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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Wednesday, 13 March 2013

Where did all the drugs go?

My annual leave could not have come a moment too soon.  There is only so much energy and motivation in the tank of one junior doctor, and although winter seems to have made yet ANOTHER appearance, training is still going well - the advantage of living somewhere really pretty is that  even when the legs and lungs start hurting on a run, chances are there's something nice to look at while you're expiring! Yet to jump in a swimming pool, but in my defence, the run happens first!

Of course I'm suppose to be doing a bit more of THIS - i.e. reading and writing, which I am currently enjoying in the rather delightful surroundings of an Oxford cafe or three.  I am nerding out to my heart's content over many a tasty cup of coffee.  I'm on nights this weekend so the freedom is shortlived, and yet another celebration is down the pan (sorry, sister, I'll hopefully make your birthday next year!). 

In reality I am doing a lot of THIS - pondering, pen in hand, and trying to get a bit of R and R, something that does not come naturally to me at all. 

As a total aside, I realise my blog has deviated somewhat from its original purpose of my chit-chat about random things going on in medicine from the perspective of one lowly junior doctor type person, and a discussion I had this weekend made me think about this a bit more carefully.  My brother-in-law was asking me about the lack of negative drug reporting and how do drugs come to be available to us anyway?  On the latter - this is essentially what I am reading about in the current module of my studies, but in a nutshell, it's a long, arduous process lined with failure at every step.  Less than 10% of all drugs that start the clinical trial process make it out the other side, and that's the ones that even reach said process.  That amounts to a seriously expensive drop out rate, and a cost which is mopped up by any successful drugs that do pop out.  Think about how much our world has changed since the human genome project - so many possible targets for drugs to reach!  The question is, which ones and how?  Pharma hasn't got that one quite sussed yet, and it's something that everyone's trying to solve - the FDA talk about a 'Critical Path' that should take drugs safely through this process - whether this works remains to be seen.

As for the former, I think I've posted this before but Ben Goldacre's talk on the lack of negative result publishing is well worth another mention.  It's a real problem that pharma-land and the publishers have yet to address.  I'll let Dr G do the talking....

Right.  FDA report reading, here I come.... 

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