Tuesday, 18 February 2014

GMC Good Medical Practice in a nutshell

Below is our selection of the best interactive cases from the GMC Good Medical Practice website regarding capacity. These cases take less than 5 minutes each - so go on, refresh your clinical knowledge.
In each case you can see how your decisions match up with the GMC guidance.

a) Severe learning disability
A young lady with severe learning disabilities presents to you with her mother. The young lady has very little speech and her mother explains that she has not been eating well and only taking small sips of water for the last 5 days. Her mother feels she may be in some kind of pain. What would you do?

b) Pelvic pain in a patient who is Deaf
A 35 year old lady is referred to O&G for ongoing pelvic pain. She is Deaf and although she can lip-read her preferred language is British Sign Language (BSL). She is deemed to need an exploratory laparotomy and your consultant has asked you to consent her for it- what would you do?

c) Alzheimer's Disease
A 75 year old gentleman diagnosed with Alzheimer's disease a year ago presents to you with his daughter. He has abdominal pain that has not settled, but is adamant he does not want to go to hospital for investigations. What would you do?

For more information regarding capacity please follow this link to GMC capacity guidance:

Sign up to our website as a member for FREE to access more articles like this!

Tuesday, 11 February 2014

Mid-year Review checklist

Mid-year Review Checklist


Set aside one evening to sit and create a list of the sections of your portfolio that need updating. Leave space opposite each point you list to add ideas of what you could add to this section/how you can make it better.

Our tip: For many of us this list will be rather long, so we suggest trying to do this at least a few weeks before your agreed mid-year review with your supervisor.


Think of all the courses/seminars you have attended and try to track all the certificates down. Then start to upload these every day for a week.

Our tip: Try to have one folder or box that you ALWAYS put certificates in, otherwise they are likely to go missing (always a harrowing experience). 

Also, upload your evidence and certificates whilst watching something on the T.V. it will make it slightly less painful.


Ensure that your list of audits/research studies and quality improvement projects is up-to-date on your portfolio.

Our tip: This mid-year review is a good time to start setting deadlines with colleagues to ensure things don't just drag on and on.


Review your study leave entitlement and budget. No-one will check this for you, you need to plan what study leave you are entitled to and start booking courses so that you don't get to the end of the year without having used the resources you are entitled to.

Our tip: A shameless plug I'm afraid, take a look at our courses on our website www.astutemedicaltraining.co.uk to see what might be of interest to you. 

We are releasing more dates regularly and plan to have new locations soon as well. Having a variety of national locations will mean that you can find a course that is local to you, which means you save on travel expenses AND get quality teaching.


Update your C.V. with your current jobs. It is an arduous task, but alas it has to be done.

Our tip: Don't wait until someone asks you for your C.V.  to update it! Make it routine practice in the first week of a new job to ensure you update your C.V. with details of this job and update roles and responsibilities of your last job.

Obviously, a lot of the advice above is easier said than done whilst balancing endless night shifts and on-calls, but even an hour every other week can improve your portfolio.

Hopefully this inspires you to start giving your portfolio an overhaul.

Let us know how your portfolio overhaul is going via twitter @Astute_Medical

Tuesday, 4 February 2014


Professor Sir Bruce Keogh, National Medical Director released a paper outlining a proposed shift in the current NHS working practices.
A summary of some of the key points can be find below:


Data for mortality rates, patient experience, length of hospital stay and re-admission rates showed a
significant trend of negative outcomes for patients admitted to hospitals at the weekend across the NHS in England.


The reduced level of service provision on the weekend has been shown to be linked with poorer outcomes for patients admitted to hospital as an emergency.
Junior doctors feel unconfident and unsupported at weekends, and hospital chief executives are worried about clinical weekend cover.
"It also seems inefficient that in many hospitals expensive diagnostic machines, laboratory equipment and pathology laboratories are underused, operating theatres lie fallow and clinics remain empty, while access to specialist care is dogged by waiting lists and general practitioners and patients wait for diagnostic results."
- Professor Keogh 2013


There is no definitive reason for variation between weekday and weekend. Rather there are consequences of multi-factorial that are likely to give rise to variation:
  • Fewer onsite consultants providing experience and clear decision making
  • Variable staffing levels
  • Lack of diagnostic and scientific services
  • Lack of supporting community and primary care services


Improvements in clinical outcomes and patient experience at weekends should be seen by the end of 2016/17.


There is no ‘one size fits all’ answer to introducing seven day urgent and emergency care services - local solutions will need to be found.

Patients (and where appropriate families and carers), must be actively involved in decision making.
This must be supported by clear information to make fully informed choices about investigations, treatment and on-going care that reflect what is important to them.

Emergency admissions must be seen and have a thorough clinical assessment by a suitable consultant at the latest within 14 hours of arrival at hospital.

Emergency inpatients must be assessed for complex or on-going needs within 14 hours by a multi-professional team, unless deemed unnecessary by the responsible consultant.

An integrated management plan with estimated discharge date and criteria for discharge must be in place along with completed medicines reconciliation within 24 hours.  

Standardised handovers: designated time and place, with multi-professional participation and the relevant in-coming and out-going shifts led by a competent senior decision maker.

Documentation, communication and handover processes should be reflected in hospital policy.

Access to diagnostic services and Consultant reporting.
• Within 1 hour for critical patients
• Within 12 hours for urgent patients
• Within 24 hours for non-urgent patients

Outpatient-directed interventions must be available either on-site or through formally agreed arrangements with clear protocols. 

For example: critical care, interventional radiology, interventional endoscopy and emergency general surgery

Where a mental health need is identified in an acute admission the patient must be assessed by psychiatric liaison:
• Within 1 hour for emergency* care needs
• Within 14 hours for urgent** care needs

All patients on the AMU, SAU, ICU & other HDU areas must be seen and reviewed by a consultant twice daily.

To maximise continuity of care consultants should be working multiple day blocks.

Newly transferred acute patients should be reviewed on a consultant ward round once in 24 hours.

Support services, both in the hospital and in primary, community and mental health settings must be available.

To ensure that the next steps in the patient’s care pathway, as determined by the daily consultant-led review, can be taken. 

All those involved in the delivery of acute care must participate in the review of patient outcomes to drive care quality improvement.

The duties, working hours and supervision of trainees in all healthcare professions must be consistent with the delivery of high-quality, safe patient care.


Tuesday, 7 January 2014

Happy New Year 2014

We would like to take this opportunity to wish all of you a happy, healthy and productive 2014!

 We are into our first few days back after the New Year and other festivities. Undoubtedly it was nice to have the mid-week time off, only thing is you come back feeling more tired than when you left AND more broke!

However this week has brought with it good news, we received our formal accreditation as a social enterprise this week! We will be uploading our social accreditation badge to our website within the next few weeks.

We  had been hoping to have the website launch by now unfortunately due to technical difficulties we have had to postpone. As soon as the site is up and ready we will be able to provide our online booking service for professional development courses- so keep watching this space.

For all those who are thinking about New Year's Resolutions this article has proved very popular with our twitter following.  What you should really do with New Year's Resolutions: http://www.theguardian.com/lifeandstyle/2014/jan/03/12-new-years-resolutions-should-be-abandoned

So now you are fully up-to-date with our news and have some food for thought regarding New Year's Resolutions. Astute Medical Training will be publishing a blog every Tuesday on topics relevant to you!

If you ever want to suggest a blog then just tweet us @Astute_Medical or alternatively drop as an email info@astutemedicaltraining.co.uk.

The Astute Medical Training Team

P.S. For medical students and aspiring doctors: www.helpmeimamedic.co.uk

Monday, 23 December 2013

Hello and Welcome to our first blog post!

Hello and Welcome to our first blog post!

Who are Astute Medical Training?

We are a social enterprise organisation designed and run by a group of Doctors and education professionals. We offer continuing professional development services for Doctors at every career stage.

Why is ‘Astute Medical Training’ different?

1) We are a SOCIALLY RESPONSIBLE organisation.

- 10% of our profits from courses are donated to help educate orphans across the globe and help homeless individuals within the UK.

- We believe that being environmentally responsible is everyone’s responsibility; as such we endeavour to recycle our waste responsibly and use products that are from sustainable sources.

- We aim to regularly work with disadvantaged children throughout the UK to help raise aspirations and help Medicine to become a more accessible career to those from non-traditional backgrounds.


Most other organisations working in the same field are managed, and have their courses designed by people who have not been to medical school.

With our experience, and wealth of knowledge from focus groups with Doctors and relevant professionals, we can provide you with focussed services that we feel will help you to be successful in your medical career.

We provide these courses in different formats because we know that finding time to allocate to professional development can be difficult. We are here to help in the most convenient ways possible!


We actively work with delegates post-course to inform you about opportunities that may be of interest, to help further your career. We are always open to guest blogs or articles and work with volunteers to develop their careers and build ideas.

So now you know all about us! Astute Medical Training will be publishing a blog every Tuesday on topics relevant to you!

If you ever want to suggest a blog then just tweet us @Astute_Medical or alternatively drop as an email info@astutemedicaltraining.co.uk.

The Astute Medical Training Team