STEM CELL BIOLOGY May 29, 2009 . Contact: EuroSciCon Email: enquiries@euroscicon.com Website: www.euroscicon.com Biochemistry / Hematology United Kingdom / Welwyn Garden City
2008 BRITISH FERTILITY SOCIETY (BFS) SUMMER COLLEGE September 02-05, 2008 Obstetrics/Gynecology / Urology Contact: BFS Secretariat Tel: 011-44-145-464-2217 Fax: 011-44-145-406-42222 Email: bfs@bioscientifica.com Website: www.britishfertilitysociety.org.uk United Kingdom / Liverpool 2008 EUROPEAN HEADACHE & MIGRAINE TRUST INTERNATIONAL CONGRESS September 04-07, 2008 - Neurology Contact: Hampton Medical Conferences Ltd. Tel: 011-44-20-8979-8300 Fax: 011-44-20-8979-6700 Email: enquiries@ehmticongress2008.com Website: www.hamptonmedical.com United Kingdom / London 2008 ANNUAL AND ACADEMIC MEETING OF BRITISH ASSOCIATION FOR PAEDIATRIC OTORHINOLARYNGOLOGY (BAPO) September 12, 2008 - Otolaryngology / Pediatrics Contact: BAPO Tel: 011-44-118-322-7137 Email: bapo@mac.com Website: www.bapo.org.uk United Kingdom / Epsom 15TH PAEDIATRIC RHEUMATOLOGY EUROPEAN SOCIETY CONGRESS. September 14-17, 2008- Pediatrics / Rheumatology Contact: Hampton Medical Conferences Tel: 011-44-020-8979-8300 Fax: 011-44-020-8979-6700 Email: pres2008@hamptonmedical.com Website: www.pres2008.ukevents.org United Kingdom / London 2008 SCIENTIFIC CONFERENCE OF THE BRITISH HYPERTENSION SOCIETY September 15-17, 2008 - Cardiology Contact: Gerry McCarthy, Hampton Medical Conferences Ltd Tel: 011-44-208-979-8300 Fax: 011-44-208-979-6700 Email: gmccarthy@hamptonmedical.com Website: www.bhsoc.org/courses_conferences.htm United Kingdom / Cambridge 2008 ANNUAL CONGRESS OF THE BRITISH ORTHOPAEDIC ASSOCIATION (BOA) September 16-19, 2008 Orthopedics Contact: BOA Tel: 011-44-207-405-6507 Fax: 011-44-207-831-2676 Email: N/A Website: www.boa.ac.uk United Kingdom / Liverpool JOINT CONFERENCE OF THE BRITISH THORACIC SOCIETY AND THE BRITISH INFECTION SOCIETY: INFECTIONS IN ACUTE MEDICINE. September 16, 2008 General Medicine / Infectious Disease / Respirology Contact: Royal College of Physicians of London Tel: 011-44-207-224-1539 Fax: 011-207-487-5218 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk United Kingdom / London 2ND INTERNATIONAL SYMPOSIUM ON PHEOCHROMOCYTOMA. September 17-20, 2008 Endocrinology / Neurology / Other Specialties Contact: Hampton Medical Conferences Ltd Tel: 011-44-208-979-8300 Fax: 011-44-208-979-6700 Email: isp2008@hamptonmedical.com Website: www.isp2008.ukevents.org United Kingdom / Cambridge
ROYAL FREE HOSPITAL HANDS ON GYNAECOLOGICAL ENDOSCOPY SKILLS WORKSHOP September 17-19, 2008 Obstetrics/Gynecology / Surgery Contact: Therese Eleftheriou, Course Administrator Tel: 011-44-20-7794-0500 ext. 33863 Fax: 011-44-20-7431-1321 Email: courses@gynendo.com Website: www.gynendo.com United Kingdom / London
2008 BRITISH ASSOCIATION OF PERINATAL MEDICINE (BAPM) ANNUAL GENERAL MEETING & FORUM ON CLINICAL GOVERNANCE IN PERINATAL CARE September 17, 2008 Pediatrics Contact: BAPM Office Tel: 011-44-20-7092-6085 Fax: 011-44-20-7092-6001 Website: www.bapm.org United Kingdom / London
CHRONIC FATIGUE SYNDROME BRISTOL September 18, 2008 Family Medicine / General Medicine / Psychiatry / Rheumatology Contact: Joyce Achampong, Regional Events Co-ordinator Tel: 011-44-20-7290-2980 Fax: 011-44-20-7290-2989 Email: joyce.achampong@rsm.ac.uk Website: www.rsm.ac.uk United Kingdom / Bristol
MANAGEMENT OF CHRONIC KIDNEY DISEASE September 22-25, 2008 Family Medicine / General Medicine / Nephrology Contact: Dr Charlotte Moonan, University of Warwick Tel: 011-44-24-7652-3540 Fax: 011-44-24-7652-3701 Email: Charlotte.Moonan@warwick.ac.uk Website: www.britishrenal.org United Kingdom / Coventry
50TH ANNIVERSARY ANNUAL SCIENTIFIC MEETING OF SCOTTISH SOCIETY OF PHYSICIANS September 26-27, 2008 General Medicine Contact: Hampton Medical Conferences Ltd. Tel: 011-44-20-8979-8300 Fax: 011-44-20-8979-6700 Email: ssp@hamptonmedical.com Website: www.hamptonmedical.com United Kingdom / Glasgow
2ND INTERNATIONAL CONFERENCE OF THE SOCIETY FOR ACUTE MEDICINE September 29-30, 2008 Emergency Medicine / General Medicine / Internal Medicine Contact: Christina Lawson, Eventage Tel: 011-44-41-639-8123 Fax: 011-44-41-639-8123 Email: christine.lawson@eventage.co.uk Website: www.acutemedicine.org.uk United Kingdom / London
CHILDBIRTH AND PELVIC FLOOR TRAUMA October 02-03, 2008 Obstetrics/Gynecology Contact: Conference Office, Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6200 Fax: 011-44-20-7723-0575 Email: through website Website: www.rcog.org.uk United Kingdom / London
REFRESHER DAY ON OBSTETRIC ANAESTHESIA AND ANALGESIA October 08, 2008 Anesthesiology Contact: Obstetric Anaesthetists' Association Secretariat Tel: 011-44-20-8741-1311 Fax: 011-44-20-8741-0611 Email: available through webpage Website: www.oaa-anaes.ac.uk United Kingdom / London
A NEW ERA FOR STROKE PATIENTS. October 14, 2008 Cardiology Contact: Royal College of Physicians of London Tel: 011-44-207-224-1539 Fax: 011-207-487-5218 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk United Kingdom / London
UPDATES IN INTERNAL MEDICINE October 17, 2008 Internal Medicine Contact: Mrs. Anne Fairbairn, Royal College of Physicians of Edinburgh Tel: 011-44-131-247-3649 Fax: 011-44-131-220-4393 Email: a.fairbairn@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events United Kingdom / Edinburgh
ACUTE AND GENERAL MEDICINE FOR THE PHYSICIAN. October 27-29, 2008 General Medicine Contact: Royal College of Physicians of London Tel: 011-44-207-224-1539 Fax: 011-207-487-5218 Email: conferences@rcplondon.ac.uk Website: www.rcplondon.ac.uk United Kingdom / London
DIABETES & ENDOCRINOLOGY: SOMETHING FOR EVERYONE October 29, 2008 Endocrinology / General Medicine / Geriatrics Contact: Christine Berwick, Royal College of Physicians of Edinburgh Tel: 011-44-131-247-3634 Fax: 011-44-131-220-4393 Email: c.berwick@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events United Kingdom / Edinburgh CARDIOVASCULAR MEDICINE October 31, 2008 Cardiology Contact: Ms. Eileen Strawn, Symposium Co-ordinator Tel: 011-44-131-225-7324 Fax: 011-44-131-220-4393 Email: e.strawn@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events United Kingdom / Edinburgh
36TH MEETING OF THE BRITISH SOCIETY FOR PAEDIATRIC ENDOCRINOLOGY & DIABETES November 05-07, 2008 Endocrinology / Pediatrics Contact: Shirine Borbor Tel: 011-44-1454-642-210 Fax: 011-44-1454-642-222 Email: conferences@endocrinology.org Website: www.bsped.org.uk United Kingdom / Swansea
2ND EUROPEAN NEW YORK SCHOOL OF REGIONAL ANESTHESIA (NYSORA) SYMPOSIUM ON REGIONAL ANAESTHESIA & PAIN MEDICINE November 07-09, 2008 Anesthesiology / Pain Management Contact: Pat Pokorny, Course Secretariat, ChoiceLive Tel: 011-44-870-013-2930 Fax: 011-44-870-013-2940 Email: pat.pokorny@choicelive.com Website: events.choicegroup.co.uk United Kingdom / London
THREE-DAY COURSE ON OBSTETRIC ANAESTHESIA AND ANALGESIA November 10-12, 2008 Anesthesiology / Obstetrics/Gynecology Contact: Meeting Secretariat Tel: 011-44-2-087-411-311 Fax: 011-44-2-087-410-611 Website: www.oaa-anaes.ac.uk United Kingdom / London
MEDICAL COMPLICATIONS IN PREGNANCY November 10-12, 2008 Anesthesiology / General Medicine / Obstetrics/Gynecology Contact: Symposium Office, Imperial College London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp United Kingdom / London JOINT UK CONSENSUS CONFERENCE ON ACUTE MEDICINE November 13-14, 2008 Emergency Medicine / General Medicine / Internal Medicine Contact: Mrs. Margaret Farquhar, Consensus Conference Co-ordinator Tel: 011-44-131-247-3636 Fax: 011-44-131-220-4393 Email: m.farquhar@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events United Kingdom / Edinburgh
55TH ROYAL COLLEGE OF OBSTETRICIANS & GYNAECOLOGISTS STUDY GROUP FOLLOW UP: CANCER & REPRODUCTIVE HEALTH November 19, 2008 Obstetrics/Gynecology / Oncology Contact: Conference Office, Royal College of Obstetricians & Gynaecologists Tel: 011-44-20-7772-6200 Fax: 011-44-20-7772-6388 Website: www.rcog.org.uk United Kingdom / London
2008 NEONATAL UPDATE November 24-28, 2008 Obstetrics/Gynecology Contact: Symposium Office, Imperial College London Tel: 011-44-20-7594-2150 Fax: 011-44-20-7594-2155 Email: sympreg@imperial.ac.uk Website: www.prossl.com/symposiassl/events.asp United Kingdom / London
NEUROLOGY: ROYAL COLLEGE OF PHYSICIANS OF EDINBURGH SYMPOSIUM November 27, 2008 Neurology Contact: Mrs. Margaret Farquhar, Symposium Co-ordinator Tel: 011-44-131-247-3636 Fax: 011-44-131-220-4393 Email: m.farquhar@rcpe.ac.uk Website: www.rcpe.ac.uk/education/events United Kingdom / Edinburgh
Browse the December 2010 PDF Booklet (Volume 3 Number 4)