In an article published in the Journal of the Royal Society of Medicine, Paul Jewell and I discuss the issue of foundation doctors and specialist training. Only around 43% of junior doctors entered straight into a UK specialty training programme after completion of their foundation programme in 2017, a substantial decrease from 71% in 2011. Given the National Health Service in the UK is under ever-increasing workforce pressures, this is a worrying trend. The decline in entry to specialty training can be partly explained by the rise in what is known as ‘the F3 year’. Concerns over this ‘junior doctor exodus’ are not new, having been previously raised in 2010, when the figures were far more favourable than they are now. Similar trends can also be seen at earlier stages, with fewer school students applying to medical school, and fewer medical students applying to the foundation programme,4 indicating wider issues. To reverse this trend and the shortage of doctors in many specialties, solutions to encourage more foundation doctors to enter specialty training need to be considered.
England is currently experiencing an outbreak of measles, with around 440 laboratory confirmed cases between January to May 2018. The outbreak is linked to ongoing outbreaks in Europe. Most cases are unimmunised teenagers and young adults. Children and young adults who did not receive MMR vaccine when they were younger, and people from under-vaccinated communities, are particularly at high risk.
Measles is a highly infectious illness that can sometimes cause serious complications such as pneumonia and encephalitis, and which can occasionally be fatal. Anyone who missed out on their Measles, Mumps and Rubella (MMR) vaccine or is unsure if they had 2 doses should therefore ensure they are fully immunised.
The outbreak also reinforces the importance of parents to ensure their children receive two doses of the MMR vaccine, the first at around 12 months of age and the second around 3-4 years of age.
An article from Imperial College London published in the Lancet discusses vaccination from migrants in Europe. Ensuring high levels of coverage is a key priority of the European Vaccine Action Plan, whereby all WHO Europe Member States have committed to eliminating endemic measles and rubella (>95% coverage with the measles mumps rubella vaccine), sustaining polio-free status, and controlling hepatitis B infection.