‘Evolution, not revolution, at the changing of the Guard’

So, as it does, the baton passes and changes are afoot. First, we say thank you, and goodbye, to our previous editor-in-chief, Professor Humphrey Hodgson, who, over the last decade or so, has both positively influenced, and then led, this journal. Those left the mantle to continue its development have a clear task: to educate, inform and entertain the members and fellows of the RCP, and the wider readership of this journal, a task that Humphrey delivered with aplomb. Clinical Medicine is a cherished product, as is made clear every time we carry out a members’ survey, and Humphrey has played an important role in ensuring its prominence.

However, we must continue to evolve, ensuring a broad range of content, including original research, review, guidance and opinion, for the continuing medical and professional education of physicians. While the conditions we treat change little over time, our ever-developing understanding of disease and the myriad of pharmacological and interventional possibilities we have available to treat them continue to evolve apace and require all of us to remain committed to life-long learning and reflection, regardless of the stage of our careers.

Clinical education is writ large in this edition, with excellent CME in cerebrovascular disease and further original research on the optimal management of headaches on the acute admissions unit (AAU).¹ Following another week on the AAU, it is clear to me that, as all specialties progress, it is increasingly challenging for the general physician to keep up. To that end, the detailed and comprehensive review of interstitial lung disease,² the review of late medical effects of cancer treatments³ and the reflection on the challenges of PPI failure in gastro-oesophageal reflux disease⁴ are all concise and highly relevant articles for the busy physician.

In addition to CME, Clinical Medicine also seeks to promote balanced and responsible debate on a variety of subjects, including the latest developments in medicine, healthcare, ethics and clinical leadership. This journal is packed with important and relevant manuscripts that give insight into the future of both clinical training and world-class research in the UK, as we all face more complex clinical presentations on the front line. I recommend the articles on the new internal medicine curriculum,⁵ the role of physician assistants⁶ and the Francis Crick Institute⁷ to you.

Finally, the journal aims to engender debate on the wider role of hospital-based medicine within the delivery of healthcare. As the editor-in-chief of the Future Hospital Journal, I often address this from a systems, process and quality improvement perspective, but, as made clear in the opening article by Maher et al,⁸ while we, as clinicians, all aspire to optimise human health, including public health and, as far as possible, occupational health, this is often detached from delivery of illness-based clinical care and requires a more joined-up approach if we are to influence the wider wellness agenda.

So, it can be seen from this edition of Clinical Medicine that it is in good health; however, it is also clear to me we have some challenges to overcome if we are to meet our obligations going forwards. We need a larger and broader editorial board: of the 30 specialties that function under the RCP banner, the board of Clinical Medicine represents less than a quarter. If you are interested in being considered yourself, please contact us (clinicalmedicine{at}rcplondon.ac.uk) and let us know why you wish to join the board and what you would bring to the RCP's oldest and most respected journal.

I would also value your collective views on how best to build on our current offering with social media; how we invite and generate content relating to the changing medical world in which we all work, and how we balance the content of this journal with the Future Hospital Journal to ensure that Clinical Medicine retains its place as a highly valued college offering.