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To be able to prescribe commonly used drugs safely and effectively is a core requirement of the newly qualified doctor since prescribing is a task often left to junior medical staff. A survey using an on-line questionnaire gathering opinions from UK medical students and first year Foundation doctors graduating in 2006–08 showed that only 38% felt confident about prescription writing, 24% about drug dosage calculation and 15% about preparing and administering drugs.1 Ninety per cent of 2008 graduates and 60% of 2007 graduates had completed a prescription chart three times or less during their training. There appeared to be marked variation between medical schools. Children offer particular difficulties to prescribers over and above those of adult patients. Here we describe some of those problems and present ideas for preparing medical students and junior doctors to meet the challenges they face when prescribing for children.
THE PAEDIATRIC ENVIRONMENT
There are many challenges facing junior doctors when they start to practise paediatrics. Undergraduate training in the UK remains dominated by experiences within adult medicine and surgery. Although some skills and knowledge are directly transferable, the maxim “children are not just small adults” is particularly pertinent to the knowledge, skills and attitudes required to enable safe paediatric prescribing. Unfortunately, there is little space for specific training in paediatric prescribing during child health attachments in most medical schools.
Not that the broader curriculum fares much better. In 1994, UK medical students received a median of 61 h of teaching related to pharmacology, clinical pharmacology and therapeutics.2 Over a 5-year medical course this equates to less than 20 min a week during term! At this time, less than two thirds of medical schools taught specifically about paediatric prescribing. Moreover, most of those responsible for delivering pharmacology education to undergraduates thought knowledge and skills pertaining to paediatric …
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