Editorial

Abstract

As I write, Jane (my wife) and I are sitting on a plane, on our way to Penang. She is going to visit buildings of architectural merit—no doubt part of the Ulster Architectural Historical Society's attempt to list the world—and I will teach and examine potential graduates of Penang Medical School. Our children, the dogs, the cat and the pony have either been farmed out to relatives or put in storage. I have two draft theses and three draft papers to read, several TOG articles to proof, several WellBeing grant applications to review (apologies to Iain Cameron—I know I said I'd have them to you yesterday) and this editorial to finish—so no complimentary wine for me, at least not until I finish this. Why do representatives of British medical schools go so far to examine? It's not only that they pay your air fare and put you up in a nice hotel, nor that it beats seeing the seventh prolapse in the morning gynae clinic (all picked up at routine cervical smear test by the practice nurse and referred directly, without further examination, for an urgent medical opinion), nor is it that being stuck in transit for 20 hours twice in 5 days gives one a chance to catch up, undisturbed. No—somewhere there is an acknowledgement that a medical degree from a British medical school is a thing to be held up as a gold standard internationally and that my opinion (yes, mine) is a valuable thing – and I haven't felt that around any British university for a while! So what makes medical schools in these islands so respected? The very tight regulation by the General Medical Council is, of course, important. Tradition? The almost universal ‘four As’ quality of our students? The teaching tradition and dedication of NHS consultants, academic consultants and juniors alike? In Northern Ireland we have a persistently high recruitment rate to our specialty. Why? Well, the undergraduate course in obstetrics and gynaecology is very patient focused and the course design, we think, is pretty comprehensive. Foremost, though, is the example set by our NHS colleagues, who take a real interest in the students, their welfare and their understanding of the subject. In TOG we have been doing our bit, too: we are now piloting a scheme where we send electronic copies of two or three articles from each edition to students at Dundee and Belfast Medical Schools. There must be a lot of potential obstetricians and gynaecologists out there because we've heard nothing back from them, just like our readership! Why does no one ever write or email us? In addition, you may have noticed our new abstract format: bulleted learning points, objectives and ethical issues—good for teaching (and even dinner party conversations for the more socially challenged). So what will we have you debating over your roasted autumnal beetroot in a balsamic jus reduction with Parmesan shavings, from this edition? A lot—enough to get you right through pudding and into coffee, with a favourable wind. Chi and Kadir take us through inherited bleeding disorders in pregnancy (very scary) while Asghar and Bowman give us the second part of their mini-series on thrombosis in obstetrics (yes, I have consumed so much water to prevent DVT on this flight that I think I may need a TVT before long). But Jha, Parsons and Toozs-Hobson are dealing with painful bladder syndrome and interstitial cystitis (does no one go on honeymoon anymore, or is that term passé?). Munjuluri, Wong and Yoong tell us about anticholinergic drugs (maybe I should try that instead of the TVT) and Pirie, Cooke, Linden and Irwin take us through the dental manifestations of pregnancy (at least in Belfast, where, perhaps, the incidence of toothpaste use is not all that it might be). Gelson, Johnson, Gatzoulis and Uebing begin their epic ‘Cardiac disease in pregnancy’ (film rights reserved), dealing with congenital disease this time around. Gillian Penney tells us how to adopt and adapt clinical guidelines and, finally, James Drife makes two appearances: the first an article entitled ‘Putting risk into context’ and, as always, on the last page in ‘And finally…’.