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We read with interest the article by Smith and Poplett.1 In a recent study, the results of which are currently being analysed, PRHOs were approached at the end of their first post (four or six months after qualification).
When questioned, 53% of those who had completed only a medical attachment felt confidant in making a diagnosis and treating a patient with an acute abdomen. Of those who had completed only their surgical attachment, 91% felt confidant to diagnose and treat pneumonia, 73% acute left ventricular failure, and 50% an exacerbation of chronic obstructive pulmonary disease. Six percent even felt able to decide when to administer thrombolysis to a patient requiring it for myocardial infarction (despite having no medical experience at all).
These data, taken alongside those of Smith and Poplett indicate that PRHOs are falsely confident in their own abilities.
This has serious implications for patient care (as PRHOs may fail to ask for help from senior colleagues sufficiently quickly, or even give inappropriate treatment), as well as for postgraduate deans, as it is important to redress this discrepancy through education.
The experience level of the doctors questioned by Smith and Poplett was not clear. Had the PRHOs started work at all? In which year were the SHOs and had any of them completed advanced life support courses? It would be interesting to take this into account, which may highlight the benefit of advanced life support-type courses.
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