Medical Journal News

Earlier this year I gave birth to a bouncing baby girl, an 8 lb 4 oz bundle of joy. The euphoric moment was made even more special by its contrast with a gruelling pregnancy. This was my third pregnancy but my first experience of following a high risk care pathway. Although I’ve rarely had a body mass index (BMI) below 35, my first two pregnancies managed to slide under the medical radar. This time I was much older, and somewhat fatter, with a BMI of 41. I was referred to a consultant led clinic and assigned to the high risk category.We know that risk operates on a continuum, but my categorisation as high risk during this pregnancy was entirely binary. It defined me for those nine life changing months. I felt helpless. Even if I had wanted to take action to reduce my weight, no one recommends dieting or a...

For the past 18 months staff at Plymouth University’s Peninsula Medical School have been working hard to develop a medical apprenticeship programme, an alternative route into medicine beyond the current medical degree course.1 In partnership with NHS employers, the university came up with a radical four year programme that would allow apprentices to work and study mainly where they lived.The programme was aimed at graduates already in healthcare who hadn’t previously had the opportunity to become doctors, says Laura Bowater, head of the medical school (box 1). But late last year, just as the team was about to seek the first cohort of apprentices to start this September, they were told by the government to pause recruitment.2Box 1What are medical apprenticeships?Medical apprenticeships (also called medical doctor degree apprenticeships or NHS doctor apprenticeships) aimed to open an alternative route into medicine beyond the current medical degree course.“The main difference between the...

I have been in a lot of spaces over the years where people were not convinced about patient engagement in research. They often feel that they already have enough to do, or that this is “yet another” hoop that funding agencies are requiring them to jump through. I am writing this for you. I am not entirely sure that I will change your mind, but hopefully I can get you to think about some of your objections and why patient engagement in research is generally a good thing.Patients are vulnerable in most systemsFirstly, I would ask you to consider that patients are pretty much at the bottom of the pecking order in most situations or settings. In healthcare, they are beholden to healthcare providers and are obliged to behave like a “good patient.”` A good patient asks questions gently or strategically (or not at all!), avoids being too “difficult,” and...

Boytchev and colleagues investigate the fossil fuel industry’s influence on medical research.1 We deeply appreciated The BMJ’s bold decision in 2020 to ban advertising and research funded by companies producing fossil fuels—a ban now being extended to other BMJ Group journals.23 This principled action sets an important precedent for medical publishing and underscores the critical need to tackle the profound conflicts of interest tied to such funding.The external costs associated with the global energy system, primarily driven by fossil fuels, are staggering. Estimates, such as the maximum of $169.43tn calculated by Sovacool et al,4 vastly surpass the entire annual global gross domestic product. These external costs include extensive damage to health, ecosystems, and economies, disproportionately affecting vulnerable populations. We acknowledge that the energy transition is complex and there is potential for responsible innovation in the energy sector, but the sheer scale of these costs highlights the urgent need for systemic...

bmj;388/jan22_11/r97/FAF1faSanath graduated in 1997 and obtained a diploma in orthopaedics in 1999 from Manipal Academy of Higher Education, Mangaluru, India. He trained and worked at St John’s Medical College, Bangaluru, from 1999 until 2003.He married his classmate, Usha Rao, in May 2000 and they came to the UK in 2003. Sanath did further training in orthopaedics and took up a specialty doctor post in trauma and orthopaedics at the Glan Clwyd Hospital, Bodelwyddan, North Wales. He was integral to the working and development of the department and was also associated with University of Liverpool School of Medicine, training juniors and acting as an examiner.Besides medicine, both Sanath and Usha, a consultant obstetrician and gynaecologist and dance teacher, took a keen interest in community activities, organising social and cultural events. They believed that children should be versed in the arts and culture of the land of their parents. Sanath was a...

It is right to highlight that NHS staff felt the “strain and trauma” of caring for patients with covid-19.1 Although the risks of this viral infection have lessened, it is still a hazard for healthcare workers and their patients.Recent advice from the Joint Committee on Vaccination and Immunisation (JCVI)2 does not make provision for healthcare workers in forthcoming rounds of covid-19 vaccination. This advice lacks its previous explicit qualification that separate considerations may apply for this group.3Both good occupational health practice and UK Health and Safety Law4 warrant a more protective and precautionary approach “to ensure health, safety, and welfare at work.”5 That healthcare workers have more than double the of risk of the general population of contracting covid-19 is well recognised, as are the post-acute consequences.6 Furthermore, the acknowledgment3 that measures such as vaccination are “reasonably practicable,”7 as well as WHO advice,8 would weigh heavily in any court judgment...

A police civic volunteer accused of raping and murdering a female junior doctor at the hospital where she worked has been sentenced to life imprisonment by an Indian court.The doctor’s murder last August, and the initially slow response by authorities, made international headlines and triggered nationwide protests, doctors’ strikes, and rioting.1The sentence has prompted outrage from activists, politicians, and the victim’s parents, who asked why the death penalty had not been applied. Capital punishment by hanging was introduced for the most egregious crimes of lethal sexual violence after a national outcry over the 2012 gang rape and murder of a female physiotherapy student on a Delhi bus.But Judge Anirban Das told the court on 20 January, “I do not consider [the doctor’s murder] as a rarest-of-rare crime” that would put it in that category. This went against a submission requesting the death penalty from India’s Central Bureau of Investigation (CBI)....

In this paper by Dell-Kuster and colleagues (BMJ 2020;370:m2917, doi:10.1136/bmj.m2917, published 25 August 2020), the author name “Orestis Ioannidis” was ordered the wrong way round in the submitted manuscript. This has since been corrected in the article and PDF.

I still remember receiving my first letter from Harvard Medical School—and no, it wasn’t an acceptance letter. I was a student in the thick of pre-med requirements, trying to decide on the next institution I would trust with my dream of becoming a doctor. The letter was from Harvard’s Office of Recruitment and Multicultural Affairs, with information to help students like me, who are under-represented in medicine, apply to medical school. I revisited the list of medical schools I was applying to and added Harvard.Initiatives like this one, which are aimed at promoting diversity, equity, and inclusion (DEI), made it clear that I am needed and belong in medicine as a black woman. Today, DEI is under attack—and the effects of anti-DEI rhetoric and legislation on medicine will further marginalise black women, both seeking and providing healthcare, for years to come.In June 2023, the US Supreme Court ruled that race...

Donald Trump declared two national emergencies and issued a spate of executive orders as he was sworn in as US president for the second time on 20 January. At his inauguration Trump immediately declared a national energy emergency and an illegal immigration emergency at the border with Mexico.123This was swiftly followed by a string of executive orders (box), including withdrawing the US from the Paris climate accord and the World Health Organization. The US is the biggest donor to WHO and also contributes scientific expertise.4 The order said the US would withdraw from the WHO “due to the organization’s mishandling of the covid-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.”It said WHO “continues to demand unfairly onerous payments from the United States, far...