- Email: [email protected]
The diagnostic value of clinical photographs taken by patients
Letters to the Editor / British Journal of Oral and Maxillofacial Surgery 47 (2009) 166–171
Recruitment of Future Maxillofacial Surgeons The recent General Dental Council (GDC) statements on ‘The practice of dentistry by non GDC registrants’ and the British Association of Oral and Maxillofacial Surgeons (BAOMS) position statement on the ‘The practice of Oral and Maxillofacial Surgery (OMFS) by non-GDC medical registrants’ are both timely and welcome (Newsletter from the President of the Br Assoc Oral Maxillofac Surg, April, 2008). These position statements will enable medical graduates to take up OMFS posts prior to attending dental school and go some way to addressing concerns we raised over the future recruitment of Maxillofacial Surgeons.1 The new Medical Foundation Programme requires doctors to make decisions on their surgical careers much earlier than before and the opportunities for doctors to gain exposure to OMFS are very limited. Where possible we would encourage all OMFS Units that currently give Senior House Officer (SHO) posts to medical graduates to consider providing slots on their training programmes for Foundation Year 2 doctors. This would maintain the pool of potential medical graduate applicants for careers in OMFS. However, medical deans may be reluctant to fund this and dental deans are keen to transfer all SHO posts into the new Dental Foundation Programme. The excellent attendance by both medical and dental graduates pursuing a career in oral and maxillofacial surgery at this year’s OMFS Junior Trainees Conference was extremely encouraging. Nevertheless, despite the GDC and BAOMS statements, the effect on OMFS recruitment of replacing SHOs with time limited Dental Foundation Programme trainees and the re-introduction of the speciality of Oral Surgery remains to be established. Reference 1. Gibbons AJ, Moss CE. From where will future Maxillofacial Surgeons be recruited? Br J Oral Maxillofac Surg 2008;46:423.
A.J. Gibbons ∗ C.E. Moss Oral and Maxillofacial Unit, Peterborough and Stamford Hospitals NHS Foundation Trust, Thorpe Road, Peterborough PE3 6DA, United Kingdom ∗ Corresponding
author. Tel.: +44 1733 874126 fax: +44 1733 875697. E-mail addresses: [email protected], andrew [email protected] (A.J. Gibbons) Available online 4 September 2008 doi:10.1016/j.bjoms.2008.07.186
167
The diagnostic value of clinical photographs taken by patients The development of digital photography in recent years has led to the widespread availability of digital cameras, many of them integrated into cellular phones. Awareness of the value of such photographs for recording clinical signs seems to be increasing among the general population, and a growing number of patients are bringing digital files or prints to consultations that depict signs that are commonly short-lived or recurrent. In our clinic, during a six-month period digital images helped to clarify the diagnosis in two cases of benign minor salivary glands cysts, one case of acute parotitis, one case of recurrent perioral angio-oedema, and one case of common mouth ulcers. It should be noted, however, that inherent differences in features among digital cameras can produce dramatically different results in brightness, colour, contrast, and sharpness. These all affect the overall quality and clinical usefulness of such records, which should be treated with caution.1,2 Nevertheless, patients should be encouraged to obtain digital images as diagnostic aids, particularly when instant access to clinics is neither possible nor warranted on clinical grounds. For medicolegal reasons, we recommend that every time that a patient produces digital images in support of their complaint, it is recorded appropriately in the medical notes, including a print whenever possible.
Reference 1. Niamtu J. Image is everything: pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon. Dermatol Surg 2004;30:81–91. 2. Galdino GM, Vogel JE, Vander Kolk CA. Standardizing digital photography: it’s not all in the eye of the beholder. Plast Reconstr Surg 2001;108:1334–44.
Liviu M. Hanu-Cernat ∗ Emily Hall Neal A. Barnard Department of Maxillofacial and Head & Neck Surgery, Worcestershire Royal Hospital, Worcester, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (L.M. Hanu-Cernat)
Available online 3 September 2008 doi:10.1016/j.bjoms.2008.07.191
Recruitment of Future Maxillofacial Surgeons The recent General Dental Council (GDC) statements on ‘The practice of dentistry by non GDC registrants’ and the British Association of Oral and Maxillofacial Surgeons (BAOMS) position statement on the ‘The practice of Oral and Maxillofacial Surgery (OMFS) by non-GDC medical registrants’ are both timely and welcome (Newsletter from the President of the Br Assoc Oral Maxillofac Surg, April, 2008). These position statements will enable medical graduates to take up OMFS posts prior to attending dental school and go some way to addressing concerns we raised over the future recruitment of Maxillofacial Surgeons.1 The new Medical Foundation Programme requires doctors to make decisions on their surgical careers much earlier than before and the opportunities for doctors to gain exposure to OMFS are very limited. Where possible we would encourage all OMFS Units that currently give Senior House Officer (SHO) posts to medical graduates to consider providing slots on their training programmes for Foundation Year 2 doctors. This would maintain the pool of potential medical graduate applicants for careers in OMFS. However, medical deans may be reluctant to fund this and dental deans are keen to transfer all SHO posts into the new Dental Foundation Programme. The excellent attendance by both medical and dental graduates pursuing a career in oral and maxillofacial surgery at this year’s OMFS Junior Trainees Conference was extremely encouraging. Nevertheless, despite the GDC and BAOMS statements, the effect on OMFS recruitment of replacing SHOs with time limited Dental Foundation Programme trainees and the re-introduction of the speciality of Oral Surgery remains to be established. Reference 1. Gibbons AJ, Moss CE. From where will future Maxillofacial Surgeons be recruited? Br J Oral Maxillofac Surg 2008;46:423.
A.J. Gibbons ∗ C.E. Moss Oral and Maxillofacial Unit, Peterborough and Stamford Hospitals NHS Foundation Trust, Thorpe Road, Peterborough PE3 6DA, United Kingdom ∗ Corresponding
author. Tel.: +44 1733 874126 fax: +44 1733 875697. E-mail addresses: [email protected], andrew [email protected] (A.J. Gibbons) Available online 4 September 2008 doi:10.1016/j.bjoms.2008.07.186
167
The diagnostic value of clinical photographs taken by patients The development of digital photography in recent years has led to the widespread availability of digital cameras, many of them integrated into cellular phones. Awareness of the value of such photographs for recording clinical signs seems to be increasing among the general population, and a growing number of patients are bringing digital files or prints to consultations that depict signs that are commonly short-lived or recurrent. In our clinic, during a six-month period digital images helped to clarify the diagnosis in two cases of benign minor salivary glands cysts, one case of acute parotitis, one case of recurrent perioral angio-oedema, and one case of common mouth ulcers. It should be noted, however, that inherent differences in features among digital cameras can produce dramatically different results in brightness, colour, contrast, and sharpness. These all affect the overall quality and clinical usefulness of such records, which should be treated with caution.1,2 Nevertheless, patients should be encouraged to obtain digital images as diagnostic aids, particularly when instant access to clinics is neither possible nor warranted on clinical grounds. For medicolegal reasons, we recommend that every time that a patient produces digital images in support of their complaint, it is recorded appropriately in the medical notes, including a print whenever possible.
Reference 1. Niamtu J. Image is everything: pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon. Dermatol Surg 2004;30:81–91. 2. Galdino GM, Vogel JE, Vander Kolk CA. Standardizing digital photography: it’s not all in the eye of the beholder. Plast Reconstr Surg 2001;108:1334–44.
Liviu M. Hanu-Cernat ∗ Emily Hall Neal A. Barnard Department of Maxillofacial and Head & Neck Surgery, Worcestershire Royal Hospital, Worcester, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (L.M. Hanu-Cernat)
Available online 3 September 2008 doi:10.1016/j.bjoms.2008.07.191