Use of adrenaline by junior doctors

The survey reported by Gompels and colleagues showing the incorrect use of adrenaline in anaphylaxis by over 50% of junior doctors reveals sobering but perhaps not startling statistics.1 Their study serves as an audit reflecting the quality of contemporary medical education in that it compares prevailing practice with established guidelines in the management of a given medical problem. Having spent 18 seamless months as a casualty officer recently and worked in two accident and emergency departments in large cities, I wish to highlight the observation that teaching on anaphylaxis was remarkably cursory in didactic sessions, as well as in the standard cardiorespiratory training workshops. When combined with the reality that moderate to severe anaphylaxis is seen infrequently, it is easy to appreciate how any superficial knowledge that exists passes into further obscurity over time. The inability to tackle emergencies adequately results from inexperience, but the large gaps in basic medical know-how (in over 50% of graduates in this study) is a direct testament to their undergraduate and early postgraduate training. Medical curricula are ever expanding with concepts that the freshly minted doctor of the 21st century must absorb, but it appears that in this enormous amount of information the crucial elements are becoming indistinguishable.