December 2014

theMEDICALSTUDENT

December 2014

The voice of London's Medical Students/www.themedicalstudent.co.uk

Another Jeremy Hunt Gaff?

World Aids Day

What has he done this time? - page 4 We chat with a Patient- page 6

War and Peace

Modern world isn’t peaceful - page 8

Who Rowed to Victory?

Reports on UH Rowing - page 18

Will you be Prepared?

Krishna Dayalji News Editor

According to a recent report published by the General Medical Council (GMC), which included data from the 2014 National Training Survey (which is compulsory for all doctors in training to complete), the Foundation year doctors of today believed they are ‘better prepared’ than previous cohorts.

So you’re an ‘off-the-shelf’ medical student and you’re reading this newspaper because your smart phone has run of battery and you need to be entertained whilst eating your lunch. So whilst you have nothing better to do, imagine yourself on the first day of your new posting as a foundation doctor.

Do you feel prepared for your first post? Do you feel the skills you have gained from medical school set up for the job? You would hope so right! But correct me if I’m wrong, the entire task seems extremely daunting!

In the survey, the percentage of those disagreeing with the statement, “Do you feel that you were adequately prepared for your first foundation post?” fell from 34% in 2009 to 24% in 2011. Following a modification of the question,the 2014 survey found that 70% of doctors either agreed or strongly agreed to a different statement of “I was prepared for my first foundation post”, and with 75% of doctors either agreeing/strongly agreeing with the statement: “The skills I learned at medical school set me up well for working as a foundation doctor.”

Whether this change in perception of preparedness has

risen as a result of the change in question is difficult to ascertain, however the report believes that this rise may be a direct result of the introduction of the revised version of Tomorrow’s Doctors in 2009, which is ‘substantially different from its predecessor, setting out clear competences required of medical school graduates and introducing student assistantships’.

Why is this important to me I hear you ask? Well, how well

you are prepared for that first posting is a good reflection of how well medical schools are training up their medical graduates. Despite the considerable variation in the way all 33 medical schools assessed students’ progress, the review showed that they were all delivering assessments in line with the standards set out in ‘Tomorrow’s Doctors’.

Yet, self-perceptions of preparedness varied across medi-

cal schools. The proportion of graduates who felt adequately prepared varied from 60% to 85%, with 60-70% of graduates feeling prepared for 17 medical schools. Interestingly, ranking the highest in preparedness and skill set was University of East Anglia (85% and 97% respectively), in comparison to University of Cambridge (60% and 62%, respectively), which ranked the lowest.

This may also reflect the

wide variations across medical schools in what specialty their graduates train after they complete their foundation training.

For example, Oxford and Cambridge medical students have a higher proportion of graduates becoming physicians or surgeons, whereas other schools produce a higher percentage of GPs. And additionally, despite the fall in the percentage that felt they were forced to cope with clinical problems beyond their competence/experience from 51% in 2009 to 31% in 2014, the percentage remains high. The report attributed this to the inevitability of F1 doctors having to deal with the unexpected, and went further to describe it as a ‘valuable learning experience’ following a good followup and debrief. Nevertheless, it does reflect a reduction in the risk posed to patients.

And of more concern to us further down the line in our medical careers, weaker evidence found that those who felt less prepared for their first posting were more likely to receive unsatisfactory outcomes in their Annual Review of Competence Progression (all doctors in training need at least one a year to ensure they are making progress as they should).

But the true assessment of how well foundation doctors are at their jobs will be in finding out what other members of the multi-disciplinary team feel about the competences and preparedness of their junior doctors. As one can imagine this may also vary between trusts and individuals, some of who [Continued on page 2]

[NEWS]

theMEDICALSTUDENT / December 2014 News Editors: Krishna Dayalji news@themedicalstudent.co.uk

Awaiting Christmas

[EDITOR’S LETTER]

We are exasperatingly close to christmas, the time of year where we can finally put our feet up, then feed up, before doing it all again with the leftovers the following evening. For some this is the first university holiday, the first time back since they made the leap into medical school, but for others, myself included, we are seasoned professionals at the train journeys back to whence we came.

For me, the minutes spent on national rail platforms surrounded by gifts for the family -cheaper each year- are a strange state of limbo, not at university but not too at home. They are the airlocks between the two.

In a way this is how it feels to be a medical student in the final two years of the degree. On the one hand we have acquired some skills and knowledge and some may even dare to say a sprinkling of ability. On the other, we haven’t quite shaken off the cloying cloak of ineptitude. Yet it seems, according to a recent survey, that once we arrive at our foundation year jobs we are more than likely to feel equipped enough to deal with their unpredictability and the trend is for this confidence to [Continued from page 1]

Editorial Staff Editor-in-Chief / Rob Cleaver News Editor / Krishna Dayalji Features Editor / Anne Tan & Hygin Fernandez Comment Editor / Oscar To Culture Editors / John Park & Katy Bettany Doctors’ Mess Editor / Narmadha Kalai Vanan Sport Editor / Mitul Patel Treasurer / James Orr

Contributors Dominique Rouse, Monica Krivchevska, Zeena Aribou, Rhys Davies, Irem Ishlek, Batool Wali, Matt Harling, Frederick Stourton, Rustam Karanjia & Sophie Legg

may have some interesting tales to tell! The Shape of Training review which took place in 2012-2013, found that some employers found a lack of professionalism and essential skills in the foundation doctors, with employers claiming that they had to re-teach basic skills as part of the postgraduate training.

As for how prepared we will be when our time arrives, the introduction of student assistantships and the prescribing safety assessment (a pass/fail assessment of final-year medical students’ skills, judgment and supporting knowledge related to prescribing medicines), have both been introduced to improve our preparedness to practice.

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creep steadily skyward.

So my confidence may be increasing but I am finding it ever harder to concentrate in clinic, I flit in and out like christmas shoppers in the doorways of packed Oxford Street flagships.

I am already listening to christmas songs against my better judgement and my dreams are of filled stockings and mince pies. Christmas for me is about celebrating family and friends and the togetherness that that all brings. In recent years Christmas may have become a commercial behemoth but it is one that I greedily and gleefully partake in. Believe me, I don’t need any extra excuses to get the cranberry sauce out of the cupboard!

This is also the time of year where we begin to make plans for the next one - in between gorging on advent calendar chocolate of course. So many of us robotically follow routine and sign up for a gym membership just like they have every January since 2004. Others take stock and task themselves with making real change. Of the latter, there will be doctors making the trip to West Africa to help contain and treat the ebola epidemic and to them we wish them good luck and good

health. To the former, we congratulate their good intentions even if their execution leaves a little to be desired.

Though I say it in every issue, the December edition of TMS is another great read. We have some great news regarding the funds raised by the Movember campaign, another brilliant display of bumbling parliamentary buffoonery from Jeremy Hunt and a great read regarding the importance of peace; both in global conflicts and in the clinical setting. As ever we have updates from the sports world regarding the healthy competition of UH rowing and UH rugby and Rhys Davies once again opens the door at St. Elsewheres in his Diary of an FY1.

From January these editorial letters will be revamped, restyled and published online on the website at greater frequency. Every fortnight I’ll be writing a little update about our ongoing content and events as we switch to a central website format. Don’t forget to follow us on Twitter and add us on Facebook too for discussion of our breaking news!

Thanks for reading this terrific TMS issue and I wish you all a Merry, merry Christmas and a cracking new year!

Areas where we are lacking competencies continue to include prescribing, but also reporting risks to patients’ safety and communicating effectively with patients.

Admittedly, much of this needs to be delivered by our respective medical schools through the core curriculum, but it does make one wonder if interpersonal skills are also a contributing factor.

Uncontrollable characteristics of foundation doctors were also found to potentially affect preparedness of a foundation doctor. These included ethnicity and age being contributing factors.

Medical education begins from the point of recruitment in to medical schools, and continues throughout a doctor’s career. And one of the first major tests of the education process is

when the student emerges from medical school to take on their first post as a provisionally registered doctor in foundation training, hence why this report is particularly interesting.

The report, titled ‘The state of medical education and practice in the UK: 2014” aims to use GMC data to provide a picture of the medical profession in the UK, to identify some of the challenges it faces, and to promote discussion and debate about some of the practical steps that can be implemented to better support doctors and improve patient care.

The full report can be found here: http://www.gmc-uk.org/SoMEP_ chapter_3.pdf_58053779.pdf

Write for Us!

If you have an idea for an article, big or small, don’t hesitate to contact us: news@themedicalstudent.co.uk

[NEWS]

theMEDICALSTUDENT / December 2014 News Editors: Krishna Dayalji news@themedicalstudent.co.uk

Steve Tran & Mohammed Amer Medgroup Chairs Welcome to the December edition of TMS! Following on from the successes of 999 and the Right to play UH sports night, the next pan-London rivalry will have to wait till the new year as we begin our patient excitement for the UH-revue. Meanwhile, UH teams continue to clash in epic performances on a number of different battlefields (flick to the back page for more!).

Last committee meeting we discussed a number of issues each union were having, and talked at length on the topic of NHS Bursaries, and will be circulating a short survey round to you via your SU. If you are concerned about your NHS bursary, or student loan, contact your Students’ Union Welfare officer.

Our next UH Medgroup committee meeting will have the special topic of ‘Medical School Identity’, so if you have anything to say on the matter or any pressing issues, don’t hesitate to contact your SU President to pass on your thoughts and ideas!

Adam Mayers GKT President Season’s Greetings from GKT! This month has been a big one for us at GKT, with a truly amazing Christmas Comedy Revue, packing out the Greenwood Theatre with laughs (and some tears of joy and/or embarrassment) for three fantastic nights and raising a huge amount for RAG. We can’t wait to showcase our comedic talent at the UH Revue in 2015!

We’ve also had SJT workshops, Electives evenings and wine tastings aplenty. The most exciting event this month however was probably hosting the most recent United Hospitals MedGroup committee meeting at GKT favourite, the legendary Café Nawaz… and almost all of them are allowed back!

Rounding out the rest of this term, we are currently looking forward to new and exciting MSA Question Time with some great, and controversial, speakers, the triumphant return at Christmas dinner, and the ever-wonderful Jingle RAG and Xmas party/post-SJT debauchery.

Merry Christmas everyone!

Alex Fleming RUMS President As we move into the last few weeks of term, RUMS looks forward to the return of several of its most festive events. Next week will see RUMS students descend on the West End for the RUMS Winter Ball (now with a Masquerade theme!), followed next Wednesday by one of the highlights of the RUMS sporting calendar: The Bill Smith’s Cup. Played between the rugby freshers and second years, this annual match commemorates the late Professor Bill Smith of the Middlesex. With just over a week to go, both teams are already vying for the crucial psychological social media victory.

Otherwise, the RUMS Welfare team has been busy putting together a series of events including our “Supporting Supporters” and “Look after your mate” workshops, where students can learn about how to support those facing mental health issues. RUMS would like to wish Merry Christmas to everybody (and good luck to the final years everywhere taking SJTs in December), and we’re looking forward to seeing everybody back in the New Year (and don’t forget that the Naked Calendar shoot is already pencilled in for 14th January)!

Dheemal Patel SGUL President These few weeks have been very busy. The performing season has kicked off and students and staff enjoyed the Diwali Show, followed by Revue’s seasonal Christmas Show. We have also had year rep elections and elected our new year 1 reps. I hope you all have a wonderful Christmas and a happy new year!

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Dariush Hassanzadeh-Baboli ICSM President Well first term has really got started proper since I sat down last time to write my last report. The ideal world of Freshers’ fortnight had to end and now the trials and tribulations of medical school life have begun to arise. Has the fun gone? Certainly not! We hosted a fantastic Arts’ Dinner at Ruby Blue with a record number of attendees. We are now looking forward to the Snow Ball 2014 in Chelsea Harbour hotel, already a sold out event!

Our students have been busy beyond their studies.

I hope some of the students from other schools were able to enjoy the Trauma weekend, hosted by our Surgical Society, which saw the medical corps come and display their sleek trauma protocols. Many of our students were involved in National Islamic Charity Week raising an impressive £83,401!

I’d like to thank the other medical schools for the participation and uptake of the finance survey. Our Welfare Officer, Jenny Watson, is making fantastic progress. I really hope we can change this for future years and ease the financial burden students are put under. Perhaps a special spread in TMS would send the message out loud and clear *cough *cough.

Sam Rowles BLSA President November has been a bumper month at Barts and The London, with far more events, talks and socials than is humanly possible to attend! One of the real stand out events was Barts and The London Asian Society’s event with Jay Sean, one of our more famous recent scholars!

The drama society has also been very active, with the older years first putting on the Senior Play, and then being shown up by the Freshers a few weeks later in the Freshers’ Play! The sketch society, a semi-autonomous branch of the drama society, then brought all the amateur dramatics to a close with an extremely witty and entertaining performance to a sold-out crowd at the end of the month. Critical reviews afterwards of “The funniest thing I have ever seen. Ever.” may have been slightly overselling it, but it was thoroughly enjoyable nonetheless.

RAG has also started up for the year, with our first “RAG Raid” to Brighton going very well, and bringing about a nice start to the year and setting the bar high for what will hopefully be another bumper year!

Finally, we will be hosting Comedy Central once more for another evening of stand-up comedy and then the great big Christmas quiz before we regrettably all part ways for the holidays!

[NEWS]

theMEDICALSTUDENT / December 2014 News Editors: Krishna Dayalji news@themedicalstudent.co.uk

The Fruits of Movember

Finalist Medical Students thrown Lifeline Krishna Dayalji News Editor

Krishna Dayalji News Editor Funds raised by men who change their appearance through the growth of a new moustache for the 30 days of November as part of the global movement called Movember have helped open new centres for prostate cancer research.

This September saw the launch of the Movember Centres of Excellence in bringing together the partnership between Movember and Prostate Cancer UK. The centre, despite not being an actual building, is a virtual concept – bringing together the minds, skills, talents and resources of existing facilities. With scientists working across disciplines, it is hoped that better results will be achieved that if they all worked independently.

The ‘research-hubs’ based in Belfast-Manchester and London, will bring together leading scientists and clinicians from varying backgrounds to address the big questions in prostate cancer research as part of a structured research programme, whilst also providing a world-class training ground for future scientists to continue with the research into prostate cancer.

The centre in London involves scientists and clinicians based at Imperial College London, University College London, the Institute of Cancer Research and the Royal Marsden Hospital, all of who will focus on identifying the genetic basis of prostate cancer. In particular, the search is for ‘gene signatures’ that can be used to identify men at a high risk of aggressive disease and to optimise treatment choices based on individual genetic infor-

mation. The overall aim is to deliver novel biomarkers that will transform prostate cancer medicine.

Higher up in the country, the joint Belfast-Manchester centre will be working on refining new and existing treatments to improve effectiveness in advanced prostate cancer.

Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year. It is hoped that these new centres will significantly boost the impact and progress of prostate cancer research and make a real life difference to men with prostate cancer, with all members of the team committing to at least five years of research.

So those of you handsome men who grew their moustaches, (feeble or strong attempts), give yourselves a pat on the back!

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Following the oversubscription news that we published in our last edition, the UK Foundation Programme Office (UKFPO) have now confirmed that those students who score exceptionally low in their Situational Judgement Test (SJT) will have their applications reviewed, including a face to face review.

Last year was the first year that this new process was rolled out. It enabled applicants to prove that they met all the requirements of the national foundation programme, without which GMC registration cannot be granted. This process has now been finalised for the both the Foundation and Academic Foundation Programmes 2015.

For those out of the loop, the SJT is a multiple-choice exam that requires applicants to use their judgement about what is effective behaviour in a workrelevant situation, replacing the previous ‘white-space’ questions. It is used in combination with the Educational Performance Measure (including medical school performance, additional degrees and publications) whether one meets the national person specification of a Foundation doctor.

This finalisation follows intense lobbying from the BMA Medical Students Committee.

Those students who are considered ‘satisfactory’ following the review will be added to the reserve list with the applications reinstated.

Further details will be sent to unsuccessful applicants on 5 March 2015.

Yet Another Schoolboy Error from Jeremy Hunt Krishna Dayalji News Editor Health secretary, Jeremy Hunt, has been accused of contradicting NHS advice after admitting that he took his children to A&E because he didn’t want to wait for GP appointment.

Whilst answering Conservative MP Lorraine Fullbrook’s question on improving access to GP surgeries in the House of Commons, Mr. Hunt admitted that he didn’t want to wait!

In his defence, Mr Hunt argued that his actions proved the need for a 7-day GP opening to relieve the overburdening pressure in A&E departments. And he further defended his actions by adding it is acceptable to bypass the GP if people do not know whether the care they

need is urgent of an emergency.

However, his critiques have questioned his responsibility as a health secretary, saying that he is contradicting the NHS advice, which he has previously been seen advocating.

The NHS advises that unless there is a ‘life-threatening emergency’ (e.g. severe blood loss, unconsciousness or difficulty breathing), that patients are encouraged to use GP appointments, out-of-hours services, and walk-in clinics, rather than overload hospitals.

Prime Minister, David Cameron, defended the Health Secretary, by adding that whilst Mr. Hunt was not giving advice, he describes an un-uniform challenge around accessing GPs that can have knock-on consequences for A&E departments before going to say what the

government is doing in terms of increasing access to GP services for the general public.

Yet, when challenged by Shadow health secretary Andy Burnham on his statement over social media website Twitter, Mr Hunt added “If parents have an unwell child needing medical attention, A&E provided a trusted service.” In response Burnham said: “If all ‘unwell people went to A&E, NHS would collapse. Surprise you continure to contradict official advice. Irresponsible.”

This entire debate comes amid the failure of the NHS to publish its weekly ‘winter pressure situation report’, with more emergency admission to English hospitals in the second week of November than in any week in NHS history, and performance against the target to

treat or admit 95% of patient within four hours deteriorating.

What are you opinions on

this matter? Send us your thoughts to news@themedicalstudent.co.uk

theMEDICALSTUDENT / December 2014 News Editors: Krishna Dayalji news@themedicalstudent.co.uk

Research In Brief ST GEORGE’S, UNIVERSITY OF LONDON New research by specialists at St George’s have found that cannabis extract can have dramatic effects on brain cancer, such that when certain parts of cannabis are used to treat cancer tumours alongside radiotherapy treatment, the growths can virtually disappear! It was found that the most effective treatment was to combine active chemical components of the cannabis plant, which are called cannabinoids. The research team are discussing the possibility of combining cannabinoids with irradiation in a human clinical trial. Brain cancer claims the lives of about 5,200 people each year, and has a poor prognosis (five-year survival 10%).

KINGS COLLEGE LONDON According to research carried out by KCL and LSE, UK student use of smart drugs – those drugs enhancing cognitive function and performance – are not as prevalent as previously claimed, with the majority of students surveyed being unaware of them, or uninterested in use. Also known as ‘pharmacological cognitive enhancement’ (PCEs), were more likely to be taken by British male students approaching the end of their undergraduate exam. Use may in prevalent in certain groups perhaps due to internal or external peer pressure. More research into smart drug use and efficacy, with better education of students has been suggested.

UNIVERSITY COLLEGE LONDON A majority of obese people in Britain would not describe themselves as ‘obese’, and many would not even describe themselves as ‘very overweight’, according to research led by UCL and Cancer Research UK. In one of the first studies to examine British perceptions of obesity, fewer than 10 per cent of those who are clinically obsess accept they have a serious weight problem. The survey included 2,000 adults. Researchers suggest that as bigger sizes become the new ‘normal’, people are less likely to recognise the health problems associated with their weight. Around 18,000 cases of cancer in the UK each year are linked to being overweight or obese. The paper suggests that health professionals need to establish better ways to address this sensitive subject and communicate with people whose health would benefit from positive lifestyle changes.

IMPERIAL COLLEGE LONDON Some studies on the relationship between microbes and human health may be producing incorrect results due to lab contamination, according to a study carried out by researchers at ICL. It was found that the source of contamination came from the DNA extraction kits that were being used to analyse the microbes. Whilst some samples contain a large number of microbes, e.g. faecal samples, which are likely to overcome the effects of contaminants, there are other samples that contain fewer microbes, e.g. spinal fluid, where contamination is more likely to be an issue. They suggest the problem can be overcome with good controls and experimental design.

BARTS AND THE LONDON, SCHOOL OF MEDICINE AND DENTISTRY 1 in 6 women who have large tissue removal (more than 15mm in depth) during colposcopy, to treat abnormal cells on the cervix, will go on to have a remature birth, according to new research published in the BMJ. This is the first study to determine a similar risk of premature birth among women who had smaller amounts of tissue removed and those not treated at colposcopy. As result this research has finally determined where the risk lies and where it doesn’t. The majority of women attending colposcopy will either have a diagnostic sample taken or a small amount of tissue removed, therefore have no additional risk of having a premature birth.

[NEWS]

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‘Promising’ Ebola vaccine after first human trial Krishna Dayalji News Editor An experimental Ebola vaccine designed to boost the immune system’s production of antibiotics has produced positive results following its first human trial in the USA. The trial, which took place at the US National Institutes of Health (NIH), involved the immunisation of twenty volunteers. Whilst this is an early Phase One trial, the NIH described the results as ‘promising’ with all participants producing antibodies and no one suffering any major side effects.

Two participants spiked high fevers, which subsequently disappeared within a day.

Published in the New England Journal of Medicine, it describes the trial as follow: Half of the participants received a higher-dose shot, and subsequently produced more antibodies. Researchers found that seven of the high-dose and two of the low dose volunteers initiated a T-cell immune response, thought to be very important in protecting oneself against the virus.

Produced by GlaxoSmithKline, the vaccine used a genetically engineered chimpanzee cold virus (adenovirus) to carry the non-infectious Ebola protein on its surface. As it unethical to vaccinate and then expose volunteers to the Ebola virus purposefully, the trial is designed to observe the im-

mune response and safety of the vaccine.

Dr Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases said: “The unprecedented scale of the current Ebola outbreak in West Africa has intensified efforts to develop safe and effective vaccines.”

He added that the vaccine under development “may play a role in bringing this epidemic to an end and undoubtedly will be critically important in preventing future large outbreaks”.

“Based on these positive results from the first human trial of this candidate vaccine, we are continuing our accelerated plan for larger trials to determine if the vaccine is efficacious in preventing Ebola infection.”

Four other trials of this same vaccine after currently underway in Oxford, Mali and Switzerland. If further results are all positive, thousands of volunteers includes healthcare workings, will be vaccinated in early 2015 in Liberia and Sierra Leone and possible also Guinea. However, it is unclear how long the protection will last. The aim of the vaccine-race is to develop a vaccine that will protect against future outbreaks.

The World Health Organisation quote that 15,935 cases have been reported of Ebola virus disease (EVD), with 5,689 reported deaths. Many cases will not have been reported, with these figures being a large underestimation.

theMEDICALSTUDENT / December 2014

Features Editors: Anne Tan & Hygin Fernandez features@themedicalstudent.co.uk

[FEATURES] /6

HIV Need Not Stop You Anne Tan Features Editor

Christopher Sandford, 67, is an Elite Controller.

This means he is part of an extremely rare group of Human Immunodeficiency Virus (HIV) positive patients whose immune systems can keep viral loads low without anti-retroviral treatment. Sandford has a mutation on the HIV’s co-receptor on the White Blood Cell (WBC), the Co-Chemokine Receptor 5 (CCR5). This mutation has allowed Sandford to be one of the few HIV positive patients diagnosed in 1984 who are still alive today.

1984 is a significant year because, on 23rd April, Dr Robert Gallo and his colleagues first revealed the test for the retrovirus that was causing the Acquired Immunodeficiency Syndrome (AIDS). Despite being diagnosed in 1984, Sandford believes he must have been carrying the virus prior to the diagnosis.

Doctors gave him just two years to live.

When asked how he coped with his diagnosis, Sandford replied that he was too busy caring for his partner, Robert, to give much thought to his own diagnosis. He remembers all too well the discrimination they faced, as well as the hopelessness.

‘Doctors and dentists refused to treat you. They refused to deliver meals to your hospital bedside. Cleaners refused to clean the room to which you were banished because you were not wanted on the ward.

We explored alternative therapies. We tried yoga, meditation… we imported anything that was rumoured to work.’

Sadly Robert, without effective treatment or a mutation on his WBC, passed away in 1987. Sandford remembers very poignantly how easy it was to carry the cachectic and weightless Robert round the house when they brought him home for his last Christmas. He would go on to lose his subsequent partner, Michael, in 1996 to AIDS as well.

Sandford remembers the

AIDS ‘Tombstone’ infomercials. He remembers the fear, the way people treated him like a modern day leper. He is a man who has endured discrimination, suffering and tragic loss.

It would be easy to expect such a man to be withdrawn, bitter and angry with the world.

No one would blame him if he were. However, Sandford is far from any of those things. He exudes a kind of buoyant energy that immediately warms you to him.

Involved in AIDS activism since the beginning, he spoke to me about the support group he set up for HIV positive patients in 1989: ‘we joined drug tri-

als - and cried when the results were so appallingly negative.

We educated and fought for benefits and rights... We started charities, support groups, political pressure groups; went

on marches, lobbied, started financial and legal advice centres, drop in centres, specialist wards with sympathetic nurses and doctors’.

After a successful career in the theatre, both as a director and then subsequently as vice principal of a drama college, Sandford continues to serve the HIV community by working as a Patient Representative at the Bloomsbury Sexual Health clinic offering ‘peer support, advice and advocacy’ to HIV positive patients.

Sandford shared with me that even today, most patients who get a new diagnosis of HIV are upset.

‘They are usually in tears when they come to our office.

I think it is really powerful just for me to shake their hand and say: I too am a HIV patient.’

He says a big part of their job is ‘contextualising the illness’ for patients, clarifying that a HIV diagnosis is no longer a death sentence. He draws the comparison between HIV treatment, which is one to two pills/ day, and daily insulin injections for Diabetic patients. They also give counselling on how to break the news of your diagnosis to your family and partner.

He feels that the main obstacle is that people are afraid to be rejected by their partner and that they will be accused of infidelity. He usually reassures patients that in his experience that has not yet happened.

With an office next to the main reception, patients are free to make an appointment or

simply pop in to see them. They also run Newly Diagnosed Courses which not only provide information but also act as a support network for people.

The Patient Representative scheme was initiated at the Bloomsbury clinic by a previous patient, who has since left.

It was set up in recognition of the fact that engaging patients is sometimes challenging and that the work they do could greatly complement healthcare professionals. With such a holistic approach to care, it is not surprising that 97% of HIV patients at the Bloomsbury clinic have undetectable viral loads.

This figure is significantly

above the UK national average of 67%.

When I asked if he enjoyed working so closely with doctors, Sandford was incredibly positive. He felt that in the past

when there were ‘no drugs and no answers’ that consultations were not ‘didactic’. Instead there was a lot of collaboration between doctors and patients, with each patient being treated like an ‘experiment’. He reminisced about the camaraderie he felt with doctors in the early days when the media was only full of negative and depressing images of AIDS. He said it really touched him to see how hard doctors fought to bring up standards of care for HIV patients and how ‘cut up’ doctors would be when a patient passed away.

I was really glad and comforted to hear that despite all the discrimination he experienced from healthcare professionals that he still felt his overall experience was a good one!

Although, I have a feeling this positivity may have more to do with his infectious energy and upbeat attitude. This is not to say that he is unaware of the flaws in the system but rather that he would choose to focus on constructive criticisms that bring tangible change.

It was overwhelming to meet Christopher Sandford. He is a special man. Special not because a genetic mutation has granted him immunity to HIV. Special because he has chosen to spend his life converting the suffering he experienced at the hands of HIV into a blessing by serving others.

He is a man who lives the advice he gives to the newly diagnosed patients he sees: ‘HIV need not stop you.’

[FEATURES] /7 An Interview with a Sexual Health Doctor - Dr. Jonathan Cartledge theMEDICALSTUDENT / December 2014

Features Editor: Anne Tan & Hygin Fernandez features@themedicalstudent.co.uk

Anne Tan Features Editor

I was a bit nervous before interviewing Dr Cartledge. This was because aside from being a Sexual Health Consultant Physician, he is also the Academic Lead for Year 5 medical students at University College London. Truth be told, he had already called me out for falling asleep in a lecture earlier this year. Luckily it was a phone interview and he would not have the chance to recognise me!

Perhaps because I have only known Dr Cartledge as the ‘Academic Lead’ who monitors my attendance, in my mind he was an impersonal member of the medical school machinery.

After listening to the answer he gave to my first question, my preconceptions were quickly put aside. I realised that he was a rather noble doctor, who was brave in ways I am not yet able to be.

The first question that I asked was why he became a Sexual Health doctor. Everyone is always asking us what kind of doctors we want to be when we ‘grow up’ so it seemed a tame enough question. The answer he gave, however, was far from tame. He pinpoints his decision to taking care of a HIV (Human Immunodeficiency Virus) positive patient in the late 1980s.

He spoke about how in those days there were no effective treatments for HIV, which meant that people of a similar age to him were dying. He said it was ‘upsetting (for the patients) on a psychological and physical level’ and that really distressed him. Upsetting on a psychological level, not just because they were dying but also because they were stigmatised by everyone - family, friends and even medical professionals. In those days HIV was a mysterious deadly virus with no known mode of infection, the fear and uncertainty that surrounded the diagnosis made the HIV patient an outcast.

Doctors were afraid to treat HIV positive patients partly

due to fear of being infected and partly because they did not want to become known as the ‘HIV doctor’. They were afraid that once they started treating HIV positive patients, and began to gain experience in managing them, that more and more would be referred to them. It seemed that most doctors did not want their waiting rooms full with the types of people that were at risk of being infected by HIV. HIV was stigmatised then, as it is (hopefully to a lesser extent) today, because it is perceived by some to be connected with certain groups, namely intravenous drug users, men who have sex with men and immigrants from more prevalent countries.

Dr Cartledge feels that these members of society are no less worthy of care than others and did not find this stigma to be an obstacle when deciding to be a Sexual Health doctor. When I questioned him about whether or not he had feared being infected, he replied saying that he felt it was his ‘duty as a doctor’ not to let the fear of infection prevent treatment of patients.

Moving away from the past, we discussed what HIV is like in a clinic today. To him, despite the many advances in drugs,

the impact of a HIV positive diagnosis on patients today is the same as it was before.

‘The impact (a HIV diagnosis has) on people’s relationships and their psychological wellbeing is the same, even if we can offer them much more physically.’

Ignorance seems to be the biggest stumbling block to acceptance. Patients and their families may still think that a HIV diagnosis is synonymous with a death sentence. However, this is not the case anymore with effective drugs that can keep the HIV viral load low.

A HIV positive patient today is unlikely to die of Acquired Immunodeficiency Syndrome (AIDS). In fact a HIV positive patient, who is adherent to the appropriate drug regime, can have a normal life expectancy.

With anti-retroviral treatments in place one would expect HIV to be in the decline, however HIV is still the leading infectious cause for death worldwide and we are still living in a HIV pandemic. Some have argued that the strategy of prescribing treatment to the diagnosed is simply firefighting and that prevention is still better than a cure. In order for preventative measures to

work, healthcare professionals need to be more proactive in discussing sexual health with patients, suggesting simple lifestyle changes and offering HIV testing.

‘In the UK too few people know that they are positive, ¼ of HIV positive patients are undiagnosed. Healthcare professionals are not good at offering a HIV test. We fear patients think they are being stigmatised, we fear we don’t have the answer to their questions. Most people you offer the test to will agree to be tested.’

Dr Cartledge quotes the recommendations set out by the British HIV Association (BHIVA), British Infection Society and British Association for Sexual Health and HIV (BASHH) in 2008, regarding the need to test all new admissions to hospital and new patients registering at a General Practice surgery for HIV in parts of the UK like London where the prevalence of HIV exceeds 2 per 1000. He laments that these recommendations are not well carried out in most places due to the lack of infrastructure and funding and argues that the Department of Health needs to provide financial incentives to healthcare providers to ensure they prioritise HIV testing.

However he does acknowledge

that opt - out testing is carried out successfully in particular settings and these should serve as positive evidence for the efficacy of the measure. Examples of these settings include antenatal, lymphoma, hepatitis and tuberculosis clinics as well as sexual health services and those aimed at drug users.

As a keen medical educator, he hopes that the next generation of doctors will feel equipped to offer HIV testing to people in a non-judgmental and informed manner. He thinks that HIV testing cannot be just a ‘Sexual Health’ test but that the test should be the responsibility of all doctors, regardless of speciality.

As our interview drew to a close, I asked if he would share with me an HIV success story.

‘There are thousands of positive stories,’ he replies.

He then tells me about one of the more dramatic ones. He said it was the Christmas of 1995 and a patient who had multiple HIV related illness was sent home with palliative treatment for what people believed would be his last Christmas. In January 1996, triple therapy was introduced and this patient managed to receive treatment.

This patient is still alive today.

December 1st is World AIDS Day and December is AIDS Awareness Month.

Wear a Ribbon and help to get new HIV diagnoses down to zero.

theMEDICALSTUDENT /December 2014 Comment Editor: Oscar To comment@themedicalstudent.co.uk

Go In Peace

Dominique Rouse Guest Writer

As we draw closer to Christmas, a time traditionally reputed to be one of joy, love and peace, it is ironic the extent to which peace is absent. Whether it be on a personal level, as you scurry around busy Oxford Street for that sought after Christmas present for grandma or on a global level, in countries where the Islamic State of Iraq and Levant (ISIL) have made daily persecutions and the destruction of communities a norm; peace simply is not a main feature of the season.

As medical students, peace does not feature often in our hectic lives, particularly around exam time, nor in our curriculum. Yet, it is believed that ‘the role of physicians and other health workers in the preservation and promotion of peace is the most significant factor for the attainment of health for all’ (World Health Assembly, 1981).

Why then is peace promotion seemingly isolated from the study of medicine?

For the medical student whose desire to help others is better served working in a local hospital in his/her conflict-free hometown, peace promotion may seem irrelevant. However, I argue that understanding the various definitions of peace, the ways in which it is related to health and acknowledging the opportunities we have as healthcare professionals to promote peace on an individual, social and global level will improve our skills to assist the vulnerable, regardless of the setting in which we practise medicine.

What is peace and how is it related to health? “[Peace constitutes] the inner peace of the soul with God; the fulfilment of nonviolence, through peaceful relationships with others; and the establishment of a just and peaceful social order.” Johann Christoph Arnold (2013) As the quote suggests, peace forms an element of how we describe our personal identity, our interpersonal relationships and our collective identity as one people, one nation, one world; It reflects how we define ‘self’.

As a result, numerous notions

of peace exist. Medical Peace Work (MPW), an organisation advocating the involvement of healthcare professionals in peace-making worldwide, summarises these notions into 3 main definitions;

1. peace as the negation of violence (2011), 2. peace as a state of complete harmony, 3. peace as the capacity to handle conflict.

‘Peace as the negation of violence’ is considered a negative definition of peace as it focuses on what peace is not; it is not violence. What is violence? Is violence merely physical harm or is it multidimensional? According to Professor Johan Galtung, a Norwegian sociologist and the principal founder of peace and conflict studies, violence is ‘an unnecessary insult of basic human needs’. Human needs being survival needs (physical needs), well-being needs (mental needs), identity needs (needs that define your social group- language, culture) and freedom needs (freedom to participate, freedom from fear) (1996). He further describes this ‘insult’ as being either direct violence, where one uses physical or mental strength to do harm, structural violence where socioeconomic or political systems are used and cultural violence that is violence through language, art, science and religion.

The World Health Organisation adds new dimensions to that definition by describing violence as ‘the intentional use of physical force or power, threatened or actual, on oneself, other person or a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation’ (2002).

Here, violence can be threatened thereby causing psychological harm rather than physical and the victim of violence can be the perpetrator himself, another individual or a group of people within a community or on a greater global or societal level.

Both definitions of violence challenge us to look beyond purely physical violence and

highlight its multifaceted nature. They encourage us to recognise the undermining of basic survival needs as well as the undermining of freedom needs as forms of violence; the necessity of healthcare intervention in assisting to prevent it and treat the consequences of it becomesnapparent. Deprivation, for example, can lead to diseases of malnutrition and the undermining of freedom needs, whether it be from political oppression or secondary to fear of one’s abusive husband, can lead to psychological harm.

If peace as the negation of violence means preventing violence that subsequently gives rise to health conditions, then is it not right to assume that peace leads to health?

Moreover, not only does MPW’s definition of peace suggest that peace can lead to health but also that peace equates to good health. The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 2003). ‘Peace as a state of complete harmony’ involves satisfying one’s physical, mental, social and freedom needs and not just the absence of violence ( MPW 2011). Similarly ‘peace as the capacity to handle conflict’ focuses on one’s resilience and ability to cope with other people or experiences that oppose their self-interests. In the context of health, it can be related to a patient having the physiological reserve to combat an illness or their mental capacity to cope with bad news or stress (Galtung 1996). Evidently, both positive definitions of peace define good health, emphasising the correlation between both peace and health.

Should it not then be the objective of healthcare professionals to participate in the promotion of peace?

How can health professionals promote peace? Peace promotion on the individual level can be and is practised in normal clinical settings, particularly when dealing with challenging patients. Patients’ sometimes present with external symptoms while internally wrestling with their vulnerability and the negative self-image they have from their illness. Their ability to cope with challenging news

[COMMENT] /8

is attenuated by their sense of helplessness; a healthcare professional has a duty to promote peace, as the ability to cope with conflict, else the patient may be less willing or too hysterical to be cooperative. This is particularly important in poor mental health where they are more likely to be self-destructive.

How does one promote peace? Communication. Giving the patient all the supportive information they need enables them to cope with their illness, and promotes a sense of peace that facilitates good management of the patient’s problem.

On my psychiatry rotation, I witnessed the effectiveness of this when a suicidal patient was successfully discouraged by a senior house officer from committing suicide. Communication matters!

On the societal level, peace promotion is in the interest of patients who are victims of structural violence. Many medical students choose to study medicine as a consequence of having an interest in helping others. However, medical treatment is insufficient to treat poverty, neither is it a cure for the homeless who pave the sidewalks of London nor for the disabled whose benefits are being cut. As healthcare professions, we can be advocates for them.

With peace promotion, that is peace as negation of structural violence, we are not limited to treating our patients when their health is compromised by injustice but rather we have the

opportunity to advocate for their human needs so that their health can be preserved.

Similarly, in the global arena, healthcare professionals have an even wider scope to advocate for the needs of others through organisations such as the World Health Organisation and Medicins Sans Frontiers.

Conflict in politically unstable countries is a medical emergency which is perpetually in need of advocacy from healthcare professionals. Lobbying for assistance for the victims of sexual, physical and psychological abuse is not a job purely for peace activists. These victims could be our future patients as refugees. Peace promotion can help to alleviate the problem and make a difference in the world.

Finally, whether you promote peace within your GP practice or as the director general of the WHO, it is important for you to have peace as well. Johann Arnold, in his book ‘Seeking Peace’, says that many peace activists are themselves filled with anger and frustration with the world. One’s interest in promoting peace should stem from a genuine love for others, an unconditional love which perseveres despite rejection.

“Only when you have made peace within yourself will you be able to make peace in the world”- (Rabbi Simcha Bunim from Arnold 2013).

[COMMENT] /9 SJT: Fifty Shades of Grey or Better?

theMEDICALSTUDENT / December 2014 Comment Editor: Oscar To comment@themedicalstudent.co.uk

Oscar To Comment Editor Many finalists will be preparing to sit the SJTs or will already have sat them depending on when you read this. This exam has been deemed as one that students cannot learn material for, but one that they can prepare for. This is a test of situational judgement where one is presented a variety of scenarios and must order them on the basis of best practice. Often it is about ensuring that in a real world situation one understands the course of action one should take in order to protect interests of patients and clinical practice. It is about being more than just a drone that does what one is told to do, it’s about accepting that we’re all human and conflicts will occur.

An interesting statistic is that people who are not native to the UK tend to do significantly worse on this exam than those that have practiced here. Some discount it as an issue of language but it can also be viewed as a distinctly British test; only by being in the UK do we understand what our culture expects of our practice as doctors and how we should act. For Oscar To Comment Editor It has recently come to light that the health secretary, good old Jeremy Hunt, has taken his children direct to A&E because waiting for the GP would take far too long. He has chosen to ignore all the other services put in place such as NHS Direct or Out of Hours services. Now surely there is a bit of hypocrisy here, is there not? Or is the health secretary of all people ignorant of his own government advice?

But the health secretary is obviously a more important person than you, he runs the country don’t you know? Of course he deserves special circumstances, he has the privilege.

The real issue here is one of contempt. That there are one set of rules for most people but that for others, not least of all politicians, are exempted. David Cameron preaches that we are ‘all in it together’ and yet he has preceded over a period that has seen the wealth of the richest shoot up at a greater rate than before the recession.

example, as the NHS (for the moment) remains a public institution and most doctors are salaried, there is a distinct focus on doing what is best for patient and team wellbeing; the murky waters of personal financial gain are not a distinct thought in most medical minds.

A complaint many other students make is that there are no correct answers. However, there is a correct order to place responses, and points are awarded based on having the correct order. There are correct answers. What students really mean when they say there are no correct answer is that it is not an exam that allows to regurgitate a fact direct from brain to paper. This exam emphasises principles and their application; Good Medical Practice helps us understand how to be responsible doctors, it is our job to fulfil its aspirations.

However, this concept is something that seems to elude most students, that they might have to one day deal with difficult situations without a clear distinct black and white option A or B. On further consideration of how medical curricula are set up however, it makes more sense. Our scientific At the same time, half a million people in the UK now rely on food banks.

But we need to lower the deficit I hear you say? The deficit has increased in the past 5 years far more than the combined 12 years Labour spent in power. And yet this is on top of cuts to public services including libraries and hospitals to ‘save money’. Yet we also now see that one of the few money producing services, Royal Mail, sold off cheap as chips. On top of this, 70% of NHS contracts have been tendered to private companies.

It is no surprise whatsoever that government made next to no effort to sort out the real problems of the recession, politicians are happily given money by rich firms to bend to their will. One only needs to look at the money from the Conservative Party conference to see that a Russian Oligarch provided £160 000 to play tennis with the Prime minister.

How do we stop this? UKIPs rise up is very much an act of publicity designed to make Far-

knowledge examinations have always been about black and white. That people become ingrained in this kind of thinking is no surprise; medical schools actively encourage it. What is more shocking is why haven’t students witnessed enough clinical practice to realise that most medical management is about managing shades of grey? It could be linked to the fact that many students choose to work at home rather than on the wards, after all, the ward isn’t going to teach the facts for the exam, although that clinical experience would probably serve patients well down the line. It is fortunate that medical schools are starting to move towards domain marking for OSCEs, promoting an overall picture rather than drones that can recite a set of tick boxes.

But how are students deciding to deal with their newfound lack of knowledge, especially when the tried and tested manner of learning every word in a book doesn’t seem to be working? Fortunately, this answer has been provided by other people: throw money at it.

Courses for SJTs are popping up everywhere run by people who can make whatever claims

A and B are in fact the same shade of grey they like. The courses are not cheap, often £50 a pop but fortunately students are willing to part with this sum because every little helps, right? Nevermind the fact that if you do badly, you’ll either think, “If only I sat on that course” or, “Thank goodness I sat on that course or I woud’ve done worse”. What do these courses offer you?

Well the SJT examiners explicitly state that only questions on their website give a real indicator of standard so these courses evidently cannot fulfil this role.

However, these courses often do have someone who has sat on the exam. This means one

thing; they know the ins and outs of the exam because they have done the best preparation: they sat it.

Fundamentally the SJT is there to test the waters. The reality is that one’s academic results only reveal so much, they do not reflect a whole person.

The SJT is there to fill the rest of the gap. The question is do you want to work with someone who knows every fact under the sun or would you rather have someone who can behave responsibly and work as a team? Actually, scrap that question, it’s a bit too black and white.

#HuntMustGo

age look like an everyday man having a pint in t’pub. Nevermind the fact he is another privately educated banker. The open borders of the EU are just a blame game that the press wants us to believe. The real problem lies in firms going overseas to bring in illegally cheap (i.e. lower than minimum wage) labour. The issue is that what we see on the surface as immigrants invading communities is actually caused by failures in laws that are designed to protect against abuses. And yet we look at people who claim benefits as lazy never do wells regardless of the fact that most employment now is on shaky zero hour contracts that give nothing remotely close to security.

The whole scope of our economic debate appears to around leaving things to happen naturally in the market. And yet the academic assumptions that we

place on a free market correcting itself is hugely flawed. One only needs to look at the energy sector where prices seem to rise ceaselessly to levels leaving people in poverty to choose between food or warmth. Another area to look at the escalating house prices in London where Global oligarchs can buy out accommodation people have lived in for decades and escalate the rent up, leaving them homeless.

Furthermore, we’ve found our political leaders locked on the idea of austerity and bailing out banks. We see banks as wealth generators that must be kept afloat no matter what.

Nevermind that all the money we’ve bailed them out with seems to have gone straight to with the usual day to day payment of executives.

We have now come to only value people based on their capacity to produce wealth. We

treat billionaires as people who deserve their wealth regardless of how it was obtained, whether that be by sitting still and waiting for their land to generate rent, or playing with tax havens to siphon out money that quite rightly should be paid as tax. We live in a system that makes it progressively easier to make money the more of it you already have. It harks back to Victorian days where the easiest way to get rich is to marry someone rich rather than actually rise up the ranks on merit.

It is on this anniversary of the century after the start of the First World War that we find ourselves approaching the same levels of inequality that were seen just after it. That time, it took the Second World War to sort things out. We got the NHS and job security that was assured. Let us not scupper the flame that people died for.

theMEDICALSTUDENT / December 2014

Culture Editors: John Park and Katy Bettany culture@themedicalstudent.co.uk

[CULTURE] /10

For your consid John Park Culture Editor It happens every year like clockwork. With a handful of prestigious film festivals over (Venice, Telluride, Toronto, London, to name a few), with the months of November and December looming, everyone interested in films gets excited about one thing: the awards race. The big awards, such as the Oscars ceremony, do not even take place until February next year, but film critics and fanatics cannot help themselves. They pick their favourite films, their favourite actors and actresses of the year, and start keeping a close eye on who will become next year’s Academy Award winners. What is incredible is that every year, there is something that amazes, shocks, and moves. It is impossible to predict a firm winner at this early stage, but we go through some of the films that you will no doubt be hearing lots about in the coming months.

Nightcrawler Featuring Jake Gyllenhaal’s best work in his career by far, this dark, twisted tale of trying to pursue the American Dream through whatever means necessary, is a sleek, suspenseful offering from debut director Dan Gilroy. Lou Bloom (Gyllenhaal) is a hard-working sociopath offering crime scene news footage to networks who will pay more if the video is more disturbing/ controversial than whatever else is on offer. Terrific stuff.

Boyhood The independent film project that took twelve years to create, and one that no one can stop talking about, Richard Linklater’s highly ambitious tale is surely the front-runner at this stage. Flawlessly weaved together to tell a 165-minute coming-of-age story utilising actors who are up for the challenge of portraying the same roles for the twelve years, the result is a remarkable, unique, and unmissable one.

Foxcatcher A strong reception at the Cannes Film Festival is always a good sign, with critics unanimously praising the performances from the three actors, Steve Carell, Channing Tatum, and Mark Ruffalo. The true story of how a paranoid-schizophrenic coach murdered the brother of an Olympic Wrestling Champion, this true crime tale will heat up the competition in most categories when it comes to the awards season.

Unbroken The sophomore directorial effort of Dame Angelina Jolie, the film’s release is certainly wrapped up until the last possible moment, going for the Christmas Day opening; telling the true story of Olympic athlete Louis “Louie” Zamperini, one that covers survival, resilience, and redemption. That is quality Oscar bait right there, starring the majorly talented Britain’s fastest rising star, Jack O’Connell (‘71, Starred Up) in the lead role.

The Imitation Game Benedict Cumberbatch did not quite get the chance to shine when he starred in the Julian Assange biopic, but things seem to be working out well with his newest role as Alan Turing, the man credited for cracking the Nazi’s coded messages during WWII, who was then chemically castrated for being gay. It has been running well around the festival circuit so far, which is always a good sign for a film to go far in this process.

Birdman Mexican film director Alejandro González Iñárritu seems to have hit a new high in his career with his newest. The plot closely mirrors lead actor Michael Keaton’s.

It deals with a washed-up actor who played an iconic superhero in his past. Now he is trying to recapture his glory days by starring in a new Broadway play.

Keaton has never been better, and he also receives strong support from his costars, including Emma Stone, Edward Norton.

Gone Girl David Fincher’s newest thriller is quite the crowd-divider, but not when it comes to agreeing on just how unbearably tense the film is. Instead it set off an endless debate related to gender, marriage and long-term relationships. Not many films this year of such graphic content have had this profound effect on an international audience, and if for nothing else, the voters should remember Rosamund Pike’s memorable turn.

Whiplash Another strong independent film entry this year comes from the story of an aspiring jazz drummer (Miles Teller) and his frighteningly ambitious mentor (J. K. Simmons). Simmons deserves every single Best Supporting Actor award there is in the industry for what he achieves here, and the various musical numbers turn out to be one hell of an exhilarating experience even for those who could not care less about jazz music.

Interstellar For some reason, it is cool to like everything Christopher Nolan does. His bold directorial vision can never go wrong with his dedicated fanboys; not that what he achieves here is anything short of truly incredible.

The technical achievements far outclasses what is managed in the rest of the film. When Anne Hathaway starts talking about love is a particular low point.

But a strong contender for the technical categories no doubt.

theMEDICALSTUDENT / December 2014

Culture Editors: John Park and Katy Bettany culture@themedicalstudent.co.uk

[CULTURE]

/11

deration...2014 American Sniper Clint Eastwood directs the true story of Chris Kyle, the most lethal sniper in the U.S. military history. Don’t expect wider appeal to any foreign markets outside the States given the patriotic hurrah that usually goes with a film like this. Two-time Oscar nominee Bradley Cooper fills the shoes of Kyle, and with well-directed shoot-outs to look forward to, this should be worth a watch, no matter your opinion on the War on Terror.

Selma Some critics are hailing this as the best American film of 2014, and a strong reception at the AFI Fest this year bodes well for the film’s future. It is certainly entering the race a little late, but any biopic of Martin Luther King, Jr. was bound to have some buzz surrounding it. Brit actor David Oyelowo is getting the recognition he deserves across the pond for his masterful work here in the main role, and this will certainly do better than The Butler.

The Theory of Everything Eddie Redmayne was so realistic in his portrayal of Stephen Hawking that the theoretical physicist said “at times I thought he was me”. Redmayne is truly mesmerising in the challenging role, heart-breaking throughout.

The film may choose to overlook the various accomplishments of Hawking in order to appeal to the mass market, but what it does focus on, Hawking’s first marriage, is a wonderful story of love, hope and courage.

Wild Without doubt Reese Witherspoon’s best role in recent years, she plays Cheryl Strayed, a truly inspirational character who walks the Pacific Trail Crest in order to find herself and face her demons after various tragedies in her life. Director Jean-Marc Vallee beautifully weaves together the past and present to give a strong role for Witherspoon to play with, whilst she receives strong support from Laura Dern.

Mr Turner Mike Leigh’s biopic about artist J. M. W. Turner has become the director’s biggest financial hit to date, with Timothy Spall’s performance as the artist winning universal acclaim. It is a tough sell however, and Leigh’s films rarely score well when it comes to awards in America. Expect lots of mentions at the BAFTAs this year, although when it comes the Oscars, the competition may be too fierce from the American market.

A Most Violent Year J. C. Chandor’s third feature, after his previously underperforming, underrated films Margin Call and All is Lost, is a crime thriller that is receiving overwhelmingly positive reviews. Stars Oscar Isaac and Jessica Chastain are receiving their fair share of praise, as well as Chandor’s directorial style that has been compared favourably to that of Sidney Lumet’s.

Will third time be the charm for Chandor? Perhaps.

Big Eyes Amy Adams has recently been shifting to the Best Leading Actress category, out of her usual Best Supporting Actress zone.

Playing Margaret Keane, whose success as an artist was sabotaged by her greedy husband (Christoph Waltz) who claimed her work was his, the two eventually ended up in a courtroom to battle over her work. There is talk of a nomination for Adams, but she might have to wait until her Janis Joplin biopic to win.

Fury David Ayer’s World War II drama focusing on the Allies’ heroic attempt to end the war in 1945 has been praised for its gritty realism, committed performances from the cast and of course, some memorable combat scenes.

This is one of those films where certain behind-the-scenes stories are almost as entertaining as the film itself, with some very dedicated members of the cast, doing whatever they can to do add authenticity to the story.

Into the Woods Rob Marshall has done two musical films so far. Chicago won the Best Picture Award at the Oscars, and Nine was panned.

How his newest effort, based on the stage musical of the same name, will pan out is of course a toss-up at this point, but with a strong cast both in the acting and singing departments, led by the always incredible Meryl Streep, possibly going for yet another Oscar nomination, might be worth a look.

Inherent Vice Paul Thomas Anderson remains a favourite with the critics, although that is a different story when it comes to voters and the public in general. The 142-minute crime drama starring Joaquin Phoenix as a drug-addicted cop investigating the disappearance of his ex-girlfriend’s boyfriend.

Expect nothing but dedication from Phoenix who always gives himself 100% into whoever he plays, whatever challenges the role brings with it.

[ONLINE] /12

theMEDICALSTUDENT / December 2014 Editor: Rob Cleaver editor@themedicalstudent.co.uk

Meet Some of the Team...

Read about all of our staff at themedicalstudent.co.uk Krishna Dayalji (RUMS) News Editor

Narmadha Kalai Vanan (BLSA) Doctors’ Mess Editor

It will be my second year working with the team at The Medical Student and I must admit that it’s been great! TMS has provided me with the opportunity to continue my passion for journalism whilst studying medicine. It has been a fantastic opportunity and I relish every moment of it!

As the news editor, it is my role to ensure that we deliver the latest and most up-to-date news for you, our avid readers!

Here at News we are always looking for writers to join us in creating and developing our monthly column.Whether you would like to cover a recent event at your university or anything medically-related that has caught your eye in the news lately, we’d love to hear from you! And all you first time writers, please do not be discouraged – I will be here to help you along the way!

I’m looking for forward to hearing from you soon!

DM is somewhere to take a well deserved break from the organised chaos that is med school.

This year, DM is being revamped to feature travel writing and creative writing. So, if you have any tales of your adventures, be it within or beyond the UK, a short story, a poem or anything you’d like to share; get in touch!

Just a little bit about me; I’m a second year at Barts who loves reading and travelling. With that, allons-y!

Anne Tan (RUMS) Features Editor

James Orr (ICSM) Treasurer Hello! I am the man responsible for the paper’s finances, as well as liaising with current and potential advertisers. If you’d like to discuss advertising opportunities, we offer competitive rates for commercials and student societies.

This year will be my 5th year in London and at UCL, but my first with TMS. Given how fun and amazing it is to be part of TMS, I can’t believe I didn’t get involved sooner (and I hope you won’t have that same regret!).

In the Features section we try to cover interesting angles of this complex field we call medicine. Our approach is multimodal so if you want a chance to interview/network with/have coffee with some famous/infamous doctors, or if you want to articulate some well researched ideas drop me a line and we can set you up!

We are also hoping to have more of an online presence this year so if you are good with technology don’t be shy! Throw your hat into the ring.

His Girl Friday is one of the reasons that I always wanted to be involved in a newspaper!

From January, TMS will be online only. Keep up to date with all medical student news and opinions at: www.themedicalstudent.co.uk

[EDUCATION]

theMEDICALSTUDENT / December 2014 Education Editor: TBC education@themedicalstudent.co.uk

NEGLECTED DISEASE OF THE MONTH WORLDWIDE DISTRIBUTION OF RISK FROM RABIES:

NOVEMBER: RABIES !

WHAT IS IT? • Rabies is a zoonosis (a disease that is transmitted from animals to humans) that is caused by a virus.

• Dogs are the source of the vast majority of human rabies deaths.

• The disease affects domestic and wild animals, and is spread to people through close contact with infectious material, usually saliva, via bites or scratches. Examples include bats, foxes, raccoons, skunks and jackals.

• Rabies is a disease of poor and vulnerable populations whose deaths are rarely reported. Under-reporting of rabies prevents mobilisation of resources from the international community.

!

WHO DOES IT AFFECT? • It is known to be present in more than 150 countries and territories of all continents except Antarctica, but more than 95% of human deaths occur in Asia and Africa.

• Rabies is wide-spread and potentially threatens over 3 billion people in Asia and Africa, where most people at risk live in rural areas with very limited or no access to human vaccines and immunoglobulins.

• Rabies is a 100% preventable disease. Infection causes tens of thousands of deaths every year despite the fact that we have all of the tools to manage the disease.

• Children are the most affected, with four out of every ten deaths by rabies being a child under the age of 15.

• Every year, more than 15 million people worldwide receive a post-exposure vaccination to prevent the disease saving many lives.

!

HOW DOES IT PRESENT? • The incubation period for rabies is typically 1-3 months, but may vary from less than a week to more than a year.

• The initial symptoms are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) at the wound site.

• As the virus spreads through the central nervous system, progressive, fatal inflammation of the brain and spinal cord develops.

• Two forms of the disease can follow. People with furious rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia and after a few days death occurs by cardio-respiratory arrest.

• Paralytic rabies accounts for 30% of human cases. This form has a less dramatic and usually longer course. The muscles gradually become paralyzed, starting at the site of the scratch or bite. A coma slowly develops eventually leading to death. This form of rabies is often misdiagnosed.

• Once symptoms develop, rabies is nearly always fatal.

!

No risk

Moderate risk

Not applicable

Low risk

!

HOW DO YOU TREAT IT? • No tests are available to diagnose infection in humans before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present clinical diagnosis may be difficult.

• Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques aimed at detecting whole virus, viral antigens or nucleic acids in infected tissues.

• It is a vaccine-preventable illness. Pre-exposure vaccination is recommended for travellers who spend a lot of time outdoors.

• Immediate wound cleansing and immunisation within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death.

• Post-exposure prophylaxis is recommended by the WHO which consists of cleaning the wound, administering a post-exposure vaccination and rabies immunoglobulin.

• There are no cures for rabies once it has become symptomatic.

• The average cost of rabies post-exposure prophylaxis is US$ 40 in Africa and US$ 49 in Asia where the average daily income is US$ 1-2 per person which makes poor people at risk.

!

HELP US RAISE AWARENESS AND FIND A CURE FOR RABIES. Sources: http://www.who.int/rabies/en/ http://www.who.int/mediacentre/factsheets/fs099/en/ Graph from WHO titled “Distribution of risk levels for humans contracting, rabies, worldwide, 2009”

DID YOU KNOW?

!

! !

High risk

Neglected tropical diseases (NTD) are a group of infectious and parasitic diseases that affect many people living in low-income countries. It is estimated that 1/6th of the world’s population is affected by at least one neglected disease. The impact of these diseases as a group is comparable to malaria or tuberculosis.

NEGLECTED, BUT NOT FORGOTTEN. !

To find out what you can do for neglected tropical diseases and much more find us on facebook @ UAEM Imperial Written by Monica Krivcevska & Zeena Aribou

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theMEDICALSTUDENT / Freshers 2014

Doctors’ Mess Editor: Narmadha Kalai Vanan doctorsmess.medicalstudent@gmail.com

By Rhys Davies St. Elsewhere’s

[DOCTORSMESS] /14

DIARY OF AN FY1

Recently, I returned to my alma mater for my graduation ceremony. Like a myriad flock of swallows returning home after winter, I and hundreds of my peers, bedecked in long black gowns, descended on the Royal Albert Hall. One by one, we were recognized as outstanding graduates of an outstanding institution. The rest of the day was spent catching up with friends seldom seen since real life began, comparing anecdotes about how hellish it is to be a junior doctor, always trying to one-up each other. Even after only a few months away, I couldn’t help but feel nostalgic as I walked through the halls of my old medical school.

Is that odd? To long for the salad days of medical school after barely four months in gainful employment? After six years, a quarter of my life, spent between the lecture hall and the library, I think it’s fair to say that I’ve been deeply institutionalized. My life before medical school is largely a blur.

But my life after medical school has led me to ask some serious questions about the previous half-decade. What exactly was I learning in medical school?

That’s not to say I learned nothing. I will surely take the Kreb’s cycle with me wherever I will go. I have been gifted with a temple of arcane and divine knowledge, building on the foundations of anatomy, physiology, pathology and other important disciplines. This religion has been tested in the crucible of the ward and clinic, talking to and examining real patients.

But these days, I find myself practicing something alongside that high art. Something with much the same vocabulary but which I learnt very little of during medical school. For example, my tutors went to great lengths to explain that patients respond better when you talk to them, better still like real people. There were countless workshops and small group tutorials on communication skills with patients. Explaining proce-

dures, breaking bad news and probing for ideas, concerns and expectations.

Talking to patients is one part of my job these days, one of the most enjoyable and rewarding parts of my job, but most of the time, I am talking to many other people whom I have never been trained to converse with. Nurses mainly. All the things that I, as a doctor, would like them to do (and they retort with all the things they’d like me to do, as a doctor). And pharmacists who persist with the patience of Job to point out my prescribing pitfalls and prove the PSA painfully prudent. Then there’s wheedling with radiologists and radiographers about what scans can be done when. The microbiology team who exist in some secret Emerald City within the hospital, knowing all about the bugs, drugs and rock and roll. And only a select number of these interactions take place face-to-face. So many in hospital are at the end of a telephone line, deprived of the milieu of non-verbal communication. Where were my telephone OSCEs? And don’t get me started on fax machines. Or bleeps.

Medical school also has a rather limited rosta of practical skills and procedures that they require their students become proficient in. When I recently asked the radiologist the likelihood of my patient getting an ultrasound scan that afternoon, he replied, “Well, that depends on the likelihood of them being in the next five minutes,” with a subtle look. Before that day, I didn’t have a single DOPS of stealing a wheelchair from Radiology, walking the length of the hospital, collecting the patient myself and depositing them in Radiology. But I do now! The same goes for tuning radios, which a surprising number of patients ask me to do for them.

A lot of clinical experience in medical school is spent following around doctors, observing and aiding where possible. But now I have been exposed to the world, disabused of my naïve illusions, I can see that shadowing a doctor is a poor simulacrum to being a doctor. As a

student, I never, could never, appreciated the bowel-rending realization that the responsibility for the patient stops with you. That a patient’s chest pain, or hypotension, or tissued cannula is more than a question to be solved with the application of correct medical knowledge.

If I don’t do this now, the patient will deteriorate. I need to do this, and this, and then later, I need to do that.

Another fact of life missing from the curriculum is the ward inside your head that is constructed soon after starting as a junior doctor. A selection of your patients are transferred to this ward so that after you finish and leave work, you can continue to worry about them.

On this ward, antibiotics and fluids are never given on time and the GMC scrutinizes your every action. This ward runs on a 24 hour shift, which can make sleeping difficult. This morning as I walked into work, I realized the sickest patient in my thought-ward would benefit from a side-room.

Maybe medical school did prepare me, in a rather perpendicular fashion. Whilst dealing out the medical knowledge in a straight, Socratic fashion, those six years of study and play were time to pupate and grow out of an overweight, socially incompetent teenager. Now I’m proud to say I’m a lanky, socially awkward junior doctor – how far I’ve come! This doctoring business is a lot more varied and random than medical school ever hints at. Perhaps not explicitly, but medical school did give me the chance to learn how to adapt to and seize the opportunity in evolving situations.

But with all things in those hallowed halls, it was always medicine with the training wheels on, medicine in the ball pit.

Medical education begins in medical school, obviously.

But there is so much emotional breadth, so much idiosyncratic width to the leviathan Medicine that, even though I have now graduated, I feel I’m only just getting started.

theMEDICALSTUDENT / Freshers 2014

Doctors’ Mess Editor: Narmadha Kalai Vanan doctorsmess.medicalstudent@gmail.com

[DOCTORSMESS]

/15

Cappadocia - A Trip of a Lifetime Irem Ishlek Guest Writer I can ensure you that my trip was as cliché and amazing as the title suggests. Cappadocia, otherwise known as “the land of the beautiful horses”, did not fail to impress, amaze and charm. Right in the heart of Turkey, Cappadocia is known for its rich history and unique mountainous, lunar-like landscape.

Having anticipated on going to Cappadocia for years, the plans were finally put into fruition in August, thanks to a small surprise cunningly executed by the Ishlek family. Oblivious to this surprise until the day of departure, it’s not hard to imagine the consequent cocktail of events upon the unveiling of it- a moment of euphoria followed by a frenzy of bag-packing, all of which would lead to 3 days that were, quite simply, unworldly.

Before I reveal the beauties and treasures of this Marsesque region with all its glory, I will enlighten you on the birth of Cappadocia. During the third century, a time when Christianity was yet to become a practiced religion, groups of early Christians from Greece sought to the central Anatolian region of Turkey, bringing life to the volcanic peaks bounded by the regions of Nevsehir, Göreme and Ürgüp. Homes were burrowed, churches were delicately painted and monasteries were built from the caves of the mountainous regions, mainly for the purpose of concealment for safety. The ingenuity behind their plans of evading to be caught had harvested an invaluable natural beauty that attracts thousands of tourists today. Who would have thought?

During my first day in Cappadocia, I indeed marvelled at the creations left from the third century, carefully preserved to this day. The mountains, which have kept their housing purposes, bear window-like holes and skilfully carved out rooms, deservedly gaining the name “fairy chimneys”. Merely looking at this rare landscape adoringly from a distance is a close taboo- you just don’t do it. It is imperative to visit and crawl

into these structures, wonder at the biblical paintings and discover the vast historical background behind each cave, each sheltering a different story. The Göreme Open Air Museum is one of the many places which are open to visitors and allow you to embrace the third century as its history comes alive.

What is more is that Cappadocia is alive underground, too.

With its underground cities, Cappadocia buzzes with liveliness and vigour metres beneath the ground. Of course, the clever Cappadocians of the third century had a plan B and dug literal homes underground, in case their disguise amongst the mountains went awry. As I walked down the steps of Kaymakli Underground City and introduced myself to the wineries, kitchens and bedrooms with metres of rock above me, I couldn’t help but fall in awe at the outcome of the efforts of a people that once gave their all for survival. A complete labyrinth of room after room, floor after floor, tunnel after tunnel, this underground metropolis is a must see. Preferably with the help of a tour guide too, as there is a faultless risk of losing your bearings within this maze of a city!

As a small time-out from the sweet exhaustion of my main attraction visits, I opted for the quiet, cobble-stoned side streets which occupied small, homely cafes and souvenir shops bursting with little gifts for those back home. The aroma of my home-made apple tea in Omurca Art Cave Café was enough to replenish my energy to take on my following pursuits as an eager explorer. The prices were convenient too!

Although, if you are lucky enough, you may even receive Cappadocia’s famous apple tea as a free treat from one of the vast pottery and jewellery workshops, which are warmly open to all visitors. The whole region of Cappadocia bathes in a wealth of art that is unmatched to any other place I have seen so far, making it a pottery and jewellery haven. As soon as I walked into Sayan Onyx Jewellery Centre, I knew I was in my niche. Delicately hand-made

jewellery were mounted onto shelves and glass cabinets that stretched across a hall; each piece with its unique pattern of stones and sculpted gems.

The mini shopaholic within me squealed with genuine delight at this sight, reinforced by the purchase of a beautiful turquoise necklace for a third the price. In places like these, haggling inarguably equates to happiness (for the consumer at least!).

The beauty of Cappadocia doesn’t restrict itself to the land and soil that it cherishes, as there is a whole spectacle to watch in its sky. The hot air balloons were the highlight of my visit that was certainly worth my 3am wake up call. As you ascend deep into the sky blemished with shades of orange from the sunrise that is shyly shining good morning onto the settlers of Cappadocia, the valleys beneath you are smiling back with their spectacular mountainous peaks, now merely an assortment of picturesque bumps amongst a vast land. Hundreds of other balloons of an array of colours and sizes also accompany you on this journey, making it a beautiful sighting to watch from the ground, too. It is probably safe to say that Cappadocia is not complete without its hot air balloon display which is entirely capable of sweeping you off your feet with its magnificence.

My three days in Cappadocia seemed like too little to absorb all its splendour, but it left me entranced by all that it had to offer nonetheless. From the hikers to the nature-lovers, the ‘peace and quiet’ enthusiasts to the shopaholics, it has something for all tastes, all interests and preferences. There will not be a space for boredom once you immerse yourself into the depths of this geography. It truly is a place with a beauty that even fancy, extravagant words could not do it justice.

Put simply, Cappadocia must be be seen to be believed.

Send your travel reports to mess.medicalstudent@gmail.com

POETRY CORNER - Please Mind the Gap There is a melancholy pooling in yesterday’s rainGoodbyes settling behind the fogged glass and false hope that these train tracks could weld the distance, Such that hearts wouldn’t ache to dissipate in these city lights.

Our pockets filled with sadness and loose change dropped by the reluctant footsteps of travelers.

I know now, that I will always be late, to places, I cannot call home.

This is the 6 am dream, strong coffee and chaos morphing into unwritten poetry dripping like sweat off a stranger’s brow.

I believe we are all raw, sensitive things seduced by London’s monochrome Secretly hoping to close our eyes and wake To the hum of Sunday morning cut grass And the bellowing laughter of loved ones, gently rising up the stairs.

I believe too, that I mustn’t dwell on such things here.

An old moon once told me how it is; The spirit is a wild thing Prone to long walks, spontaneous Heart clenching thoughts Unwarranted detours amongst The things this city has to offer I am grateful to be here Despite the void in my chest Where my roots grow into cracked pavements And the gap between all I miss and the train home.

Perhaps it is part of growing up to accept that some nights the rain comes pounding Bringing only nostalgia and restless sleep.

Batool Wali BLSA

[SPORT]

theMEDICALSTUDENT / December 2014 Sports Editor: Mitul Patel sport@themedicalstudent.co.uk

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United Hospitals RFC Dominate Oxford U21s Matthew Harling Guest Writer An excited UH rugby squad headed down to Oxford for the opening UHRFC fixture of the season. From the warm up it was apparent that the UH boys would enjoy a size advantage over their opponents, perhaps compensating for the lack of familiarity within the invitational side.

The match started at a fast pace, with Oxford looking to play their brand of loose, offloading rugby from the kick off.

However, their initial forays yielded little ground gained, and UH drew first blood. A clever kick through from flyhalf Zac Vinnicombe allowed former Cambridge Under 21 Luke Thompson to dot down in the corner. Vinnicombe stepped up to accurately slot the conversion from the sideline, and UH led 7-0.

A safely gathered restart and a series of big carries from No. 8 Andrew “Bumble” EdwardsBailey allowed UH to assert themselves on the gain line, and good kicking game allowed UH to dominate territory for much of the first half. The pressure eventually told, with a score in the right hand corner for Ed

Underwood after good backline play, UH leading 12-0 after a missed conversion.

From the kick off the UH physical dominance continued, and some good phase play allowed them to work their way up the pitch. A strong carry from left winger Dele Famokunwa made headway down the left, before the ball was moved all the way across for Underwood to muscle his way over for a second score. Vinnicombe rued UH’s inability to score anywhere near the posts as he pulled the conversion wide, UH now ahead 17-0.

As the first half moved on, Oxford started to compete well at the breakdown, forcing a series of penalties. They moved into the UH 22, with their quick midfield play making some inroads. However, strong defensive work kept them from breaking the UH line, with Michael Nally and his back row colleagues putting in some big tackles. At the halftime whistle UH lead 17-0.

UH came out for the second half much-changed, and ready for a battle against a purportedly fitter Oxford side and a fairly serious uphill slope.

Much of the early play was Oxford’s, and eventually the pres-

sure told with a series of drives around the fringes leading to a try. The conversion was missed, and the score stood at 17-5.

As the half wore on, UH managed to regain some control.

The stern UH defence however forced Oxford to play more of a kicking game, allowing the UH back 3 to make ground on the counter attack.

As the half wore on, UH found themselves on driving for the Oxford line after a midfield penalty, and good handling allowed debutant winger Alex Zervudachi to burrow in for a score in the corner to put the game out of sight at 22-5.

Oxford continued to show ambition until the end, rewarded with an unconverted score, but they could not turn the result around. Final score 22-10 to the United Hospitals.

A promising result means that UHRFC go into their game against Cambridge Under 21s on the 29th November confident and looking to maintain an unbeaten season.

Got a sports report to publish? Send it to us!

Email us at sport.medicalstudent@gmail.com

Right to Play Toughen Up Frederick Stourton Guest Writer Right to Play Imperial will be the first to admit that after last month’s half marathon, the last thing we felt like doing was running.

On the morning of the 26th October, five ICSM students and a number of athletes from University of London Officers’ Training Corps travelled to Mattersley bowl in Hampshire for 12 miles of what is advertised as “Probably the toughest mud race in the world”; Tough Mudder.

Competitors are sworn to the“Tough Mudder Oath”, and are introduced to the race fol-

lowing an equally intimidating billow of orange smoke.

The first ‘obstacle’ was the track winding up and down a hillside more than a couple of times, which left us all horribly leggy and rather unimpressed!

Rounding the corner, however, we came to the Blades of Glory; eight foot walls that slanted towards you. This was followed by “Walking the Plank” – a 5-metre drop into icy water., which geared us up nicely for the rest of the course, albeit with horribly chafed nipples.

Other memorable obstacles from the course included the Arctic Enema (a shipping container full of ice water), the

UH Rugby 1st XV (in no particular order) M Harling (ICSM), E Underwood (SGUL), L Thompson (RUMS), A McManus (SGUL), D Famokunwa (RUMS); Z Vinnicombe (SGUL), W Rea (RUMS); C Horn (SGUL), B Ridley (GKT), N Cox (RUMS), T Philip (GKT), A Briki (SGUL), M Nally (RUMS), O Cummin (Captain, SGUL), A EdwardsBailey (RUMS)B Rudran (SGUL), V McGeoch (ICSM), D Howden (SGUL), G Child (GKT), A Muhoza (SGUL), A Barrie (ICSM), A Zervudachi (RUMS)

Hero Walls (12-foot walls to climb) and Electric Eel (A crawl through 10,000 Volt carrying electrical wires hanging 6 inches above the floor).

Our thanks to everyone who partook and helped us with logistics for the day.

Right to Play would also like to thank all the sports captains who made the latest edition of UH Sports Night Possible; with your help and enthusiasm we raised over £7000 which, as always, goes straight to educating and training children in disadvantaged countries through sport! We are udnerstandably already looking forward to next year’s edition.

[SPORT] /18

theMEDICALSTUDENT / December 2014 Sports Editor: Mitul Patel sport@themedicalstudent.co.uk

Spoils Shared Across UH Rowing Pathé Dig into UH History Sean Morgan Staff Writer

Georges

boys

win

the

Mitul Patel, Rustam Karanjia & Sophie Legg Sports Editor & Guest Writers

The 2014-15 UH racing calendar opened with the Cambridge Winter Head and Novice Regatta events and failed to reveal dominance in any sector of London in this early stage of the season.

The Head, contested by senior crews, saw ICSM pull the fastest time in the men’s division whilst GKT came through quickest in the women’s. Meanwhile, the first novice event of the year brought victory for Georges’ boys and Vets’ Girls.

With no single UH club laying down a statement of intent, the stage is nicely set for a competitive Allom Cup meet in late November as the sprint season draws to a close.

The winter head is a 2.5km time trial which was held on the River Cam on Saturday November 15th. Roughly 200 men’s and women’s crews raced two time trials each, with the fastest times ranked per category based on the experience and seniority of the members in each crew.

Last year ICSM men won their overall category at the

Novice

Regatta.

Photo

Courtesy

head and arrived in Cambridge keen to once again throw down the gauntlet for the rest of UH, despite wholesale changes in the make up of their squad over the summer.

ICSM Mens 1st VIII set the 5th and 7th fastest times of the day, beating their nearest UH rivals George’s by 16 seconds and coming 2nd in their category to University of London.

In the battle of the UH 2nd VIIIs, it was RUMS 2nd VIII who finished 4 seconds ahead of ICSM and 11th in their category.

Arguably the result of the day as far as Uh crews are concerned, was the victory of GKT in the women’s division, coming joint 1st in their own category in a time of 10:01; some 18 seconds ahead of RUMS and beating a number of men’s eights crews across the country on the way. The women’s 2nd VIII contest was won by ICSM who came through the finish line 2 seconds faster than RUMS .

The Novice Regatta on the River Thames in Mortlake is an annual 800m knockout regatta where newly trained UH rowers, with less than

of

SGULBC

Twitter

two months rowing experience typically, aimed to emulate their seniors in bringing success to their clubs.

The boys division was won by St Georges who squeezed past last year’s winners RUMS in the final having already despatched of both ICSM boats en route.

Current UH captains Vets were delighted to see their girls storm home in the final against George’s, preventing the South Londoners from the double and repeating the feat of the Vets girls crew from two years ago. They had previously beaten ICSM 2nds and RUMS en route to the final.

The repercharge, where losers of the heats are drawn into, was won by Vets in the boys division and Barts in the girls.

The results should make for a fascinating Allom Cup on 30th November, which is a knockout regatta over the same stretch of water as the novice regatta, for both novice and senior crews. The spread of early season results will undoubtedly serve as motivation for all chasing crews to close the gap as we edge ever closer to the Head season.

In the past months, British Pathé has released a number of gems from their archives illustrating days of old of UH Sport. Not only does the footage give us grainy images of life for medical students and doctors in the early 20th Century in London, but it also shows us that the tradition and passion, which us students of United Hospitals’ uphold today, stems back long before our time.

The first brings us back to 1920 and the United Hospitals Cup Final between Guys and Barts, the first held since the end of World War one. A victory on this day for Guys, who would go on to defend the cup for the next 3 years, before Barts would seek revenge and take the cup back to West Smithfield in 1924.

Such is the importance of the UH Cup that the footage shows King George V

congratulating the players of both sides before the game.

The students of Barts are seen decked out in Black and White scarves, colours that are proudly celebrated today and the fervent cheering from the Guys supporters is not unalike to the support I witnessed at the recent Barts vs GKT football fixture.

In order to view the videos, simply search “British Pathé, United Hospital” on YouTube. I encourage you all to do it. They are a great reminder to all of us to be proud of the identities of our individual medical schools.

The footage also acts as a reminder to us that despite our fierce rivalry and individual characters, we have a common cause in UH, which makes us very special. It is unique for five rivals to come together and form a greater entity, as we do in UH and it is a lesson, which we can apply to all aspects of life.

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