The initial period adjusting to the roles and responsibilities of a new foundation doctor can be a challenging and anxious time for graduating medical students and new trainees. Over recent years, many educational initiatives such as shadowing placements, assistantships and compulsory induction programmes have been implemented to improve medical student preparedness for clinical practice. Despite this, many graduates still report a lack of confidence and preparedness when starting their clinical placements, specifically within the context of on-call shifts. Bleep Roulette simulation sessions are progressively being used to further bridge the gap from student to trainee and ensure trainees develop prioritisation, organisational and clinical reasoning skills, improving trainee efficiency during an on-call shift. In this article, we provide 10 tips for medical educators, detailing how to design an efficacious Bleep Roulette session for final year medical students and new foundation trainees.

We highlight the case of a woman who had elective gynaecological surgery with bilateral prophylactic ureteric catheterisation, indicated for the excision of a mucinous cystadenoma arising from the right ovary. Surgery was successful with no intraoperative complications. Anuria and subsequent acute kidney injury developed within 12 hours of surgery. A CT of the kidneys, ureters and bladder revealed mild bilateral hydronephrosis and perinephric stranding surrounding the left kidney with no discernible injury to the lower urinary tract. Further investigation did not reveal a clear cause for her anuric state. Management involved aggressive renal support, rigid cystoscopy and bilateral ureteric stenting. Diuresis and a prompt improvement in renal function ensued with no further complications. She was discharged a week after her initial operation, with a 6-week review for stent removal. We believe this to be a rare instance of reflex anuria due to ureteric spasm and encourage consideration of ureteric stenting as part of subsequent management.

The ability to study effectively is an essential part of completing a medical degree. To cope with the vast amount of information and skills needed to be acquired, it is necessary develop effective study techniques. In this article we outline the various methods students can use to excel in upcoming examinations.