Medical Journal News

The BMA’s Resident Doctors Committee (RDC) has reached an agreement with the government over how exception reporting in England will be reformed, officially ending the union’s dispute with the government over the issue.Exception reporting is the process through which doctors can report differences in their total hours worked when compared with their set schedule—times when they were unable to take their contractual rest breaks or when educational or training opportunities were missed—and the levels of support available to them.The BMA has said that the current system is “not fit for purpose” because inaccessible systems, time consuming processes, and the fear of repercussions are deterring doctors from reporting such instances. “This not only means doctors don’t get the pay and training opportunities they deserve but also means that NHS hospitals are missing out on crucial information about how they are functioning,” the BMA said.The RDC voted to go into dispute with...

This editorial by McCartney et al(BMJ 2025;388:r593; doi:10.1136/bmj.r593, 25 March) has been amended to clarify that the benefits review described in the sixth paragraph applied to recipients of employment and support allowance.

The need for shared decision making and informed consent in gynaecology is not new.1 When the Supreme Court enshrined it in law in Montgomery v Lanarkshire Health Board,2 it was not doing anything revolutionary; these concepts were already part of General Medical Council guidance.3 But practical implementation was, and is, problematic.Good communication with a sympathetic and empathic listener is crucial for patients to feel safe. Safety is so fundamental to compassionate healthcare that it beggars belief that women frequently leave their gynaecology appointments feeling distressed, violated, or traumatised. Once a woman feels unsafe, once trust is lost, she is unlikely to return.Despite concerns about invasive gynaecological procedures being expressed over many years, progress is glacially slow, a fact emphasised by the recent report of the House of Commons Women and Equalities Committee4 and the UK government’s response.5 The gaslighting of women in gynaecological settings is commonplace; severely painful, invasive procedures,...

My husband lives with a spinal cord injury. Hospital admission can be traumatic when I’m excluded despite being his carer.1 I’m privy to information about his care that can’t be gleaned in a single handover with clinicians. I’ve felt unwelcome during the admission process, and healthcare staff haven’t treated me as an expert partner in care. Transitions involve patients and families moving between different clinical contexts—but too often their experiences and expertise are lost or undermined in the process.Problems with admissions and transition are seen across care settings and patient groups. Al Aynsley-Green, the first national clinical director for children in government, has expressed his concerns about patients receiving chaotic care and scant communication, which is often inappropriate for their age group or condition. He tells of a young woman with a complex health condition being cared for in a cramped overflow hospital bay alongside older people with dementia and...

The United Nations has called for “justice and answers” after the bodies of eight Palestinian medics, six first responders, and one UN staff member—still in their uniforms and gloves—were recovered from a mass grave in southern Gaza after an attack by Israeli forces.1The UN said that the “clearly identified” humanitarian workers had been dispatched to collect injured people on 23 March in the Rafah area and had been travelling in five ambulances, a fire truck, and a clearly marked UN vehicle. They then “came under fire from Israeli forces who were advancing in the area,” after which their teams lost contact with them.On 31 March the UN’s emergency relief coordinator, Tom Fletcher, posted on the social media platform X,2 “15 emergency and aid workers in Gaza were found buried by their wrecked and well-marked vehicles . . . They were killed by Israeli forces while trying to save lives.”The Israel...

New England Journal of Medicine, Volume 392, Issue 13, Page 1297-1309, April 3, 2025.

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New England Journal of Medicine, Volume 392, Issue 13, April 3, 2025.

New England Journal of Medicine, Ahead of Print.

bmj;389/apr02_1/r631/FAF1faChristian Ip-Yam was born in Mauritius, the eldest of four sons. He attended Royal College Port Louis, a prestigious state grammar school in the island’s capital. Being academically gifted and diligent, he was awarded the Mauritian state scholarship in 1979 and applied successfully for medicine at Manchester Medical School where he was a friendly, easy going, and hardworking student who seemed to sail through his undergraduate exams. He qualified with honours in 1984 and opted for a career in anaesthesia.He trained at Northwick Park, Charing Cross, and Harefield hospitals in London and undertook lectureships in cardiothoracic anaesthesia at the University of Liverpool. He published at least 20 research papers in highly respected academic journals.In 1994 he took a sabbatical in Singapore, where he met his future wife, Georgia, a doctor in aesthetics. He settled permanently in Singapore in 1995 and he and Georgia were married in 1996. He quickly established...

The death toll continues to rise in central Myanmar after a 7.7 magnitude earthquake hit South East Asia on 28 March. Over 2700 people have died so far, with another 4521 injured and 441 reported missing.1The disaster prompted Myanmar’s ruling military junta, the State Administration Council (SAC), to make a rare call for humanitarian aid on 29 March, despite the ongoing civil war. On 1 April, however, aid agencies reported that the junta was preventing humanitarian assistance from reaching earthquake survivors.2 SAC resumed airstrikes in rebel areas barely three hours after the earthquake struck.3A UN assessment found that many health facilities in Myanmar have been damaged by the earthquake and warned that a “severe shortage” of medical supplies, including trauma kits, blood bags, anaesthetics, and assistive devices, was hampering response efforts. According to the World Health Organization4 three hospitals were severely damaged, with 22 sustaining partial damage.In a 30 March...

by Lin Geng, Lilith K. Whittles, Borame L. Dickens, Martin T. W. Chio, Yihao Chen, Rayner Kay Jin Tan, Azra Ghani, Jue Tao Lim

When hurricane Helene flooded a North Carolina plant that made 60% of the US’s intravenous fluids in October 20241 it was a grimly familiar situation. The damage worsened a shortage that had lingered since hurricane Maria hit the same company’s production in Puerto Rico in 2017.Medical procedures had to be altered to reduce the use of IV products. Fluids were rationed and surgeries postponed, and some patients had to get by with sports drinks.2 It took three months to bring the crisis under control.A broader, more intractable crisis has replaced it. Trump’s aggressive reconfiguration of US trade relations and a pledge to make all of the country’s essential drugs and their inputs at home is threatening the stability of medical supply chains that have only just recovered from covid.Additionally, tariffs targeting both traditional US allies and rivals are likely to hamper progress already made on relocating some medical sourcing from...