Editor's Choice

CME, GMC, and Florence Nightingale

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2699 (Published 20 May 2010) Cite this as: BMJ 2010;340:c2699
  1. Tony Delamothe, deputy editor, BMJ
  1. tdelamothe{at}bmj.com

    This week sees the launch of a brand new, free service for BMJ readers: certified CME credits for reading research articles and answering a linked series of multiple choice questions. It marks the first phase of a collaboration between the journal and the Cleveland Clinic. In their accompanying editorial, Steven Kawczak and Kirsten Patrick explain the mechanics and the outcome: credits towards the American Medical Association’s Physicians Recognition Award (doi:10.1136/bmj.c2410). We’ll be linking roughly one article a week to a CME module, but in this inaugural week we’re kicking off with three. While US doctors will immediately appreciate their value, we’re seeking accreditations elsewhere. In the meantime, answering the questions should help all doctors with their continuing learning needs. We hope UK doctors will find the initiative useful when seeking revalidation with the GMC.

    Meanwhile, is it fanciful to detect improvements at the GMC under its new chief executive officer (Niall Dickson) and chair (Peter Rubin)? The council was admirably quick to announce an expert committee to review guidance for paediatricians doing child protection work (BMJ 2010;340:c2551, doi:10.1136/bmj.c2551). This happened on the same day as the Court of Appeal quashed one of the barmier decisions of the council’s fitness to practise panel and hopefully signals the end of its prolonged period of self harming around the vexed issue of child abuse.

    However, there remains some more unfinished business from the previous regime: the council’s attempts to keep secret its handling of a case involving a lay member with undeclared links with the Church of Scientology. “Why are lay panellists treated differently from the doctors they sit in judgment on, who can expect very public revelation of their misdemeanours?” asks Oliver Dearlove in his letter (doi:10.1136/bmj.c2651). The case only came to light when documents were released in response to requests under the Freedom of Information Act, and further such requests are currently in progress (www.bmj.com/cgi/eletters/340/mar30_4/c1766#233737).

    Suddenly, requests under the Freedom of Information Act have become the way of extracting information from the UK’s secretive public bodies. When Adrian O’Dowd, Josephine Hayes, and Deborah Cohen couldn’t find whistleblowing policies on the websites of NHS foundation trusts they invoked the act—and largely got what they wanted (doi:10.1136/bmj.c2350). Returns from 118 of 122 English trusts show “widely differing policies,” to put it mildly. Sadly for something that is meant to protect whistleblowers against recrimination, sanctions against malicious or false claims seem to be the most frequently mentioned feature of the policies. It’s not all bad though: while Barnsley Hospital NHS Foundation Trust mentions the word “disciplinary” 21 times, the Walton Centre NHS Foundation Trust gets its message across without using the term once. The authors quote Peter Gooderham, law lecturer at the University of Manchester, who argues for the centralisation of whistleblowing policies, with a model disclosure policy produced by the Department of Health.

    Concerns about whistleblowing extend north of the border, where doctors are calling for better protection when speaking out (doi:10.1136/bmj.c2591). A BMA survey in Scotland found that four in 10 doctors failed to report concerns because they did not think it would make a difference or feared the consequences of speaking out. (However, suspicions must be high that a 13% response rate produced a biased sample.)

    Was Florence Nightingale an early whistleblower? It’s worth a thought. Like whistleblowers she’s remembered mostly for her trenchant criticisms—in this case of army medicine. But unlike most whistleblowers, her fate was to be lionised rather than ostracised. In this week’s journal, Colin Martin reviews the revamped Florence Nightingale Museum at St Thomas’s Hospital, London (doi:10.1136/bmj.c2595). It doesn’t sound as if its treatment of St Florence of Scutari is any less hagiographic than the museum’s treatment of her in its previous incarnation. Those pondering a visit might first want to fortify themselves with Keith Williams’s demolition job (BMJ 2008;337:a2889, doi:10.1136/bmj.a2889).


    Cite this as: BMJ 2010;340:c2699

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