Medical students’ attitudes towards increasing early clinical exposure to primary care

Context: The sustainability of the future UK General Practice (GP) workforce is reliant on half of medical graduates choosing a career in primary care (1), but while good quality undergraduate GP placements (particularly those which are early in the curriculum and integrated into ongoing learning) have been linked to subsequent GP career choices (2), exposure has plateaued at 13% of UK undergraduate teaching time(3).Of students in UK medical schools, undergraduates at the University of Nottingham(UON) spend towards the least amount of time in primary care.Research questions: We set out to investigate Nottingham medical students’ attitudes towards a proposed increase in the primary care component of their “early clinical exposure” module from ten half days to fourteen full days during the first two years of the undergraduate course. We sought to assess the potential impact on perceived student learning and experience.Description: We recruited nine students from across the five undergraduate year groups to take part in audio-recorded semi-structured interviews which lasted 30-60 minutes. All participants provided informed consent. Having set out to include 20-30 participants in our sample, recruitment was impaired by students’ busy teaching schedules and overlapping exam seasons within the University. Interviews followed a theme guide and explored topics of exposure time, learning opportunities, and career intentions. We analysed verbatim transcripts using a constant comparative approach, assigning and grouping codes, and merging and revising categories until new data did not alter the resultant themes. We considered data to be saturated once ideas were repetitively expressed and did not prompt revision of themes. A larger sample would have strengthened confidence in our theoretical integrity. Outcomes: Students reported that opportunities encountered in primary care settings allowed them to contextualise their scientific learning and develop core practical and communication skills (Table 1). Their GP placements were multi-disciplinary and holistic, enabling them to build professional relationships with mentors and ultimately feel better-prepared for both their undergraduate clinical phase and future careers. Immersing students into the clinical environment at this early stage of their training provided drive and focus for their academic studies, but some students shared their awareness of a stressful GP workplace with time and administrative pressures, reflecting how this experience discouraged them from choosing GP careers. Participants unanimously supported an expansion to the timetabled early primary care clinical exposure

Medical students’ attitudes towards increasing early clinical exposure to primary care

Context: The sustainability of the future UK General Practice (GP) workforce is reliant on half of medical graduates choosing a career in primary care (1), but while good quality undergraduate GP placements (particularly those which are early in the curriculum and integrated into ongoing learning) have been linked to subsequent GP career choices (2), exposure has plateaued at 13% of UK undergraduate teaching time(3).Of students in UK medical schools, undergraduates at the University of Nottingham(UON) spend towards the least amount of time in primary care. Research questions: We set out to investigate Nottingham medical students’ attitudes towards a proposed increase in the primary care component of their “early clinical exposure” module from ten half days to fourteen full days during the first two years of the undergraduate course. We sought to assess the potential impact on perceived student learning and experience. Description: We recruited nine students from across the five undergraduate year groups to take part in audio-recorded semi-structured interviews which lasted 30-60 minutes. All participants provided informed consent. Having set out to include 20-30 participants in our sample, recruitment was impaired by students’ busy teaching schedules and overlapping exam seasons within the University. Interviews followed a theme guide and explored topics of exposure time, learning opportunities, and career intentions. We analysed verbatim transcripts using a constant comparative approach, assigning and grouping codes, and merging and revising categories until new data did not alter the resultant themes. We considered data to be saturated once ideas were repetitively expressed and did not prompt revision of themes. A larger sample would have strengthened confidence in our theoretical integrity. Outcomes: Students reported that opportunities encountered in primary care settings allowed them to contextualise their scientific learning and develop core practical and communication skills (Table 1). Their GP placements were multi-disciplinary and holistic, enabling them to build professional relationships with mentors and ultimately feel better-prepared for both their undergraduate clinical phase and future careers. Immersing students into the clinical environment at this early stage of their training provided drive and focus for their academic studies, but some students shared their awareness of a stressful GP workplace with time and administrative pressures, reflecting how this experience discouraged them from choosing GP careers. Participants unanimously supported an expansion to the timetabled early primary care clinical exposure

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes