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Artificial intelligence (AI) is becoming part of everyday clinical life. From drafting clinic letters to suggesting differential diagnoses, it is changing how we learn and practise medicine. For doctors in training, its use can often feel like progress, saving time, reducing uncertainty, and making us more efficient. But we should pause before celebrating too quickly. If we rely on AI too early in our clinical training, before core clinical reasoning skills are fully developed, we risk losing the one skill that defines our profession: the ability to think.Recent evidence suggests that this risk is not theoretical. In a multicentre, observational study, endoscopists who routinely used AI to detect polyps saw their accuracy drop when they performed colonoscopies without AI assistance.1The adenoma detection rate fell from 28% to 22% after just a few months of exposure.1 The researchers concluded that continuous exposure to AI might dull independent ability, subtly changing how...

“So, I’m a rheumatologist—obviously we specialise in gossip,” Matthew Hutchinson says, pausing before clarifying the pun: “rumour.”Humour might be the entry point to Are You Really the Doctor? but Hutchinson’s book touches on difficult topics—from examining what it means to practise medicine to navigating race, identity, and institutional power in the NHS.Medicine can be a challenging profession, and Hutchinson turned to comedy initially as a pressure valve—a way to manage the stress of frontline medical work. “Having something outside of medicine helps to keep perspective, stay sane, and keep going,” he says.Hutchinson, also a PhD candidate as well as a stand-up comic and soon-to-be consultant, writes not simply about being a black doctor, but about how identity shapes clinical encounters, professional expectations, and public trust. Comedy, he says, is not a detour from medicine but a lens through which to examine it.Belonging and perceptions of credibility and competenceIn Hutchinson’s book,...

What is hantavirus?Hantavirus is not one virus but a group of negative stranded RNA viruses in the family Hantaviridae, within the order Bunyavirales. They contain three segments of single stranded, negative ribonucleic acid (RNA) molecules.2 The viruses are primarily carried by rodents such as mice, rats, and voles. People usually contract disease from them through exposure to rodent urine, faeces, and saliva.34Although relatively uncommon worldwide, with around 10 000 to 100 000 infections reported each year, the virus causes two diseases.5 The first, haemorrhagic fever with renal syndrome (HFRS)—formerly known as Korean haemorrhagic fever—was first detected in US soldiers fighting in Korea in the 1950s. The second, hantavirus pulmonary syndrome, or hantavirus cardiopulmonary syndrome (HPS/HCPS), was first recognised in a 1993 outbreak of severe respiratory disease in the Four Corners region of the southwestern United States.6The highest incidence of HFRS is in East Asia, particularly China, followed by Russia and...

Complications of diabetes pose a noticeable burden for individuals and society.12 In a recent review in The BMJ (doi:10.1136/BMJ-2024-081217), Fridman and colleagues describe advances in the pathophysiology and treatment of diabetic peripheral neuropathy (DPN).3 The review of DPN covers epidemiology and risk factors, pathophysiology, diagnosis, treatment, as well as global considerations.3 The authors acknowledge that translation of emerging evidence into clinical practice remains challenging. However, since microvascular complications of diabetes are often systemic,45 clinical assessments should account for the patient’s total complication burden.In the review, the authors suggest that the presence of atypical neurological features should lead to more extensive investigations, such as electrodiagnostic testing to explore alternative causes of peripheral neuropathy.6 However, this should also be the case if there is peripheral neuropathy without accompanying retinopathy. Clinical assessment should also involve consideration of autonomic neuropathic features. For example QTc prolongation in those presenting with type 2 diabetes and foot...

In December 2024 and January 2025, a private members bill to ban cousin marriage was debated in the UK parliament.1 The bill was accompanied by attacks on the community most affected by recessive disorders, the UK Pakistani community, and the integrity and motivation of researchers. Claims were made in parliament and by sections of the media that cousin marriage signified a malaise in this community wider than its impact on child health and suggested that the impact on health and wellbeing was more severe than research reported.23 When a health issue is politicised there is a risk that a blame approach emerges and erodes trust, harming vulnerable communities.Autosomal recessive disorders are more prevalent in communities with high rates of customary consanguinity, where marriage between blood relatives is common (over 20% of births).4 Understanding of risk factors in autosomal recessive disorders and patterns of mortality and morbidity in children is improving...

Last year, Abbasi and colleagues highlighted the lack of progress towards nuclear disarmament.1 Recent US-Iran nuclear diplomacy probably followed a familiar script.2 Diplomats discussed enrichment levels, deterrence, regional security, and escalation risks, with input from intelligence, military, and foreign policy experts. But one voice was noticeably absent: doctors.Nuclear weapons are often treated as political tools, but their use would cause mass death, illness, and system collapse. Yet nuclear diplomacy proceeds as if medical expertise is optional, excluding doctors.In humanitarian settings, doctors are trained to anticipate unlikely scenarios with severe outcomes, from emerging infectious diseases to mass casualty events. By contrast, nuclear policy regards catastrophe as theoretical until it occurs, excluding professionals equipped to evaluate its medical consequences.Negotiators often rely on invisible medical optimism. They assume that healthcare systems would function, with hospitals operating, supply chains intact, doctors available, and long term care assured. These assumptions are infrequently stated, stress tested...