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Schaefer regularly uses the television series to teach medical students. When he saw the patient with heart failure in May 2012, he had recently prepared a lecture on the show’s cobalt poisoning case, where House’s future mother-in-law falls ill after receiving a faulty metal hip. Though the German patient’s previous doctors thought he needed a heart transplant, Schaefer and colleagues immediately tested his cobalt levels after he complained his problems started after his last operation to replace a broken ceramic hip. Schaefer said some small fragments of the ceramic hip remained and were grinding into the metal replacement, which leaked cobalt and chromium into the patient’s bloodstream. Once the hip was replaced, the patient’s heart got better and his other symptoms improved. Schaefer and colleagues wrote about their experience in a case report published online Friday in the journal, Lancet. The patient wasn’t identified. “We would have diagnosed this even without Dr. House,” Schaefer said. “You could have also typed his symptoms into Google and gotten the diagnosis.” He said doctors should be aware of possible cobalt poisoning in patients with metal hip replacements. While Schaefer said he is sometimes referred to as the German Dr. House, he isn’t sure the nickname is a compliment. The television doctor was known as much for his rude, abrasive manner as for his expertise in diagnosing rare ailments. “I would have fired this guy after the first three episodes,” Schaefer said.
“A first step in this direction was the introduction this year of salary supplements for medical residents, representing a salary increase of about 20-25%,” she said. Astarastoae said Romania was losing out twice by paying to train thousands of doctors only for other countries, including the UK, to reap the benefits. “Romania spends 3.5bn (2.9bn) educating doctors; we are basically spending it on solving problems in the UK, Germany and France. You can earn 4,000 [a month] as a doctor overseas rather than 400 in Romania. For some specialities, like anaesthesiologists or cardiovascular surgeons, they can earn 30 times more.” Last October medical workers in Romania picketed the ministry of labour and the ministry of health demanding changes. The government subsequently agreed to increase the starting wage for resident doctors from 200 to 350 a month through a scholarship scheme, as well as agreeing to increase the health budget from 3.7% to 4.3% of GDP. But for doctors like Dorin Gherasim, a 28-year-old neurosurgical resident from Targu Mures in the north of country, this is unlikely to stop the exodus. “This really feels like a crisis,” said Gherasim, who earns 400 a month. “Any medical resident my age is thinking about emigrating. Germany, France, the UK. You can work there and have a decent salary who wouldn’t want that?” Earlier this month the Guardian revealed some Romanian and Bulgarian doctors and nurses working in the NHS were experiencing growing hostility from patients following an “anti-Romanian” campaign by some politicians and newspapers in the runup to the change in working restrictions on 1 January.