DIARY SPRING 2008

21/02/08

Following the interactive day at Hartlebury last time, we met today at Redditch for the first "normal" session of this term. Group 3 were scheduled to present Living Wills and as arranged last time we planned to sort the timetable for the rest of the term, so there was a lot to fit in.

During a delay due to technical difficulties, Emma told us about a difficult ethical case involving a serious allegation by a third party of a crime against a minor. This prompted a lively discussion about how best to tackle this sort of case, although the consensus was that involving the child protection team as Emma had was the best way forward.

The session proper was kicked off by Emily who made a great job of presenting the intricacies of the new Mental Capacity Act which came into being in 2007. Despite this being a complex topic the presentation was clear and she told us about some real life scenarios first up which helped to put the topic in context. I will not easily forget the mental picture of Emily chasing patients around the grounds of the Alex armed with a haloperidol loaded syringe.

Tom (C) then followed this on with a good overview of living wills/advance directives with the recent capacity act in mind. Again this was a clear presentation and clarified a difficult topic.

After coffee (unfortunately without the usual cakes), I gave the Hot Topic presentation and having done the AKT recently, gave an overview of the exam and the resources I found useful, namely

AKT revision

Passmedicine.com

Onexamination

RCGP nPEP

Rob Daniels practice papers book.

Finally, with what seemed very little time remaining, we split into groups and brainstormed the timetable for the rest of the term. The topics were decided on a majority vote – very democratic! The feeling was that we had selected some useful topics and seemed to be done fairly quickly and painlessly.

Roy Williams

28/02/08

Sorry about the delay – I forgot I had to write this and have now managed to lose the notes I made so I’m gonna make it up!

3^rd Session of the year, Venue: Kiddi – Room 1, Weather: visibility excellent, sunny spells, slight south westerly, coldish breeze. Parking – dismal.

Opened up in typical fashion, Chris had a quick (prolonged) moan about GP bashing by the press, there was a general belief around the room that the most recent releases about overpaid and under worked GP was simply a way of softening us up for the bashing that will inevitably follow the result of the ‘vote’. I’m sure the discussion will continue in 2 weeks when group 4 talk about current issues in GP. A slightly depressing start but certainly topical.

Olu told us about a snooker player who seemed to playing a game of Russian Roulette with his form….lets hope he won. For a more light hearted look at snooker or to re-live those memories of Top Trumps check out this link:

 http://news.bbc.co.uk/sport1/shared/spl/hi/other_sports/03/sn_world_champs/game/html/initial.stm

Todays main event was led by group 5 on Childhood behavioural problems. Muna kicked off with an in depth presentation on Autism and ADHD queue debate about ADHD vrs Bad Parenting/Normal boisterous Boys (and girls). After tea/coffee we had some cases to discuss as groups and then as a whole to consolidate the previous presentation. Caron then told us about Childhood sleep disorders – sleep walking/night terrors etc and Nick finished up with a very interesting presentation on Child Protection and Abuse using the most recent tragedy of Victoria Climbie to illustrate points.

Cakes provided by ??Veera were of a very high quality – great shout on the custard donuts. Unfortunately there was no time for what I imagine would have been a great hot topic! Oh well.

All in all a good session and most importantly I think we finished on time.

Tom G.

06/03/08

Bottoms – Group 1

We kicked off the session with role play; divided ourselves into 6 groups of 3 with each person taking turns to be examiner, pt and doctor. The cases were very carefully prepared and mostly involved patients with PR bleed and pain ‘down below’, but coming in with other non specific complaints or for routine follow ups. The cases focussed mainly on the fact that patients are reluctant to discuss these kinds of problems, even to the doctor, probably because of embarrassment or due to fear of invasive investigations. Overall, the role plays once again proved to be extremely useful and everyone enjoyed doing it.

After the role plays we had a small ‘Rectal Quiz’ by Vir which mainly involved different slides of common presentations ‘down below’ like haemorrhoids, peri-anal haematomas, fistula, fissure, dermatitis, genital warts etc; we had some discussion regarding whether ‘external haemorrhoids’ and ‘peri-anal haematoma’ meant the same and Roy tried his best to convince everybody that they were not, and that external haemorrhoids arose from the external plexus and peri-anal haematomas didn’t!

This was followed by presentations by Manuel, Emma and Roy regarding common clinical presentations and their clinical features, red flags and management.

The hot topic was done by Tom and was about Cardiovascular Risk Calculation and the use of QRISK, which NICE is likely to recommend for use throughout England. There is some controversy regarding whether this is a cost-cutting exercise by Nice and regarding the validity of the results of the studies which led to the recommendation of QRISK as a method of risk assessment.

Overall the session proved to be really useful and everyone seemed to appreciate the way it was put together by Group 1 and also the Hot Topic presented by Tom which was very interesting and relevant.

Looking forward to see you all next week at Kidderminster!

Bipin

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