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COVID-19 has had a significant impact on healthcare resources and the medical workforce. Clinically-based medical education is the principal source of learning, and this has been profoundly impacted by restrictions due to COVID-19. It follows that junior medical staff and their education would be significantly impacted due to the altered volume and breadth of their clinical exposure. Some literature has been published regarding the impact to medical training during COVID-19. This study sought to review junior medical staff perceptions and their reported impact of the COVID-19 pandemic on their education and training. Nine databases (three Ovid MEDLINE databases, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre and PsychINFO) were searched for studies published in 1 January 2020 through 24 August 2020. Via a scoping review protocol, an iterative process was used to perform the identification, review and charting analysis of the reported outcomes and themes. Descriptive analysis was performed using quantitative and qualitative methods. Of the 25 343 sources identified, 32 were included in the review. There were studies published from nearly all continents, predominantly in surgical journals, with a wide spread of specialties. Themes identified included the current impact of the pandemic in relation to continuation of and modifications to training programmes, as well as the future impact due to training requirements and career progression. Junior medical staff report that the COVID-19 pandemic has had a significant impact on their education and training. Whether the changes imposed by the pandemic on education are temporary measures or permanent fixtures, and whether standards of competence may be impacted, is not yet known. This scoping review forms a basis for further investigation in the field.

Introduction: The use of computed tomography (CT) imaging of the cervical spine (CS) is now the recommended primary screening modality for suspected CS injuries following trauma. The aim of this audit is to review the appropriate use of CS CT imaging in the emergency department (ED) and assess compliance with the National Institute for Health and Care Excellence (NICE) head injury clinical guidelines. Methods: Charts were reviewed for the last 50 trauma patients to receive a CS CT scan following a request from the ED at University Hospital Limerick between 10 July 2013 and 19 December 2013. The NICE clinical guideline 176 on head injury was used as the standard of care. These data were used to perform a retrospective audit to assess patients who satisfied NICE criteria to qualify for a CS CT scan. Results: 45 patients who had undergone a CS CT scan were identified, this group had a mean age of 42 years and 71% of them were male. At least one of the NICE guideline criteria was fulfilled in 100% of patients who had a CS CT, with 2.64 of the criteria fulfilled on average. Plain-film X-ray radiography (PF) was inadequate for diagnosis in 20 (44.4%) patients. Discussion: ED consultants appropriately refer patients for CS CT scans following CS trauma and adhere to NICE head injury clinical guidelines. Conclusion: Having guidelines in place in the ED and adopting CS CT imaging as an initial screening modality following CS injury may reduce time to definitive care and improve resource implications.

A 26-year old athlete suffered a full thickness tear of the Achilles tendon. After initial casting, biological reconstruction by prolotherapy was undertaken. A satisfactory result in terms of function and imaging is reported, at four months follow-up.