Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
And the correct answer is....
- David J Haldane (9 January 2009)
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Revealed
- Kinesh Patel (11 January 2009)
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Hens tooth?
- Nicholas B Argent (12 January 2009)
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Diagnosis, diatribes and dilemmas
- Patrick K Plunkett (15 January 2009)
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The answer
- Kinesh Patel (16 January 2009)
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Re: The answer
- Dipak Mistry (12 March 2009)
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David J Haldane, Consultant Occupational Physician NHS Greater Glasgow and Clyde
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It would have been nice to know exactly what this infintessimally rare condition was that allowed Dr Patel to secure his cash prize. Competing interests: None declared |
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Kinesh Patel, Gastroenterology registrar Welwyn Garden City
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Think of a rare pancreatic neuroendocrine tumour... Competing interests: None declared |
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Nicholas B Argent, Medical assessor Health Canada, Ottawa Canada, K1A 0K9
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Tough to diagnose with not much to go on. But - I'm going to guess necrolytic migratory erythema (NME)with glucagonoma, for no better reasons that it is the rarest disease I can think of on a Sunday morning, and I have never seen it (or at least recognised it if I did). So what is it really? Competing interests: None declared |
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Patrick K Plunkett, Consultant in Emergency Medicine St James's Hospital, Dublin 8, Ireland
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Dr Patel, For a "junior doctor", your words carry the wisdom of the ages. As one who feels that it is important to allow both breadth and depth of knowledge to guide the physician, and having examined postgraduates under "Ancient and Modern" systems, I could not agree more with you that the postgraduate ladder has become a game, to be played by specific rules which can be manipulated by clever players. The result is that successful game players become champions for The Game. This may work well for 90-95% of patient encounters, and not so well for 5%. It is the other few unfortunate patients I feel sorry for, as they will be left adrift in our "Brave New World." New clinical discoveries, outwith the molecular laboratories, will become "avis rara" But forget the diagnosis - what was your reason to admit the patient to hospital? Could this patient have been adequately investigated and managed in the Primary Care environment? If not, why not? If so, why did you admit the patient? And what can a fiver buy nowadays? Competing interests: None declared |
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Kinesh Patel, Spr Gastroenterology Welwyn Garden City
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No, the other one! Think hypoglycaemia.... Competing interests: None declared |
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Dipak Mistry, ST3 Emergency Medicine Newham General Hospital, E13
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Dr Patel, I read your point of view with some interest. Whilst, I completely agree that specialty Membership examinations should be a prerequisite for Higher training, I fear this clause has crept in to accommodate pre-Tooke report trainees. Due to the huge selection pressure in the current job climate, I think that you'll find short listing of current candidates ensures that they possess the academic prerequisites. Perhaps, you were hinting at an insulinoma with or without MEN inclusion? Dipak MISTRY. Competing interests: None declared |
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