Microcystic adnexal carcinoma is a rare tumor; however, because of its aggressive local infiltration, ophthalmologists should consider this diagnosis and complete surgical excision. Long-term data are needed to establish outcomes from the different treatment options.

The most common method of assessing the quality of medical education is through a selection of qualitative assessments, usually as part of a programme evaluation. Common qualitative assessments include measurements of students' and teachers' participation, outcome measures such as assessment results, and qualitative assessments such as interviews and questionnaires of students and teachers. Programme evaluation can therefore be a process that is both laborious and subject to accusations of a lack of objectivity. As a result, the development of a quantitative tool that could be used alongside a programme evaluation may be both useful and desirable. A pragmatic scoring system, utilizing routinely collected quantitative data, termed as the Quality Assessment Tool, was developed during the 2013 academic year within the setting of an Emergency Medicine training programme in the UK. This tool was tested against the standard assessment currently used for this programme to establish whether the quantitative tool correlated with the programme evaluation. Second, the individual items within the tool were investigated to identify any correlations with the current assessment of quality established by the programme evaluation. The Quality Assessment Tool appears to be correlated to the quality of training delivered at individual training sites in a single specialty. It certainly identifies those centres delivering the highest quality of training and also identifies those centres whose training is consistently of a lower standard. The assessment tool is less accurate at ranking those training centres whose training is merely 'satisfactory'; whether this is a result of the imprecision of the tool itself or a reflection of the subjective nature of the current assessment (i.e. whether the current evaluation system lacks validity) cannot be stated. In summary, it appears to be possible to use a single quantitative tool to reliably, and with validity, measure the quality of training delivered at a postgraduate medical training centre. Although it is not envisaged that this would, or should, replace ongoing quality assurance systems such as programme evaluations, a validated tool can be derived for a given setting to usefully inform and augment current quality management systems in postgraduate medical education.

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Summary A 61‐year‐old male presented to the emergency department with acute life‐threatening massive haemoptysis. His previous history was remarkable for extensive mandibular and retromolar resection and reconstruction for squamous cell carcinoma ten years previously. A recent computed tomography scan of the thorax showed severe bullous emphysema. There were several features suggestive of a difficult airway, such as reduced mouth opening and fixed neck flexion. A technique was required, therefore, that avoided the use of a double‐lumen tube or bronchial blocker. We report the successful use of a post‐carinal Aintree intubation catheter to facilitate oxygenation of the right lung with a concurrent bronchially‐advanced single‐lumen tracheal tube to isolate and ventilate the left lung. This temporising strategy successfully bridged the life‐threatening phase of acute haemoptysis and the patient later received definitive treatment for a newly‐identified right upper lobe adenocarcinoma.