news bites

US emergency rooms in trouble

The US emergency medical system lacks space, staff, and equipment, and almost nothing has been done to bring things back from near breaking point despite numerous warnings, emergency room professionals told Congress.

MATT SLOCUM/AP/EMPICS

Three Institute of Medicine reports issued in June found severe problems in emergency rooms and other emergency medical services, including rising demand at a time when bed numbers have fallen and hundreds of emergency departments have closed. Doctors and legislators said they were worried about what would happen if a flu pandemic or other large scale disaster occurred.

"I can tell you without qualification that the emergency care system in this country in general... is worse today than it was last year, and if we don't change things by next year it will be worse than it was today," Dr Rick Blum, an emergency room doctor and president of the American College of Emergency Physicians, told the legislators (www.reuters.com).

"Brain drain" blamed for Polish deaths

A Polish newspaper has linked the death of an 83 year old man to a shortage of anaesthetists, at a time when a "brain drain" has drawn medical staff to richer European Union countries. An investigation has been launched in the southern town of Racibórz, where the man died from complications after an operation, said to have been caused by an underqualified anaesthetist.

Gazeta Wyborcza, a Polish newspaper, reported under the headline "He died because there were not enough anaesthetists" that an agency anaesthetist had been appointed after 10 of the hospital's 13 anaesthetists walked out after rejecting a pay offer. Anaesthetists are able to increase their salaries by as much as 300% by moving to the Czech Republic or Britain.

The hospital denied that the anaesthetist caused the patient's death. About 5000 doctors have left Poland over two years and 14% of anaesthetists have applied for a certificate to work abroad (www.guardian.co.uk).

Should UK medical schools take only older students?

Doctors attacked proposals for a complete revamp of entry requirements for UK medical schools that suggested a minimum age of 23 for students. Dr Christopher Cowley, writing in the Journal of Medical Ethics, suggested that schools should require students to have studied a humanities subject, such as drama or history. "The 18-yearold pure science pupil is no longer suitable for medicine," he wrote. He said students should not be allowed into medical school until they were 23, and that 18 year olds were ignorant of what medicine entails and of their own ambitions. He also suggested students should complete a year's full time work experience in a voluntary sector or healthcare organisation. Doctors said many students would be put off a medical career by his suggestions (www.scotsman.com).

Junior doctors in Zimbabwe strike

Junior doctors in Zimbabwe went on strike in July, defying a government order to return to work. They demanded a more than fivefold increase in pay to compensate for inflation, which is running at well over 1000%.

Doctors said that the government was not paying fees for students at medical school who could not pick up their final exam grades as a result. The government said that students' fees were insignificant compared with the cost of the training, and that it was working on new salary scales and transport allowances. Many medical practitioners have fled the country during the country's eight year economic crisis, which has seen the economy shrink by more than a third. Critics accuse President Robert Mugabe's government of mismanagement (www.allafrica.com).

Schemes fail to lure Australian doctors back to practise

Multimillion dollar schemes to tempt doctors and nurses back into practice to alleviate Australia's crippling workforce shortages have largely failed. Initiatives had sought to provide refresher training and other help to doctors who had opted out of clinical work to have families or pursue other careers. But targets for the programmes have been slashed after few specialists and nurses showed interest (www.theaustralian.news.com.au)

UK wants to soften burden of misconduct proof

Britain's General Medical Council would lose its influence over medical education and some of its roles as the doctors' regulatory body under new proposals by the government's chief medical officer designed to detect failing doctors sooner.

Sir Liam Donaldson proposed that the GMC would no longer be a doctor's judge, and that the burden of proof in any prosecution would be reduced to the civil level from the current criminal standard.

Tougher revalidation systems would be introduced to make sure doctors were competent to be relicensed. The report follows inquiries into the GP Harold Shipman, who murdered about 250 patients. The inquiries were widely critical of the GMC. The BMA said that it was hugely critical of the proposal to change the burden of proof in misconduct cases (www.telegraph.co.uk).

France calls on medical students as surgeons strike

Fears that the summer heat wave could overload France's health- care system as surgeons and specialists went on strike led the government to urge medical students and retired doctors to show up for work in July.

Private clinic surgeons and specialists, joined by several other doctors' unions, walked out to demand an increase in the fees they can charge to offset rising insurance premiums.

The heat wave had already boosted demand for health care services by 20%, with at least 30 people dying from heat related causes. It appealed to medical and nursing students and retired doctors to man medical advice hotlines to ease the pressure on emergency response teams (http://online.wsj.com).



studentBMJ 2006;14:309-352 September ISSN 0966-6494