Getting Ahead in Medicine: A Guide to Personal Skills for Doctors

193 Pages·1998·41.56 MB·English

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GETTING AHEAD IN MEDICINE
A GUIDE TO PERSONAL SKILLS FOR DOCTORS
C.J.H. Johnson, C.R. Hall
Anaesthetic Department, Southmead Hospital,
Bristol, UK
and
F.C. Forrest
Sir Humphry D a y Department of Anaesthesia,
Bristol Royal Infirmary,
Bristol, UK
BIOS
0 BIOS Scientific Publishers Limited, 1998
First published 1998
All rights reserved. Nop art of this book may be reproduced or transmitted, in any form
or by any means, without permission.
A CIP catalogue record for this book is available from the British Library.
ISBN 1 859960 21 9
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Important Note from the Publisher
The informationc ontainedw ithint hisb ook was obtained byB IOSS cientific
Publishers Ltd from sources believed by ust o be reliable. However, while every effort
has been made to ensure its accuracy, no responsibility for loss or injury whatsoever
occasioned to any person acting or refraining from action as a result of information
contained herein can be accepted by the authors or publishers.
The reader should remember that medicine is a constantly evolving science and while
the authors and publishers have ensured that all dosages, applications and practices
are based on current indications, therem ay be specific practices which differ between
communities. You should always follow the guidelines laid down byth e manufactur-
ers of specific products and the relevant authorities in the countryi n which you are
practising.
Typeset by Creative Associates, OxfordU, K.
Printed by Biddles Ltd, Guildford,U K.
Cover Design by Designersa nd Partners, Oxford, UK.
CONTENTS
(The logos denote topics of practical interest at the skill levels shown.)
Abbreviations viii
Using this book ix
Preface xiii
About the authors XiV
1. Getting a job 1
Career planning 1
Preparation 2
Producing a curriculum vitae 3
The job application G
The appointments procedure 9
Induction procedures 13
2. Organizing yourself 15
Time management 15
Assertion 18
Stress 19
Advice 20
3. Structured training 25
Structure of medicale ducation in the UK 25
Organization of training 26
The process oft raining 27
Appraisal and assessment 29
Counselling 33
Mentoring 34
4. Teaching and learning 37
Learning techniques 37
Small group teaching 41
Problem-based learning 43
Preparing for examinations 45
Passing examinations 47
5. Computers and information technology 51
Computer hardware 51
Computer software 55
Computers in hospitals 58
Basic use of a computer m GO
Finding out information m G3
CONTENTS v
G. Talks and lectures G7
General principles G7
Presenting a clinical case m 71
Presenting at a journal dub m 72
Research presentations m 74
Lecturing m 77
7. Visual aids 81
The media 81
Graphic design 84
Displaying data 85
Producing a basic OHT -l 86
Using a presentation program - 87
8. Quality in medicine 91
Quality 91
Clinical audit 94
Collecting data m 98
Completing a criterion-based clinical audit m 99
Evidence-based medicine 102
Other ways of using evidence to make judgements 103
The valueo f quality initiatives 105
9. Research 107
Research skills 107
Selecting at opic for research 108
Getting ethical consentf or human research 109
Performing research 11 2
Writing a paper 11 4
10. Getting things done 11 9
Management 11 9
Planning 120
Marketing 123
Committees 124
Budgets 127
11. Beginning a consultant job 131
The consultant contract 131
Getting started 133
The clinician as leader 135
Writing a reference 137
Private practice 139
vi GEllING AHEAD IN MEDICINE
12. The structure of health care 145
Historical perspective 145
Organization of health care in Britain 146
Funding health care in Britain 147
Management structurea nd finance in trusts 150
The underlying dilemma of health care 151
The health of the population 152
13. Society, medicine and doctors 153
The historical context 154
Oaths, codes and declarations 156
An ethical approach to decision making in medicine 1G O
Doctors, duties, discipline and complaints 1G 2
14. Skill exercises 163
Appendix Further reading 173
Index 175
CONTENTS v i i
ABBREVIATIONS
A-V audio visual (aid)
ACME Advisory Committee on Medical Establishments
AGMETS Advisory Group on Medical and Dental Education, Traininga nd Staffing
(England and Wales)
AOB any other business (in a committee meeting)
APACHE acute physiology agec hronic health evaluation
ARR absolute risk reduction
BIT binary digit
BMJ British Medical Journal
CAL computer-aided learning
CCST Certificate of Completion of Specialist Training
CD-ROM compact disk-read only memory
CEPOD confidential enquiry into pen-operative deaths
CME continuing medical education
CPC clinico-pathological conference
CPU central processingu nit (of a computer)
CV curriculum vitae
dpi dots per inch (computer screen or printer definition)
DVD digital versatile disk
EEC European Economic Community
EPR electronic patient record
GMC General Medical Council (of the United Kingdom)
GP general practitioner (family doctor)
HMO health maintenance organization
IT information technology
LREC Local Research Ethics Committee
M&M morbidity and mortality (meeting)
MAAG medical audit advisory group
MB megabyte (one million bytes - a unit of computer memory)
MCQ multiple choice questionnaire
MRC Medical Research Council
MREC Multicentre Research Ethics Committee
NCEPOD National Confidential Enquiry into Pen-operative Deaths
NHD notional half day (unit of workload inc onsultant contract)
NHS National Health Senrice (of the United Kingdom)
NNT number needed to treat
OHT overhead transparency
OMR optical mark reader
OSCE objective structured clinical examination
PAS patient administration system
PC personal computer
PRHO pre-registration house officer
POWAR place of work accredited representative
quango quasi-autonomous non-governmental organization
RAM random access memory (of a computer)
RRR relative risk reduction
SHO Senior House Officer
SWOT Strengths/Weaknesses/Opportunities/Threats- a management tool
SPR Specialist Registrar
TRISS trauma injury scoring system
WORM write-once read-many( a form of computer memory)
viii GElTlNG AHEAD IN MEDICINE
USING THIS BOOK
This book consists of 14 chapters, each sub-divided into sections. Each
chapter begins witha set of objectives. Some sections are practical gutiod es
completing a task; others provide background information designed to
make you think more deeply about a topic, or enable you to answer an
interview question. At the end of the book we have included a set of skill
exercises to emphasize the points mentioned in the text and to enable you
to assess your progress.
You could read this book from beginning to end, but we think that you
would rapidly become saturated with information. Instead we recommend
that you select the sections that are relevant to you at each stage in your
career. To help you select which topics to read about, we have divided the
book into four skill levels:
Level 1 Appropriate for student and pre-registration house officer years
Level 2 Required as a senior house officer
Level 3 Learneda s a registrar
Level 4 Acquired as an experienced registrar or consultant
You will find these categories in the boxes overleaf. Practical information
relating to these skill levels isa lso indicated in the Contents list.
We have been anxious to keep this book compact, so there are some large
topics that we have deliberately covered superficially. Whapenp ropriate, we
have included references to other texts whichw e think will enable the inter-
ested reader to explore a subject in greater detail.
We know from the comments we received from those who read drafts of
this book thatd octors hold disparate views about, for instance,t he best way
to give a case presentation or produce a CV. We think that the advice we
offer is sensible, but would always recommend that you also seek advice
from seniors in your own region.
USING THIS BOOK ix