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Biomedical subjects

T S Murray

Publications and source records attributed to T S Murray.

At least 73 records · Page 4Linked to original sources
PubMed1991

Twenty years of vocational training in the west of Scotland.

OBJECTIVE: To assess the career paths of doctors who completed vocational training in the west of Scotland between 1968 and 1987 and their views on the hospital component of their training. DESIGN: Retrospective analysis of the experience and opinions of vocationally trained doctors obtained from a postal questionnaire. SETTING: West of Scotland. SUBJECTS: 1255 Doctors identified from Glasgow University records who had been vocationally trained in the west of Scotland between 1968 and 1987. MAIN OUTCOME MEASURES: Personal details; employment; jobs held currently; additional professional commitments; importance of hospital posts held in various specialties to respondents currently in general practice; and retrospective choice of hospital posts, based on subsequent experience. RESULTS: 619 Responses were received, 543 initially and 76 after a letter of reminder, from a possible total of 974 (excluding 153 questionnaires returned by the post office and 128 returned because of misunderstanding between the name and address); the overall response rate was therefore 64%. 607/619 (98%) Respondents were employed at the time of the study, of whom 517/607 (85%) were in general practice. A third (202/609) had been unemployed at some point, significantly more of them women (122/243, 50% v 80/376, 21%; chi 2 = 54.8, p less than 0.001). 510/563 (91%) Respondents held one postgraduate qualification or more, and 284/612 (46%) had additional professional commitments. The hospital posts most commonly held were in obstetrics and gynaecology, psychiatry, paediatrics, and medicine. Medicine, obstetrics, paediatrics, and dermatology were considered to be the most relevant hospital specialties by those who had experience of them and were now in general practice. Although ophthalmology and ear, nose, and throat were not rated highly by these doctors, other respondents wished that they had held posts in these specialties (32 and 40 respectively). During the hospital training 354/475 (75%) respondents thought that they were looked on as a junior hospital doctor and not as a trainee for general practice. CONCLUSIONS: Most of those who had entered vocational training were in employment, and most were in general practice. According to them, the most beneficial hospital posts for vocational training are medicine, obstetrics, paediatrics, and dermatology. Trainees should be encouraged to attend clinics in gynaecology, ear, nose, and throat, and ophthalmology.

Adult↗
PubMed1991

Twenty years of vocational training in the west of Scotland: the practice component.

A retrospective analysis of the experience and opinions of doctors receiving vocational training in general practice was obtained by postal questionnaire. Questionnaires were received by 974 doctors who had been vocationally trained in the west of Scotland between 1968 and 1987. The response rate was 64%. It was found that 94% of the respondents had enjoyed their trainee period, 82% had been given a choice of training practice and 86% had spent 12 months in a training practice. Only 81 respondents had trained in two practices. The most common method of monitoring the trainee's consultation was the trainer sitting in on the consultation; half of the doctors had experience of this (51%). For the majority regular tutorials were commonplace, but for 41% of respondents this was not so. However, those training after 1979 were significantly less likely to have never had tutorials than those training earlier. Nearly half of the doctors (49%) felt that certain aspects had been poorly covered or omitted from their training, notably practice management and finance. Again, this was significantly less likely among those training after 1979. When asked to give a rating of the training they had received 21% of the respondents rated it as excellent, 37% as very good, 30% as fairly good and 12% as poor/fairly poor or very poor. Notably, significantly fewer respondents training after 1979 rated their training as poor/fairly poor or very poor. Very few respondents had participated in a practice exchange but virtually all of those who had felt it had been beneficial.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Medical, Continuing↗
PubMed1991

An analysis of the trainee year in general practice.

A survey of 12,425 trainee consultations is reported. Chronic illness only constituted 19.4% of their workload. The greatest number of consultations occurred with younger patients in the 20-30 age group. Only a small proportion of consultations involved anticipatory care and health education (0.3% and 1.1% of total workload respectively). Women patients showed a strong preference to consult a female doctor with twice as many seeing a lady trainee in preference to a male doctor. The study has implications for teaching and learning during the trainee year in general practice.

Adolescent↗
PubMed1990

Trainee assessment--a regional survey.

A postal questionnaire was sent to all 140 trainers in the west of Scotland region and to the 102 trainees who had completed their training three months prior to the survey. The aim of the study was to identify the types of trainee assessment in use, the proportion of trainers using the various methods, the attitudes of trainers and trainees to the assessment methods employed, and their views on a regional assessment programme. Response rates of 89% for trainers and 71% for trainees were obtained. Almost all respondents reported the use of some from of assessment. The mean number of assessment types reported by trainees was 3.7 and by trainers 5.2. The most commonly used method was videotaping of trainee consultations, used by 76% of respondents, and the least common the use of hard data, for example prescribing statistics or referral rates. Videotaping was also rated the most useful method by both groups. Those with experience of the assessment methods gave them a higher score for usefulness than those without such experience. Approximately half of the respondents favoured a regional protocol for assessment. This study has shown that if trainers and trainees can be encouraged to use assessment methods they will find them helpful. However, universal assessment will only become a reality when it becomes a requirement for accreditation as a trainer.

Education, Medical, Graduate↗
PubMed1987

Is nifedipine a suitable first-line treatment for essential hypertension in general practice?

Nifedipine has been used in hypertension, mainly as a third-line drug for rapid blood pressure reduction, for over 10 years. More recently it has been shown to be effective and safe in reducing mild to moderate blood pressure when used alone in a slow release formulation. A placebo-controlled study investigating the efficacy and safety of nifedipine in comparison with cyclopenthiazide-potassium has now been carried out by 4 general practitioners in the Glasgow area. Ninety-four patients were entered into the study. After a 4-week placebo run-in phase, patients were randomly allocated to receive either slow-release nifedipine 20 mg b.d., or cyclopenthiazide 0.25 mg with 8.1 mmol potassium daily. The dose was doubled at week 8 for non-responders, and at week 12 the alternative drug was added if there was still no response. The patients were studied for up to 28 weeks. Nifedipine was found to have similar blood pressure lowering efficacy to cyclopenthiazide-potassium, but withdrawals from nifedipine due to side-effects at an early stage were more common.

Adolescent↗
PubMed1985

Is the distribution of training practices appropriate for the needs of general practice?

The distribution of practices that train general practitioners in the west of Scotland was examined. The concentration of training practices is lowest in conurbations that are grossly deprived. Several topics require debate: should trainees be given experience in such areas as an elective? Should the criteria for selecting training practices be similar in all areas? Should practices in deprived areas be encouraged to apply to become training practices?

Education, Medical, Graduate↗
PubMed1985

Audit of the drug treatment of Parkinson's disease in general practice.

In a general practice population of 57 000, 32 patients suffering from Parkinson's disease were identified from repeat prescription indexes and direct questioning of all members of the primary health care team. Of these patients 26 were receiving an L-dopa preparation and 10 an anticholinergic drug. The only newer drug found to be in use was bromocriptine and three patients were receiving this treatment.Of the 26 patients receiving an L-dopa preparation one received L-dopa alone, six L-dopa with benserazide (Madopar, Roche) and 19 L-dopa with carbidopa (Sinemet, Merck, Sharp and Dohme). The patients treated with Sinemet were receiving inadequate doses of carbidopa - three quarters received less than 75 mg per day which was in part a reflection of the low doses of L-dopa the patients received, the average dose being 468 mg per day. The L-dopa preparations were given in adequately spaced doses.The general practitioner made the diagnosis in 20 of the 32 cases and was in control of the drug therapy in 15 cases, however 25 cases were referred for specialist advice.

Aged↗
PubMed1979

Doctors accept a challenge: self-assessment exercises in continuing medical education.

A new approach to continuing medical education by distance learning has been implemented. A series of six patient-management problems or challenges were posted to 20 000 doctors throughout Britain. Each doctor had to decide on the diagnosis, investigations, and treatment of the patients described. The challenges covered problems that were important in the doctor's day-to-day work and were designed so that he could obtain immediate feedback about his decisions and compare his own responses with those of a specialist and those of his colleagues. Additional information was available by telephone and by post on request. The series has been well received and is being widely used.

Attitude of Health Personnel↗
PubMed1979

Use of recording booklets to evaluate teaching in general practice.

Recording booklets have been introduced for students during their course of general practice teaching at the University of Glasgow. The booklets guide the students with patients in the community who have chronic and complicated diseases. Each case history in the booklet was marked and this provided an evaluation of the teaching. This showed an improvement in the students' overall ability but was most marked in the areas of social history and problem list, thus fulfilling the aims of the teaching.

Education, Medical, Undergraduate↗
PubMed1978

Early treatment of myocardial infarction in the community.

The prehospital management of acute myocardial infarction by general practitioners and emergency-treatment service physicians was analysed in 53 patients. The correct clinical diagnosis was made or suggested before admission in 47 patients. Only 25 patients received analgesics from the general practitioner, and 32 were still in pain and needed diamorphine on admission to hospital. Only one patient received antiarrythmic treatment. The findings suggest that, despite accurate clinical diagnosis of acute myocardial infarction, deficiencies exist in the prehospital phase of management and that education programmes are worth consideration.

Analgesics↗