Abstract:
BACKGROUND:Workforce studies show a declining proportion of UK junior doctors proceeding directly to specialist training, with many taking career breaks. Doctors may be choosing to delay this important career decision. AIM:To assess doctors' views on the timing of choosing a clinical specialty. METHODS:Surveys of two cohorts of UK-trained doctors 3 years after qualification, in 2011 and 2015. RESULTS:Presented with the statement 'I had to choose my career specialty too soon after qualification', 61% agreed (27% strongly) and 22% disagreed (3% strongly disagreed). Doctors least certain about their choice of specialty were most likely to agree (81%), compared with those who were more confident (72%) or were definite regarding their choice of long-term specialty (54%). Doctors not in higher specialist training were more likely to agree with this statement than those who were (72% vs 59%). Graduate medical school entrants (ie, those who had completed prior degrees) were less likely to agree than non-graduates (56% vs 62%). Qualitative analysis of free text comments identified three themes as reasons why doctors felt rushed into choosing their future career: insufficient exposure to a wide range of specialties; a desire for a greater breadth of experience of medicine in general; and inadequate career advice. CONCLUSIONS:Most UK-trained doctors feel rushed into choosing their long-term career specialty. Doctors find this difficult because they lack sufficient medical experience and adequate career advice to make sound choices. Workforce trainers and planners should enable greater flexibility in training pathways and should further improve existing career guidance.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Lachish S,Goldacre MJ,Lambert TWdoi
10.1136/postgradmedj-2017-135460subject
Has Abstractpub_date
2018-11-01 00:00:00pages
621-626issue
1117eissn
0032-5473issn
1469-0756pii
postgradmedj-2017-135460journal_volume
94pub_type
杂志文章abstract::A previously undescribed type of congenital abdominal wall hernia is described. Presentation was with the symptoms and signs of subacute large bowel obstruction. The diagnosis was suggested by barium enema and confirmed at laparotomy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.760.112
更新日期:1989-02-01 00:00:00
abstract::A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.660.746
更新日期:1980-10-01 00:00:00
abstract:INTRODUCTION:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been caused the greatest pandemic of our century. Many of the deaths related to it are due to a systemic inflammatory response, which has been called 'cytokine storm'. OBJECTIVES:We developed a comprehensive review of the pathophysiology mec...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138791
更新日期:2020-10-02 00:00:00
abstract:OBJECTIVE:To establish a cerebral hypoxia ischaemic model in piglets and to explore the early diffusion weighted imaging (DWI) as well as the expression of heat shock protein 70 (HSP70) with hypoxic ischaemic encephalopathy (HIE). METHODS:Twenty four 3 day old piglets were permanently ligated common carotid arteries b...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.030114
更新日期:2005-09-01 00:00:00
abstract::A 65 year old man was admitted with segmental consolidation of the left upper lobe after having stayed in a hotel for 2 days. He deteriorated rapidly on conventional antibiotic therapy and required ventilatory support. Acinetobacter calcoaceticus var. anitratus was grown from the sputum and blood cultures, which was t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.818.934
更新日期:1993-12-01 00:00:00
abstract::Video evaluation of resuscitation is becoming increasingly integrated into practice in a number of clinical settings. The purpose of this review article is to examine how video may enhance clinical care during resuscitation. As healthcare and available therapeutic interventions evolve, re-evaluation of accepted paradi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2016-134357
更新日期:2017-08-01 00:00:00
abstract::Six cases of tuberculous meningitis, all occurring in patients over the age of 65, are described. All patients presented with an acute illness, primarily with a confusional state. Headache was a symptom in only two patients and the cases were not confined to ethnic minority groups. The mortality was 50%. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.707.586
更新日期:1984-09-01 00:00:00
abstract::We report the case of a young man with Fusobacterium necrophorum meningitis who developed bilateral carotid artery stenosis associated with thrombosis of the cavernous sinuses. Intraluminal clot was present in the region of the stenoses for which he was anticoagulated. The clinical presentation, problems with diagnosi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.779.747
更新日期:1990-09-01 00:00:00
abstract::The clinical syndrome of heart failure has been investigated so extensively that it may now almost be regarded as a metabolic disorder. Although an initial insult reduces cardiac pump efficacy, the resultant physiological response culminates in complex neurohormonal dysfunction. This has created confusion and prevente...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.75.886.453
更新日期:1999-08-01 00:00:00
abstract::A patient with carcinoma of the stomach invading multiple adjacent organs and fungating through the anterior abdominal wall was treated by en bloc multiple organ resection and abdominal wall reconstruction. The patient is alive and well at the time of writing, six months after the operation. The rationale for embarkin...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.835.303
更新日期:1995-05-01 00:00:00
abstract::Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic rev...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/thx.2006.075754
更新日期:2007-11-01 00:00:00
abstract::Four studies have been carried out on propofol in this department, one being part of a multicentre trial. The minimum induction dose in unpremedicated patients was found to be 2.5 mg/kg. Propofol has been shown to be an acceptable induction agent, although with an incidence of pain on injection which is much higher wh...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1985-01-01 00:00:00
abstract::We report a 71 year old lady who presented with weight loss, rectal bleeding and bilateral foot drop having been previously fit and well. Clinical examination, laboratory investigation and postmortem examination confirmed the diagnosis of active Crohn's disease and acute peripheral neuropathy. The clinical course of t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.828.762
更新日期:1994-10-01 00:00:00
abstract::We describe the occurrence of primary hyperaldosteronism in two sisters. Although this is only the second published report of familial Conn's syndrome, it does have implications for the relatives of patients with Conn's syndrome and these are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.806.976
更新日期:1992-12-01 00:00:00
abstract::A 27 year old woman with hepato-lenticular degeneration (Wilson's disease) was found to have primary hepatocellular carcinoma (PHC) three and a half years after she was started on treatment with D-penicillamine. The tumour was resected since when she has remained well. Her liver function tests were normal throughout t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.714.357
更新日期:1985-04-01 00:00:00
abstract::The effective training of facilitator/ tutors is crucial to the success of a problem-based learning approach to medical education. New skills are needed to accomplish the change from giver of information to facilitator of learning, coach, and guide. This paper outlines considerations for the design of a tutor training...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.850.474
更新日期:1996-08-01 00:00:00
abstract::Serum concentrations of LH, FSH, testosterone and prolactin were measured in patients with hypertension treated with propranolol (34 cases), methyldopa (13 cases), and methyldopa + propranolol (11 cases). The results were compared with those obtained in 18 controls (hospital out-patients). There were no differences in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.669.425
更新日期:1981-07-01 00:00:00
abstract::Colonoscopies performed in patients aged 80 years or older at the Sheba Medical Center were analysed according to the primary indication for the procedure: 101 colonoscopies were performed because of rectal bleeding of at least 2 months duration, and 335 for all other indications. Carcinoma of the large bowel was foun...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.799.355
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:This explorative study was triggered by the '#hellomynameis' campaign initiated by Dr Kate Granger in the UK. Our objectives were twofold: first, to measure rates of introduction in an Irish hospital setting by both consultant and non-consultant hospital doctors. Second to establish whether such practices we...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2017-135402
更新日期:2018-04-01 00:00:00
abstract::I report a case of a large liver abscess causing a severe debilitating condition in which the diagnosis was delayed by several weeks following two normal ultrasound scans at days 5 and 19 of the illness. Up to one in four cases of liver abscess can be missed on ultrasound. A high degree of clinical suspicion must be m...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.751.373
更新日期:1988-05-01 00:00:00
abstract::A case of skin necrosis at the sites of injection of subcutaneous heparin is described. The patient went on to develop heparin-induced thrombocytopenia and pulmonary embolism. Review of the previously described cases of heparin-associated skin necrosis reveals that this sequence of events is not uncommon. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.66.777.573
更新日期:1990-07-01 00:00:00
abstract::The earliest manifestations of leukaemia often include rheumatic signs and symptoms. Arthritis is a well recognised complication of leukaemia in children, but acute and chronic leukaemia may also cause arthritis in adults. Leukaemic arthritis may occur at any time during the course of leukaemia and may be the presenti...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.885.425
更新日期:1999-07-01 00:00:00
abstract::Amlodipine is a dihydropyridine calcium antagonist with a unique pharmacokinetic profile providing advantages over other therapies of its kind. It has been shown to possess high oral absorption, long elimination half-life, smooth onset of action and long duration of pharmacodynamic activity. These properties result in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::The effects of infusions of prostaglandin E1 (PGE1) on platelet deposition at atherosclerotic sites in vivo in man have been examined. Thirteen patients with atherosclerotic vascular disease received intravenous PGE1 25 mg/kg/min for 6 hours daily for 5 days. Prostaglandin E1 had no effect on platelet uptake at athero...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.738.245
更新日期:1987-04-01 00:00:00
abstract::Very few cases of acquired severe copper deficiency have been described. The principal effects are haematological, but the precise abnormalities are uncertain due to the possible association of other deficiencies. A case of isolated severe copper deficiency associated with late onset hypogammaglobulinaemia is reported...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.737.205
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Obesity has been declared a 21st century pandemic by WHO. Yet surveys reveal physicians-in-training are uncomfortable managing obesity. One major barrier is the lack of residency education on obesity management. This study incorporates an obesity-specific didactic curriculum into an internal medic...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132821
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Despite obesity being a major risk factor for ischaemic stroke (IS), the association between body mass index (BMI) and IS in patients with hypertension remains uncertain. OBJECTIVE:To assess the association between BMI and IS among elderly hypertensive patients in China. METHODS AND RESULTS:We recruited 35...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-137457
更新日期:2020-03-27 00:00:00
abstract::Thirty patients who had undergone major abdominal surgery were randomly assigned to a continuous infusion of either 0.45 mg meptazinol/kg/hr or 0.3 mg pethidine/kg/hr. Analgesia was assessed by rating scale, ranging from 0 (no pain) to 10 (unbearable pain), and by questionnaire. Respiration rate was closely monitored ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-01-01 00:00:00
abstract::Two hundred and sixty one patients attending a geriatric service were asked to give details of their usual medications without reference to drug bottles or written lists. Recall was tested in 4 categories: name of drugs, drug dosage, frequency of administration, and reason for the drug being prescribed. Drug recall wa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.772.116
更新日期:1990-02-01 00:00:00
abstract::A 12 year old boy presenting with hypercalcaemia (calcium 3.25 mmol/l) and osteopaenia with multiple osteolytic lesions was found to have acute lymphoblastic leukaemia without lymph-adenopathy or organomegaly. Hypercalcaemia is a rare feature of acute leukaemia, but the patients previously described all show very simi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.812.483
更新日期:1993-06-01 00:00:00