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One of the most obvious but striking differences between life as a medical student and life as a junior doctor is that your clinical knowledge no longer has the luxury of operating in a calm and academic environment. In real life, things do not always go according to plan.

You might make an excellent clinical diagnosis, and the patient’s symptoms might respond to treatment as well as you could expect, but your patients may not always be so predictable or adaptable. Throughout your career you will see it all: patients who will stretch you to the limits of your kindness and compassion.

Recently-qualified junior doctor Dr Lynelle Govender answers the perplexing question: how do you deal with the most challenging of patients, often at the most challenging of times? As with all pathology, having an approach to dealing with the different types of challenging patient, prior to seeing one, often makes the difference between a successful consultation and a near-disaster.

We take a closer look at risk management and reveal the top five medicolegal hazards for junior doctors – and how to avoid them. There are things you can do to reduce your risk too – practising with professional integrity and remembering the need for probity is a good ethical start.

Honesty really is the best policy when it comes to job applications, academic research, record keeping, and preparing medical reports. Our feature, ‘practice with professionalism’, outlines the basics. As ever, do let us know your feedback on this issue – we welcome all comments and suggestions. If you’d like to write for us, or have a feature idea, please get in touch.

Dr Graham Howorth – Editor-in-chief,
MPS Head of Medical Services (Africa)

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