Today was my second exam: the Clinical OSCPE.

This exam is all about doing things with patients. As usual, there were three stations with a patient at each, and each with a time limit of five minutes. On the first patient, I was required to test eye movements and answer lots of questions about nerve supplies to the eye muscles, and explain why certain movements might be hindered. The second patient was playing a pregnant lady, to who I had to give lifestyle advice. With the third patient, I had to elicit different arm reflexes, and explain various things about them, such as the range of results possible from a reflex test and the causes of these results.

Overall, I think I did okay. There are obviously things that I could have done better looking back, but that’s to be expected when you’ve had hours to digest what you were asked to do, but I certainly feel more confident about this particular exam than I did last year. However, like last time, I’m dreading tomorrow’s Non-Clinical OSCE the most… check back tomorrow to see how it goes!

Ms Hewitt’s spell of virtual insanity continues, with her now announcing that she wants to make those who spread MRSA criminals:

Private cleaning contractors, managers and even visitors could face criminal liability for spreading the hospital superbug MRSA in the NHS.

Presumably, these people would then be forced to wear the uniforms proposed by her Crazy Cabinet colleague, Hazel Blears.

But, seriously, what does Ms Hewitt hope to acheive by making spreading MRSA a crime? To do so would mean that doctors would have to take every possible step to avoid litigation – is she seriously suggesting that all doctors should have a full surgical scrub before seeing every patient? That would more than triple the length of the average consultation, so I hope she’s got some money squirrelled away for lots of extra doctors. And what about the emergency situation? Are we all to completely scrub up before performing emergency procedures? A few more deaths might well be occuring if that’s expected.

MRSA will only be brought under control with sensible steps to educate medical staff and the public about prevention, and the necessary funding to keep hygeine standards up. If the funding had been available to put alcohol gel next to every bed five or six years ago – instead of only just getting round to it – then MRSA wouldn’t be such a big a problem now. Threatening people with litigation is simply absurd, and deeply unhelpful. And if she’s going to start slapping fines on cleaning companies, standards are unlikely to improve much but costs will sky-rocket. So I hope there’s lots of money available for the government to pay its own fines, too.

Update: Typo corrected

Today, I had my first exam: the DIPSE paper.

This essentially consists of the traditional short-answer exam questions. At almost fifty pages, it’s certainly one of the longest exams I’ve ever done, and ended up taking the full three hours available. There were quite a few questions on which I had little idea, but on the whole I think I probably scored above the pass mark, so I’m quite happy. To summarise: Not fantastic, not terrible.

Tomorrow: Clinical OSCPEs.

For the coming week, I’m once again in an exam period. As has become almost traditional (see here and here), I’ll be letting you know how I get on each day. The week works out so that I have DIPSEs on Monday, Clinical OSCEs Tuesday, Non-Clinical OSCEs Wednesday, and MCQ/TF/EMI on Friday. I’ll explain all as I go along. So watch out for the first post, about the DIPSEs, tomorrow.

We’ve had Jamie Oliver and the school food. We’ve had Jamie Oliver and the hospital food. Now it’s Paul Rankin and the care home food.

Aside from the fact that my limited knowledge of TV chefs doesn’t include him, and even aside from the fact that he’s clearly desperate to raise his profile, why’s he bothering making such a fuss when even he admits this:

“The standard was not too bad,” Mr Rankin told BBC News 24. “They had a cook in there cooking everything fresh but there just wasn’t any real emphasis on quality tasty foods.

So he’s not too fussed about the nutritional content of the food, he thinks the standards are quite good, but the food just doesn’t taste quite good enough?! Is this really worthy of a campaign?

It’s not even as if they’re particularly underfunded meals:

Shelia Scott from the National Care Homes Association said its members were already spending a average of £20-£30 a week on meals for each resident.

That’s compared to the £1.85 per week Mr Oliver apparently had to deal with (I can’t say I’m over familiar with his methods, having actually not watched the programme).

So where will the celebrity chefs go next? Gordon Ramsay launching a campaign because the turkey in the Ritz is a bit dry?

Today, I’ve finally launched an oft-requested feature… you can now subscribe to this blog by email.

If you give me your email address here (or on the ‘Subscribe by Email’ link on the sidebar), the system will send you an email each time I write a new post, and I’ll even include the full text of the post for your perusal. I’ll throw in a link to the post, as well, so that you can see it complete with any formatting or pictures, and also comment on it or see any other comments that have been left. This is in addition to the recently-launched comments feed subscription options, which allow you to be notified each time a comment is left on a post which you have already comment on.

The service is (of course) completely free of charge, and your email address will be used for nothing other than sending you these updates.

I hope this feature proves useful to you!

Update: Link URI updated

Or, rather, 110 lucky cookies, as 110 people who played the numbers found within their Wonton Foods fortune cookies actually won, netting $100,000 each.

I do love these US feel-good stories. I think I might start posting more of them.

Reacting to the news that Andrew Marr is joining the other political resignees, The Independent today has something which closely resembles an obituary for him. He is a good political editor, but I’ve always preferred Mark Mardell’s reports to Marr’s. What is it with political reporters and names beginning with M?

Given that Mr Marr has chosen to leave, and that the BBC are likely to try and poach Mr Robinson from ITN, it seems probable that the three biggest political posts in British TV are going to be contested over the next few months. It’ll certainly be interesting to see how it all pans out.

And Marr should, perhaps, worry that his picture (above) reminds me very much of ‘Come Hither Bill’. Even the Independent says he has “the perfect face for radio”.

In one of the most bizarre royal stories I’ve seen for a while (and, let’s face it, most royal stories are pretty odd), the Queen has chosen – of all the artists in the country – Rolf Harris, to paint her eightieth birthday portrait.

This decision has not gone down well in art circles. The editor of Modern Painters (a fascinating read, I’m sure) said “Oh God, how depressing”. The Guardian’s art critic: “You couldn’t make it up”

But at least one observer’s happy: Tracy Emin said it was “great for Rolf”. Unfortunately, Rolf was more “overwhelmed” and worried he might “get stage fright and panic”.

Really though, it’s probably good for the Queen to be seen to be doing something ‘fun’, and connecting with the public a little. Though I’m not sure this is quite the way to do it.

This mildly absurd plan made me smile this evening:

The health secretary, Patricia Hewitt, today signalled that NHS hospitals face the possibility of closure if they fail to attract sufficient numbers of patients.

Speaking at the International Convention Centre in Birmingham in her first public address as the newly appointed health secretary, Ms Hewitt echoed her predecessor, John Reid, by saying it was possible that some services could close if patients deserted them.

So any departments that don’t attract a critical number of patients will be closed? Surely this means that there will no longer be treatment available on the NHS for anything rare…

“Hi doc, I think I was bitten by a deadly spider on my holidays, and now I’ve turned a perculiar colour and my heart is failing”
“Sorry, can’t help, not enough people have that problem”

And will we see doctors inflicting obscure injuries, in order that their speciality be saved?

Another ill-thought out plan…

Fears around NHS service closures circle around the introduction of a new NHS funding system, Payment by Results, whose roll out coincides with the expansion of patient choice. Under the new financial arrangements, money follows patients more directly, with treatments paid to hospitals – whether in the NHS or the private sector – according to a set of national tariffs (standard price).

This means that if far fewer patients choose a certain hospital, an NHS trust could face a dramatic loss of funds, leading to possible closure.

So a minor surgery clinic, specialising in ingrowing toenails which presumably get only a small tariff will no longer have the funding to hire a receptionist and have the heating on in the winter, because it doesn’t attract the huge money that goes to the big transplant centre down the road.

Whilst clearly batty, Patricia Hewitt does fit rather more comfortably in the role of Health Secretary than did John Reid. At least now you can have a concerned looking softly spoken minister saying “I’m terribly sorry, we can’t do that for you” instead of a rather less comforting man yelling “No, I won’t fix you, and there was no need to ask me in that tone of voice.”

All we need now is an appropriate and competent minister. When’s the next election?