Fusion of positron emission tomography/computed tomography with magnetic resonance imaging reveals hamstring peritendonitis in polymyalgia rheumatica.

Objectives: To characterize 18F-fluorodeoxyglucose (18F-FDG) uptake on whole-body PET/CT in PMR, and identify its precise anatomic correlate using MRI. Methods: Patients with newly diagnosed PMR according to the 2012 EULAR/ACR classification criteria were prospectively recruited. Participants with GCA were excluded. A whole-body 18F-FDG PET/CT scan was performed in all untreated patients. Qualitative and semiquantitative [standardized uptake value maximum (SUVmax)] scoring of abnormal 18F-FDG uptake was undertaken. MRI of the pelvis, knee and wrist and hand was performed in three representative patients with anatomical correlation of FDG-avid sites carried out using Medview fusion software. Results: Twenty-two patients with PMR were recruited. Their mean age was 68.3 years (s.d. 6.3) and 13/22 were male. On whole-body PET/CT, 18F-FDG uptake adjacent to the ischial tuberosities was observed in 21 participants (95.4%) and recorded the highest mean SUVmax value [3.6 (s.d. 1.7)]. A high frequency of posteromedial knee (61.9%) and wrist and/or hand involvement (66.7%) was also appreciated. MRI of the pelvis revealed high T2 signal surrounding the proximal hamstring tendon origins of both semimembranosus and the conjoint tendon of the semitendinosus and biceps femoris. At the knee, peritendonitis at the distal insertion of the semimembranosus was observed. PET/MRI fusion at the pelvis and knee confirmed semimembranosus peritendonitis as the anatomical correlate of 18F-FDG uptake adjacent to the ischial tuberosities and of posteromedial knee structures. Conclusion: Hamstring peritendonitis is a common and distinctive manifestation of PMR on whole-body PET/CT. Trial registration: Australian New Zealand Clinical Trials Registry, http://www.anzctr.org.au, ACTRN1261400696695.

Flexible but boring: medical students' perceptions of a career in general practice.

Australia will continue to face a general practitioner (GP) shortage unless a significant number of medical students make general practice their chosen career. Perceptions regarding general practice may influence career choices. Thus this study investigated what Australian medical students perceived to be the advantages and disadvantages of pursuing a career in general practice via an anonymous online survey. Fifty-one students indicated general practice to be their first ranked career preference, 200 indicated a career other than general practice, and 106 were undecided. Two-hundred and two students reported having been on a GP placement, whereas 88 students had not. Flexibility, continuity of patient care and work-life balance were the three most common stated advantages to pursuing a career in general practice whereas general practice being boring, poorly paid, and of low prestige were the three most common disadvantages stated. Some disadvantages stated by those with a non-GP preference were not stated by those with a GP preference (e.g. lack of procedural skills, lack of career advancement opportunities). Students with more than 80 h of GP placement experience were more likely to list the advantages of work-life balance and a diversity of problems/illnesses/patients than those with no placement experience but were also more likely to list the disadvantage of low prestige. Negative stereotypes regarding general practice continue to exist which may influence students' career choices.

The need for a peer physical examination policy within Australian medical schools.

BACKGROUND: Peer physical examinations (PPEs) are often used to enhance medical students' clinical examination skills. Previous research indicates that there are several issues of concern regarding PPEs suggesting that it is important to have a PPE policy in place to respond to these issues appropriately. However, it is unknown as to how many Australian medical schools actually have such a policy. AIMS: The aims of the present study were to enumerate how many Australian medical schools use PPEs and have a PPE policy. METHODS: Surveys were sent to all Australian medical schools. RESULTS: Our findings show that most Australian medical schools use PPEs, but none appear to have a thorough PPE policy. CONCLUSIONS: The findings of our study show that the majority of medical schools practise PPEs but do not have a policy. This in turn could lead to significant problems arising.

Medical graduates' knowledge of bloodborne viruses and occupational exposures.

A survey of medical graduates commencing employment as junior doctors was performed to investigate knowledge of bloodborne viruses and occupational exposure management, coupled with their experience of occupational exposures. There was a mismatch between general knowledge (excellent) and knowledge of postexposure management (poor), and graduates had commonly experienced an occupational exposure and not reported it. The knowledge deficit regarding postexposure management and history of poor practice (ie, nonreporting) following an exposure implies that the transition period from student to junior doctor may be associated with increased occupational health and safety risk.

Would you consent to being examined by a medical student? Western Australian general public survey.

BACKGROUND: Patients generally have positive attitudes regarding being examined by a supervised medical student as part of their medical care. However, it is difficult to obtain model patients for students to examine purely for teaching purposes (i.e. in the absence of medical treatment). AIMS: This study explored the effects of participants' demographics, characteristics of medical students, and the type of examination/procedure on whether individuals would consent to be examined by a medical student purely for teaching purposes. METHOD: Four-hundred-and-two Western Australians completed an online survey in 2009. RESULTS: Individuals were generally unconcerned regarding a medical student's gender and ethnicity. However, they would either not permit or wanted more advanced medical students to examine more intimate body regions and conduct more invasive procedures. Less observing medical students were permitted to be present for intimate examinations. Individuals who were male, aged≥25 years, Caucasian, and of no religious affiliation were more likely to permit formative year medical students to examine and conduct procedures on them. Additionally, these individuals were more likely to have had prior experience with a medical student and/or been hospitalised previously. CONCLUSIONS: This information may be useful in terms of recruiting patient models for teaching purposes.

How relevant is undergraduate medical law teaching to clinical practice? A graduates' perspective.

The Monash University medical law tutorial program was implemented in 2002. A major aim of this program is to enable medical students to recognise and understand their legal obligations in clinical practice, thereby improving clinical standards and contributing to better patient outcomes. The present study examined whether, from a graduate perspective, the medical law tutorial program provides adequate legal information of relevance for a clinical context. Monash University medical graduates from 2007 to 2009 who were working at a Victorian hospital or who were members of the Royal Australian College of General Practitioners were invited to participate in the study. Fifty-six participants completed the survey. Overall, participants had positive perceptions of the medical law program. The medical law program is an essential component of students' medical education and provides information relevant to future clinical practice.