NMSJ Nottingham Medical Students’ Journal
“The Corona Cohort”
Cover Image: Jasmine Plummer
Within this issue: • Welcome from the editors The Corona Cohort • FiY1: My first week • NHS vs Corona: My Personal Experience • Cancelled Electives: Medical Students Facing the Cost • A Junior, Junior... Junior Doctor • Lessons From Quarantining With My Twin • Life after Coronavirus: How Plagues of the Past have shaped our Future • The state of global health cooperation • What a time to be a medical student... Societies and Covid-19 • MedSoc and Covid-19 • UNAD and Covid-19 • Overcoming technical difficulties Advice and Wellbeing • Maximising Your Mornings • 10 tips for maintaining wellbeing • Alternative careers with a medical degree • Relaxing music: does it note-ably impact on stress? • Beyond medical school • “Bored in the house and I’m in the house bored” – how to make the most out of lockdown Stories and Views • Why I cannot stand pea soup • Passion projects: YouTube • Foundation year medicine: Medicine for Dummies? • From law to medicine: or how I learnt to love the suffering • My Instagram revision account • A journey • A letter to the body I dissect Creatives • 10 reasons not to date a medical student • A step by step drawing process • Creative pieces by medical students
With contributions from: Alisha Gupta India Capper Alex Sharp Issy Walker Anjali Mehta Jake Wilkinson Anna Kober Jasmine Plummer Arthur Joustra Jessie Meyer Aviv Ginsberg Joe Kirk Callum McIntyre Krish Shah Catherine Furlong Laura Owler Chandar Jaipal Lucy Brett Chant Navarro Megan Battenfield Claire Read Milap Rajpara Danni Cooper Minnan Al-Khafaji Douglas Mbang Natasha Harris Eleri Clarke Nhi Dang Erica Colwill Nic Miller Ibrahim Mutlib Yasmin King Ignacy Kozlowski
Members of all cohorts contributed to this: reflecting the whole medical school: A108, Y1, Y2, CP1 (Y3/GEM2) CP2, CP3 and GEM1
Welcome from the editors Issy Walker and Nic Miller Welcome to the first edition of NMSJ. By setting up this journal, our aim is to demonstrate the breadth and depth of experiences of medical students at Nottingham, showing we spend our time in places other than the lecture theatres, library and wards and do things other than study (even though it may not feel like it sometimes..!) It's an opportunity to be together, work together and create
together in a time when many of us are apart. It is also something that will hopefully continue, allowing us to learn from eachother for years to come by collaborating on our shared, but also varied, experiences of what it means to be a medical student at Nottingham and beyond.
In this first edition our focus is on the issues presented by the COVID-19 pandemic, and we particularly wanted to shine a light on work from those who either have, or will soon be, starting life as FY1s having graduated in probably the most unique ceremony the medical school has ever seen. Therefore we have highlighted a number of works by final years in the first few articles. We also have other pieces from a wide spectrum of the medical school too - CP2s, CP1s, BMedSci students, GEMs and Foundation year medics have all contributed to this exciting publication. And the variety doesn't just lie in the people speaking, but also in what they are saying. With discussion pieces, tips and advice, stories, interviews and light-hearted pieces we aim to showcase diverse voices that do one simple thing... Inspire, inform and intrigue.
May 2020 4
"The Corona Cohort"
Medical students and new doctors in the face of a pandemic FiY1: My first week NHS vs Corona: My Personal Experience Cancelled Electives: Medical Students Facing the Cost A Junior, Junior... Junior Doctor Lessons From Quarantining With My Twin Life after Coronavirus: How Plagues of the Past have shaped our Future The state of global health cooperation What a time to be a medical student...
FiY1: My first week Dr Laura Owler
This piece is taken, with permission from Laura, from a blog, "Living in Uncertain Times" run by NUH teaching fellow, Dr Rosie Arnott, and has contributions from a variety of final year students going through a particularly uncertain period. https://covid19livinginuncertaintimes.wordpress.com
What is FiY1? FiY1 stands for interim Foundation Year 1. Foundation year 1 is the first year as a doctor after medical school in which you rotate round 3 different 4-month long posts as the most junior member of the team. The interim part simply means the post will be between now and your start date in August. It is a measure brought in by the government to help fill the gaps and bring more healthcare workers in to help in the current pandemic. It has meant final year medical students having exams cancelled or switched to online, graduating early and missing out on their final placements or electives abroad.
Laura's 'graduation'
How do you apply? It was a fairly simple process of filling in a form and stating a preference between trusts near where you attended medical school and the trust that you are due to start working at in August. I opted for the trust I was starting at in August as I thought it would be useful to get to know the people there and how the hospital ran, as well as it being in a beautiful area close to the outdoors so I could make the most of it during lockdown. We also had to apply for our GMC registration early, again a simple process of filling a form in online. Then it was a waiting game. The process was simple for us but a logistical nightmare for those coordinating it as it involved 4 different organisations having to work together and was a new process, whereas the foundation allocations for August have been done in the same system for many years.
The weeks ticked by and I was given no information. It was frustrating but as I was doing a placement I was enjoying at the time I didn’t mind too much. Then on a Wednesday, I was sent the pre-employment forms, I filled these in expecting the start date to be in a couple of weeks. The next day I got an email with the induction timetable telling me I start on Monday. This gave me 4 days of notice to move 4 hours away. Luckily, I managed to arrange to stay with a friends’ family in a village a few miles from the hospital. So the next day I said my goodbyes to the lovely team I had been working with and started packing. I did my last bike ride on our university cycling club route and had a last brunch with my housemates. Saying goodbye was tough as I didn’t know when I’d next see them. I arrived Sunday evening.
Day 1
Dorset County Hospital, where Laura's FiY1 is
I was so, so nervous the night before that I barely slept (also may have been all the coffee consumed on the way down!) but I didn’t need to be as nervous as I was! Luckily the hospital is small and I knew someone who used to work in the hospital so I found my way to the education centre. I was 15 minutes early and the first one there which is very unusual for me! There were 6 FiY1 doctors and 6 doctor’s assistants (medical students in paid roles) starting this week. We are the first cohort of FiY1s in the hospital. We had a really warm welcome from the admin team, director of education, director of F1 and medical director of the hospital. Then it was a long day of fire safety, IT training (without a trainer!) and BLS. It was a great way to meet everyone, though. We also had a free lunch where we could meet some of the mess committee and doctors from our new teams.
Day 2 Today was more induction. We had respiratory skills training all morning which was super useful. Then it was an afternoon of elearning before fit testing. Fit testing is where we get fitted for the PPE masks that need to be worn with Covid patients or when doing an aerosol generating procedure on any patient, including CPR. The testing involves trying on the mask then putting on a hood and having a bitter tasting spray put into the hood whilst breathing through your mouth and moving. If you taste the spray with the mask on, you fail and need to try a different mask.
Day 3 We had a really useful talk from some of the F1s and core trainees first thing covering basics such as prescribing fluids, responding to bleeps and doing ward rounds. We then met our consultants and were introduced to the ward teams. We have all started in surgical jobs because the juniors on these jobs were mostly moved to medicine. We are in small teams with 1 or 2 other juniors. Although elective surgeries have been cancelled, the surgical wards are still relatively busy. I have started on orthopaedics, where we are seeing lots of car and bike accidents, as well as elderly patients who have fallen. However, it is still not as hectic as normal so we have been really well supported and the other doctors have had lots of time to provide extra teaching sessions and help familiarise us with the IT systems. They have also showed us the most important thing – where the doctor’s mess is!
Hannah Bone, Holly Richardson and Katherine Livesey, part of Laura's 'Corona Cohort' of 2020 all had their own makeshift graduations too.
Day 4 On orthopaedics, we arrive just before 8am to do the trauma meeting. In this the night reg presents any new patients that have come in and any patients that are for theatre that day. At the moment the only orthopaedics operations going ahead are trauma and emergency operations and they are having to wear PPE as well as scrubbing in. We then do our ward round. The consultants see 1 or 2 patients and it’s up to the junior ward team to see the rest. It was a really useful day; taking notes on ward round, prescribing on the e-prescribing system, learning to order and chase test and doing e-discharge summaries. It may not sound very impressive or like much fun, but this will all be the bulk of our day to day jobs for the next 2 days.
Day 5 Today I felt really well settled in and like a proper doctor! I saw a patient on my own during the ward round then did the jobs that were needed for them that day – chasing a blood result, doing their discharge summary and helping with their discharge planning. The patient was relatively complicated, they had come in with a NOF which was repaired but since then they had developed post-op delirium and a low potassium level. It was a really useful learning experience. We had another free lunch today where we met our F1 buddies. These are F1s that mentor us and we can approach with any queries or worries, both medicine and life related. My F1 buddy is absolutely lovely, has done similar jobs to those that I have lined up and also wants to go into CAMHS!
The Weekend This weekend has felt like the first weekend in ages where I haven’t had a long list of things to do and have been able to properly relax. I have enjoyed lying in (until 9am!!) and reading my Kindle. I have also used the opportunity to explore the area. On Saturday it was a beautiful sunny day so I went for a dog walk along the coastal path and Sunday I went for a run in the countryside. I am feeling refreshed and ready for another week.
The Dorset Coast: Home, for now
NHS vs Corona- My Personal Experience Alex Sharp
I’d like to begin my brief insight into the NHS with a disclaimer… I promise I did not gain my job through use of my medical student status and most definitely do not claim to be one of the incredible and crucial key workers worthy of so much more than just a clap and a sauce-pan bash at 8pm on a Thursday!* This is merely a reflection on the insights I have gained over the past few weeks, working as a small cog within the gigantic machine that is our health service. From the moment I received an email asking whether I’d like to begin to put some of my wages aside into my NHS pension (slightly earlier than expected!) it dawned on me that this was my first experience of working in the establishment that my career will hopefully one day be based in, the one and only National Health Service.
I imagine the camaraderie I’ve recently had the opportunity to experience in my role working alongside other healthcare staff to be unique. Unlike my previous work in the entertainment and catering sectors, where my role mainly centred around pulling pints for drunken wedding goers, I am suddenly now involved in the provision of an utterly essential service in the form of medication that people rely upon for survival.
*Editor's note: I think she does deserve this!
My job involves simply allowing the pharmacy, interlinked with a GP surgery, to continue its work in the provision of prescriptions to local people by ensuring all individuals queue outside the building itself at a minimum of 2m apart. I basically assume the role of a yoyo, running back and forth taking names, collecting medication and handing it out. During the 4-week period in which I have been there, the pharmacy team and the way we operate has changed beyond recognition, so much so that the concept of ‘normal functioning ’ now seems quite alien. The new norm is such that my scrub/apron/mask/face shield/ glove-clad self stands waiting for patients to come forward to enquire about their prescription. To onlookers it must appear to be a strange new dance- the "Covid-19 Tango" or even the "Corona Waltz"- as they inch forward, I inch back, politely reminding them of the 2m social distancing policy! I feel for those hard-of-hearing whom rely upon lip reading, as every member of society now appears to hide half their face, be that with a scarf, one of the desperately sought after surgical masks or even a rather intimidating Darth Vader style mask that I’ve now learnt was originally designed for protection when using aerosol sprays.
The personal protective equipment (or PPE) has evolved even as I have worked there. Initially it involved the use of only masks to protect one’s nose and mouth, to be changed every 15 minutes or so after interaction with members of the public. Despite being invaluable to us, they did have some downsides regarding the discomfort and irritation they inflicted, making an already stressful job increasingly inconvenienced. Shortly after however, we were informed of the PPE shortage and this resulted in one of the more novel lessons I have been taught: how to ‘cook’ a face mask in the oven in order for it to be appropriately sterilised and reused. Luckily for us, a kind gentleman recently dropped a huge supply of disposable face masks outside our door, meaning that much to the relief of my mum the oven remains, once again, solely for food! In addition, we now have a range of multicoloured face shields, generously made and donated to the pharmacy by local schools with 3D printers.
Interacting with the great ‘general public’ in a healthcare setting has been a very eye-opening and valuable experience. Times like this really do bring out the best and the worst of people. Myself and my fellow temporary workers have had patients thank us profusely (and sometimes unnecessarily) for the work we are continuing to do (myself, initially, with very little understanding of how the pharmacy actually works)! While others even delivered Easter eggs to outside the pharmacy for staff who continued to work over the Easter bank holiday weekend. Flowery 'thank you' cards given to the volunteer drivers as they dropped off medications to high-risk patients are left on show; in what other organisation would these gestures of goodwill take place daily? However, we’ve also had tougher situations to deal with. Occasionally patients have been dissatisfied with the service they’ve received, something that has arisen in these anxiety inducing and, dare I say it, unprecedented times. Increasing demand has been placed upon the over-stretched, tightly budgeted and volunteer run delivery service and we must explain to some patients that if they do not fall under the government’s high-risk category, they do not qualify for their medication to be delivered. These are some of the more difficult moments: we must search to offer alternative solutions, whilst sinmultaneously prioritising both our own and patient safety. Even the small role I have played in these extraordinary times has emphasised to me how, in the face of the virus, we are all equal. We are all scared. We are all at risk, some more than others of course, but even in this time of increased unease, worry and panic we all must remain rational and reasonable. Like never before we need to come together in support of the NHS’ stance against this global pandemic. When finally, some form of normality is restored, I hope that we will all be able to carry forward this sense of unity, staff and patients alike.
Cancelled Electives- Medical Students Facing the Cost Dr Erica Colwill
With the travel industry in disarray, the coronavirus crisis could not have come at a worse time for final year students undertaking electives overseas. Cancelled electives have created financial woes leaving some students thousands of pounds out of pocket.
For many fellow students, the elective placement is seen as the highlight of our time medical school and travelling abroad to experience health care systems different to our own is strongly encouraged. Whether it’s visiting subSaharan Africa to deliver services in rural villages, or jetting off to south-east Asia to sample the culture: one thing is sure, adventure is the goal! This is what so many medical and healthcare finalists had planned for summer 2020, but unfortunately now with the FCO advising against all but essential travel indefinitely in place from 30th March, these plans had to be abandoned. At Nottingham, half of CP3 started their elective in early March, so for those abroad at the time of the travel ban, this lead to a scramble to get flights back to the UK before the borders shut – at the expense of the individual. Once safely back on home turf, the struggle began to recoup the sometimes thousands of pounds spent on flights, accommodation, and other travel costs. If getting refunds for unused flights wasn’t important enough for the average traveller, spare a thought for the students who have saved up for years on end even fundraising to afford the stifling cost of overseas electives. Reports of airlines offering only vouchers or credit notes, with no guarantee of a refund has enraged travellers and may, frankly, be unlawful.
In these unprecedented times it can feel like the wild west with customers at the mercy of the travel industry. So what are the options if you’ve had your elective cancelled, and what advice should other students take in the future regarding elective placements?
Approach your travel company and know your rights In the first instance, you should try and get a refund from the travel company itself. It you booked flights and accommodation separately, that will include going to each individual company, which can be a lot of work. Some students, like myself, decided to book a trip with a tour operator, someone who arranges accommodation and hospital placement as an ‘all-inclusive’ style package. These types of companies have grown in popularity over the last few years and seem to offer a stress free way of booking a ‘ready-made’ elective. You may have heard of some of the big names offering this style of elective: they look great, have a flashy website and seemingly hundreds of 5-star reviews. However dig a little deeper and the deal may not be so sweet after all.
These companies take a set fee for administration to book your place and another set fee to cover the cost of the placement, once these have been paid, it leaves the student to arrange the flights, visa costs and insurance. Sometimes the company will refer customers to a travel agent who advises them on booking flights, it is likely this person is paid a commission should the customer choose to accept. This style of selling is slightly different to the classic package deal, and is called a ‘linked-travel arrangement’, meaning it does not need to be Atol protected. Normally package holidays will be Atol protected to ensure that customer can get their money back, should the travel company go into administration. If you booked a package holiday you should be entitled to a refund within 14 days of cancellation due to natural disasters causing significant changes to your agreed plan, under the Package Travel Regulations 2018. Linked travel arrangements on the other hand are less well protected. Further to this, it is worth checking that the company you are buying from is a member of the Association of British Travel Agents (ABTA) or the Association of independent Tour Operators (AITO). The bodies regulate the businesses in the travel industry and can hold them accountable should something go wrong.
Finally, you should always check the terms and conditions of the contract before you enter into any agreement which could save you heartache when the worst comes to the worst. It might seem daunting reading through a long 30 page document, but it is probably the single most important step. However, if you are reading them for the first time now the key parts to consider are: what the company will provide, the refund policy, timeframes pertaining to payment and cancellation. Other points that have become clearer in hindsight include, the level liability the company will hold should an event outside of their control occur and what they class as ‘events outside their control’.
There are companies selling elective placements to students today, who will not give refunds under any circumstance which is deemed ‘outside of their control’. They may try and offer a placement in a completely different continent or a postponement, claiming that they have satisfied their side of the contract, leaving you with the expense of booking flights to said continent in a short period of time. This is the way that some elective companies can hold onto your cash, please do not fall victim to them! Students planning electives in future should look for companies who offer a fair deal.
Insurance Insurance, you should never travel without it! For medical electives, it is even more important to find the right insurance cover for your trip. Everyone should have a policy which covers the types of activities which we undertake in hospitals such as the dreaded needle stick accident which could cost thousands in fees to get anti-HIV PEP doses flown out in an emergency. This is not to mention other activities such as scuba diving and hiking, which if you plan to do must also be covered. Though adding to the premium, it’s not worth risking invalidating your policy. Another key policy addition favoured by specialist insurers, is cover for trip curtailment should you need to come back to the UK to re-sit your exams. As well as having all the bells and whistles, checking that the policy also has decent cover for the standard problems that trips have, such as cancellation, is a must. Similar to referring for flights, insurance may also be advertised on the tour operator’s website as a ‘suggested’ add-on, however customers have no obligation to accept this offer and should in all cases shop around first! Set aside an hour or two to read the policy wording document and understand the product that you are buying. If there is any doubt, call the insurer and ask, if you find a problem, they may also offer you a cooling off period in which you can cancel the policy for a full refund.
Check what other cover you might have, for example with your bank, which you may have forgotten about. Remember that if you need to make a claim, it is important to declare all other policies you have in place, and claiming on two policies at the same time can make the process a lot longer as the two insurers fight it out as to who covers what. It has come to light that some of the big names in specialist elective insurance have clauses excluding claims relating to ‘pandemics’, effectively making the policy useless at this time. Double check and triple check, get in contact with the insurer as soon as possible. Underwriters can and do change their policy in unusual circumstances like these, but you may need to be persistent.
Use the NHS Bursary This is an excellent way for students to get reimbursed for some, but not all of the costs of the elective. Claims can be made for the cost of visas, the insurance policy, vaccinations, travel between accommodation and placement and the accommodation itself. Make sure you have the right evidence to support your claim, including receipts, tickets, invoices and /or bank statements. If the cost of the placement was purchased as a package style, you may need to ask for the breakdown of costs from the tour operator. This really is the saving grace for many students who have found themselves in a tricky situation and is worth completing this form as soon as possible.
My travel company will not offer a refund and my insurance won't pay out- what should I do? This is a very unfortunate position to be in, and sadly one that many students have found themselves in. It can be easy to feel defeated at this point, but there are steps that you can take to recover money. Firstly, ensure that you have everything in writing: a letter from the travel company stating that no refund is being given and a letter from the insurer stating the claim is not valid. Next, contact your bank. They should be able to help, especially if the trip was purchased on a credit card. Credit card purchases above ÂŁ100 are protected by law and the credit card company has dual liability with the company you purchased the product from. This means that you can be refunded under section 75 of the Consumer Credit Act 1974, it is relatively easy to do and can be used on any type of purchase (worth remembering for the long term). 16
But what if the trip was purchased on debit card or by bank transfer? In this case it is harder to get a refund, however banks have a system called ‘chargeback’ which means you might be able to get the funds returned to your account if you can prove the company went out of business or breached their terms and conditions. Be aware that the money could be ‘clawed’ back as this process is not enshrined in law, and there are sometimes strict time limits, some banks require you to log the claim within 120 days of the purchase or noticing that there was a problem. The Competition and Markets Authority, a consumer watchdog focuses on investigating companies who are acting unfairly, such as unfair pricing and lack of refunds. The CMA is inviting reports of companies behaving unfairly during the Covid-19 crisis, and you can submit this using a simple online form using the link at the end of this article. Small claims court could be the final step if you’ve been treated unfairly or you feel the travel company may have acted unlawfully. It is easy to log a claim online with a small expense to yourself, depending on the amount you are claiming for. However be aware if you lose you could be liable to pay the opposition’s fees. Start by asking the university and Student’s Union to point you in the direction of free or affordable advice. The Citizen’s Advice Bureau also has many useful free resources including the live chat service where advisors can help you with template letters and contacting the appropriate regulatory bodies.
Final thought If you have been affected by problems with your elective, remember there are plenty places you can go for advice and support. Taking simple steps can often get you on the right track to refund or compensation and it is important to know your rights as a traveller. The future of the travel industry looks uncertain for now and claims could take a long time to process, so patience is a virtue.
Where to go for advice FCO travel guidance https://www.gov.uk/foreign-travel-advice Report unfair treatment to the Competition and Marketing Authority https://www.coronavirus-business-complaint.service.gov.uk/?fbclid=IwAR0ESfH0J2tVUU2CmQGC3BmAQLK176szMp7HIyrZaAFgMUXq4Q9BDwJkig
Citizen’s Advice Bureau for help getting refunds due to Covid-19 https://www.citizensadvice.org.uk/consumer/holiday-cancellations-andcompensation/claim-compensation-for-a-holiday/ Citizen’s Advice Bureau advice on small claims court https://www.citizensadvice.org.uk/law-and-courts/legal-system/taking-legalaction/small-claims/deciding-whether-to-make-a-small-claim/ Guide to the NHS Bursary https://www.nhsbsa.nhs.uk/sites/default/files/2017-06/university-guide-topractice-placement-expenses.pdf Which? Consumer group advice about section 75 and chargeback https://www.which.co.uk/consumer-rights/regulation/section-75-of-theconsumer-credit-act https://www.which.co.uk/consumer-rights/advice/how-do-i-use-chargeback
A junior, junior...junior doctor Ibrahim Mutlib
It was after an obs and gynae ward round on one dreary morning, I came home and found out CP2 placements had been cancelled until further notice. It was like England had won the world cup, there was screaming shouting and borderline tears in our house of six medics. A few hours had passed, and it had dawned on us that the email hadn’t said the exams were cancelled but were just going to be later. The next few weeks of lockdown felt like limbo. Should I revise? Should I consider this a holiday? Will I really get a free Deliveroo meal with my NHS email? Weeks passed, but then CP2 were made aware of an opportunity to work for the NHS as a doctor's assistant. So, thinking “Doctor is in the title… I made it”, after an awkward phone interview in Tesco, I was told to come to the Royal Derby Hospital the following Monday. The day finally rolled around, and it felt weird being back, almost like placement had resumed. I was surprised that in the induction the chairs were 2 meters apart although it took me 0.2 seconds to realise why. The induction felt strange, there was an air of seriousness along with light humour and we were told we were actually wanted and that we were going to be useful. However, my experience of medical school was that students were the lowest on the rung. We aren’t allowed to do much, and we don’t really know much, I’ve even had it where a consultant didn’t me in his clinic so tried to palm me off on someone else. So, I thought it was strange that we were actually wanted there. For the most part the induction was useful, however what I remember most, was being so lost about the form we had to fill out in the end, never had I felt like a failure of an adult for not knowing what my national insurance number is. The only way I know how to find it, is to log in to the Next (yes, the shop) careers website for that job I applied for in year 11 when I actually knew my NI number.
We were told we could only work for 20 hours a week, this was to allow us to revise content for the rest of the week. The first day of working rolled around and honestly, I felt nervous. Everyone but me had been given a partner to go with but I was on my own so I was a little scared I would be asked to do something I wouldn’t know how to do. I sat in the doctor’s office not knowing what to do with myself, unsure if It was professional to be on Instagram. Finally, the doctors started to trickle in, and I introduced myself as the new doctors assistant. This was almost always followed with “so what can you do?” and me replying “I’m not too sure”, so basically the same as being a medical student. I was shown around the ward and shown how to do some of the admin jobs, I was happy to help, I really just wanted to make the ward run smoother. As the ward round started, I felt just like a medical student, cling to the F1 for your life and just keep quiet. As the ward round ended, I was asked to take some bloods. Taking bloods was not something I was all too comfortable with. We got to practice in the induction, and I had done a few in CP1, but I was still scared to do it on a patient. Bleeding a patient felt different this time, it felt as though there was a lot more responsibility, people actually need these bloods and it wasn’t like medical school where if you didn’t want to do it you could just leave it and go home (not that I do that, of course). Luckily, it went well, the patient was somewhat calm, and I managed to get flashback the first time. As the day went on, I did more and more bloods, and I felt as though my confidence in my clinical skills had grown considerably. Lunch eventually rolled around, and I was invited to go for lunch with the doctors. I felt like a celebrity. Me? A medical student sitting in the Derby doctors’ mess, this was a bit unexpected. As I walked in, I felt as though everyone shot eyes at me, even though they probably didn’t. My lanyard is a simple black one, the exact same as the locum consultant ones: maybe they thought I was a consultant…or not. I felt like a little bit of a fraud waiting for someone to read my title and ask me to leave but - no one did. The banter definitely felt more mature, it was around jobs, hours and general adult things.
Finally, we went back to the ward and due to the efficiency of the morning the ward was quiet in the afternoon. It was around 2.30pm and I found myself hanging around the doctor’s office very quietly as the doctors went about their jobs. This is what a lot of it involves - just hanging around acting as a doctor’s literal shadow, waiting to be told what to do. However, this time there turned out to be nothing that needed doing and I was allowed to go home early.
Walking away from the hospital, I felt like I learnt a lot, I gained confidence in my skills and got to know the team I would be with a lot better. I was still finding my feet but I could see where I could help and fit in. On this first day, I found myself wondering whether this would help me be a better junior doctor? Now though, I am 3 weeks into my role as a Doctor’s Assistant, and yes - I think it definitely will help make me a better junior doctor.
Lessons From Quarantining With My Twin Milap Raipara
Not identical - but close enough.
I have been a twin for 20 years. We are not genetically identical, but growing up, we were easily confused. So much so that even today, I respond when called by either name – Milan or Milap. It really doesn’t help anyone that our names are so similar. We aren’t quite telepathic, although we do sometimes find we burst out singing the same song from opposite sides of the house – we call it ‘twin-stinct.’ Growing up, we were partners in crime – in school and at home. Until we were eight or nine, our parents had it easy when clothes shopping – they just bought 2 of everything. At some point after this, we really wanted to be recognised as individuals. During secondary school, we were in separate friendship groups, although we were always known as ‘the twins’ by teachers and friends. During college, we were unable to shake off the title despite studying different subjects. We went off to different universities to study different courses. He went off to the University of Birmingham to study Chemical Engineering. Choosing different universities wasn’t a major shock, since we had always expressed that we would prefer to ‘split-up.’ I hadn’t successfully predicted just how different life was to become. As if starting university isn’t a big enough change. I was without my twin for the first time ever. Being a twin had become a personality trait, which was reduced to just a conversation starter when we went to different universities. While I’m happy to answer questions my university friends ask about him, the short answer is: He’s like me (just a bit different).
What have I learnt from quarantine with my twin? Despite all our efforts to experience life independent of each other, this pandemic has brought us back under one roof with our parents and older brother.
Lesson 1: Having a twin is a bit like having a therapist Quarantine is hard. Most people will go out daily, so shutting ourselves physically from the outside for weeks on end is unthinkable. This can build a lot of emotional tension. Me and Milan share a bedroom and also study and relax in the same room. We spend around 20+ hours a day in the same room. A lot of this is filled with sleeping. Much of the remainder is spent talking. Usually this is non-sensical talk out of boredom about entertainment, gossip or what we are having for dinner. But occasionally, the conversation can steer to more deep, interesting matters. About the future, about beliefs and feelings. This helps me release this ‘quarantine tension.’ Unfortunately, this first lesson can’t be acted on by most people – science hasn’t quite come far enough to let us buy a twin off Amazon just yet. Although, I can say: take care of yourself. This might be in the form of family, exercise or Netflix. Release your ‘quarantine tension.’
Lesson 2: Try something new Our ordinary lives have been put on hold. How often will we find we can press pause on the hectic demands of life? Even though my exams are going ahead, a massive part of my day has been freed up. Milan’s exams have been cancelled altogether. So, I’ve learnt maybe I should have considered choosing to study at the University of Birmingham instead to have my exams cancelled too. Milan is relaxed but has filled his days with activities. The usual suspects of Netflix and a daily workout present themselves among newcomers. Chess and a Paint-By-Numbers – neither of which he has tried before. Why not give it a go?
If we’re going to be stuck at home for so long, we may as well try something 23 we wouldn’t normally do.
Lesson 3: We may not have ordinary lives, but we have each other We’ve gone from different lives in different cities to lockdown together. Life has suddenly become very similar for everyone. We no longer have our university experiences or jobs. Instead, we can use this time together to reconnect. Although we have shut ourselves off from the outside world physically, socially, we are still a network. Technology has helped, friends and family are just a call away. This lesson is embodied by my dad too, who spends at least an hour a day on the phone to relatives (normally distant and abroad). When he’s off the phone, he reminds us that suddenly, everyone is available to talk, no matter how busy their ordinary lives are.
Before our lives return to their ordinary hustle and bustle, take a moment to relax, try something new and reconnect with your loved ones.
Life after Coronavirus:
How plagues of the past have shaped our future India Capper The pertinent question on everyone’s mind at the moment: what will life be like after coronavirus? Whilst these are, undoubtedly, unprecedented times for us, they are not in the history of our civilisation: this pandemic is not the first, and most probably not the last of its kind to ravage the human race. Reflecting on plagues that have preceded our existence reveals that some consolation can be sought; there is an end, and we do emerge, if anything, stronger than before. Diagnosis: the process of determining the nature of a disease and distinguishing it from others, from the Greek '– gnosis', meaning knowledge. Integral to the practice of Medicine today, the word 'diagnosis' can be traced back to the Plague of Athens, 430-427 BCE. During the plague, the Greek historian, and only surviving eyewitness of the epidemic, Thucydides, described the symptoms of the disease, ‘Violent heats in the head; redness and inflammation of the eyes; throat and tongue quickly suffused with blood; breath became unnatural and fetid.’ (1) Thucydides, himself not a physician, justified his recording in order to enable future people to recognise the illness, should it strike again - and indeed the plague did, twice more. Recording of symptoms such as this established the foundations of grouping symptoms into a specific disease, namely, ‘diagnosing’.
Epidemiology: the causative factors.
study
of
disease,
its
incidence,
distribution
and
The ‘Father of Epidemiology’, John Snow, uncovered the cause of a cholera outbreak that erupted in the Golden Square of London in 1854, subsequently killing 616 people (2). By meticulously mapping victims, Snow was able to identify the source of the epidemic: a water pump on Broad Street. This laid the foundations for the method of contact tracing, which irrevocably redefined Epidemiology. His discovery that water can serve as a vehicle able to transmit Cholera facilitated some of the first public health actions on record such as improvements in sanitation facilities, including repairing sewers and drains which were no longer seen as benign, and instead as public health threats. It is estimated by WHO that each year Cholera kills 21,000 to 143,000 people globally (3). Regrettably, 1 in 3 people worldwide remain without access to clean, safe drinking water. However, thanks to the observation of John Snow, we now have the ability to recognise access to clean water as a fundamental right, and work to change this statistic.
John Snow's Map of Cholera Cases, Soho, 1854
Global Impact From Paris to New York, the landscapes of our cities today were revolutionised by outbreaks throughout history. The Cholera outbreaks that devastated New York City in 1832 and again in 1849, had as profound an effect on people’s lives as it did on the city itself.
Nineteenth century New York was immensely different from today; crowded, visibly filthy and unhygienic: riddled with animal and human waste, it provided ideal grounds for the spread of disease. Recognised by medical professionals, this correlation drove the movement to rid the city of noxious vapours, or ‘Miasma’, a term coined in the Middle Ages. The ‘Miasma Theory’ proposed better ventilation, sanitation and waste removal. This resulted in installations such as underground wastewater systems, the product of which is evident in today’s wide and straight paved roads, the trademark of modern Manhattan. Central Park, to this day, is known as ‘the lungs of New York’, and was the product of a Miasma theorist, Frederick Law Olmsted. Olmsted identified the ability of parks to ‘rid cities of foul air’, generate pure air, and provide an inlet for sunlight. Amidst the aftermath of the second Cholera outbreak, Olmsted designed Central Park and subsequently more than 100 public parks across Boston, Buffalo, Chicago and Detroit (4). Despite the Miasma Theory having evolved with new medical insights and being disproved by Germ Theory, modern studies affirm the health benefits of parks and outdoor spaces: improving mental health, increasing capacity for physical exercise and reducing the severity of conditions such as asthma. Almost simultaneously in Paris, amid a Cholera outbreak that claimed the lives of 19,000 people, Baron Georges-Eugène Haussmann sought to redesign Paris; in 1853, 12,000 buildings were torn down, while boulevards were lined with trees and parks were constructed – assembling Paris as we know it.
Parallels Perhaps most relevant for today, the concept of ‘quarantine’ can be traced back to the Black Death, or the "plague", 1346-1353, the most fatal pandemic ever recorded, killing an estimated 75-200 million people across Europe and Asia. Venice became the first city to close its port to incoming ships. A compulsory 30 days of isolation, subsequently increased to 40 days, was implemented for ships admitted to the city before sailors could disembark.(5)
A painting of a typical Venetian doctor during the Black Death, by Jan van Grevenbroeck
Measures even extended to dedicating an entire island in the lagoon, Lazzaretto Vecchio, to care for and ultimately bury victims of the plague. In 2007, more than 1,500 skeletons were excavated from the island. Despite these extreme and relatively prompt measures, the plague’s immodest destruction claimed an estimated 100,000 lives of Venice’s small population. In spite of the devastation that Covid-19 has caused Italy today, their ability to respond and survive is entrenched in their historical legacy. Epidemics have resulted in undeniably profound effects on civilisations. The legacy of such changes can be seen every day, from our city landscapes to the current lockdown we patiently endure. Amidst the darkness cast by the current epidemic is hope; our ability to adapt and the changes that ensue are ultimately what will inform our lives after Coronavirus. Whilst Italy was experiencing the worst of Covid-19, Francesca Melandri, an Italian author, wrote a warning letter to the UK as we tip-toed towards the precipice of disaster. She ended the letter, ‘when all of this is over, the world won’t be the same’. She is correct. However, perhaps our history of resilience suggests that in time we will come out stronger and leave something lifechanging for the future – Andrà tutto bene
A banner hanging in Venice amidst the COVID-19 pandemic, conveying a national message of hope.
1 John Horgan, The Plague at Athens, 430-427 BCE. 2016 < https://www.ancient.eu/article/939/the-plague-at-athens-430-427-bce/>
2 Kathleen Tuthill, John Snow and the Broad Street Pump on the trail of an Epidemic. Cricket, pp. 23-31, 2003 < https://www.ph.ucla.edu/epi/snow/snowcricketarticle.html> 3 WHO, Cholera, 2019 < https://www.who.int/news-room/fact-sheets/detail/cholera> 4 Christopher Klein, How Pandemics Spurred Cities to Make More Green Space for People, 2020 <https://www.history.com/news/cholera-pandemic-new-york-city-london-paris-green-space> 5 Helen Carr, Black Death quarantine: how did wetry to contain the most deadly disease in history, 2020 < https://www.historyextra.com/period/medieval/plague-black-death-quarantine-history-how-stop-spread/>
The State of Global Health cooperation Ignacy Kozlowski
The need for coordination of action, as well as establishment of common health related policies emerged from the growing connections and inter-dependence between key powers in the world. The first international sanitary conference took place in 1851 and was a meeting forum between 13 European states. Its topic was the establishment of common quarantine regulations for sailors in order to control the spread of Cholera. The conference was called as it became apparent that the differing rules were sources of unnecessary costs for all parties involved and made international trade more difficult.1 Since then, multiple such conferences were called to discuss health matters, and international health conventions started to be put into play. In 1903, it was agreed that a permanent bureau should be established for the purpose of such cooperation. Numerous bodies were founded, including the International Health Bureau in Washington (later renamed to the Pan American Health Bureau, and then the Pan American Health Organization), Office International dâ&#x20AC;&#x2122;Hygiene Publique (OIHP) in Paris, and following WW1 the Health Organisation of the League of Nations. In the inter war period, these main bodies cooperated with each other, and following WW2 the World Health Organisation was formed by the United Nations. The WHO permanently took over to continue the work of the previous organisations on the 31st of August 1948 and as we know is still active to this day.2 Given the current situation, itâ&#x20AC;&#x2122;s not hard to see why international cooperation is more relevant than ever. Currently, the World Health Organisation stands as the main agent in providing guidelines for, as well as coordinating the agenda of research in light of the COVID-19 pandemic but is far from being the sole player.
In our time, the topic of health has expanded beyond the sole concern of health departments and is now regularly discussed at many forms of multilateral meeting and conferences, take the G8, the European Council, or even institutions such as the World Economic Forum. There is also the important contribution of non-profit organisations, non-government organisations, and private-public partnerships, many of which are dedicated to specific causes or provision of specific relief to poorer areas of the world. . This plurality stems from the conscious decision to transition from International Health Governance (IHG), (more bilateral and more dependent on the perceived key states to form decisions), to Global Health Governance (GHG), the complex dynamic we see now. 3 In a globalising world, we can see benefits of this plurality. With the complexity in the field of health and the drastic differences in development all around the world, it only makes sense that a wider range of organisations and initiatives are able to provide more attention to issues. However, the plurality leads to inevitable fragmentation and difficulty in forming an overarching health agenda for the world. Whilst providing a more dynamic approach, the GHG approach struggles to clearly delineate the roles and responsibilities of different actors.4 In light of the COVID-19 pandemic, coordinated action is needed both to ensure the crisis is dealt with as efficiently as possible, but also to ensure the fastest possible economic recovery. With the great inter dependence of states economically, alongside which comes the constant movement of people, the globalised economy as we know it can only be reinstated with coordinated action. At the smaller level of the European Union, problems stemming from the lack of cooperation on health matters and policy came into light immediately as member states began to close borders in response to the pandemic. For example, Poland had adopted different restrictions than its neighbours, with no formal agreement or protection for workers who work in the neighbouring countries. As a result many Polish workers working across the border in the Czech Republic lost jobs as they were unable to return to work due to the obligatory quarantine placed on anyone that crosses the Polish border.5 The impact of this is clear. Problems of this nature can only be solved by increased cooperation of nation states in the field of health. The EU Health Coalition has already made the call for greater solidarity in light of this crisis, encouraging more cohesive action and offering aid from the EU solidarity fund for the most affected nations.6 Given the reluctance of certain EU governments for greater solidarity of the Union, pressure for common action from the WHO could have an important role to play.
This translates beyond the level of the EU. The United States, the largest economy in the world is one of the countries that has taken action the latest, with testing numbers still low. The WHO guidelines were disregarded by the US administration early on, and the failure of the government to undertake action was blamed on the organisation itself. 7 Whilst economically, new measures put into play by the US may dampen the impact on itself and the rest of the world, the cutting of funding for the WHO by such an influential actor may set a dangerous precedent and hinder global cooperation in the future. This could move the world further from initiatives like the solidarity proposals made by the EU health coalition, towards an environment of increasingly isolated yet economically inter-dependent actors; losing valuable research, knowledge and strategy-based cooperative initiatives. Whilst progress in the field of health is largely decentralised, the overarching role that a body such as the WHO can play should remain emphasised. Large scale research is a must in tackling global issues. We know of the great differences between how certain countries have dealt with the pandemic, as well as the great variety of different strategies adopted. Countries like Germany have had relative success using a strategy of heavy testing and contact tracing. 8 Likewise, by responding early, the Czech Republic will also be one of the countries who unfreeze their economy first.9 Learning from our global partners should form the foundations of our future health initiatives.
"Large scale research is a must in tackling global issues"
1 https://www.who.int/global_health_histories/background/en/ 2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981564/ 3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983705/ 4 https://tvn24.pl/katowice/koronawirus-w-polsce-pracujacy-w-czechach-polacy-traca-dochody-4519212 5 http://www.euregha.net/news/the-eu-health-coalition-calls-for-more-solidarity-and-coordinated-eu-action-to-tacklecovid-19/ 6 https://www.vox.com/2020/5/1/21242589/coronavirus-testing-swab-reagent-supply-shortage 7 https://www.vox.com/2020/4/15/21222756/trump-halts-who-funding-coronavirus-pandemic 8 https://www.politico.eu/article/germans-being-german-about-coronavirus/ 9 https://www.praguemorning.cz/could-czechs-measure-to-fight-coronavirus-save-thousands-of-lives-2/
What a time to be a medical student... Nic Miller
A tough time. That’s what it is. Whether you’re still studying while at home, volunteering to help out in the NHS, or returned to an old job to help out, every single person is in a difficult bind at the moment. We are medical students in a peculiar way - not only is our ability to help frustratingly limited, but there’s a sadness in the fact that some of us, especially those in earlier years and with long-standing health conditions, can’t be on the wards to help in the way that we will in years to come. We want to rush and help, but have to bear in mind the long journey towards becoming a doctor we are already on.
On top of that, whichever position you’re in, the constant onslaught of social media can leave you feeling bad for not doing (or not being able to do) something. It seems like everyone is revising, shopping for their neighbours and sporting PPE on the wards all at once. And then it becomes a vicious cycle as you feel bad for feeling bad while your friends and colleagues are doing amazing things. However, it’s important to remind yourself that you too are doing amazing things. Whether you’re doing several of these things, or struggling your way through, it doesn’t matter. Often in medical school, we find ourselves comparing how we study, how we party, how we progress to the point that comparison becomes second nature. In a pandemic it’s already a difficult time and emotions are heightened beyond compare… unprecedented some would say. And you should know that you are making a difference. And, sometimes you do so in a way that you perhaps can’t even comprehend. People do things their own way, and always will. But if you can do things your way, that’s great. And don’t be afraid to reach out to friends, colleagues and others - the glossy front of social media isn’t all it seems and while they may appear to be coping with some elements of the craziness in the world at the moment, odds are they may want to chat about other things. It’s easy to lose touch from feeling overloaded, or even sometimes feeling like you’re not enough for someone to keep in touch with. But you are. And everyone is probably thinking the same thing right now. Whatever you are doing be in no doubt there will be someone, somewhere, that you are helping somehow.
Societies and COVID-19 How have some of our Medical societies faced up to the pandemic?
MedSoc and COVID-19 UNAD and COVID-19
Overcoming technical difficulties
MedSoc and COVID-19 Callum McIntyre- MedSoc President
COVID-19 has affected everyone in the Medical School and MedSoc have had to adapt as an association in order to support its students in this time of uncertainty. Soon after the hugely successful and memorable Halfway Ball for the third years, the COVID crisis began to escalate at a rapid pace.
The 3rd Yr MedSoc committee members that could be located during the Halfway Ball!
Due to the suspension of studies across all cohorts, many students expressed a desire to volunteer to help the NHS and local communities in the fight against COVID. As a result, the MedSoc committee held a virtual meeting in which we sat down to discuss how MedSoc could help our students achieve this. Following this meeting, a COVID Aid Facebook group was established for those students wanting to volunteer and the page gained over 500 members in just 2 days. Feeling extremely proud of the altruism of the students that we represent, MedSoc began working with the Medical School Faculty to help match students to appropriate roles within the NHS to enable them to help the COVID effort. Whilst national guidance from the Medical Schools Council and the BMA indicated that pre-clinical students should not be placed in clinical areas, we were able to signpost 1st, 2nd and 3rd year students towards ways they can support their local communities and helped facilitate connecting 4th year clinical students to healthcare roles in local NHS trusts.
At the same time, the government had announced that final year Medical Students would have their graduation accelerated to allow them to work in the NHS frontline sooner. This unfortunately meant that our final years would not be able to complete the electives they had only just begun, and the graduation they had worked so hard towards over 5 years would no longer be happening. In order to give our final years the celebration and recognition they deserve, MedSoc worked with the Medical School press to organise a rather special graduation ceremony. The Class of 2020 (the “Corona Cohort”) were graduated virtually on Zoom by Dean of Medical Education, Gill Doody, live on BBC’s ‘The One Show’, broadcast across the nation. It was not the graduation anyone had expected, but it was very special and MedSoc feel very proud to have played a part in celebrating our students’ achievements. While MedSoc were busy working on all things COVID related, it was unfortunate that the remainder of our calendar of events for the year were cancelled. Lots of hard work had gone into planning many upcoming events such as our Boat Party, Trampolining Social, Post-Formative Bashes and many more, and it was disappointing for committee members to see their hard work go to waste. However as an association we had to adapt, and instead of hosting events, we worked with our sponsors to provide educational material to our students to support their new, unprecedented online learning. Discount’s to medical textbooks and access to pre-clinical and clinical online masterclasses were our main focus, and through providing these to our students we were also able to raise £500 towards our final yearly total of just over £4000 to go to Nottingham Children’s Hospital to support them during the pandemic.
At the same time, we were coming to the end of our year as a committee so had to face the challenge of elections during the pandemic. Unable to hold an AGM for our students, we worked hard to put together an online version, with videos from all committee members outlining what their role entails and what it is like to be a part of MedSoc. Social secs making full use of virtual backgrounds during the AGM!
A lot has been happening within the Medical School during this pandemic and MedSoc are extremely proud of the ethos and determination of its students to support those suffering due to the crisis. Personally, I am extremely proud of the entire MedSoc committee. Not only have they worked hard all year to make life in the Medical School that little bit more exciting, but they have all stepped up to the challenges posed by COVID and offered support in any way they can. It was not the end we expected to our year as committee, but we are very happy with what we have achieved, and what we have been able to offer during the pandemic.
Some members of the committee during the Welfare â&#x20AC;&#x2DC;Rechargeâ&#x20AC;&#x2122; week, when we could all fit within 2m of each other!
UNAD and COVID-19 Nic Miller- UNAD President
Over at UNAD, weâ&#x20AC;&#x2122;ve had an interesting time with a response to COVID-19. With the nature of the GEM course at Derby our handover occurs in February, so as well as having an international pandemic in the mix we were also arriving as a relatively new committee. While we managed to fulfill some of our aims as a committee pre-pandemic (such as providing free sanitary products in the bathrooms at Derby), many of our exciting plans had to be put immediately on hold. Furthermore, at Derby a lot of us have been spread back across the country. Many of our graduate entry medics have made us really proud by returning to their NHS or social care jobs alongside studying for a looming exam, and others have returned home to be with their children/partners/families and loved ones to look after them during this difficult time. As a committee, we have been working on a coordinated virtual response that focuses the welfare of our cohorts whatever they may be doing in this pandemic.
Although we're all in different settings, the UNAD committee are still busy working as one
With this in mind we've really tried to do things that our cohorts can engage with as and when they need such as; virtual pub quizzes, fun videos to provide amusment, launching a 'motivation exchange' where people can send encouraging postcards to eachother, having a UNAD netflix watch party in celebration of Earth Day. We've even been working hard with societies within our body with Yoga providing some instagram sessions for beginners and our amazing new Derby Anatomy Art Society which had only just started runing an amazing 30 day anatomy art challenge (A collection of which you can see later in the journal!) We've also been working hard to keep up with some of those projects people were excited about. We've still managed to launch through Microsoft Teams our GEM-MPT (Medical Physiology and Therapeutics) career support scheme, and UNAD hoodies are now available for people to order to remember their now certainly unique time at Derby! And we've made sure people know that are great welfare team are always on hand if they need a new face/voice to call and talk to. Most impressively for me, is that we've managed to provide all this support while many of our committee are working hard towards upcoming summatives and some even working alongside to support the NHS against the pandemic.
Overcoming Technical Difficulties SCRUBS' Experience of Remote Teaching
It feels both like ages and equally not that long ago when normal university and society activities gradually ground to halt as the country responded to the coronavirus. SCRUBS Anatomy Cell still had many events to look forward to, such as finishing the first-year anatomy teaching and Dr Nasherâ&#x20AC;&#x2122;s revision sessions.
However, as the situation continued to change, we had to think of alternative ways to run our planned events. Together we discovered how challenging circumstances do not necessarily mean an end to plans - just a change of tactic. We would like to share what we have learnt and to encourage everyone to see how they can use experiences and new skills from these strange times in the future.
Anna: With our first-year anatomy teaching, we suddenly found ourselves having no face-to-face sessions to support the online PowerPoints. Personally, this made me appreciate how teaching relies not only on the content but also on the presentation and interaction with the audience and I believe this is something that we have all become aware of as we have sat through many lectures during our time at university. I also found how anatomy is topic which is really based on a living subject and hence a future patient. As much as I liked using GIFs found online to demonstrate muscle movements, itâ&#x20AC;&#x2122;s not quite the same as waving your hands about and making everyone palpate surface landmarks on themselves, such as the jugular notch and sternal angle.
Prosection images are also very handy to illustrate that real life is sadly not quite as neat or colour-coordinated as diagrams (that M shape in the brachial plexus just about looks like the letter), however I found it harder to see the depth of the structures, or even sometimes orientating myself to which way is top and bottom, something which hopefully wonâ&#x20AC;&#x2122;t be an issue outside of the virtual world.
Cecilia: When I thought about what it would be like as part of the SCRUBS committee, I certainly anticipated sending many emails to surgeons, but what I did not expect was teaching them how to minimise windows in order to share their screen on Zoom. It certainly has been a learning process, and one very much dependent on the teacherâ&#x20AC;&#x2122;s willingness to laugh about silly mistakes and technical difficulties. The approach to virtual learning that made most sense to me was trial and error of different techniques. So, while the newly recruited CP2s that have applied to teach Specials to their peers will be recording audio files and attaching them to their slides, Dr Nasher completed his CP1 refresher anatomy session in a 2 hour long session followed by a COVID-19 debate. The most interesting experience has definitely been Prof Hopeâ&#x20AC;&#x2122;s Clinical Neuroanatomy series: I was surprised by his suggestion to hold virtual lectures for anyone interested in the brain and its workings, and I was even more surprised at his willingness and excitement to learn how to join a Zoom meeting. Despite the anxiety preceding a session (Will my WiFi be up to the challenge?), seeing Prof Hope answer questions from students from every year made it all worth it. He was just as keen to gather feedback, improve and enjoy teaching as he was when students gathered in a lecture theatre to listen to him, and although he missed bedside teaching, was willing to learn from his experiences.
Krishna: One of the biggest advantages of accessing sessions online is the ability to watch them from the comfort of your own home. You can also view at your own leisure, which increases the number of people who are able to access the resources, particularly as they can also fit it around their own daily schedule. This has increased the number of people who will be accessing our resources and has also improved communication significantly as less confident students
can ask questions and still be safe in the knowledge that they will be answered by a trusted expert. Despite the many advantages of online sessions, we had to adapt the style, format and type of content we delivered in our resources due to the changes in the exam format for the pre-clinical years. Our pre-clinical anatomy mock spotter saw significant changes. As the spotter exam will this year be intertwined with the preclinical summative paper, we created a digitalised spotter which integrated pro-sections, radiology, true and false questions, MFQs and a whole host of labelling images to cater for the differing needs of pre-clinical students. We threw in some curveballs to not only assess gross anatomical knowledge, but also test the intimate relationship between anatomy and physiology through questions which required an amalgamation of knowledge to reach the right answer. Having said that, being able to identify key structures is still a core skill to develop and we made this clear.â&#x20AC;?
Final thoughts: In the end, the art of teaching remains the same whilst our expression of this art has had some modern twists on it. Despite the difficult times we are in, we as a committee have come together to continue providing learning resources and modifying them in any way possible to ensure that the quality of teaching is consistent. By working collaboratively with students and staff, we are confident that we are all going to come out of this stronger than ever, as a society and as a wider medical school community.
Advice and Wellbeing
Advice and ideas from other medical students Maximising Your Mornings 10 tips for maintaining wellbeing Alternative careers with a medical degree Relaxing music: does it note-ably impact on stress?
Beyond Medical School Bored in the house and Iâ&#x20AC;&#x2122;m in the house bored â&#x20AC;&#x201C; how to make the most out of lockdown
Maximising your Mornings Alisha Gupta
As medical students, it can be difficult to fit in everything we want to do into each day. Early on into the year, I realised that I was doing something every evening of the week, whether that be attending talks, sports training or spending time with friends. I was struggling to keep on top of work because there were so many fantastic opportunities but not enough time (or so I thought...). In the new year, I decided that this was going to change - I was going to wake up earlier and get things done in the morning. I never thought I was a â&#x20AC;&#x2DC;morning personâ&#x20AC;&#x2122;, but I can honestly say that it has transformed my mentality and I can now fit a lot more into my days. I aim to be in bed by 10pm, read for 30 minutes and then wake up at 6.25am, giving me approximately 7.5-8 hours sleep So, here are some things which I have been doing to maximise my mornings!
Night-time Necessities Establishing a night-time routine helps you to sleep better and you can wake up feeling ready to go. By preparing things which can be done the day before, you reduce the number of decisions and tasks you need to do when you wake up, meaning you can focus on the things which are important to you.
I make sure my bag is packed the night before (including all those EXTREMELY important mid-lecture snacks). Deciding what to wear can be very stressful but this morning stressor can be removed by planning your outfit the night before, so the next morning you can just get dressed.Having a clear outline of what you want to achieve during the day is a great way for your mind to keep focused. Writing a to-do list the night before ensures that you know what you want to get out of the day, and it is very satisfying to tick things off as you go along!
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Morning walk along the Victoria Embankment
Morning Movement Exercising in the morning helps you to feel more awake, and it increases BDNF levels, improving neuroplasticity and mood, and therefore your ability to learn and stay focused during lectures and placement. The public spaces and gyms are much quieter in the morning compared to in the evenings, so you can FIT in (pun intended!) an effective workout without having to wait for equipment or watch out for pedestrians whilst you are running/walking. There are lots of online workouts which can be done in your bedroom!
Screen Suppression We want to start our days being focused as this mentality will carry on for the rest of the day, however, as soon as we check our phones, this focus lessens. Imagine that you have just woken up and 30 people come into your room and all started talking to you. You would not want to speak to them as you need time to get ready and wake up properly.
This is similar to how you use your phone, if you use it as soon as you wake up, you are bombarded with notifications and your body is not ready to respond to this intense stimuli as soon as you wake up. You need time to wake up properly, and then you can start responding to these messages. Creating these good habits will allow you to stick to them and ultimately you will waste less time on your phone. At night, the blue light emitted by our devices keeps us awake for longer by delaying melatonin release. By turning your phone and electrical devices off at least 30 minutes before bedtime, your hormones are less affected and will help you to achieve good quality sleep, so you are refreshed the next morning.
It took me a few weeks to adjust to this new routine and have been flexible as things can go on past bedtime. My friends know about my routine and are understanding when I leave early to go to bed (as much of a granny as that makes me sound!). Gradually try these tips and wake up 15 minutes earlier every week until you find a suitable time for you and hopefully you will be able to realise the benefits of waking up early!
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10 Tips for Maintaining Wellbeing Douglas Mbang
Interestingly, I have decided to write this piece at 3am after very prematurely waking from my sleep. Naturally, one of the tips I am going to recommend shall be about getting good quality sleep (spoiler alert). Without any further ado, here are my top 10 tips for maintaining wellbeing at any time, which is of the utmost importance now in light of the obvious global circumstances. I think it would be a disservice to rank these 10 tips in terms of importance, as there are times when some are more helpful than others due to individual circumstances.
Apologies in advance - I like quotes, therefore each tip will be accompanied with a quote, some will be very relevant, some less so.
Sleep ‘Sleep is not an optional extra in life; it is a fundamental requirement. In fact, you could survive for three times as long without food as you could without sleep’- Professor Espi (Sleepio).
We’ve all had a bad night's sleep, or even nights where we can’t get to sleep at all (if you have never experienced this, congratulations and please teach me your ways). Sometimes we sacrifice sleep for a few more episodes on Netflix or, for more noble reasons like catching up with university work. However I think this is something we could all work towards improving on. Sleep hygiene is something we should take very seriously as it is the foundation with which we start the day on.
Mindfulness ‘The mind is our most precious resource, through which we experience every single moment of life. Are you looking after yours?’- Headspace (Mobile App). Unfortunately for us we can’t always change what’s happening around us, the only thing we can do is work toward changing how we react to things.Mindfulness is not about getting rid of negative thoughts, or only having positive thoughts, it's about being at ease with whatever thoughts may arise.
Eating right ‘You are what you eat’ - Wise mothers everywhere
What we eat and drink are the fuels that keep us going through the day. It's important to make sure we are getting a good balance of nutritious food. With that said, enjoy what you eat. If you’re eating healthy most of the time, a cheat day here and there can be a very welcome break, so be kind to yourself.
Exercise ‘The only bad workout is the one that didn’t happen’- Pinterest (please don’t judge me) I don’t think I need to enlighten anyone about the benefits of exercise on both the mind and the body. So much so, the government has given us a pass to get out of the house once a day for this. Personally, I’ve been using this daily allowance to go for a daily walk, taking in the sights and smells of tranquil Derbados (pet name for Derby, for those not in the know)
Yoga ‘Yoga is not a work out, it’s a work in’- Pinterest (okay, you can start judging me now). I know some people would class this as exercise and I know that yoga can feel like a workout, but for the purposes of this list, yoga gets its own section.In my own experience, yoga feels as though mindfulness and exercise got together and had a super baby. A baby that dates back over 2000 years.
Reading ‘Literature frees the mind’- Buddy Dyker (Ozark, Season 2 Episode 3). Literature does free the mind and a good book can take you places. Sometimes this is a welcome distraction from our busy lives, a little bit of escapism can be therapeutic in these times.
Journal Writing ‘I can shake off everything as I write; my sorrows disappear, my courage is reborn’- Anne Frank Some of the many benefits of journal writing include, organising one's own thoughts, relieving stress and self-reflection. Trying to focus on things you are grateful for in a journal entry is a nice way of reminding yourself of the good things in life and is a useful perspective exercise.
Connecting With People ‘I just wanted to hear your voice’- Mary (My mum) As social animals we are not used to the current limitations placed on us. It’s important to make sure that we are connected now more than ever. This is especially important if you are isolating alone. Luckily, we live in an age where there are so many ways we can connect digitally (Houseparty app, anyone?).
Cut Down on Screen Time I know, I know. To stay connected with people we need our screens to a certain extent, but there is a difference between using our screen time to connect with people and being glued to our screens all day scrolling Instagram and feeling a bit terrible about ourselves. Covid-19 is all over the news and social media and while some people are not as affected by this, others may find this media oversaturation damaging and inescapable. If you’re one of those people that may be affected, make sure to consciously take some time away to limit your exposure to constant Covid-19 related news and messaging.
Do Whatever You Like To Do To Chill ‘One good thing about music, when it hits you, you feel no pain’- Bob Marley With all things said, no one knows you better than you. So do whatever makes you feel relaxed. For me, this is putting on some music and dancing in my room for no reason whatsoever. Thanks for taking the time to read through this. I hope you’ve gotten some value out of it, or at least been reminded to take time out to look after yourself, treat yourself and prioritise yourself. With that being said, I will now practice what I preach and see if I can get back to sleep at this ungodly hour.
Alternative Careers with a Medicine Degree Yasmin King
We have all asked ourselves the question: what if I change my mind? What if I spend all this time, effort, and money on getting a medical degree and then decide being a doctor isnâ&#x20AC;&#x2122;t for me? When we look at the lives of our school friends, already earning a salary and settling down whilst we are still unsure of what part of the body we want to devote our lives to, it makes sense to think about â&#x20AC;&#x153;easierâ&#x20AC;? ways to earn a living. Alternatively, perhaps after trying every specialty, you still cannot find an area that makes the night shifts seem worth it.
Luckily for us all, a medical degree has many transferrable skills and is widely recognised across many fields. Having decided patient-clerking and skinsuturing are not the way you see your future being spent; you might want to know what else is out there for you. Many of these can also be integrated alongside a clinical career if you just have too much time on your hands (what a crazy thought) or if you go less than full time.
Research One of the most obvious pathways is research. Whether your BMedSci project left you hungry for more stats and lab time, or you are determined to find the mechanism of action for paracetamol, research can be a very fulfilling and varied career. Often this involves getting a PhD after medical school and then gradually establishing yourself in the competitive research world. What can you do now if you think this might be for you? As with anything, say yes to all opportunities: shadowing researchers, attending conferences, or helping others with their projects. It is all valuable experience and the worst that can happen is you do not enjoy it, and then you know what not to do!
Teaching Another way to stay at university for as long as possible is to go into teaching. Being taught by people as inspirational by a certain pharmacology professor, it is easy to see why being a lecturer is so rewarding. If you want to pass on your enthusiasm and knowledge onto future generations of doctors, this could be the career for you. Medical education is growing due to the increased demand for doctors, so it has never been a better time to join in! This usually requires additional postgraduate qualifications (e.g. a PhD or teaching qualifications) so you would get to be a student for even longer. That means more Ocean Fridays, right?
Travelling What about travelling? For all those with some wanderlust unsatisfied by a â&#x20AC;&#x2DC;gap yarâ&#x20AC;&#x2122;, there are many opportunities to work around the world, as a doctor or not. The main options are working with charity organisations (such as Medecins Sans Frontieres, The Red Cross, Mercy Ships) or as a locum doctor. Another medical role that can involve travel is Defence Medical Services, providing both primary and secondary medical care to the British Army, Royal Navy, and Royal Air Force. To find out whether military life is for you, the University Officer Training Corps could provide a valuable insight. There are also generous bursaries and scholarships if the excitement of being in the military was not enough to convince you. Finally, another career path that involves travel is expedition medicine: supporting adventure travellers or overseas field researchers. There are endless opportunities with medicine abroad, including providing emergency aid in developing countries, or learning from the health systems in other developed countries. For those who do want a clinical career in the UK, sabbaticals are a great way to take time out to see alternative approaches to medicine and develop your skills in a new environment, or learn from top clinicians and surgeons around the world.
Administration, Organisation and Management If it is the blood and shift work that puts you off a clinical career, there are lots of medical-related desk jobs. The main opportunities lie in central government (e.g. Department of Health) and the Civil Service. Similar roles include working in medical politics and ethics: working for organisations such as the MDU, BMA, or GMC. Getting involved in local politics and showing interest in BMA activity or conferences is a great way to see if this is for you. NHS Management is also a good way to go if you want to have a direct impact on the organisation of the NHS. Within all these organisations there are also legal positions, requiring further qualifications, if medical school was not long enough for you.
Public Health Coronavirus has taught us many things: how long we can go without washing our hair, how to turn kitchen appliances into musical instrumentsâ&#x20AC;Ś the list goes on and on. One of the other outcomes of the pandemic is the realisation that all those public health and epidemiology lectures were actually quite important. Perhaps you want to be part of the team that helps prevent this happening again. If so, organisations such as Public Health England or the World Health Organisation may be the place for you. Using analytics and modelling, you would be able to improve health in greater areas and communities, maybe saving even more lives. Coronavirus is also a nice (or not-so-nice) reminder of how necessary and important doctors are, as if our god-complexes were not ingrained enough.
Writing If none of these make you excited, perhaps writing is what you need. Medical communications and journalism are important ways of informing (and entertaining) the lay folk as well as the medical community. Many of you will remember Adam Kayâ&#x20AC;&#x2122;s This Is Going To Hurt; maybe it inspired you to do something similar. Whether it is to excite the future doctors, or merely utilise your creative talent, there are many opportunities in medical writing and also medical art.
As you can see, there are many more career options in medicine than working in hospitals and general practices. This list is not exhaustive, though; I have not even mentioned prison health services or pharmaceutical medicine! Hopefully, there is something for everyone, so next time you doubt whether you are in the right course, remember the uses for your degree are far from limited. Medicine is notoriously challenging so any employer will recognise its value.
Relaxing Music-Does it Note-ably Impact on Stress? Anna Kober
Music. Whether it is making it or listening to it, it is an enjoyable pastime for many. In recent times we have witnessed just how powerful music can be in uniting people together despite being far apart; I have seen some incredible examples of virtual performances being created by musicians recording their parts from home and everything being arranged together. I too, have taken some more time to practise my instrument now that my days have a slightly different structure. After realising that this was indeed quite a fun activity, I began to wonder about the other potential benefits music can have other than the impact on mood. This short article covers some of the information I found interesting after my adventure of going down the rabbit hole of google searching. Music has a strong emotional component and research has shown that people use music to not only match or change their current emotion but also to release emotions as well as to enjoy or comfort themselves or relieve stress 1. However, studies have also gone on to look at the effect of music on physiology. In particular I focussed on research exploring the stress response, not only because I have slightly more awareness about cortisol after covering it in the first semester of year two but also because I was intrigued to see whether relaxing music is actually relaxing.
Admittedly I was surprised to find that the answer was not quite so straight forward. One study I found involved undergraduate students preparing for an oral presentation (an example of a cognitive stressor task) either in silence or in the presence of Pachelbelâ&#x20AC;&#x2122;s soothing Canon in D major. The authors found that the significant increase in subjective anxiety, systolic blood pressure and heart rate caused by the stressor were absent in students who had listened to Pachelbel. However, music had no significant effect on cortisol levels and the standard deviations were the greatest out of all the parameters, which indicates that cortisol production was very variable between people. It may also be worthwhile to note that 42% of the students did not actually find this task stressful making it harder to determine whether the observed effects were in fact responses to a state of stress, and so whether Pachelbel was any use at all 2. Another study investigated whether listening to relaxing music (this time they listened to Allegriâ&#x20AC;&#x2122;s Miserere), or to the sound of rippling water or having no acoustic stimulation prior to the stress test caused a difference in the stress response. The results demonstrated that music had no significant effect regarding autonomic responses or psychological measures of the subjective perception of stress, however cortisol concentrations were actually found to be the highest in the Miserere group and lowest in the participants listening to rippling water. The authors were surprised to see the relative increase in cortisol in the music group compared to controls, particularly in the context of the findings of other studies observing the effect of music on baseline HPA axis functioning. One idea they began to consider after comparing to other studies, was whether the chronology of events (i.e. whether music was played before, during or after stress) had an impact on how beneficial it was on the functioning of the HPA axis.3 Or perhaps Miserere is not so relaxing after all. The release of cortisol, commonly known as the stress hormone, is under the control of ACTH from the anterior pituitary which in turn is under the control of CRH from the hypothalamus. The hypothalamus itself is affected by many things in relation to cortisol release. These include diurnal rhythms via the superchiasmatic nucleus, negative feedback as it is part of the hypothalamic-pituitary-adrenal axis (HPA axis) and of course stress stimuli, such as emotional states like fear or anxiety and physiological states like pain, fever, injury, and surgery among others. The studies I looked at measured cortisol levels but they also observed other parameters, such as heart rates and subjective feelings of anxiety.
I was intrigued to find a study that not only evaluated the effect of music on the endocrine and immune systems, but also investigated it in a more clinical context of the requirements of sedative drugs during surgery. In this case the patients either listened to instrumental music (a selection of 15 pieces ranging from Bach to Paganini) or a non-musical stimulus two hours prior to and during the operative period. IgA was not significantly different between the groups, however the results from this study did show lower cortisol levels in the music group during the intra-operative period. The difference was not due to circadian rhythm changes as the day time of surgery was matched between the two groups. The authors noted that although cortisol has an important role in helping to adapt to environmental challenges, the reduction in levels caused by music could be beneficial in terms of minimising unpleasant effects such as associated stress, worry and anxiety. Moreover, the music group also required around a lower concentration and dose of propofol by about 15% compared to the controls, thus showing that music may be helpful in lowering the sedative required to reach light sedation under regional anaesthesia 4. This was only a quick search, but it seems that over the years, research has not come to an agreement on whether or not relaxing music does in fact have significant effect on the stress hormone, cortisol, and other markers of stress. Although it could be a useful non-invasive technique to manage stress, the variation in results indicates it is more of a personal choice whether you find relaxing music to be relaxing.
1 JUSLIN P. N., and D. VĂ&#x201E;STFJĂ&#x201E;LL, Emotional responses to music: the need to consider underlying mechanisms. Behavioural and Brain Sciences. 2008. Volume 31, Issue 5, pp. 559-575. doi:10.1017/S0140525X08005293
2 KNIGHT W. and RICKARD N, Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure and heart rate in healthy males and females. Journal of Music Therapy. 2001. Volume 38, Issue 4, pp. 254272, https://doi.org/10.1093/jmt/38.4.254 3 THOMA M. V. et al., The effect of music on the human stress response. PLoS One. 2013. Volume 8, Issue 8, e70156, 10.1371/journal.pone.0070156 4 KOELSCH S. et al., Effects of music listening on cortisol levels and propofol consumption during spinal anaesthesia. Front Psychol. 2011. Volume 2, 10.3389/fpsyg.2011.00058
Beyond Medical School Yasmin King
For some of us, anything after medical school seems a lifetime away and it is the last thing we want to think about. For others, foundation applications are right around the corner. You have worked so hard to get to medical school in the first place ; getting the grades at GCSEs and Alevels (or equivalent); feeling in the way whilst shadowing at hospitals; doing countless volunteering work. Shouldnâ&#x20AC;&#x2122;t that be sufficient? Is just being a doctor not enough? Well, yes and no. If you pass all your exams, you will become a doctor and be able to practice medicine. But the more you have to make yourself stand out, the more control you will have over where you go. Even if you are thinking that you only want to apply to non-competitive locations or specialties, surely it is better to be overqualified in case you change your mind? Something that is very important to remember is to get evidence. Ask for certificates, letters, anything to prove what skills you have gained and used in everything you do. It may seem overwhelming to think about and it is important to recognise the vulnerability of being a doctor so first and foremost, find techniques that help you stay grounded and healthy, before filling up your plate with more than you can handle.
Before explaining what you can do now to make yourself stand out, I am going to do a quick run through of the post-medical school timeline. In your final year, you will apply for Foundation Programmes, which take into account your Situational Judgement Test score (50%) and your Educational Achievements (43% for medical school exams and 7% for extra degrees and publications).1 If you like research, the Academic Foundation Programme may be for you. Depending on where you go, you will either have one or two research rotations in your foundation years. You can apply for up to two AFPs alongside the normal Foundation application and will be required to attend an interview. This considers a few more things, such as prizes and distinctions. After your FP or AFP, you can either take an F3 year, or go into specialist training. An F3 can include providing health services or getting further training as a locum doctor, doing a clinical or academic fellowship, or even getting experience abroad. During your F2 year (or F3 if you decide to take one) you will apply for run-through training programmes (you only apply once for the duration of specialty training) or core training programmes (the first stage of uncoupled training which requires later application), upon which you will embark the following year, unless you take time out. It is at this point of application where additional achievements and activities are most important, due to the competitive nature of some training programmes. Many have over 6 applicants per place!2
For Foundation applications, there is not much more you can do beyond doing well for your cohort, getting a high SJT score, and having extra degrees and publications (the BMedSci counts, although to a lesser degree (pardon the pun) than other degrees). AFP application is slightly more complex, given it requires an interview. Although you require a sufficiently high SJT score to be considered, currently SJT scores are not considered in the ranking of AFP applicants.3 This puts more pressure on academic achievement and things like publications and prizes. When it comes to training programmes, there are more ways to stand out, both on paper (or rather on screen) and at interview. Many of these can be done whilst you are still a medical student! Training programmes will be looking for achievements and involvement in various areas: undergraduate education, postgraduate education, prizes and awards, presentations, teaching and leadership, and quality improvement. So, what can you do at the moment, whilst you still have a bit of free time (relatively so)?
It may seem obvious but working hard and good exam results help. You gain points for prizes, distinctions and other achievements that recognise academic excellence.4 This also includes scholarships, bursaries, and local or national prizes. More information about the prizes available can be found on the UoN website or you can ask your personal tutor. If exams are not your strong suit, do not worry as there are other ways to show your talents.
One valuable skill in medicine is communicating ideas and research to others. Therefore, there are points awarded to those who have given oral or poster presentations at local or national medical meetings and conferences. Being a significant contributor to posters is also recognised so you do not have to do your own project from scratch. Seek opportunities to present your research; whether it is your BMedSci project or research you have contributed to. Another important way of demonstrating this is through publications. PubMedcited original research or medical-related books are included in this. You do not have to be the first author to get points, so find ways to contribute and help in other peopleâ&#x20AC;&#x2122;s research.4 Similar to research communication, being able to teach is an important characteristic of a good doctor. If you can provide evidence of teaching medical students or healthcare professionals, this will enhance your application. Find ways to do tutoring or lectures for students in medicine and health sciences (e.g. society-run sessions). (Tutoring can also be a great way to fund CRISIS Wednesdays!)
Leadership is a very transferrable skill and so even nonmedical leadership or management experience is valued in these applications. If you can provide evidence of having a positive impact due to your leadership/management at a local or national level, you will stand out even more. This could even be for sports, societies, or scouting and girl guiding.
As we will all come to learn, if not already, audits and quality improvement projects are essential for effective change in clinical practice. Thus, demonstrating involvement and commitment to these gains you points, too. Once again, this requires seeking opportunities to help others with their projects and presenting or implementing the changes. Overall, the most important thing is passing exams and looking after your mental heath and well-being. If you burn out during medical school, it will just make life harder in the long run. However, if you find yourself with some extra time and energy after establishing healthy coping mechanisms and safety nets, it could be worth doing a bit more now to help your future self. The main thing to take away from this is to jump at any opportunities you get. If a lecturer offers shadowing experience, take it; maybe they are also doing a research project you can get involved in. There are so many things we can do to stand out against other applicants, and even a few bits of evidence can make a big difference. So remember to say yes to all opportunities (within reason â&#x20AC;&#x201C; we only have so many hours in the day) and collect letters/certificates/any form of evidence for everything you do; you never know what will gain you those extra points that get you the dream job!
1. UK Foundation Programme 2020 Applicantsâ&#x20AC;&#x2122; Handbook 2. 2. Pharmacology C, Sexual C. Specialty Recruitment Competition Ratios. Spec Train | NHS. 2019:65-68. https://specialtytraining.hee.nhs.uk/Portals/1/Competition Ratios 2019_1.pdf. 3. Working Across the West Midlands ACADEMIC FOUNDATION PROGRAMME 2020-APPLICANT GUIDE. 4. Application scoring. https://www.imtrecruitment.org.uk/recruitment-process/applying/applicationscoring. Accessed May 3, 2020.
"Bored in the house and I'm in the house bored" How to make the most out of lockdown Krish Shah
“I’m bored in the house and I’m in the house bored.” Never before has a TikTok seemed more relevant in my daily life. During these unprecedented times, it is harder than ever to be productive, and university work can feel like a pain. It’s very easy to binge watch every single show on Netflix, but there comes a point where the idea of spending another day on the sofa is unbearable. That’s where this article comes in.
Let’s start with three important tips to increase your productivity.
1. Have a regular daily routine This is super important so that you can keep your circadian rhythm in check. Now, I’m not saying that you have to wake up at an ungodly hour every day and start working straight away, but I would definitely recommend waking up and sleeping at a consistent time. 60
2. Have a to-do list I personally make a daily to-do list of the tasks that I wish to complete during the day. This to-do list normally includes uni work, some form of exercise and some type of hobby for the day. While uni work is of utmost importance, I think it is equally important to put a focus on your hobbies, whatever they may be.
3. Take regular breaks Studies show that an average concentration span for adult’s ranges from 2030 minutes of ultra-productive work. After this, it becomes a lot easier to be distracted. This is why I personally use and recommend the pomodoro method for most home studying. The premise of this is that you take a 5minute break for every 25 minutes of studying.
So, you’ve increased your productivity, but you’re still bored. Well, here is a short list of various different hobbies or skills you could learn during this time: • • • • • • • • •
A new workout / exercise Read a book Learn how to type faster Learn how to code Learn how to take better photos & edit photos Learn about how to invest money Start to learn a foreign language Learn to meditate Learn / improve your skills with an instrument
Stories and Views
Personal stories and views from life as a medical student Why I cannot stand pea soup. What a time to be a medical student... Passion Projects: YouTube Foundation year Medicine; Medicine for Dummies? From Law to Medicine: or how I learned to love the suffering My Instagram Revision Account A Journey A letter to the body I dissect
Why I cannot stand pea soup. Chant Navarro
Pea soup. To this day I cannot stand the taste or scent of pea soup - it has scarred me for life. New and negative emotions in a clinical setting are not uncommon. Nearly every healthcare professional has an arsenal of memorable experiences that have shaped and moulded them into who they are today, often learning from their mistakes as well as from others. Working in an environment that is inherently intimate, vulnerable and constantly changing not only alters how you perceive the world professionally, but also how you interact with others in general. Now back to the soup in question.
I was 17, bright-eyed and bushy tailed, excited and thrilled to have finally started getting clinical experience. As always, the most enthusiastic people on the wards are not the patients, nor are they the staff - but the work-experience-futurehealthcare-applicant-keeno. It was a particularly busy day on the ward and I was volunteering as a Mealtime Assistant. Dressed elegantly in a blue and green apron that could have easily been mistaken for a tablecloth upcycled into a clinical poncho, I was taking trays of food to assigned beds for lunch.
There was an elderly man, perhaps in his 80s who had ordered pea soup for his lunch. He was wearing a tunic and wasn't fussed by the hustle and bustle of the ward, nor was he paying any attention to who he was surrounded by. He couldn't speak to me, but merely gestured with his head that I should put the tray in front of him. He was hungry but lacked the ability to feed himself. I asked the head nurse what to do and she suggested that I help him eat. As I was lifting spoonfulâ&#x20AC;&#x2122;s of lukewarm pea soup to his lips and pouring it into his open mouth, I inched closer so not to spill any on his gown. This is when it happened. It wasn't until the bowl was half empty that I realised his tunic had moved below him and risen. Something under his tunic had changed. I realised that he had gained an erection whilst I was feeding him, and I caught it out of the corner of my eye immediately looking the other way. I felt the blood rush to my cheeks and palms get sweaty. The pea soup felt hot again. Why was I embarrassed? What did I do to cause this? Is pea soup really that sexy? Was it an aphrodisiac? My fight or flight mode kicked in, but frozen, I chose a new option - feed. Unable to gather my thoughts together I kept giving him spoonfulâ&#x20AC;&#x2122;s behind a stressed-out smile until a nurse saw the situation, scolded me to put the bowl down and go straight to the staff room. In hindsight, I believe she was my guardian angel, because if not for her, I believe I would have kept going.
As comical as this story may seem, there is a deeply human side to it. This man did not have the ability to control what was going on, nor did he have the capacity to stop it. Anyone in his position would have felt humiliated, uncomfortable and self-conscious. Wards in general are not the most appetising places to eat. This is not a take on hospital food, but rather the reality of the environment. People in beds next to you are coughing, wheezing, breathing through tubes or perhaps throwing up. Needles going in and out of your body, medication that makes you feel woozy and the smell of the cleaner’s disinfectant is enough to make anyone lose their appetite. However - and more importantly - losing the ability to feed yourself is a huge loss in independence. To be reliant on someone else, a stranger, to aid you in doing what you have done your whole life can knock your confidence and your pride. One patient told me that they felt infantilized, once being a CEO of a major company and now, sitting in incontinence pads unable to open a yogurt pot. To every patient, there is a person too, and they have felt every emotion that we have. Pain, fear, embarrassment, discomfort, humiliation. They put a huge amount of trust into medical students/staff and it is our responsibility to continue respecting, listening and most importantly, understanding how they feel. The hospital is the lowest point for many people, and we forget this as healthcare students, it's not just a place of work or academia in action, it is shared humanity – to be vulnerable and afraid.
This perspective was reflected to me in the nurse’s staff room after I scurried across the room with cold pea soup in my hands. I sat on the old blue leather sofa violently bouncing my leg trying to force water down my throat. The nurse who scolded me sat next to me and reassured me saying that "kid, you're not getting paid to be here" and "you don't have to do anything that makes you uncomfortable" but it was "important that you cared". Charlie Chaplin said it best: "We think too much and feel too little. More than machinery, we need humanity; more than cleverness, we need kindness and gentleness." So, may we approach our ‘shocking clinical experiences’ with kindness and gentleness, self-respect for ourselves as well as for others, and remember that pea soup may mean more to someone than what’s on the tin.
Passion Projects: YouTube Lucy Brett
Passion project = something outside of your usual work that gives you satisfaction, happiness and puts you into a state of flow; a means of escape; a contribution you make to the world I started my YouTube channel about a year ago when I was in second year. I felt that I wanted a creative space where I could both document my experience of medical school and spread a little bit of motivation and advice into the world. I remember getting my first 100 subscribers back in July and how amazing it felt to know that I was informing, motivating or entertaining 100 people for a few minutes a week. Now, I have just over 500 subscribers and am excited to work towards growing my channel further throughout lockdown and for many years to come! YouTube is an amazing creative space that we all have access to. In fact, many of my daily habits for productivity and happiness have been inspired by content creators and I like to think that such habits have shaped my life into what it is today (for example, waking up early to make the most of the morning, prioritising meditation and mindfulness, and limiting time on social media). Having gained so much from watching others, I felt passionate about giving something back to the YouTube community and giving advice and insights of my own.
YouTube allows me to get in touch with my creative side through filming and editing while talking about topics I am truly passionate about – for me this is medicine (of course!), exercise, mindfulness/meditation and productivity. I also love watching back old vlogs to relive past experiences and remind myself how far I’ve come. It’s comforting to watch my younger self revising, writing my dissertation and muddling through exams week, knowing now that the hard work paid off in the end.
My channel also allows me to create informative content to help people who might be considering medicine as a career, which is something I know I would have watched when I was going through the application process for medical school. For me, YouTube is a true passion project. It’s something I love putting time and effort into that is outside of my studies. It has also allowed me to develop so many personal skills: I have learnt how to vlog (it’s harder than it looks), how to edit (the improvement from my first video to now is actually crazy!) and how to make thumbnails. There is so much that goes on behind the scenes when maintaining a YouTube channel that your viewers never see like planning videos, coming up with new ideas each week, scheduling time to work on videos to ensure you meet your own deadlines, and battling with video editors which crash, lag and take up all the storage space on your laptop (fellow YouTubers out there, you know the struggle). But all of these things have taught me the importance of perseverance, problem solving and self-discipline and so if no one ever even watched my videos, I would still be gaining a lot from having my channel.
If you’re currently not a key worker, then lockdown is a perfect time to find or work on a passion project of your own: whether this be learning a new skill, writing a book, getting creative or starting your own YouTube channel. It doesn’t have to be something you’re amazingly good at or that you want to showcase to the world. Just something personal to you that gives you that feeling of motivation, accomplishment and, most importantly, enjoyment in these truly testing times.
Although my YouTube channel is a constant work in progress and is far from perfection, if you want some inspiration for starting your own channel or just want to watch the videos that I enjoy making then you can find my channel by searching my name. If I can add even a little bit of motivation, support or enjoyment to someone in lockdown at the moment then the time I spent putting together my videos will have been time well spent!
Foundation Year Medicine; Medicine for Dummies? Catherine Furlong
There’s a lot of stigma surrounding foundation year students. You can almost see the cogs in people’s brains turning as you spell the words out to them. A look of confusion, a moment of doubt, always ending up with a hint of pity. Don’t get me wrong, some people have reasonable responses, but sadly, the majority follow with the same old question that I’ve pretty much got down to a T by now. ‘Oh, so you didn’t make it onto the normal course?’. But I’m not here to talk about them. I’m here to debunk the myths, rumours and any assumptions that surround us and hopefully make you laugh. So, let’s begin. Unlike most courses where you’d have 300 or so students crammed into a dingy lecture hall, we were a class of 27. Feeling that we ought to get to know one another a little, our lecturer decided we were going to speed date around the classroom, trying to remember each other's names. Now it may sound like a swell idea, but 27 highly caffeinated students all talking at once? It wasn’t pretty. Like, “hi nice to meet you, let me just scream in your face for two minutes while we wait for the bell to ring and then I can repeat this 26 times over”. Possibly the worst first impression I’ve ever given. And yet somehow, I ended up making a nice circle of friends. One of the major perks of this course? You can confidently name every single one of your peers, especially with the traumatic image of a complete stranger yelling ”ALEX, LIKE THE LION” in your face well before 10am.
I hadn’t even had my second coffee yet. One of the best parts of being on the A108 course has to be the close knit group; I can say with total conviction that I was comfortable speaking with every single one of my peers. It was a rare experience for a university student, one that I feel privileged to have been a part of. I can’t talk about the Foundation Year without talking about our beloved main lecturer. He is one of those people who never fails to put a smile on your face, even when you’re at the point of pulling your hair out. Not only did he remind us consistently that we are no less intelligent or worthy of learning medicine than the students on the A100 course, but he also shared personal stories amongst the class, usually when our brains had reached full capacity and he may as well have been speaking Spanish for all we cared. Not to mention his total determination when it came to making sure we all understood a topic fully, no matter how long it took. Admittedly, I did come to regret one Friday afternoon where cis and trans isomers became the topic of conversation for a staggering 45 minutes at least. By the end of the lecture, we’d managed to confuse the lecturer himself. Safe to say we never mentioned that again.
In between lectures, a small collection of couches in the hospital cafĂŠ soon became the favoured spot to catch up on some much needed zzzâ&#x20AC;&#x2122;s. Having to commute every morning to and from Derby at as early as 7:50am really did take its toll. A few of us may have even spent more time asleep than in lectures. The hopper bus soon became a huge part of our daily lives, for better or for worse. Initially, the thought of spending close to 2 hours on a bus every single day felt like a nightmare, but as time went on, I secretly grew to love it. Not only was it a great place for a nap, but there were many last-minute cramming sessions that took place on that double decker.
Now, you may be thinking, this sounds easy, I could do this... and you may be correct. But on the contrary, we all worked extremely hard throughout the year. We had our work cut out, doing content similar to that of the biomedicine degree, not to mention the labs. Alongside the science, we also worked on our communication and professionalism skills. In many of her classes, we were lucky enough to have guest speakers who worked within healthcare. While most of the workshops run by various doctors and academics were a great success, there was one in particular that made us all look about five years old. As part of the activity, we had an actor come in and pretend to be a patient; individually, we were asked to go up and try to take a history of this patient and eventually, figure out what was wrong with them. That didnâ&#x20AC;&#x2122;t happen. What did happen was the entire class sitting in utter silence for ten minutes, flatly refusing to volunteer themselves and avoiding any and all eye contact with the lecturer. Not one of our finest moments. Let's just say that the next time this workshop was run, they chose the volunteers, not us.
Being a foundation year student at Nottingham is pretty cool. What I’ve learnt, despite what most may think, is that the A108 course is a step up, not a step down. By the time we enter the first year of the A100 course, whilst the new students joining us are bumbling around, learning to live away from home, juggling academia and clubbing, we’ve got it down. Or at least, a little bit more than your average first year. Perhaps the best advantage of all being that we have the time to figure out what societies are for us, get our extracurriculars in order so that next year, our sole focus can be on our studies.
Being human, there have been moments where I’ve yearned to be on the A100 course getting on with ‘real medicine’. And why wouldn’t I? I’m just hoping that being a couple years older really does make you wiser. But all jokes aside, hopefully this has given you a sense of what the course over at Derby is all about. And most importantly, that while we may have been blessed with an extra year of studies and arguably an easy ride, we’ve all worked our socks off the last academic year. If anything, it only gives us more to prove.
From Law to Medicine: or how I learned to love the suffering Natasha Harris
It is a truth universally acknowledged by medical students that we all love science. Biology is endlessly fascinating, chemistry is challenging but ultimately rewarding, and even physics is a necessary member of the Big Three (thanks for that, anaesthesiology!) As for me, prior to starting GEM, science had always been something to avoid at all costs. While I will admit to having enjoyed dissecting a sheep’s kidney at GCSE, A-level Biology was a whole different beast. Call me strange, but I couldn’t see myself spending the next two years of my life learning about the adaptations of the snow shoe lynx, trying to grow cheese and spending more time with a microscope than can ever be considered healthy. A-level Chemistry failed to entice me either, despite the teacher’s valiant promises that we would finally learn ‘the truth’ about electron orbits. And while I will admit to having done A-level Physics, it was only because my physics teacher enticed me by saying that there would be plenty of maths for my nerdy soul to gush over. By the time I had left school, science was the furthest thing from my mind. I was going to become a Lady Supreme Justice, study law and actually help people. Not necessarily in that order but still. If the lawyers on TV could help people, I was determined to follow in their footsteps, and I didn’t need pesky biology and chemistry to make my dreams come true.
Of course, no one had informed my dreams that I am an impressionable little thing, and that one law school assignment would be enough to change my career path for good. You see, while battling my way through criminal law, I came across forensic psychiatry, and was, quite honestly, star struck. As a forensic psychiatrist, I could have my moments of glory in court as an expert witness, work up close with prisoners that even seasoned barristers were wary of and, most importantly, be respected. Unlike lawyers, I was sure that doctors were adored by the general public - after all, didn’t doctors save lives? They were not ‘greedy’ or ‘pedantic’ or any other number of things I had heard people call law students.
So, my career was once again decided for me. My grand plan was that I would easily nab a place in medical school, graduate with a multitude of awards and publications to my name and be welcomed into psychiatry with open arms. There was just one small problem with my brilliant plan. If psychology, psychiatry, mental health or statistics were not the 'science topic of the day/discussion/textbook' I had absolutely no interest in the topic/discussion/ textbook.
However, I also had no interest in giving up on my dreams and forced myself to descend into the hell that is teaching yourself A-level biology and chemistry. Not to obtain official AQA/Edexcel/ AQA qualifications, mind you. Oh, no. I was getting to take on the GAMSAT. So, my first tip for all of you non-science/science hating grads out there is this:
Sometimes, you just have to force yourself to learn about topics you have no interest in. One of these days, you will catch yourself staring at yet another PBL learning objective that has nothing to do with your dream career. After all, you want to be a surgeon (all medical students want to be surgeons, as we all know), so why do you need to research about the importance of the role of a community nurse in the management of heart failure? Try to think about the patient for a second. Mr Jones is more than just another surgery. He is a person, with hopes, memories and dreams, dreams much like your own.
To him, the community nurse who comes to his house to titrate his medications, take his obs and check on his wellbeing is just as important as you and your pristine scrubs. When you joined GEM, you agreed that you would learn to treat the patient holistically, to see them as an autonomous being, and that includes recognising the care they receive from other healthcare professionals and having an understanding of the roles the nondoctors of the NHS have to play. Tip 2: If you need/want a cynical reason to study, just remember that any objective can be made into an MCQ or, god forbid, an MEQ. While on the subject of MEQ, some of your colleagues will love them. They will keep on getting a 5 after 5, while you sit and look at your 1s and 2s and wonder what you did wrong both in the exam and in your life in general. For the vast majority of GEM students, this is just a sad reality that you will need to adjust to. You Miss/Mr-No-Science-Wanna-Be-Surgeon will be in the same cohort as nurses with years of clinical experience, scientists with a PhD and more publications than you can name and that annoying jerk who has a degree in English Lit but somehow knows more about medicine than all the other non-science grads put together. But, I think itâ&#x20AC;&#x2122;s worth it.
My third tip would be: Stop comparing yourself to everyone and especially those in your PBL group. Everyone on the course has strengths and resilience; after all, everyone survived the GAMSAT and a tough interview to make it here.
I couldn’t compete with the pharmacy grads when it came to remembering drugs names. But medicine is about more than pharmacy. There is no other subject quite like medicine, and no one will be 100% prepared for the course to come, regardless of their background. You will find your strengths, and failing several formative exams on GEM doesn’t mean that you will fail the all important summative exams in the summer. And that annoying English Lit grad? He may ask for your help when it comes to practising for the OSCEs. My final piece of advice? When it gets too tough, remember why you applied to medical school in the first place.
For me, medical school is just another stepping stone to becoming a Dr and eventually specialising in forensic psychiatry. Every time I wanted to quit, I would remind myself that GEM was the only thing standing between myself and an BMBS. And so, I carried on working. And I’m still working.
And let me tell you, if I can make it through the 18 months of GEM and finally start CP1, so can you. But if I’m honest, I still don’t like science very much. But I have learned to roll with it and embrace the suffering, as that science will eventually get me to where I need to be.
My Instagram Revision Account Chandar Jaipal "Hey guys, its Chandar!" So, my placement is over, university is shut but we are still expected to study? I know, it sounds crazy! Who wouldn’t be tempted by the comfort of their warm duvet and the endless movies/shows you can stream at the click of a button?
With hours that turned to days and days that turned to weeks, everyone I knew lost the motivation to do any work (myself included). Naturally, I decided rather than focus on work I would attempt something else that I’ve not really done before, try my hand at making graphics. It was something I’ve always wanted to do but never had the time to get any good at, amongst the buzz of normal life. With some basic graphics software and a standard colour palate, I decided to create a cartoon version of myself. I know you’re thinking who draws themselves, but let’s be real who hasn’t done that before? I started by following some basic templates trying to see what works for me. It took a few attempts at the face, especially the shadowing and highlights but eventually I made a character that seemed to resemble me to some vague extent. It took 2 whole quarantine days in the end, but it was worth it! I would definitely recommend it to anyone especially if you have toooooooo much time on your hands, hmm…
If you know me, you will know how much I love anatomy and so I thought to combine this with my newbie graphic design skills to create more useful graphics. I started with the basic sternum anatomy which turned out decent. It was surprisingly quick and helped me revise some essential knowledge. It was a short but nice way to keep something fresh in my mind without too much effort. Making some revision card styled graphics seemed quite an interesting challenge which would be useful for both me and any other medical student. I thought Instagram would be the perfect platform because of its accessibility and format. It would prompt follower to engage with a small burst of learning amongst their daily scroll through their feed. They could quiz themselves and swipe through to reveal answers or learn something new. I started brainstorming and came up with the name of the account (@hey.its.chandar), basic format of regular posts (anatomy, jokes and casestudies) and some posts that teach small topics in bitesize pieces.
It started slowly but has now started growing in number of followers, with regular posts throughout the week targeting clinical and pre-clinical students. Iâ&#x20AC;&#x2122;ve tried to cover different topics each time, some of which have been requested by you guys, which is awesome â&#x20AC;&#x201C; I love to hear about any requests or suggestions on my content!
A Journey Text and illustration by Anjali Mehta Coming from an Indian background, society expects me to find the â&#x20AC;&#x2DC;perfect boyâ&#x20AC;&#x2122; by the age of 22, get married at 25, and have at least two children before reaching 30. At this rate, I am clearly set to disappoint.
In fact, the average age of first-time parenthood is increasing all over the world. Individuals are making more informed decisions with better sex education; the role of a woman is changing; and careers are being prioritised. I believe that these are important achievements that should be celebrated as people come together to combat the traditional stereotypes. Alongside this, however, comes the reality of increasing infertility due to people having children later in life. Today, in the UK, it is estimated that infertility affects 1 in 7 heterosexual couples, and this number is only going up. Yet, this is a topic we rarely speak about. During work experience at an IVF centre, I was shocked by the number of baby pictures and pregnant women plastered all over the walls. Although I understand that from a financial point of view it is advantageous for the clinics to share their success stories, I believe that this could be very inconsiderate of failed cycles and miscarriages. Wanting to produce something more tailored to the environment and raise awareness on this diagnosis, I decided to create my own artwork.
In order to gain a better understanding of the emotional impact of infertility, I joined various support groups online. It was beautiful to witness the sense of community present, but it also made me realise the extent to which infertility can impact one’s life. As one individual describes; ‘this has shaken up the core of who I am as a woman, and I now feel like a failure’, whilst another expresses; ‘I give up now, I really do. I just wish I had someone to talk to’. From broken relationships to financial difficulties and mental health problems, infertility can be all-consuming and no one should have to go through it alone. Researching the impact of art in a clinical setting was also very eye-opening. The largest study, "Beyond traditional treatment...establishing art as therapy," shows that the majority of patients prefer art on the walls of hospitals, instead of white, sterile walls. According to their order of preference, nature imagery top the list and have been shown to reduce stress levels, lower blood pressure and decrease the need for pain medication. Interestingly, abstract art is the least popular, as not being able to recognise the subject of the painting has been shown to increase anxiety levels in patients. Equipped with a better understanding on the subject from both a scientific and emotional perspective, I decided to use the symbol of a lotus flower for my painting for the following reasons: 1) As part of nature, the lotus corresponds with the preferred form of artwork for patients in a clinical environment. Moreover, it is the symbol of fertility and self-regeneration in Hinduism, because even when its roots are in the dirtiest waters, the lotus produces a beautiful flower. In my opinion, this is the perfect analogy: your self-worth is not dependent on your ability to conceive or not. 2) Both male and female reproductive organs are visible on a lotus, which challenges the common misconception that infertility is just a female problem. In many developing countries, there are serious issues with male acceptance of infertility, despite the fact that male factors account for 25-40% of the total cases. For too long, females have solely been held responsible and this is something I strongly believe needs to be changed through education.
3) There has been a number of studies showing an increased risk of birth defects in infants conceived using assisted reproductive technology. These findings, however, remain controversial, and the missing petals on the lotus serve as a platform to open up this debate.
4) The missing petals on the lotus illustrate both the ups and the downs of a journey through fertility treatment. It therefore provides a more realistic view of this process and doesnâ&#x20AC;&#x2122;t only limit itself to the desired outcome, unlike the images displayed by most fertility clinics. Yet, despite being incomplete, the flower remains beautiful which is an important reminder to patients, especially during the harder times. There is room for the viewer to draw their own interpretations from the painting, and I hope that it provides a platform to encourage further discussion on the topic. The bold and bright colours of the lotus serve as a reminder to speak out, raise awareness and most importantly, be compassionate - towards others and yourself. Together, we can break the taboo of infertility.
A letter to the body I dissect Text and illustration by Jessie Meyer
When I applied to medical school, the fact that I would take part in the full body dissection of a deceased individual was always in the back of my mind. But, unzipping the body bag on that harsh January morning could never have prepared me, at 18, for what it would be like to look at, and touch, someone who is no longer alive. Your nails are painted pink, the indentation of a wedding ring encircling your cold finger, and the first session we had, I could have sworn I saw your hand move. As atheist as I am, for a moment you made me question everything I feel about faith and, even now, I marvel at the psychological effect seeing you has upon me. I half expect you to sit up and look shocked, even with half of your face cut out, no brain.
As my scalpel blade cuts the skin of your face, I watch the deterioration of your body from something so human to just a collection of bones, muscle, fat. I trace your wrinkles, touch your still soft skin. How many times have you laughed in life? What was your favourite mascara brand? When was the last time you cried? I fight the urge to put you back together when I cut you. I want to stitch you up and make you whole once more, and feel so destructive when I dehumanise you even further. But you will never heal: you will never move again, or talk, or laugh. When I am with you, my peers and I will make small talk as we dissect. Some people have developed a dark sense of humour to help them through. Like everything though, it helps us learn. If doctors are too emotionallly invested, they burn out. Not enough, and they come off callous and insensitive. For me, this is the same: if I think too hard about your life , the fact you were my age once, it becomes too hard for me to bear. But I hold a great respect regardless. Medicine is a balance, and everyone in healthcare must walk the line. This is, yet again, something you teach me.
Anatomy is one of the hardest things I study. But, you make it so much easier. Being able to discover the organs within you helps reinforce their structure, function and location. I shuddered when I first picked up the bone saw, but you told me not to be afraid. You made me a better medical student, and you will make me a better doctor. You gave me the greatest gift you could, and I will remember you forever. Thank you.
Creatives
10 Reasons not to date a medical student Text: Nic Miller/ Illustrations: Yasmin King As someone who has dated a few medical students before being one, here’s my honest advice of why not to…
1) They love to ask questions- open questions, closed questions, intimate questions… you’ll never stop being asked questions. You’ll also probably therefore never have a secret. 2) You’ll probably end up with a neck injury from nodding along to pretending to understand all the acronyms and other words that you’ve never heard before. But at least they can fix that injury, right? 3) Wrong… legally anyway. They’ll be able to tell you all (or most) of the things that are wrong with you, but you’ll still have to go to a doctor to get it fixed. 4) They’ll probably seem perpetually more attractive than you without explanation. How do they do it? What secrets are they teaching them at the med school? Does the title medic immediately confer a filter on them?
5) They don’t really understand personal space anymore, they’ve seen a lot. Like, a LOT.
6) They’re really bad at replying to the point of making you have to ultimately reflect on your immense neediness. (That sounded less bitter in my head…) 7) Cold hands. Doctors always have cold hands, right? They develop them at medical school. I’m sure you can imagine why that’s annoying… handshakes and all that.
8) Every 3 days they’re going to selfdiagnose with a new disease they just learned about (Because they have 1 similar vague symptom). That’ll probably expand to you too. Feeling tired? Oh, it’s a lot more than just feeling tired now. 9) Nothing you say at a party will ever beat their stories. They have them all, a dramatic story, a gross story, an emotional story… they also have no filter sometimes though, so watch out for that. 10) Once you let your parents know you’re dating a medic, you better be planning on dating an Olympic athlete next because they will never let you live down not marrying a doctor.
Trust me!
A step-by-step drawing process
Minnan Al-Khafaji, in memory of her grandmother, Radhiya Al-Khafaji
Jake Wilkinson
Derby Anatomy Art Society
Derby Anatomy Art Society
Derby Anatomy Art Society
Derby Anatomy Art Society To be involved with DAAS, join the mailing list by emailing mzycb16 or mzyjp14
Jessie Meyer
Nhi Dang
Issy Walker
Anjali Mehta
Megan Battenfield
Joe Kirk
Aviv Ginsberg
Claire Read
Eleri Clarke
Arthur Joustra
Danni Cooper