Medical Trainees

What grade is this pressure ulcer?

pressure ulcerA 62 year old man with poorly controlled type 2 diabetes mellitus is admitted to hospital with hyperosmotic hyperglycaemic state. While examining him you note this ulcer on his left ischial tuberosity.

What’s your assessment of the grade of his ulcer?

Check your answer in Challenges in hospital care: pressure ulcers. This highly practical module walks you through three case histories, giving you the option to delve deeper if you want. Covering prevention, assessment, complications and management, this is an important challenge for clinicians at all levels. It’s getting great feedback from other users:

Detailed module giving important information about an easily neglected subject despite its prevalence. The cases help to give it relevance and interest while learning

Memory loss: can you distinguish reversible from irreversible causes?

Would you feel confident to identify a patient whose progressive memory loss is caused by a reversible cause such as pseudo-dementia? In patients with true dementia, what features in the history and presentation can help you to distinguish between different forms, including Alzheimer's disease, vascular dementia, frontotemporal dementia and dementia with Lewy bodies?

Build your confidence with our new Hospital Presentations module on Memory loss, in which you'll work through a patient case that might arise in your daily work on the wards or in the emergency department. It covers assessment and immediate management of patients who present with progressive memory loss, the range of potential causes and practical tips on using bedside cognitive assessment tools. Other junior doctors are already finding it really helpful:

“Great module. Has essential information in managing and understanding patients with cognitive impairment. Also I liked how the screening tools were presented.”

What's the diagnosis?

You are asked to assess an 18 year old man who has presented to the emergency department with a one week history of rash. He also reports a sore throat and a mild fever. On examination, you note multiple small, pink, scaly macules over his arms, trunk, and thighs. There is redness of his pharynx, but no other oral signs. His nails look normal.

What is the most likely dermatological diagnosis and what treatments would you recommend?

Check your answers in our new Hospital presentations module on Rash. You’ll learn as you work through two patient cases, with tips on the key differentiating features of common rashes and advice on how to manage skin conditions that often present present acutely or on the wards. The module also covers noncutaneous associations of skin conditions and is already getting great reviews from other users:

"Very informative, interesting module with great learning points, good evidence and great images."

What sign can be seen on this x ray?

A 25 year old man presents with a one week history of crampy abdominal pain and frequent passage of bloody stools. His radiograph is shown below. What sign can be seen?

Check your answer in our new module on Interpretation of abdominal radiographs, which will help you to differentiate normal from abnormal features and reach the right diagnosis for a range of common and rarer conditions.

In the module, consultant radiologist Dr Vikas Shah takes you through the ABDO X system for analysing abdominal x rays and offers invaluable practical tips on how to assess bowel gas patterns, soft tissue structures and bones. Other users are loving the module:

"Magnificent module, very highly recommended."

"An absolute highlight. A dedicated teacher with an extraordinary didactic skill has delivered a perfect introduction into a not-so-easy topic."

Tips for referring a patient to a senior colleague

Do you feel stressed when you know you will need to refer a patient to a senior colleague for advice, to request an investigation or to transfer their care? Making a referral by phone or in person is a common clinical activity, but many junior doctors find it difficult. Our new interactive module, How to make effective referrals, covers what can go wrong, how to prepare by using the core elements of a good in-hospital referral, and strategies for dealing with an aggressive or obstructive response. It includes practical tips, video scenarios, and templates to use in your daily practice. Other users are finding it really useful:

"Very relevant, useful and great realistic examples of referrals made by junior doctors!"

“Very clear and structured approach to referrals. Provides clear advice on how to prevent and manage difficult referrals.”

How confidently can you assess possible causes of blackout?

Do you have a clear strategy for assessing a patient who presents following a transient loss of consciousness? How can you confidently distinguish cardiovascular from neurological and other possible causes? What are the key features to look out for in the history and eyewitness reports? Which investigations are important and which may not be needed?

Check your answers in our highly rated Hospital presentations module on Blackouts and collapse. You’ll learn as you work through typical patient scenarios that you might see in your day to day practice. Other junior doctors are giving the module great reviews:

"Well written, excellent presentation of this very common clinical scenario in the emergency department."

“Very good and easy to learn from.”

Get up to speed on sepsis

A 45 year old woman is admitted with right iliac fossa pain following a laparotomy two weeks ago for endometriosis. She has a respiratory rate of 24 breaths per minute, oxygen saturations of 94% on room air, heart rate 117 bpm, blood pressure 108/68 mmHg, and a temperature of 38.5℃. On examination she has tenderness in the right iliac fossa with pus draining from the incision site. You are asked to do a structured risk assessment for possible sepsis. How will you proceed, and how should your findings guide your management plan?

Check your answers in our new Hospital challenges module on
Sepsis in adults. You will work through patient scenarios that are typical of the situations you face in everyday practice as you learn about all the latest practice changing developments in the evidence, guidance and classification of sepsis. The module is already proving very popular with other users:

"Excellent module with important details about updated sepsis guidelines."

"Very informative and relevant in clinical practice."

Also try the companion module on Sepsis in children to ensure you know how to identify and manage paediatric patients with infections that put them at high risk of serious illness or death from sepsis.

Join our audience panel

If you’d like to help BMJ Learning ensure we deliver the content that you need as a medical trainee, join our audience panel to provide feedback and ideas. Email clinical editor Jo Haynes.

Animated practical skills modules to support you in your first years on the ward