685 Back Pages.Qxd

The Back Pages viewpoint “... magical superheroes protecting A career in the community HERE has been much discussion recently about general practitioners with a special the world from interest those GPs who extend their remit into areas that have traditionally been the parasitic aliens, shape- Tprovince of hospital specialists. shifting politicians, and This leads us to think about hospital specialists whose remit extends into the community. transsexual Brazilians” Many specialities are now considering the training needs for a slightly different branch of Johnstone on essential comics for their specialism. Liaison psychiatry, care of the elderly, community paediatrics, and GPs, page 687 community gynaecology are four that are more common. “Sure, things can Some of our future consultants may have had the opportunity to spend four months in general practice as a pre-registration house officer. Those doctors who are lucky enough to secure one and will go wrong, of these prestigious posts find their training rewarding and stimulating. However, the review and yes, call me an old of the senior house officer (SHO) grade presents an ideal opportunity to consider how general technophile if you practice could contribute to training programmes for all doctors. must — but what an If the review of the senior house officer grade reflects the previous reviews of higher training interesting time to be and the pre-registration year, basic training will move from posts and rotations to placements alive!” and programmes. This will create opportunities for experience in general practice and the values of primary care to be included in training programmes for specialist medicine, Hodgkin coping with info- particularly that relating to community orientated specialities. Those intending working in the biological inadequacy syndrome, community would learn how to be an effective member of the health and social care team, page 688 contributing to the team but not needing to lead it. They would learn about the impact of illness on the family and the influence of social circumstance on health, encompassing the “Humans are well strengths of general practice of considering all illness in psychological, social and physical known to be story- terms. They would learn how to manage care in the patients home, negotiating a care plan that is realistic and compatible with social circumstances. They would also learn about telling animals, and patient autonomy and that many prescriptions are neither cashed nor taken unless there is never more so than at careful explanation and negotiation. Perhaps most importantly they would value the difficult times.” importance of being patient-centred, learning the skills of listening, observing, and reflection. Murray et al on Patients as Poets, There are already SHO pilot programmes throughout the country, combining paediatrics with general practice or medical specialities with general practice. Some specialities; for example, palliative medicine already include general practice as an option in higher training. However, contents there is a danger that without commitment of the profession and our managers, time spent in general practice could be seen as a soft option or, worse still, serving time. Just as general practice needs SHO placements to be modified to meet explicit learning needs, so general 686 lists practice placements would need to be modified to satisfy the learning needs of specialist ... of books, pictures and comics trainees. They will need release to group sessions with fellow trainees of the same speciality, for our aspiring GP 688 postcards from the working perhaps with a specialist programme director and GP educator who will help them 21st century place their learning into the context of their intended speciality. Working with local government Tom Knowlands The review of basic training is also considering how each trainee should be assessed as 690 essay having completed the placement satisfactorily. General practice will need to be involved in Patients as poets this process and consider the criteria and standards necessary for satisfactory completion. We Scott Murray, Marilyn Kendall, already have skills in workplace observation and assessment; with our specialist colleagues Kirsty Boyd, Allison Worth, we will need to clarify how specialist trainees can be assessed and how general practice Frederick Benton, Hans Klauser should contribute to the annual review process. 691 mazza on Indian palliative care 692 digest Hepburn on domestic violence, The RCGP is already working with specialist colleges to agree standards for GPs with a Godley on COPD, Minns on special interest; maybe we should also be working with those Colleges that are moving to Vermeer and the Delft school community based care. Together we could agree criteria and standards for specialists with a plus greenhalgh’s books general interest, and how the Royal College of General Practitioners will be involved in the 695 diary training and assessment of specialists who want to work in the community. plus goodman on Latin 696 our contributors Jacky Hayden and millar standardising... The British Journal of General Practice, August 2001 685 We asked for 10 recommended non- Greenland, the heroine, Smilla Jasperson, is medical texts for aspiring general an expert in the varied forms of snow and practitioners, and have got rather 10books ice. Packed with geophysics, meterology, more than we bargained for ... pathology, anthropology and much more. herewith a selection. Each And finally, River God by Wilbur Smith. contributor can choose from any Nick Howlett Wilbur is the man for holiday reading, title by Radcliffe Medical Press. Captain Corelli’s Mandolin by Louis de producing brilliant boy s adventure yarns, (Thanks again to Radcliffe for their BerniŁres is the beautifully written story of generosity.) generally set in Africa. River God is a saga a Cephalonian GP, Dr Iannis, and his of Ancient Egypt, as the new Queen Lostris Further entries gratefully received, daughter, Pelagia. Full of useful medical and her faithful eunuch slave Taito flee via email, to [email protected]. advice the returning soldier with seven from their enemies up the River Nile into separate dermatological problems; that the highlands of Ethiopia. Alec Logan love is a kind of dementia with very precise and oft-repeated clinical symptoms . Jonathan Evans Paula by Isabella Allende. In 1991, Just as the faithful will see vindication for Isabella Allende s daughter, Paula, their religious beliefs in all things, it may be contracted porphyria and fell into a coma. A possible to draw lessons from any literary year later she died. The book takes the form source. It may be possible to work from a of a letter to Paula, written during the long list of medieval tomes, but it is not hours at her bedside. Interwoven is necessary. Since, for the next few decades, Isabella s life story, and thus also the recent our future GPs will have been born in the history of Chile. Achingly moving. 20th century it would seem reasonable to Perfume by Patrick S skind. The suggest a more contemporary reading list. fabulously grotesque tale of Grenouille, born into 18th century France with the Literature s greatest strength is to illuminate perfect sense of smell, but no personal areas of the human condition outside our odour. He becomes apprentice to a leading own experiences. Ruth Picardie s Before I perfumier, then endeavours to create the Say Goodbye and John Diamond s C — ultimate perfume, adopting increasingly because cowards get cancer too superbly gory means of capturing smells. Part document life with terminal illnesses. Of Charles Dickens and part Stephen King. particular interest to GPs would be those The Complete Sherlock Holmes by Sir books that provide us with insights into Arthur Conan Doyle is arguably the finest patient s lifestyles far different to our own work of literature by a GP. There is much to Trainspotting by Irvine Welsh would learn from Holmes powers of visual probably qualify for most of us and deduction. My favourite is the clever Caroline Knapp s Drinking a love story diagnosis of a well-marked case of pseudo- for rather fewer. leprosy or ichthyosis in The Adventure Of The Blanched Soldier. Authors will often (or perhaps, always?) be The Name Of The Rose by Umberto Eco. more articulate than writers of medical My all-time favourite book. A perfect texts, so may be better able to describe combination of medieval whodunnit and particularly difficult areas of medicine, such learned study of hereticism, along with lots as the psychiatric experience. Freefall by of evidence-based 14th century herbalism: Tom Read is an account of emerging the use of the snakeroot rhizome to treat paranoid psychosis and its effects on his diarrhoea and certain female complaints. family; Emily Colas Just Checking charts I Bought A Mountain by Thomas her obsessive compulsive disorder and Firbank. As a rural GP, this is my favourite rings too many bells. book about farming. In 1931, the author, a Canadian, buys Dyffryn Farm, encom- Worthy volumes have traditionally been passing much of the Glyders in North used to explore the role of the doctor within Wales, and struggles to run a 2400 acre society AJ Cronin s The Citadel and sheep farm without any prior experience. Albert Camus The Plague ought to be on Very educational and very moving. any medical reading list. An Instance Of The Fingerpost by Iain Pears. The beautifully crafted story of the Ultimately, the real role of literature must murder of a 17th century Oxford academic, be to entertain, and if the above list were described by four witnesses a brilliant insufficiently stimulating and our aspiring young Venetian GP (responsible for the first GP was just leaving school, Will Sutcliffe s blood transfusion), the chief cryptographer hilarious Are You Experienced? will do to Cromwell, the son of a Royalist traitor, that while inoculating them against the and one of the victim s fellow academics.

Load more