Lee Hudson and colleagues report on the low levels of knowledge on the assessment of underweight in children and adolescents among middle-grade doctors in England and Wales. They conducted a cross sectional telephone survey of paediatricians working on middle grade rotas to assess their knowledge of the recognition and management of underweight in children and young people. Only 50% of respondents identified BMI as the appropriate measure for underweight in children and most did not identify any clinical cardiovascular complications of severe underweight. Only 13% identified corrected QT time (QTc) as an important ECG finding. Knowledge of the refeeding syndrome was poor with 20% unable to define it at all, 21% able to identify some clinical features and 57% aware of potential phosphate abnormalities.
They conclude that "the knowledge base among middle-grades doctors in England and Wales on this topic is worryingly poor, particularly in relation to several life-threatening features. Existing and new training approaches should recognise this."