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It could be said that the past 12 months have been an exciting time in the field of acute medicine. In addition to the high profile afforded by the publication of Reforming Emergency Care and the ongoing Emergency Services Collaborative, the significance of the recent acquisition of subspecialty status for Acute Medicine cannot be understated. This, in turn has enabled approval of a new competency-based training curriculum by the JCHMT. Hopefully within the next few months, specialist registrars in General Internal Medicine with Acute Medicine will be appointed to the first few numbered posts in this discipline. Clearly a rapid expansion in posts of this nature will be required in the next few years in order to meet the enormous demand for consultants in Acute Medicine. Recently, in common with other medical specialties, hospitals have experienced difficulties in recruiting suitable applicants for such posts resulting in many vacancies across the UK. One challenge for those of us already working in the field is to maintain enthusiasm for the concept, while we are waiting for the trainees to mature into competent consultants.

This edition includes another varied selection of reviews. Community acquired pneumonia may be of particular relevance over the remaining winter months, although hopefully the brief mention of SARS in this paper will now only be of historical significance. Patients with hypercalcaemia, dysphagia and Guillan Barre syndrome may be less frequent attenders, but nonetheless often create management dilemmas with which the admitting physician needs to be familiar. In a departure from our previous format, we have included two case reports this time, both highlighting an important clinical scenario. Power kite flying may not be a familiar activity for many readers, but the outcome described by Merrison and colleagues justifies its inclusion as ‘a case to remember’. Mark Mallett, on the other hand, reminds us that syncope can, on occasions, reflect significant underlying pathology, even in an apparently healthy member of the hospital portering staff. Once again we would like to encourage similar submissions for future editions of the journal.

After several years of association with CPD Acute Medicine and its predecessor, it is with great sadness that this edition is Paul Jenkins ’last as sub-editor. We wish him well as he moves on to new challenges in his role as President of the Society for Acute Medicine, and gratefully acknowledge all of his hard work in establishing the journal.

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Community-Acquired Pneumonia

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