They say time flies when you’re having fun – and the 5 years since Paul Jenkins convinced me to take over as editor of this journal have certainly flown by. This period has seen a dramatic expansion in the numbers of physicians specialising in Acute Medicine, the confirmation of subspeciality status and development of a training curriculum. Addressing over 300 delegates at the recent Society for Acute Medicine meeting at the Royal College of Physicians, President Mike Jones reminded us that only seven years earlier the Society’s entire membership had sat around a small table in a public house just a few hundred yards from that spot. At that time many were predicting that recruitment to the speciality would be a major challenge. ‘Why would anyone choose to specialise in acute medicine?’ was a question, sometimes whispered in the corridors of St Andrew’s Place. And yet many have made this choice, and many more continue to do so. The Society for Acute Medicine now has upwards of 400 members, a figure which has doubled in the past 12 months. Even more encouraging was the large number of trainees who visited the Acute Medicine stand at the recent BMJ careers fair. Many junior doctors clearly view Acute Medicine as a positive career choice, not the ‘last resort’ which some predicted it may become.

However, challenges remain. By the time this edition hits the press the Medical Training Application Service (MTAS) will be swinging into action to produce the first applicants for ‘post MMC’ training positions across the UK. For those of us who are involved in the shortlisting and interview process, the enormity of the task is rapidly becoming apparent. In Wessex, the Deanery has suggested that Acute Medicine shortlisting may take as much as a week, with a further week set aside for interviews of the hopeful candidates. Then comes ‘round two’, later in the year, when potentially we do it all over again. Suddenly the prospect of annual leave in the months of March or April looks like a forlorn hope. But before I break this news to my wife and family, I should spare a thought for those readers who find themselves on the opposite side of the process. To be part of the first cohort of trainees to be involved in this must be a daunting prospect. Many of those enthusiastic potential recruits to the speciality are clearly struggling to know where to turn to for advice on the process, confused by often contradictory messages and unanswered questions. Hopefully all will become clearer as the deadlines approach.

A smaller ‘Reviews’ section in this edition reflects a dramatic increase in the number of articles submitted for consideration of publication in this journal over the past 6 months. As a result we have accommodated more case reports than normal, along with two papers in our new section for research and audit. I would encourage similar submissions in the future; case reports need not be rare or esoteric, provided they contain a clear teaching message clinicians involved in the acute ‘take’. Completed audits will be considered if they demonstrate clear evidence of how to improve practice in an acute medical unit. Owing to some software problems, Rila has temporarily suspended their submissions website which, until recently, had been the mechanism for submission of articles to this journal. Until these problems are resolved, I would be grateful if any articles could be e-mailed directly to me at the address shown on this page, so that I can arrange for peer review.

Finally, a reminder that this edition concludes the cycle of reviews which started in 2002 and has now covered the majority of conditions presenting as emergencies on the acute medical ‘take’. The new cycle, starting in 2007 with volume 6 issue 1 will follow a modified pattern, with different authors hopefully providing a fresh perspective in their updated reviews. My thanks go to all of the authors who have produced material over the past 5 years as well as to the editorial board for their ongoing hard work in commissioning articles for the past and future cycles.


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