Tag Archives: training

Drug therapy From treating dropsy… Treating congestion is an essential role of the heart failure specialist with diuretic therapy being the cornerstone of treatment. There is an evidence vacuum, however, in how best to relieve congestion. For example, which agents to use, at what doses and with what escalation strategy? Dr Peter Cowburn (Southampton General Hospital) delivered an exemplary lecture highlighting the importance of relieving congestion, the current evidence base and practical advice from his personal experience on how best to achieve the goal of euvolaemia. Relieving congestion matters and, when achieved, is associated with lo

Opportunity for global health Over 40% of UK medical students gain experience in a developing country during their elective rotation, broadening perspective on disease and healthcare, as well as personal development by experiencing different cultures.3 Experience in low- and middle-income countries (LMICs) during postgraduate training offers similar benefits, but the number of trainees who embark on such rotations is comparatively small and restricted to particular specialties in the UK. According to the 2012 British Junior Cardiologists Association trainee survey, 66% of trainees had completed or planned to undertake a clinical fellowship, w

The consultant workforce in ACHD in the UK is small, and faces substantial shortages. With very few trainees currently opting to train in ACHD, the workforce will fall even further behind, as patient numbers and complexity increase.5 A career in congenital heart disease – what does it offer the cardiologist? A career in ACHD offers a professional lifetime of endless variation. In outpatients, you will see patients with infinitely variable anatomy and often complex physiology, over the course of many years, and through many medical and non-medical lifetime events. Fewer patients need inpatient care, and, when required, this is usually due to

(more…)

The three trainees and their supervisor. From left to right: Dr Sarah Soar, Dr Philippe Wheeler,Dr Laura Styles and Dr Abdallah Al-Mohammad Introduction For newly qualified doctors, the Foundation Programme provides a stimulating and exciting entry into a career in medicine. As the name suggests, doctors work within a range of specialties and environments in order to build on the knowledge learnt at medical school, and develop as a clinician in preparation for specialty training. We had the privilege of being the first to work as foundation doctors in a new role – FY1 in heart failure – and, in this article, we hope to outline some of the

Professor Miriam J Johnson Overcoming barriers The misunderstanding that palliative care is only for those in the last few days or weeks of life, only to be implemented once all other options are gone and irreversible deterioration is certain, forms a major barrier to access to palliative care. Attempts to identify a prognostic tool to identify when palliative care should be employed have failed, and the consensus is that a problem-based approach is more fit for purpose.11–12 Such a model would enable the “concerns of today” facing the patient to be addressed in the context of the management options appropriate at their stage of disease

Introduction In the modern era, patient safety has become one of the most important issues facing doctors and institutions. Cardiology is a craft speciality. Procedures must be learnt by trainees, but there is a risk, in so doing, of harming patients. The purpose of this study was to ask whether it is possible, albeit within a single institution, to provide training in coronary angiography at a district general hospital (DGH) without causing harm, by comparing the complication rate of trainees with consultants in a large case series. Methods Between August 2010 and December 2013, procedural complications resulting from cardiac catheterisation

Moreover, the quality of ECG interpretation remains completely obscure to the patient. When any healthcare professional speaks to a patient about that patient’s ECG, the patient automatically assigns to the healthcare professional a degree of competence in the said professional’s ability to read the ECG, which the patient (very reasonably) presumes the professional to have. Sadly, this confidence is usually misplaced. Furthermore, the healthcare workers themselves are often completely unaware of their lack of competence. Possible solutions There are three possible approaches to the alleviation of this problem: (i) the use of computers in

Introduction The scientific evidence for cardiovascular (CVD) disease prevention is compelling but, as demonstrated by the EUROASPIRE and ASPIRE-2-PREVENT surveys, translating this evidence into effective patient care in the real-world in clinical practice is challenging.1,2 However, the same academic group have undertaken a number of trials and have shown that it is possible to implement national and international clinical guidelines and achieve the lifestyle, medical and therapeutic targets associated with reduced cardiovascular events and improved health outcomes.3-5 In recognising the need to bridge the implementation gap for prevention a

(more…)