The objectives of the present cross-sectional study were to assess the screening, prevalence and management of malnutrition and identify any co-existence with obesity in adult hospital in-patients. The Malnutrition Universal Screening Tool (MUST) was applied to all medical, surgical, orthopaedic and critical care in-patients in an acute hospital in North-East England on a single day in 2007. An audit was also performed of malnutrition screening using a locally developed tool. Patients were excluded from study if they had been an in-patient less than 24 h or if discharged on the day of study. Of 328 patients meeting inclusion criteria, 100 % had full data collection (143 males, 185 females, median length of stay 8 d (range 1 -90 d), median age 76 years (range 17 -101 years)). Only 226 patients (68·9 %) had been screened for malnutrition and thirty-one (13·7 %) were at highest malnutrition risk, of which only 45·2 % were appropriately referred to nutrition and dietetic services. The prevalence of malnutrition (MUST $ 1) was 44 %. The prevalence of highest risk (MUST $2) increased with age (20·6 % ,60 years, 29·7 % 60 -79 years and 39·4 % $ 80 years). In total 37·8 % (n 70) of female patients had a MUST score of $ 2 compared with 24·5 % (n 35) of males. Obesity (BMI .30 kg/m 2 ) was identified in 9·5 % of those with a MUST score $2. We have shown that malnutrition is a common problem affecting over 40 % of patients in this hospital-wide study. Currently malnutrition is often unrecognised and undertreated in clinical practice. Hospitals must develop comprehensive strategies to both identify and treat in-patients with this common condition.

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Role modelling has been identified as an important phenomenon in medical education. Key reports have highlighted the ability of role modelling to support medical students towards careers in family medicine although the literature of specific relevance to role modelling in speciality has not been systematically explored. This systematic review aimed to fill this evidence gap by assimilating the worldwide literature on the impact of role modelling on the future general practitioner (GP) workforce. A systematic search was conducted in Medline, Embase, Scopus, Web of Science, Cochrane, ERIC and CINAHL, and all authors were involved in the article screening process. A review protocol determined those articles selected for inclusion, which were then quality assessed, coded and thematically analysed. Forty-six articles were included which generated four broad themes: the identity of role models in general practice, role modelling and becoming a doctor, the impact of role modelling on attitudes towards the speciality, and the subsequent influence on behaviours/career choice. Our systematic review confirmed that role modelling in both primary and secondary care has a crucial impact on the future GP workforce, with the potential to shape perceptions, to attract and deter individuals from the career, and to support their development as professionals. Role modelling must be consciously employed and supported as an educational strategy to facilitate the training of future GPs.

OF GENERAL PRACTICE General practice is struggling to recruit and retain high-quality trainees. There is a national target to increase recruitment to general practice in order to create 5000 extra GPs by 2020. 1 However, the attractiveness of the specialty has fallen relative to hospital practice. 2 Currently only 15.3% of doctors completing foundation training are appointed to GP training programmes. 3 Reasons for this are multifactorial but one postulated influence is students' misperception that general practice is not a prestigious or academically challenging career choice. 4 National studies support this concept: the recent 'Destination GP' survey jointly led by the Royal College of General Practitioners (RCGP) and the Medical Schools Council (MSC) found that only 3% of medical students associated general practice with being intellectually challenging. 5 It has been acknowledged that correcting this misperception and raising the profile of academic general practice among medical students is vital in order to attract high-quality doctors and potential future educationalists and researchers into general practice, and we offer some consensusbased and evidence-based suggestions. The Wass report By Choice-Not by Chance was commissioned by Health Education England to support medical students towards careers in general practice. 6 The report found that students perceive that the specialty fails to offer the variety of academic challenge that they aspire to. The report made suggestions to support institutions with raising the profile of academic general practice. These included making academic training opportunities in primary care more accessible, ensuring that all students have access to scholarly activity and supervision by primary care leads, and raising the profile of senior academic GP leaders.