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Athletic patients may be susceptible to staphylococcal infection of their cartilaginous non-synovial joints

Reports have highlighted a shortage of consultant diabetologist posts in the UK. The number of doctors completing specialist training in diabetes has increased in recent years, but little is known about their employment after they receive their certificate of completion of training. An online survey was sent to all doctors who completed specialist diabetes training from January 2008 to September 2010. Of the 95 eligible respondents, 69 (73%) completed the survey (61% men; median age 36 years). Forty-three (62%) respondents secured substantive NHS consultant posts, and of those who gave their job breakdown, 48/51 (94%) were contributing to specialist diabetes care. Five (7%) respondents held substantive academic positions, while 11 (16%) were locum consultants. Seven (9%) respondents worked abroad, with half of these attributing their emigration to lack of opportunities in the UK. When asked about alternative choices, 39% of respondents were likely to seek ‘general physician’ roles, which equalled the number who would consider emigrating. Overall, only two-thirds of doctors who complete specialist training in diabetes secure substantive NHS consultant positions, which suggests a failure in workforce planning and a lack of expansion of the number of consultant posts despite progression of the diabetes epidemic.

Athletic patients may be susceptible to staphylococcal infection of their cartilaginous non-synovial joints

5 Tips for non-specialists Patients with a new foot ulcer, a foot ulcer with osteomyelitis or gangrene, or those with or without a foot ulcer who have cellulitis should be referred to a specialist foot clinic Patients with pain on resting or intermittent claudication, plus those with an ankle brachial pressure index â[per thousand]¤0.5, should also be referred Patients with severe infection-systemic toxicity or fever, tachycardia, vomiting, confusion, severe hyperglycaemia, or renal failure-should be admitted to hospital Patients with peripheral arterial disease and non-healing wounds should be urgently assessed by vascular surgeons Patients with infection and foot ulcers who are unlikely to comply with outpatient medical treatment and who lack home support will need to be admitted A hot swollen foot is indicative of Charcot's foot, which needs early diagnosis and treatment to avoid permanent deformity Additional educational resources Resources for patients Patients UK ( www.patient.co.uk/health/Diabetes-Foot-Care-A-Summary.htm )-This leaflet summarises how people with diabetes can prevent foot ulcers Family Doctor ( http://familydoctor.org/online/famdocen/home/common/diabetes/living/352.html )-Useful tips for patients with diabetes on how to look after their feet Uptodate ( www.uptodate.com/patients/content/topic.do?topicKey=~hL//tcPc67nF2 )-Patient information about foot care in diabetes Resources for healthcare professionals: