Reliability of residents' assessments of their postgraduate medical education learning environment: an observational study.

Background: Even in anonymous evaluations of a postgraduate medical education (PGME) program, residents may be reluctant to provide an honest evaluation of their PGME program, because they fear embarrassment or repercussions from their supervisors if their anonymity as a respondent is endangered. This study was set up to test the hypothesis that current residents in a PGME program provide more positive evaluations of their PGME program than residents having completed it. We therefore compared PGME learning environment evaluations of current residents in the program to leaving residents having completed it.

[Recognition of nasopharyngeal carcinoma].

In two patients the presenting symptoms of nasopharyngeal carcinoma were non-specific: a woman aged 35 years born in Hong-Kong with unilateral hearing loss, and a man aged 59 years with acute otitis media who later developed cranial nerve palsy. The woman was successfully treated with chemotherapy and radiotherapy, the man was in a poor general condition and refused treatment; he died within 9 weeks. Nasopharyngeal carcinoma is rare and can occur at any age.

The "wandering needle".

Suspected aspiration of a radiopaque foreign body can easily be confirmed by a chest film. We report a case of a boy with chest-film confirmed aspiration of a needle into his right main bronchus, in whom no needle was found during bronchoscopy. In retrospect, the boy had expectorated the needle without noticing it in the interval between making the diagnosis and the actual bronchoscopy.