Postgraduate medical journal (Postgrad Med)

Publisher: BMJ Publishing Group

Journal description

Published on behalf of the Fellowship of Postgraduate Medicine, Postgraduate Medical Journal aims to: Help doctors in training to acquire the necessary skills to enable them to deliver the highest possible standards of patient care; Help trainers to develop suitable training programmes for their trainees; Allow doctors, once training is completed, to maintain these high standards by a process of continuing medical education; As well as editorials and original articles, Postgraduate Medical Journal includes up to six review articles in each issue and has a Self-Assessment Corner.

Current impact factor: 1.55

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.549
2012 Impact Factor 1.608
2011 Impact Factor 1.939
2010 Impact Factor 1.605
2009 Impact Factor 1.384
2008 Impact Factor 1.587
2007 Impact Factor 1.218
2006 Impact Factor 1.093
2005 Impact Factor 0.944
2004 Impact Factor 0.807
2003 Impact Factor 0.676
2002 Impact Factor 0.552
2001 Impact Factor 0.441
2000 Impact Factor 0.339
1999 Impact Factor 0.402
1998 Impact Factor 0.478
1997 Impact Factor 0.496
1996 Impact Factor 0.572
1995 Impact Factor 0.442
1994 Impact Factor 0.448
1993 Impact Factor 0.357
1992 Impact Factor 0.325

Impact factor over time

Impact factor

Additional details

5-year impact 1.63
Cited half-life 8.30
Immediacy index 0.27
Eigenfactor 0.01
Article influence 0.45
Website Postgraduate Medical Journal website
Other titles Postgraduate medical journal
ISSN 1469-0756
OCLC 66425979
Material type Periodical, Internet resource
Document type Internet Resource, Journal / Magazine / Newspaper

Publisher details

BMJ Publishing Group

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • On author's personal website, institutional website or institutional repository
    • Publisher copyright and source must be acknowledged
    • Must link to publisher version
    • Publisher's version/PDF cannot be used
    • If funding agency rules apply, authors may post articles in PubMed Central and mirror sites, website, institutional website or institutional repository
    • On PubMed Central after 12 months embargo, or as required by funding agency
    • Publisher last contacted on 08/12/2014
  • Classification
    ​ green

Publications in this journal

  • Khang-Li Looi · Anthony Tang · Sharad Agarwal
    [Show abstract] [Hide abstract]
    ABSTRACT: In the era of widespread use of implantable cardioverter-defibrillators (ICDs) for both primary and secondary prevention of sudden cardiac death, a significant proportion of patients experience episodes of multiple ventricular tachycardia/fibrillation over a short period of time requiring device interventions. The episodes are termed ventricular arrhythmia (VA) or electrical storms. VA storm is a tragic experience for patients, with many psychological consequences. Current management for VA storms remains complex. Acutely, administration of β-blockers, amiodarone and sedation or intubation is generally required to suppress sympathetic tone. Interventional treatment includes catheter ablation and sympathetic blockade by left cardiac sympathetic denervation. Strategies to modify autonomic tone to suppress VAs are the rationale of various novel interventions that have been published in recent studies. All patients with VA storm should be considered for transfer to an experienced high-volume tertiary centre for evaluation and treatment to prevent further recurrence of VA storm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2015-133550
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    ABSTRACT: Social media may blur the line between socialisation and professional use. Traditional views on medical professionalism focus on limiting motives and behaviours to avoid situations that may compromise care. It is not surprising that social media are perceived as a threat to professionalism. To develop evidence for the professional use of social media in medicine. A qualitative framework was used based on an appreciative inquiry approach to gather perceptions and experiences of 31 participants at the 2014 Social Media Summit. The main benefits of social media were the widening of networks, access to expertise from peers and other health professionals, the provision of emotional support and the ability to combat feelings of isolation. Appreciative inquiry is a tool that can develop the positive practices of organisations and individuals. Our results provide evidence for the professional use of social media that may contribute to guidelines to help individuals realise benefits and avoid harms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2015-133353
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    ABSTRACT: There is rapidly increasing pressure to employ social media in medical education, but a review of the literature demonstrates that its value and role are uncertain. To determine if medical educators have a conceptual framework that informs their use of social media and whether this framework can be mapped to learning theory. Thirty-six participants engaged in an iterative, consensus building process that identified their conceptual framework and determined if it aligned with one or more learning theories. The results show that the use of social media by the participants could be traced to two dominant theories-Connectivism and Constructivism. They also suggest that many medical educators may not be fully informed of these theories. Medical educators' use of social media can be traced to learning theories, but these theories may not be explicitly utilised in instructional design. It is recommended that formal education (faculty development) around learning theory would further enhance the use of social media in medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2015-133358
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    ABSTRACT: Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-133195
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    ABSTRACT: Preventable harm is one of the top six health problems in the developed world. Developing patient safety skills and knowledge among advanced trainee doctors is critical. Clinical supervision is the main form of training for advanced trainees. The use of supervision to develop patient safety competence has not been established. To establish the use of clinical supervision and other workplace training to develop non-technical patient safety competency in advanced trainee doctors. Keywords, synonyms and subject headings were used to search eight electronic databases in addition to hand-searching of relevant journals up to 1 March 2014. Titles and abstracts of retrieved publications were screened by two reviewers and checked by a third. Full-text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted. Clinical supervision documents were assessed against components common to established patient safety frameworks. Findings from the reviewed articles and document analysis were collated in a narrative synthesis. Clinical supervision is not identified as an avenue for embedding patient safety skills in the workplace and is consequently not evaluated as a method to teach trainees these skills. Workplace training in non-technical patient safety skills is limited, but one-off training courses are sometimes used. Clinical supervision is the primary avenue for learning in postgraduate medical education but the most overlooked in the context of patient safety learning. The widespread implementation of short courses is not matched by evidence of rigorous evaluation. Supporting supervisors to identify teaching moments during supervision and to give weight to non-technical skills and technical skills equally is critical. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-133130
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    ABSTRACT: Digoxin has been a key therapeutic for heart failure and atrial tachyarrhythmias for over 200 years following Withering's groundbreaking work depicting the therapeutic benefit of the common botanical foxglove in his 1785 monograph. The use of digoxin preceded any randomised evidence or even basic understanding of its mechanism of action. Over the past two decades, there has been mounting evidence further challenging the safety and efficacy of digoxin, while multiple other therapies for both heart failure and atrial tachyarrhythmias have proven to be more effective and safe. Altogether, digoxin still has an important role in contemporary pharmacotherapeutics, though its role remains controversial and should be reserved for selective patients and clinical situations, with careful attention to serum concentrations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-132937
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    ABSTRACT: Cigarette smoking is a well-established risk factor for the development of coronary heart disease. However, the relationship between smoking and acute ST-segment elevation myocardial infarction (STEMI) is less well described. To determine the relative risk of acute STEMI in smokers and ex-smokers, compared with individuals who had never smoked. This observational study studied all patients with STEMI undergoing percutaneous coronary intervention (PCI) in South Yorkshire, UK from 1 January 2009 to 6 April 2012. Additional contemporary demographical data for the South Yorkshire population, supplied by the Office for National Statistics, allowed derivation of the incidence rate of STEMI in South Yorkshire-both overall and stratified by smoking status. Incidence rate ratios and population attributable risk (PAR) were calculated to quantify STEMI risk. There were 1715 STEMIs in 1680 patients during the study period. Smoking status was obtained in 96.2% patients. The prevalence of smoking was 47.3% in patients with STEMI and 22.0% in the general population. In patients with STEMI, smokers were ∼10 years younger, mean (SD) 57.2 (11.1) years, than never-smokers, 66.4 (12.1) years, and ex-smokers, 67.9 (11.9) years. The age-standardised incident rate ratio of STEMI was 5.2 (4.5-6.1) for current smokers and 1.1 (1.0-1.3) for ex-smokers, with the reference group being never-smokers for both. Almost 50% of STEMIs were attributable to smoking (PAR=48.3%). Cigarette smoking is associated with a fivefold increased risk of STEMI. Smoking cessation reduced this risk to a level similar to never-smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2015-133269
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    ABSTRACT: Although biostatistics and clinical epidemiology are essential for comprehending medical evidence, research has shown consistently low and variable knowledge among postgraduate medical trainees. Simultaneously, there has been an increase in the complexity of statistical methods among top-tier medical journals. To develop the Biostatics and Clinical Epidemiology Skills (BACES) assessment by (1) establishing content validity evidence of the BACES; (2) examining the model fit of the BACES items to an Item Response Theory (IRT) model; and (3) comparing IRT item estimates with those of traditional Classical Test Theory (CTT) indices. Thirty multiple choice questions were written to focus on interpreting clinical epidemiological and statistical methods. Content validity was assessed through a four-person expert review. The instrument was administered to 150 residents across three academic medical centres in southern USA during the autumn of 2013. Data were fit to a two-parameter logistic IRT model and the item difficulty, discrimination and examinee ability values were compared with traditional CTT item statistics. 147 assessments were used for analysis (mean (SD) score 14.38 (3.38)). Twenty-six items, 13 devoted to statistics and 13 to clinical epidemiology, successfully fit a two-parameter logistic IRT model. These estimates also significantly correlated with their comparable CTT values. The strength of the BACES instrument was supported by (1) establishing content validity evidence; (2) fitting a sample of 147 residents' responses to an IRT model; and (3) correlating the IRT estimates with their CTT values, which makes it a flexible yet rigorous instrument for measuring biostatistical and clinical epidemiological knowledge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-133197
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    ABSTRACT: sec> Background The Accreditation Council for Graduate Medical Education requires residents to learn and demonstrate proficiency in practice improvement. Quality improvement (QI) projects are a way to improve patient care as well as facilitate education on this core competency. There are inherent barriers to completing these goals in the structure of residency training including rigorous resident schedules and a limited number of projects and resources. Objectives We developed a QI programme using an experiential class project and incorporated it into our Internal Medicine Resident Core Curriculum to improve the residents’ knowledge of QI methods. We assessed the residents’ experience, knowledge and interest in practice and QI subject matter with a survey preimplementation and postimplementation. Methods In 2009, 24 residents in the Internal Medicine resident programme completed a survey measuring their experience, knowledge and interest in QI initiatives. They then completed a QI 1-year programme, with monthly, 1-hour sessions combining didactics and a resident-designed project. At the conclusion of the year, the residents completed the same survey, and the results were compared and analysed. Results Postcurriculum questionnaires revealed residents were more knowledgeable about QI methods, showing improvement in knowledge about institutional-wide QI projects, better preparation for implementing a QI project, and more likely to participate in QI in the future. The project completed was one which improved patients’ knowledge of their anticipated date of discharge from the hospital. Conclusions A class quality project can teach QI to residents incorporating both didactic and practical methods to maximise the experience and minimise the barriers. We found that this method improved residents experience, knowledge and interest in quality initiatives. </sec
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-132886
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    ABSTRACT: Musculoskeletal (MSK) conditions affect millions of people around the world. Gait, Arms, Legs and Spine (GALS) is a simple and useful screening tool for routine MSK examination in hospitals and general practice and has been integrated into the undergraduate medical curriculum. Despite this, there is evidence that doctors lack competency in MSK examination and that GALS are underperformed routinely. The study explored the views of junior doctors (JDs) on how they were taught MSK examination as undergraduates; the usefulness of GALS as a technique for excluding significant MSK problems; why MSK examination was often poorly carried out and how this could be improved. A qualitative study was performed with data gathered through focus group interviews from 32 JDs working in two acute NHS hospitals. Six interviews were conducted over a 6-week period from mid-June to the end of July in consecutive years 2013 and 2014. Ninety JDs were invited to participate in the focus group interviews; 32 (36%) agreed to participate, 28 (88%) of whom had graduated in the UK. The perception of JDs was that undergraduate training for GALS and regional MSK examination was adequate, but reasons for lack of MSK competency in the workplace are multifactorial and complex. Proposing more practical and interactive sessions to reinforce MSK skills during postgraduate training may not resolve issues of MSK competency among JDs. Recognition of the complexity of workplace learning and the influence of tacit learning is required if MSK competency is to be enhanced. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2015-133340
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    ABSTRACT: Acute aortic pathologies include traumatic and non-traumatic life-threatening emergencies of the aorta. Since the clinical manifestation of these entities can be non-specific and may overlap with other conditions presenting with chest pain, non-invasive imaging plays a crucial role in their rapid and accurate evaluation. The early diagnosis and accurate radiological assessment of acute aortic diseases is essential for improved clinical outcomes. Multidetector CT is the imaging modality of choice for evaluation of acute aortic diseases with MRI playing more of a problem-solving role. The management can be medical, endovascular or surgical depending upon pathology, and imaging remains an indispensable management-guiding tool. It is important to understand the pathogenesis, natural history, and imaging principles of acute aortic diseases for appropriate use of advanced imaging modalities. This understanding helps to formulate a more appropriate management and follow-up plan for optimised care of these patients. Imaging reporting pearls for day-to-day radiology as well as treatment options based on latest multidisciplinary guidelines are discussed. With newer techniques of image acquisition and processing, we are hopeful that imaging would further help in predicting aortic disease progression and assessing the haemodynamic parameters based on which decisions on management can be made. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-133178
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    ABSTRACT: The 5-year survival of patients with pancreatic cancer is poor and, despite oncological advances over the past two decades, has not significantly improved. However, there have been several surgical and oncological advances which have improved morbidity and mortality in surgery and more efficacious chemotherapy regimens, resulting in a better patient experience and an increase in survival by a number of months. Most patients have a tumour at the head of the pancreas and those with resectable disease undergo a pancreaticoduodenectomy, which can be performed laparoscopically. Those who have a pancreatic resection have an increased survival in comparison with those receiving oncological treatment only; however, only a quarter of patients have resectable disease at diagnosis. Some centres are now performing venous resections and/or arterial resections in order to increase the number of patients eligible for curative surgery. Innovative techniques using ablation technologies to downstage tumours for resection are also being investigated. After surgery, all patients should be offered adjuvant gemcitabine-based chemotherapy. Those with locally advanced tumours not suitable for surgery should be offered FOLFIRINOX chemotherapy, after which the tumour may be suitable for surgical resection. The use of radiotherapy in this group of patients is controversial but offered by a few centres. Patients with metastatic disease at diagnosis should also be offered FOLFIRINOX chemotherapy, which can improve survival by a few months. As our knowledge of the tumour biology of pancreatic cancer progresses, a number of new agents targeting specific genes and proteins are under investigation and there is hope that median survival will continue to improve over the next decade. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Postgraduate medical journal 08/2015; DOI:10.1136/postgradmedj-2014-133222
  • Postgraduate medical journal 08/2015; 91(1078). DOI:10.1136/postgradmedj-2015-133684
  • Postgraduate medical journal 07/2015; 91(1077). DOI:10.1136/postgradmedj-2015-133443
  • Postgraduate medical journal 07/2015; 91(1077). DOI:10.1136/postgradmedj-2015-133562