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BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7208.526 (Published 21 August 1999) Cite this as: BMJ 1999;319:526

Good clinical reasoning does not come naturally, and although it can be taught, it rarely is (Medical Education 1999;33:480-3). Fourth year students given a two hour session on the biases that can derail the diagnostic process—such as overestimating the likelihood of dramatic or exotic diseases—improved their reasoning skills to the level expected of experienced housemen. How long the effect lasts, however, remains to be seen.

The American College of Pathologists wants every sexually active American woman to have a cervical smear every year—and to make sure they do, the college is offering to send them an email reminder. It has set up a website (www.papsmear.org) urging responsible Americans to sign up for “an email that could save your life.” One obvious flaw in the strategy is that the kind of women who are likely to access this site are probably those least in need of a spam reminder to go for a smear test.

Young health services researchers who need a break could apply for a new fellowship launched by the UK's Nuffield Trust. The successful applicant will be given £8000 to enter a different realm for a month—the theatre or civil aviation, for example—and to draft a …

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