bmj.com:

News

Australia operates "closed shop" to restrict doctors from overseas, say critics

Overseas trained doctors seeking to work in Australia often face unwarranted restrictions on practising, say leading Australian medical specialists and healthcare reform advocates. Ian Hickie, a psychiatrist at the University of Sydney, says that shortages in the medical workforce are being exacerbated by restrictions caused by an "evil axis" of immigration policy, health regulations, and the monopoly of specialist medical colleges over training and accreditation.

Also published on 16 November:

Image of brain tumour wins competition

Poor service provision is blamed for overuse of antipsychotics in dementia patients

GP is struck off for lying to police

First official citywide electronic record system for patients is launched in London

Education

Generalised tetanus in a patient with a chronic ulcerated skin lesion

In developed countries, tetanus is uncommon and cases are usually diagnosed in elderly patients. Levels of tetanus antibodies are progressively lower with increasing age in groups over 50 or 60 years old. Acute injuries and chronic wounds can allow entrance of Clostridium tetani. We report the case of a non-immunised patient with generalised tetanus after biopsy of a chronic ulcerated skin lesion

More education articles published on 13 November:

Should we use bath emollients for atopic eczema?

Podcast

Monitoring modernisation

Home fetal heart monitors can help prospective parents bond with their babies, but do they offer false reassurance when things go wrong? In this week's podcast Rebecca Coombes hears a cautionary tale from Abhijoy Chakladar, from Princess Royal Hospital in West Sussex. Also this week, the NHS Modernisation Agency has been tasked with improving care for patients. Andrew Hutchings, from the London School of Hygiene and Tropical Medicine, tells us about his analysis of how effective the agency's adult critical care initiative has been.

Research

Teenage pregnancy and social disadvantage

Youth development programmes that tackle deprivation and help children and young people enjoy school are successful in reducing teenage pregnancy rates. The researchers found that dislike of school, poverty, unhappy childhoods and low expectations for the future were all linked to early pregnancy. They argue that policies aimed at tackling these issues, combined with high quality sex education and contraceptive services, are successful in lowering teenage pregnancy rates.

Other recently published research:

Evaluation of modernisation of adult critical care services in England

Comment

Legislation is needed to stop children using sunbeds

Sunbeds are putting an estimated quarter of a million 11-17 year olds in England at increased risk of developing malignant melanoma. Catherine Thomson and Chris Twelves warn that sunbeds raise serious issues, and they call for urgent legislation to stop children in England using sunbeds, as is already in place in Scotland and proposed for Wales.

Other comment published on 12 November:

Education

Endgames

Endgames is the BMJ's free interactive quiz to help doctors prepare for their postgraduate examinations. Questions are made up of case reports and picture quizzes, providing you with a practical and quick revision tool on common topics rather than clinical rarities.

This week's Endgames articles:

Other recent education articles:

A woman with acute myelopathy in pregnancy

Rational testing: Investigating recurrent respiratory infections in primary care

Career Focus

Practice based commissioning: what future?

Practice based commissioning was last month characterised as "a corpse not for resuscitating" by the English national clinical director for primary care and former pro-fundholding firebrand, Dr David Colin-Thom�. An ailing patient, certainly, commentators agree, but most of them believe that survival is the most likely outcome, although probably after some radical surgery. Mark Pownall asks whether the government's flagship policy for improving quality and saving money has any future.

Student BMJ

How old is too old?

The Student BMJ considers the taboo of older mums. Recent articles also look at religion and drugs: doctors must consider the faith of their patients when prescribing. Plus bullying and sexism in medical school--has anything changed? Let us know what you think by sending a message on student.bmj.com.

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