The presence of fractures seen on routine chest radiography was assessed in patients with liver disease to see whether it might provide a useful marker of alcoholism. Chest radiographs taken at the time of liver biopsy were examined in 149 patients--72 with alcoholic liver disease (32 (44%) cirrhotic) and 77 with various forms of non-alcoholic liver disease (15 (19 . 5%) cirrhotic)--and in 149 controls. Fractures (85 rib, two clavicular) were much more common in patients with alcoholic liver disease (20 subjects; 28%) than in patients with non-alcoholic liver disease (1; 1 . 3%) or controls 10; 6 . 7%). In alcoholic liver disease rib fractures were significantly more likely to be bilateral or multiple (more than two) or both (p less than 0 . 01). Of patients with alcoholic liver disease, those with fractures were significantly older than those without, but there was no difference in sex, social class, the proportion with cirrhosis, or the proportion known to be alcoholic at the time of the radiograph. In liver disease fractures on the chest radiograph diagnosed alcoholism with 95% specificity and 28% sensitivity. These often overlooked or ignored findings in the chest radiograph may have a wider role in the detection of alcoholism.

Adult↗

PubMedDate not supplied

Re-training refugee and other overseas doctors: re-qualification through the United Examining Board examination.

The Professional and Linguistic Assessments Board test is well suited to overseas doctors who have migrated for reasons of career development but less so for groups such as refugees who have not had time to prepare for migration and may not speak English. We describe a 12-month structured clinical course leading to re-qualification, for 70 refugee and other overseas doctors. Between 1996 and 2003, 69 of the 70 overseas doctors on the course (27 of whom were refugees) re-qualified through the examination of the United Examining Board. We report on early and later outcomes of these 69 doctors who, by achieving provisional registration, were entitled to pre-registration house officer posts. Of the 69, 33 are now principals in general practice or GPs in training; a further 32 are in NHS hospital posts. Opportunities for disadvantaged overseas doctors to re-train are severely lacking; yet in the UK there are significant numbers who warrant special help. A very modest investment of resources could help them re-qualify and contribute to the health and economy of the nation.

Adult↗

PubMedDate not supplied

A training course for the UEB examination. The case for retaining an examination for overseas doctors excluded from practising in the UK.

BACKGROUND: Some overseas medical graduates choose to take the United Examining Board (UEB) examination to achieve UK registration; others have no other option. We have devised a course for overseas doctors who wish to re-qualify via this route. THE COURSE: Eighteen doctors enrolled during 1995-1997; all passed the UEB examination. Regular formative assessment allowed us to identify students adequately prepared to pass the examination. The main predictor of examination outcome was performance in a mock examination. Gender, residential status and interval since original qualification were not predictive. The eight doctors whose primary medical course was conducted in a language other than English did not seem to be disadvantaged. OUTCOME: Successful examinees obtained pre-registration house officer posts without delay; one has since passed the full MRCP (UK) and another MRCP Part I. All but one of the intend to pursue their medical careers in the UK. SUMMARY: After a structured course (average 9.5 months) at this medical school, selected overseas doctors can reach a standard appropriate to a UK primary qualifying examination. These findings have implications for overseas doctors living here and not practising, as well as for those concerned with expanding the UK medical workforce.

Certification↗