Oxford Medicine November 2015

Oxford Medicine THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI OXFORD MEDICINE . NOVEMBER 2015

Contents

Academic primary care – central to health service reinvention

President’s Piece . . . . . . . . . . . . . . . . .2 Academic primary care

. . . . .2

BM BCh Graduation

. . . . . . . .3

People in the News

. . . . . . . .4

The Weston Library . . . . . . . . .5

Kennedy Trust for Rheumatology Research

Kennedy Trust for Rheumatology Research

Dr. Eric Sidebottom Interview

Emanoel Lee Prize

From Osler House

. . . .6

. . . . . . . . . . .7

Callum Miller . . . . . . . . . . . . . . .8 The Junior Doctors contract: Not Fair Not Safe? . . . . . . . . . .9 . . . . . . . .10

Dr. Eric Sidebottom Interview 14 With Sadness

. . . . . . . . . . . . .15

OMA Events . . . . . . . . . . . . . . . . .20

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President’s Piece

Oxford Medical Alumni as an organisation has two purposes: to keep those who graduate from our medical school in contact with one another throughout what are tremendously diverse medical careers; and to keep them in touch with what is happening in the Oxford Medical School. As you will see when you read further in this issue, ‘Oxford Medicine’ tries to reflect both of these purposes. Some of our preclinical students study clinical medicine in schools other than Oxford and therefore, for the past two years, we have held a reception for all the preclinical students immediately after their final 3rd year examination and before they

disappear for a well-earned summer break.

Following on from last year’s very successful, but very crowded, reception in the Medical Sciences Teaching Centre for those who have just qualified BM, BCh and the parents and friends who have supported them through their course, this year’s reception was held at the much more spacious Mathematics Institute on the old Radcliffe Infirmary site. Page 3 shows you some of the happy faces at that event.

The programme of ten-yearly reunions postqualification which OMA organises continue to be very well attended, with some people travelling from overseas to catch up with old friends. The first reunion at 10 years is a garden party held at Osler house and it is a delight to welcome back not only our students but also in many cases their young families. Later reunions usually take the form of a reception and dinner in a college with a variety of after dinner

speakers; at the most recent event at Balliol we were also enjoined to sing along with some of the ‘tindzwik’ numbers of that year! 2016 will see an Australian reunion at Margaret River, and we are working on a reunion for those now working in North America.

We have made one organisational change, merging what were the Council and Executive Committee into a single board to avoid unnecessary duplication.

Our three major annual lectures continue, and full details of these and the reunions can be found on the final page of this issue of Oxford Medicine, so you really do need to read it right through! I hope that you will find it an interesting read and, if you have a view or an experience you would like to share, do please send us an article for the next issue.

John Morris

Academic primary care – central to health service reinvention Oxford’s primary care researchers are on the look-out for GP surgeries to get involved in research projects.

Dan Richards-Doran, Nuffield Department of Primary Care Health Sciences.

“Academic primary care is the exciting place to be.” This was the last word from NHS England Chief Executive Simon Stevens in his speech during the Society for Academic Primary Care’s 44th Annual Conference this July, hosted by the University of Oxford’s Nuffield Department of Primary Care Health Sciences. While giving his insight on the indispensable role of primary care in a future NHS, he talked about the importance of academic primary care in answering some of the health service’s biggest challenges, underlining that clinical research is central to the task of reinvention.

This research is only possible with the involvement of general practices. At a recent clinical update event for Oxfordshire general practitioners (GPs), Nuffield Department of Primary Care Health Sciences’ clinical researchers focused on the importance of working with practices across the UK to recruit a wide variety of patients into their studies, creating data that is representative, reliable and relevant to the population.

In addition to leading on undergraduate primary care teaching in the Medical School, the department brings together clinical researchers with medical statisticians, social scientists and health economists to work with GPs to rethink how healthcare is delivered to people locally, nationally and internationally reducing the numbers that need to be admitted to hospital and the overall cost to

health services. Many studies are run through the department’s dedicated Primary Care Clinical Trials Unit.

With advances in mobile technology, patient self-care is one area of considerable interest to department researchers. For example, results from a study published recently demonstrate just how beneficial it can be for high-risk patients to self-manage hypertension - the second biggest risk factor for death and disability in England and the reason for 12 percent of all GP visits. Patients recruited into the Oxford-led study measured their own blood pressure from home and adjusted their medication accordingly, without needing to make regular visits to their GP. Importantly, by the end of the study they had significantly lower BP compared to those in normal care – and this was at no additional cost to the NHS. The study, which involved 56 general practices, has recently gone on to win a 2015 Royal College of General Practitioners Research Paper of the Year Award, and is currently being followed up by the TASMINH4 randomised controlled trial. Evaluating how hypertension can be managed through self-monitoring blood pressure, the study utilises SMS text messaging to enable patients to inform the clinic instantly of their latest BP reading. This allows GPs to react quickly with any necessary adjustments to medication, and reduces the number of consultations otherwise needed.

Courtesy of GP Nasir Hamid Through this ongoing work, led by Richard McManus, an Oxfordshire-based GP and Professor of Primary Care in the department, the researchers aim to build a strong evidence base for including self-monitoring in clinical guidelines for the routine management of hypertension.

Generating reliable data to support this, and other studies, means GPs and academics working together to recruit patients into research, and evaluate new ways of working.

This provides an exciting opportunity for those at the coal face of primary care to become part of NHS reinvention.

GPs can sign up their practices to TASMINH4 and other studies led by the University of Oxford’s Nuffield Department of Primary Care Health Sciences – www.phc.ox.ac.uk/get-involved

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2015 BM BCh Graduation reception 2015 graduation reception 11th July at the Mathematics Institute.

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People

QUEEN’S BIRTHDAY HONOURS Frances Ashcroft Royal Society GlaxoSmithKline Research Professor in the Department of Physiology, Anatomy and Genetics and Fellow of Trinity College, is appointed DBE for services to medical science and the public understanding of science. Her research focuses on ATP-sensitive potassium (KATP) channels and their role in insulin secretion, in both health and disease.

FELLOWS OF THE ROYAL SOCIETY

Rory Collins, Rory Collins, Professor of Medicine and Epidemiology, has created and led large studies that transformed statins from esoteric drugs for familial hypercholesterolaemia into safe, widely used generics that annually prevent millions of heart attacks and ischaemic strokes. His large placebo-controlled trials and worldwide Cholesterol Treatment Trialists’ meta-analyses confirmed heart attack reduction, discovered stroke reduction and demonstrated safety and efficacy in many different types of patient.

Gero Miesenböck, Waynflete Professor of Physiology and Director of the Centre for Neural Circuits and Behaviour, has pioneered the science of optogenetics. He established the principles of ptogenetic control in 2002, using rhodopsin to activate normally light-insensitive neurons, and was the first to use optogenetics to control behaviour. He has exploited optogenetics in a succession of experiments illuminating synaptic connectivity, the neural basis of reward, mechanisms of sleep homeostasis and the control of sexually dimorphic circuitry.

Kia Nobre Director of the Oxford Centre for Human Brain Activity, Professor of Translational Cognitive Neuroscience and a Professorial Fellow at St Catherine’s seeks to understand the principles of the neural systems that support cognitive functions in the human brain and investigates how neural activity linked to perception and cognition is modulated according to memories, task goals and expectations.

Jeremy Farrar, Professor of Tropical Medicine and Global Health at Oxford until 1 October 2013, when he became Director of the Wellcome Trust, was also elected FRS for his outstanding contributions to our understanding of the epidemiology, pathogenesis and treatment of several globally important infectious diseases, especially those affecting South East Asia.

FELLOWS OF THE ACADEMY OF MEDICAL SCIENCES Matthe w Fre eman, Professor of Pathology and Head of the Dunn School of Pathology, has made notable contributions to the field of biochemistry (especially regulated proteolysis), membrane tracking, signal transduction and developmental cell biology.

His research focuses on how cells communicate with each other, as well as the biological and medical consequences of this signalling between cells.

Simon Hay, Professor of Epidemiology, investigates spatial and temporal aspects of infectious disease epidemiology to provide an improved cartographic evidence base for programmes of disease control. He has led initiatives to map the global distribution of a wide variety of pathogens, including malaria, dengue, Leishmania and Ebola, to help optimise the allocation of disease control efforts.

Ian Pavord, Professor of Respiratory Medicine, is an internationally renowned respiratory medicine researcher with a particular interest in asthma, chronic pulmonary disease and chronic cough. He has played a leading role in the emergence of three of the most promising emerging treatments for these conditions, developing new methods to assess and treat airway inflammation and airway diseases.

Irene Tracey, Nuffield Professor of Anaesthetic Science and Head of the Nuffield Division of Anaesthetics, uses advanced neuroimaging techniques to understand how the human central nervous system processes and modulates nociceptive inputs to produce pain and analgesic experiences. She and her colleagues are also contributing to a better understanding of how the brain produces altered states of consciousness during anaesthesia.

OTHER AWARDS MEAKINS McCLARAN MEDAL 2015 – Prize awarded for the outstanding overall performance of a student graduating with the degrees of BM, BCh (Oxon): Michael W. Shea, St Hugh's College Ester Hammond, Associate Professor in the CRUK/MRC Oxford Institute for Radiation Oncology, is the recipient of the 2015 Michael Fry Research Award from the Radiation Research Society. The award recognises junior scientists who have made extraordinary contributions to the field of radiation research.

Gly n Humphrey s, Watts Professor of Experimental Psychology, has won the British Psy chological Society ’s lifetime achievement award.

Kay Davies, Dr Lee’s Professor of Anatomy and Director of the MRC Functional Genomics Unit, has been announced as the 2015 recipient of the annual William Allan Award of the American Society of Human Genetics.

Keith Channon, currently Professor of Cardiovascular Medicine in the Radcliffe Department of Medicine; Honorary Consultant Cardiologist at the John Radcliffe Hospital; Director of the NIHR Biomedical Research Centre; and Director of Research and Development, Oxford University Hospitals NHS Trust, became Field Marshal Earl Alexander Professor of Cardiovascular Medicine in the Division of Cardiovascular Medicine, Radcliffe Department of Medicine, on 10 November 2014. He also became a Fellow of Exeter.

Professor Channon’s research is focused on understanding mechanisms in cardiovascular diseases, particularly the importance of nitric oxide and redox signalling in endothelial function and vascular disease pathogenesis. He was elected a Fellow of the Academy of Medical Sciences in 2009 and is currently Associate Head of the Medical Sciences Division (Clinical Research).

Joel Tarning, associate professor and Head of Clinical Pharmacology at the Mahidol Oxford Tropical Medicine Research Unit in Thailand, has been awarded the Giorgio Segré Prize by the European Federation for Pharmaceutical Sciences for his scientific research work on the pharmacokinetic and pharmacodynamics properties of antimalarial drugs in vulnerable populations such as pregnant women and young children.

Evan Dale Abel has been elected to the National Academy of Medicine. The NAM elects no more than 70 national and 10 international members annually; membership reflects the height of professional achievement and commitment to service. Dr Abel, D.Phil, is John B. Stokes Chair in Diabetes Research, professor of internal medicine and biochemistry, director

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of the Division of Endocrinology & Metabolism, and director of the Fraternal Order of Eagles Diabetes Research Center at the University of Iowa Carver College Of Medicine.

Eleanor Stride, from the Department of Engineering Science Institute of Biomedical Engineering and a world expert in biomedical engineering, has been announced as the winner of the £300,000 IET A F Harvey Engineering Research Prize. She was chosen because of her outstanding contributions to biomedical engineering and her research into the treatment of major diseases. In winning the prize she was chosen from high calibre candidates from across the world to be awarded the prize.

Professor Stride’s ‘targeted drug delivery’ research concerns the treatment of major diseases such as cancer and stroke, where there is a pressing need to target drugs to specific parts of the body in order to minimise exposure of healthy tissue. The key motivation is to reduce serious side effects and increase the number of patients eligible for treatment.A promising approach to this challenge is to encapsulate drugs within a carrier particle that can be transported to a target site in the body and then activated to release the drug in a highly localised manner. But for this approach to be effective, it is essential to be able to manufacture particles with a very high degree of control. The £300,000 IET international prize will be used to further this research.

Dr Anne Kiltie, who works at the Oxford Institute for Radiation Oncology, helped develop Cancer Research UK’s innovative app Reverse The Odds. In the game, players score points by spotting brightly-coloured proteins in 800 images of tumorous cell taken from 300 real bladder cancer patients.

UNIVERSITY OF OXFORD MEDICAL SCIENCES DIVISION 2015 LIFETIME ACHIEVEMENT AWARDS The following academics were recently acknowledged by the Medical Division for the high quality and sustained commitment to education and research demonstrated throughout their careers at Oxford • Prof Christopher Ashley (Department of Physiology, Anatomy & Genetics) • Dr Richard Boyd (Department of Physiology, Anatomy & Genetics) • Miss Jane Clarke (Surgery, John Radcliffe Hospital) • Dr Stephen Goss (Sir William Dunn School of Pathology) • Dr Simon Hunt (Sir William Dunn School of Pathology) • Dr Jennifer Lortan (Clinical Immunology, John Radcliffe Hospital) • Prof John Morris (Department of Physiology, Anatomy & Genetics) • Dr Piers Nye (Balliol College) • Prof John Stein (Department of Physiology, Anatomy & Genetics) • Prof Derek Terrar (Department of Pharmacology) • Dr Christopher Winearls (Jesus College)

70th WEDDING ANNIVERSARY Finally OMA sends many congratulations to Drs Geoffrey Venning (matric. New College 1940) and Ruth Venning (matric. St Hilda’s College 1941) who celebrate their 70th wedding anniversary in 2015.

The Weston Library

The Weston Library provides a new home for the Bodleian's special collections and its £80m refurbishment was designed to create high quality storage for its collections, to develop the space for both advanced research and to extend public access to the Libraries' treasures.

In addition to three reading rooms, seminar rooms and study spaces, the library now includes a Centre for Digital Scholarship and Visiting Scholars Centre. The public has access to exhibition galleries, a lecture theatre, the Bodleian Café and The Zvi Meitar Bodleian Shop.

Before

Dr Kiltie’s team compares levels of the proteins spotted by players with those patients’ survival rates to work out which treatments work best for different sorts of people. The ‘citizen science’ project saves scientists hundreds of hours doing menial work that requires little or no specialist knowledge. The app has now been downloaded more than 100,000 times – providing doctors with 3.5m individual classifications. For her help developing and promoting the app, Dr Kiltie was awarded the top prize for research engagement at Cancer Research UK’s Flame of Hope awards in June. Dr Kiltie said: ‘It was a complete surprise – I didn’t even know there was such an award.’

During

The refurbishment of the grade II-listed Weston Library has already generated praise from users, visitors and the media alike. It has undergone major work to turn it into an exciting and dynamic resource that will encourage greater access and engagement for the University and general public. The Weston Library opened to the public in March 2015 after a three-year transformation by Wilkinson Eyre Architects.

New facilities include study rooms, reading rooms and a visiting scholars centre. Above and below ground, more than 40km of state-of-the-art storage facilities now house the special collections, including four of the 18 surviving copies of Magna Carta.

After

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Kennedy Trust for Rheumatology Research – a move to Oxford is enabling the Kennedy Institute to expand networks and focus on a range of chronic inflammatory diseases The Kennedy Institute for Rheumatology has been a UK institution since its inception in 1965, with an historical link to that most British of brands, M&S. But it has only been an Oxford institution for the last four years and physically in Oxford for the last two.

In 2011, when it became part of the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science (NDORMS), the Kennedy brought with it a record of top-class research. The world’s first centre dedicated to arthritis was responsible for much of our understanding of human cartilage, paving the way for today’s osteoarthritis research. In the 1980s and 1990s its research into Tumour Necrosis Factor (TNF) found that anti-TNF treatments were effective in tackling the destructive inflammation that causes rheumatoid arthritis. That research led to a licensed treatment for the condition in 1999, and anti-TNF has also been found to be beneficial for a range of other conditions.

With that track record, why quit London and move 50 miles up the M40? The answer seems obvious when you enter the Kennedy Institute’s building on the University’s Old Road Campus. The modern architecture highlights the fact that this is a purpose-built facility, only completed two years ago, and Kennedy Institute director Professor Fiona Powrie initially confirms that impression: ‘This is a wonderfully designed building. The labs are state of the art. That’s what you’d expect if you want to do world-class research.’ She points to the development of a germ-free facility as an example of the resources that have been made available by the move. It enables the Kennedy to raise mice in sterile conditions, which facilitates research into the effects of specific micro-organisms.

But do not be misled: the Kennedy was not simply seduced with promises of shiny new labs in Oxford. The Kennedy Trust for Rheumatology Research, the successor to the charitable organisation that once ran the institute and which still provides significant support, made a strategic decision that recognised how medical research was changing. Multidisciplinary research, bringing together specialists from across the sciences, is now critical. Professor Powrie explains how the Oxford move has enabled the institute to increase its opportunities to collaborate with other medical and non-medical researchers: ‘We are broadening the scope of what the

smaller Kennedy Institute in London could do.

Those people who moved here have embraced the opportunities to diversify their work. We are building networks with structural genomics and computational biology, for example. Access to that wider research environment is important.’ She adds: ‘Physically, we are located next to the Target Discovery Institute [which links advances in genetics, genomics, cell and chemical biology to identify areas for drug research to target] and the site of the Big Data Institute [which will analyse large sets of health data], while the Wellcome Trust Centre for Human Genetics is nearby. We are working closely with each of those.’ Oxford has not just offered the opportunity to expand networks, but also to expand the Kennedy Institute itself. The Kennedy is changing from a focus on arthritis to addressing the range of chronic inflammatory diseases. These often share underlying causes and mechanisms, so the institute studies these fundamental issues rather than specific diseases. It will be a broad focus on chronic inflammation and repair in the human body. Inflammation is a critical part of the immune response, delivering critical disease fighting and damage-repairing factors to wounds and infected areas. In inflammatory diseases, however, this goes wrong and it appears that the body continues to respond even after the initial cause has been addressed.

In the long run this can see human tissues damaged and destroyed by a process that should be achieving the opposite. The current

research programme, led by 18 principal investigators, is still mainly focused on joint and gut research. Professor Powrie herself is an immunologist but she is clear on the need to broaden the Kennedy’s outlook: ‘We’re not full.

We’ve got a good critical mass made up of people who moved from London and new recruits.’ As part of that, the Kennedy Trust is providing support for the Kennedy Institute to recruit researchers who are ready to make the move to running their own research group. As Professor Powrie puts it: ‘I’m not going to recruit five of the world’s top researchers, but I am interested in recruiting five of their top people who show great potential. Institutes don’t do science. It is the people in them. We are creating an opportunity for outstanding scientists to do their research and deliver their potential.’

The next few years look exciting for the Kennedy Institute. Not only is recruitment expanding, but the ambition is to develop new technologies to support the research programmes. At the same time, new networks will be established with clinical staff to build a centre that will encompass everything from basic research to translating that into improved diagnosis and treatment for patients.

Professor Powrie concludes: ‘There is a commitment from the Kennedy Research Trust to support a world-class medical research institute. That was behind the move of the London Kennedy Institute. The Oxford Kennedy Institute will develop a new identity, but our ambition is to do as well as they did.’

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Timeline 1965: Encouraged by their GP, who had rheumatoid arthritis, Mathilda (a daughter of Michael Marks, founder of M&S) and Terence Kennedy founded the Kennedy Institute of Rheumatology, as the world’s first research institute focused solely on arthritis 1966: After laboratories are built, the institute appoints its first director.

The Kennedy is based at Bute Gardens, Hammersmith, at the back of the West London Hospital 1985: The Kennedy Institute begins to collaborate with Charing Cross Sunley Research Institute on studying TNF 1992: The Kennedy and the Sunley Research Institute are merged 1997: The Institute leaves Bute Gardens for an extended building at the former Sunley Institute site 1999: The first anti-TNF treatment is licensed for medical use

2000: The staff and research activities of the Institute are incorporated into Imperial College, London, becoming the Kennedy Institute of Rheumatology Division, while the institute is renamed The Mathilda and Terence Kennedy Institute of Rheumatology Trust 2010: After outgrowing its site at Charing Cross, the Trust reviews the optimal location for its financial support and decides to move the institute from Imperial 2011: Agreement is reached for the Kennedy Institute of Rheumatology to become part of Oxford University’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences 2012: The Trust changes its name to the Kennedy Trust for Rheumatology Research to reflect its wider role in funding research 2013: In July the Kennedy Institute moves into its new purpose-built facility at Old Road Campus

From Osler House So here we all are, returned from our 'summer' Some faces are tanner, some bodies are plumper Refreshed? Paha! At least our med school status Has jumped from 4th year — 5th year now awaits us.

So there's a lot of changes, within and without Here up at Osler there's certainly no drought With coffee on tap we're a real caffeine nation, The quiz machine tunes our cerebral circulation, At the end of the year we threw a great Ball, No glass slippers just glasses, and fun had by all.

Now we're in clinic, there's one big question people are asking, They're craving the answer, they're desperate — but it's just so taxing!

'Do you know how you want to specialise?'

Inside us there are sighs, But we look straight into their eyes, And with a kind smile we try to summarise, The notion that none of us have any idea whatsoever.

So with that, one eve we decided to stop playing docs, To don our most piratical waistcoats and frocks, Set sail we did as an epic motley crew To the coast of Jericho, Port Arzoo Sconces sounding port and starboard, Curry tasting suspiciously of cardboard, In Tikki paradise we searched more for treasure In fun and camaraderie we found it in equal measure.

Nearing September and the time is nearing, That time that all the consultants are fearing, FOURTH YEARS – oh Lord, Holy Cow! Their niche undergrad facts won't save them now!

Our 4th year kids, no, we'll nurture them through Give 'em the skills that (don't) kill, show 'em what to do!

We look forward to meet them, not least to remember The progress we've made since last September.

Liam Loftus is President of Osler House

Tom Buckley

Tom

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Calum Miller were few in number and, I assumed, anomalous.

But when I reached Oxford, I met wonderful expublic school kids: in my own class at College, in my halls, in societies, and elsewhere.

The overwhelming majority cared not the slightest bit that I continued to dress in tracksuits and hoodies, listen to hip hop or talk with Croydon slang. Yes, there are some elitists hiding away in some unexplored crevices, but they are rarely found.

The myth of Oxford elitism: perpetuated by the Left

Financially, Oxford was more than welcoming.

I had virtually all my tuition and living expenses paid for with grants and bursaries alone, even without the loans I received on top. And most of the students are passionately vocal on behalf of the poor.

By Calum Miller BM BCh 2015 When I moved from my Croydon comprehensive school to Oxford, I had been led to expect terror. I was on the full bursary and grant available, listened to hip hop and dressed to reflect my home town.

Oxford, on the other hand, was a playground for the upper echelons, a vestige of the feudalism which subjugated my ancestors for centuries. And the inevitable narrative of this clash was to my own detriment. I would be alienated by the formal attire, by the private school kids, and the nepotistic Oxford dons.

This view of Oxford, relentlessly perpetuated by the Left’s insistence on making themselves into victims and the popularity of persecution complexes, is not just false; it is also damaging to those it claims to stand up for. Why? The answer is simple. More people fail to get degrees at Oxford because they feel too unwelcome to apply than because they are discriminated against while at Oxford.

This is the fault of those who invent an aristocratic caricature of Oxford so far removed from reality that anyone trying to deter poorer students from applying would come up with something almost exactly like it.

Here is the truth: when I arrived at Oxford, I resented students from public schools. I had some publicly schooled friends before arriving, but they

Some of them have saviour complexes. Some of them shout a lot with little action or sacrifice. Many of them have considerable contempt for the social conservatism and political incorrectness among former comprehensive school kids. But they will not ostracise people for being poor, and they certainly do not do so as a result of Oxford traditions or public school snobbery.

If anything, some archaic Oxford idiosyncrasies actually help underprivileged students to integrate. The university’s student body has recently held a referendum on whether to keep Oxford’s academic dress – ‘subfusc’ with mortar boards and gowns – a mandatory requirement for exams.

While this sort of dress is often seen as a remnant of Oxford’s traditional and elitist past, it actually functions as a wonderful equaliser.

Students do not have to win approval with expensive or fashionable clothes. They do not have to spend more than they can afford on impressing people with what they wear.

Instead, everyone wears the same thing.

And yet faux saviours have hijacked this cause, too, saying that the academic dress tradition alienates people from poorer backgrounds. It is difficult to articulate just how condescending this is for us – the idea that we are so fragile as to have our dreams crushed and spirits obliterated by the idea of wearing a suit and a gown.

But in an environment where we are encouraged to shut up while the real men do the talking, and where we are ushered back to our cotton wool houses to be pacified and brainwashed by (gluten-free, organic) bread and circuses while champagne socialists fight our cause for us, this patronisation is par for the course.

I have many wonderfully minded state school friends who would excel at Oxford. The number who have left Oxford because they have not felt welcome is negligible. But the number who felt too unwelcome to even apply in the first place is deeply concerning.

Why did they feel unwelcome? Not because they had the opportunity to listen to the experiences of people like them who attended Oxford – an opportunity which the university goes to great lengths to facilitate through access schemes. Rather, it is because of the unrelenting dogmatism of those privileged wannabe saviours who – despite our contrary voices – insist on fuelling the pernicious narrative of Oxford’s oppression of us plebeians.

The irony is, of course, that these voices, apparently standing up for us, patronise us too much to dignify us by allowing us to use our own voices.

So if you are worried about applying and cannot navigate the media’s portrayal of Oxford life, take it from me – one of your own – a boy on the maximum opportunity bursaries, who went to a comprehensive school in Croydon where we called girls ‘peng’ and football skills ‘greazy’, you are welcome at Oxford. You will be supported, listened to, respected, and sometimes even indulged. If only bourgeois lefties would treat you the same way.

Calum Miller is an academic philosopher and a final year medical student at the University of Oxford. He blogs at calumsblog.com and tweets @CdoggMiller

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There has been much discussion in recent weeks amongst students and clinical staff about the new junior doctors’ contract. In light of this Dr isobel Ramsay has submitted this comment.

The Junior Doctors contract: Not Fair Not Safe?

In recent weeks my Facebook wall and twitter feed have turned into a stream of petitions. Petitions for strike action, petitions for a vote of no confidence in Jeremy Hunt and many others along a similar theme. In addition this week I have seen a number of familiar faces from my medical school year out marching with placards in London. The terms of the new junior doctors' contract which the government plan to impose from next August have been met with a great concern, not only from the juniors ourselves but also our consultants and our royal colleges.

The key changes to our current working patterns are as follows: • Change in 'normal' hours from 7am-7pm Monday to Friday to 7am10pm Monday-Saturday. Although there would be an increase to the basic rate of pay, out of hours pay would decrease due to this reclassification of the hours. For a more in depth explanation of how this affects individual specialties, there is an excellent financial model made by a trainee anaesthetist which can be accessed via the AAGBI website. Acute specialities appear to be hit particularly hard as well as GPs who will lose their trainee supplement.

• Year on year increment to be removed and replaced by increases in pay at certain levels of responsibility. No pay increase for those taking time out for maternity leave or research.

As well as the likely decrease in pay and subsequent effect on morale and life outside work, a major concern is the effect on patient safety. At present our hours are monitored and if, as many juniors do, we work beyond those hours, our trusts incur a financial penalty by having to pay the out of hours supplement (or band). The new contract would remove this financial penalty thus potentially removing the incentive for trusts to protect their doctors from working unsafe, long hours.

One of my major concerns is the effect that these changes will have on those who wish to pursue an academic career, particularly those like myself who plan to have children at some point, due to the cumulative financial disadvantage over the course of training which I fear may dissuade others from electing to pursue research as part of their training.

I have really enjoyed my time as a doctor since leaving Oxford but along with many others at my stage am now wondering whether to emigrate to Scotland or Wales (neither are imposing the contract) or whether taking time out for a PhD and children is a financially sensible option. It is heartening to see the support that we have had from the majority of our royal colleges but we have yet to see if their opinions have the hoped for outcome. If not, I may reluctantly be joining the picket line soon…

Isobel Ramsay MRCP BM BCh

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Emanoel Lee Prize 2015

Elective Placement Report, February – April 2015 Matthew James Stone, Green Templeton College

1. Bilga General Hospital, India; CMC Ludhiana, India; Centre Hospitalier de Soavindriana, Madagascar; (from left)

I split my elective between several sites including two very different hospitals in the Punjab, India, before finally finishing in Madagascar. I felt that splitting my elective in this manner would allow me to experience as much as possible in the ten weeks and to gain the most from the elective placement. I also wanted to work in environments that were both very challenging but also which were very different from the UK. Madagascar also offered the valuable opportunity to practice medicine in another language. More selfishly, I also knew that these would be fascinating countries to visit and explore in my spare time.

Bilga General Hospital The first place I visited was the Bilga General Hospital, a charity hospital in the Punjab which I arranged through Professor Robert Arnott, a member of the college who is the Chairman of the UK charity. I had to leave Delhi at 6am to get the train to Phagwara where I was met with a sign for “Dr Metthew Stone” and the hospital ambulance which took me to Bilga. I met Dr Chander Mohan, the Director of the Hospital and general surgeon. He was incredibly respected by the locals and often people would insist on seeing him about non-surgical complaints just because his opinion was so highly valued. He was the person I spent most time with over the placement both in the outpatient department and also in operating theatres seeing a range of common surgical complaints.

This was a rural hospital with only one surgeon, one medic and one general doctor who covered emergencies as well as a dentist and physiotherapist. Facilities were basic with simple radiographs and blood tests but little

more than this. Patients requiring anything more complicated faced a long trip to a nearby city (often on a motorbike). The lack of resources was at times shocking, particularly relatively basic drugs and diagnostic equipment which we rely on here in the UK. I began to appreciate some of the challenges that the hospital faced. It was located outside of the main town and as a result sometimes people struggled to get there. When it rained people would frequently not come at all. There were also issues with funding and in retaining staff in an isolated location and many doctors had to be brought in when required (such as anaesthetists for when operations were scheduled). The hospital also had a significant local problem with alcohol drug abuse, due to relative affluence and readily available strong spirits and heroin crossing the Pakistan border.

2. The ambulance that met me and took me to the hospital One challenge which I hadn’t fully considered was the impact of local community healers.

These individuals were free to visit and often have very good basic medical knowledge.

Unfortunately this also meant that many patients presented to hospital late with more advanced disease or following inappropriate

treatment, especially antibiotics. This also contributes significantly to antibiotic resistance in India and action is really necessary to enforce rules on prescribing to prevent this becoming uncontrollable.

I also spent a day at a local charity school and orphanage which worked closely with the hospital which treated the children. This included a visit to the slum where many of the children had come from which was invaluable in understanding their health problems. The director also talked about the children in his care who had benefited from treatment and this was very interesting in understanding the wider role of the hospital in the local community rather than just the acute side I had seen at the hospital.

Christian Medical College, Ludhiana I then continued on to the Christian Medical College in Ludhiana, a hospital where many of the more complex cases at Bilga were referred. Ludhiana is a much larger, industrial hub with the dubious honour of being the most polluted city in India. Here I undertook a placement in medicine, split between the Hospital Medical and Community Medicine teams. My placement in the hospital operated much like UK hospital medicine and I was attached to a firm complete with medical students, took part in ward rounds and spent time on take. The hospital itself was very different however with just one ward for all the male medical patients and another for the females, each holding around 50 individuals.

I gained exposure to a number of conditions that are rare in the UK, including typhoid fever, tuberculosis and rheumatic fever.

Furthermore, there was a major outbreak of swine flu in India resulting in many fatalities.

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As a result the wards and outpatient departments were full of people concerned they had swine flu. This placed a lot of pressure on the system and resulted in medication rationing and it was interesting to see how the hospital coped with this.

I attended daily teaching sessions which were often very informative. I remember one in particular from a visiting lecturer on palliative care, a subject often dealt with poorly in India. I was surprised by the lack of knowledge around basic concepts and found my knowledge to be better than many senior doctors. As well as reiterating how lucky I am to have received a high quality of training, it reinforced the value of volunteering overseas to educate doctors in this manner which is something I may consider in the future.

One thing I found fascinating was the differing view of medicine and doctors from the UK. Compared to the UK, medicine in India is much more paternalistic and hierarchical, both with respect to patients but also hospital staff. Doctors worked hours that would be illegal in the UK, with final year medical students on my firm working long days (8am-6pm) and being on-call on alternate nights – being expected to work a normal day after this. As a result mistakes were made and the adverse effect of this work pattern on the staff was obvious. On multiple occasions I was asked questions by family in preference to female members of staff purely on the basis of gender, despite them being far more qualified to comment.

Patients also often had fixed views of healthcare, for instance if patients didn’t receive an injection they usually felt they had received a substandard service. This leads to poor practice to satisfy patients including lots of unnecessary antibiotic prescribing and vitamin injections. Because families have to provide many of the basic services we take for granted in terms of feeding and washing patients, they would frequently move into hospital when a relative was admitted, sleeping on the benches outside.

One particularly memorable case was of a man with likely myeloma.

Having seen the management of similar patients in the UK the differences were obvious. No investigations could be carried out until the family had paid in advance for what was required. The cost of this was considerable and took time to arrange leading to totally avoidable delays and further suffering as a consequence. Seeing this put into perspective just how fortunate we in the UK are at not having to get into debt just to treat health problems, nor in having to make difficult decisions on limits of treatment based on what we can afford. He also had to undergo a trephine to get a sample of bone marrow with no local anaesthetic – a traumatic experience even only to witness. Once diagnosed he required numerous blood products to treat the condition which in India requires relatives or friends to go to the blood bank to donate an equal number of blood products (as well as paying for the blood products). This idea helped circumvent a cultural unwillingness to donate while in the UK we are fortunate that people are generally more willing to donate altruistically.

The second part of the placement was spent at Field Ganj, a smaller satellite unit working in some of the main slums in Ludhiana and focusing on the health of young children and women of reproductive age. The facilities here were basic but focused life-changing conditions like anaemia, tuberculosis and malnutrition, effectively providing a very basic version of a UK GP service but targeted exclusively at the most vulnerable areas of society. This included not only doctors but also outreach workers who were responsible for going out into the slums to see out those people in need but who may be reluctant to engage with healthcare. Being able to go out into the community with them allowed

3. Field Ganj Unit; The surrounding slums; The team at Field Ganj; (top to bottom) me to get a much better appreciation for the conditions people were living in and as a result to better understand the problems this created in terms of their health.

The work at Field Ganj was also a great demonstration of how medical students can engage with the local community on a different level to ultimately prevent ill health. Each week the students would go out into the community and educate the local people on a health topic of their choice, including subjects like hand hygiene, diabetes, how to deal with simple viral illnesses and anaemia.

There was also a daily student clinic for the poorest patients which was entirely free where students could prescribe drugs that had been donated for this purpose. I attended every day (with a different student each time) and each day saw different drugs prescribed for identical problems depending on the student running it! Although some of the decisions were probably less evidence based that might be ideal they provided at least basic healthcare to a very vulnerable sector of society.

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Centre Hospitalie r de S oav indriana, Antananariv o Five weeks into my trip I then travelled to my final destination, Madagascar. Here I was undertaking a placement in Paediatrics at the military hospital, one of the best equipped and largest hospitals in Madagascar.

Many of the conditions seen were very similar to a paediatric unit in the UK including lots of asthma, bronchiolitis and premature births.

There were however several cases such as congenital heart disease which I knew would have been treatable in the UK but for which nothing could be done. While this was difficult, in the context of a system that could not provide many more basic things it was very understandable.

by repurposing bottles of soft drinks and one of the nurses showed me how you could chop the top off a bottle of water in order to create a homemade spacer to administer drugs to a child. These imaginative solutions which would fall far short of the standards we expect in the UK were ultimately the difference between having access to treatment or not.

Exploring I was also fortunate to have time at weekends and outside of work to enjoy myself and see some of the incredible opportunities that both of these countries had to offer.

I was in India for the festival of colour, Holi which was an amazing experience. I was generally amazed by the kindness and helpfulness of people and over my five weeks I was invited to a ridiculous number of events. The physiotherapist at Bilga Hospital, Neeraj invited me to her family home in a neighbouring city one weekend as well as taking me to visit the Golden Temple in Amritsar, while an English doctor I met at the hospital even took me to an Indian wedding. I was also able to spend a few days prior to leaving to explore Delhi and Agra including seeing the Taj Mahal which was breathtakingly beautiful.

In Madagascar I explored Antananarivo, the capital, while in a couple of days at the end of my trip I visited the National Park at AndasibeMantadia to see some of the incredible wildlife that Madagascar is famous for (including lots of lemurs!). I then finished the trip with a brief visit to the small island of Ile Sainte-Marie which was probably the most relaxing place I have ever visited!

4. The paediatric team, Centre Hospitalier de Soavindriana Practicing medicine in French was extremely challenging, especially with the Malagasy accent. My French improved significantly over the placement and I even learnt some Malagasy as well. By the end I was able to give a presentation on Down syndrome in French. This placement also provided an excellent opportunity to refresh my paediatrics skills from 5th year.

The hospital worked closely with charities including MSF who referred patients from isolated rural communities onto the hospital for further treatment. It was interesting to see how the work of the government hospitals and the charity sector came together to help people who would not otherwise be able to access healthcare.

Madagascar is an extremely poor country, and healthcare resources are very limited with even basic equipment like pulse oximeters being unavailable and doctors having to provide their own thermometers. I was amazed by the ingenuity displayed to get around the resource limitation.

Sharps bins were created

Conclusions In summary my elective was an incredible experience and one which I feel sure I will remember for the rest of my life. I had amazing times in both of the places I visited and I know that this experience has helped me to develop as a person and will crucially make me a better doctor in the future. It wasn’t always easy or fun (although most of the time it was!) and at times it was stressful but reflecting on my experience I achieved all of my aims and I don’t think there is anything about it I would change.

The overwhelming sentiment I was left with from this trip is one of gratitude; both for the kindness of the people I met but particularly an appreciation for the generally excellent standard of healthcare that we have in the UK. I was especially impressed by the efforts of healthcare professionals working in the low-resource settings I visited with the limitations this presented. While the healthcare challenges faced in India and Madagascar are not directly comparable to the challenges we face here in the UK, both ultimately come down to a lack of resources to pay for the standard of healthcare that would be desirable, and I think that many of the principles I came across, in terms of the creative use of staff (and indeed medical students!) can help to overcome some of the hurdles we face in the UK in the future. I would also like to explore similar opportunities and hope to be able to do some work abroad in the future, perhaps at a point where I can contribute more.

With thanks to Green Templeton College and the Walter Guinness Trust for their financial support which helped to make this elective possible, and to Professor Robert Arnott for helping to arrange both of my placements in India and for his very helpful advice.

5. Sharps Bins Malagasy Style

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6. The Golden Temple, Amritsar; The Taj Mahal, Agra; The wedding; Hira Gasy (Traditional Malagasy storytelling); The view from my room on Ile Sainte-Marie; An Indri, Andasibe National Park (Clockwise from top left).

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Dr. Eric Sidebottom Profile

by Dr Marisa Benoit

Dr. Eric Sidebottom has been an integral part of the Oxford medical community for over fifty years. Whether through his work as a lecturer at the Sir William Dunn School of Pathology, or a tutor at Lincoln College, his dedication to telling the true story of the discovery of penicillin, or his knowledge about the medical landmarks of Oxford, Sidebottom’s impact on the culture and the history of medicine in Oxford is notable. A dedicated teacher and a talented scientist, Dr. Sidebottom’s long history with Oxford is an inspiring personal and professional journey.

Early Life and Coming Up to Oxford If Eric Sidebottom were to give his life a headline, it would be ‘Boy from nowhere makes good.’ He describes his impressive academic and professional achievements with endearing humility and a warm sense of humour.

Sidebottom grew up in rural Derbyshire. His father died when he was four, and his mother was determined to give her only child the educational opportunities that weren’t available to her. Eric’s talents were noticed at his state school in Kirkham, Lancashire, and the school applied to Oxbridge for him. While there was no legacy of medicine in the family, Sidebottom was always interested in medical research, and as a teenager he wrote to the Medical Research Council to ask about pursuing a career in medical research. The answer he received? ‘Get a medical degree first.’

Sidebottom came up to Corpus Christi in 1957 and humbly describes his acceptance at Oxford as ‘pure fate’. He was ‘a sporting character’, keeping busy playing rugby and cricket, and socializing with his many new friends. He loved the intensity and challenge of academic work and life at Oxford, and later used his personal experience of the intense environment in his approach to teaching , stating ‘You are incredibly busy when you are here [at Oxford]; challenged and pushed the whole time... and that has become my philosophy. My role as a university teacher is to stretch students until they squeal. Because they are incredibly bright and they’ve all got talent and I’ve got to get it out of them.’

He enjoyed his three years at Corpus ‘enormously’, and he praises the personal attention that the Oxford college system provides. At Oxford, ‘you are not one of the great crowd’, and the dedication to individual care is something that Sidebottom carried with him from his undergraduate days to his later post as university lecturer and college tutor.

After Corpus, Sidebottom went on to complete his clinical course at St. Bartholomew’s in London, where he qualified in medicine in

1963. He notes, with a laugh, that ‘‘You can tell a Bart’s man anywhere, but you can’t tell him anything.’ He enjoyed his time at Bart’s and was spent a year as a houseman there before he returning to Oxford to pursue research in pathology. Why pathology?

‘Because pathology gives you the answers’. He then moved to the Dunn School to study for a DPhil on nucleolar function under Professor Henry Harris. A university lectureship in experimental pathology soon followed in 1969, as did a college fellowship at Lincoln College in 1972. As Medical Tutor at Lincoln, Sidebottom was once again heavily engaged in college life, and he was a talented teacher. He describes himself fundamentally as a teacher rather than a researcher, although his work on metastasis produced several publications and he continued to lead a small research team in addition to fulfilling his teaching responsibilities, until he left the Dunn School.

A New Kind of Research Sidebottom was also a gifted administrator, and he chaired committees, organized courses and exams for the pathology department and medical school, stepping in after the untimely death of John French in the early 1970’s. He also occupied the anachronistic post of University Assessor for one year (1979/80) and this, he says, gave him a unique insight into the real workings of the university. It was these skills that resulted in him being ‘headhunted away’ from Oxford in 1989 by the Imperial Cancer Research Fund (ICRF), now known as Cancer Research UK (CRUK), where he became the assistant director of clinical research. It was a job that took him all over the country, although after five years at the ICRF financial setbacks within the charity resulted in Sidebottom returning to work at Oxford. Back at Oxford, he worked again as a demonstrator.

As well as teaching, this allowed him to pursue a new interest: the history of medicine, which would provide him with an opportunity to do a whole new kind of research.

Sidebottom’s work with the history of medicine has kept him very busy over the last several years. He was particularly interested in sharing the remarkable history of the Dunn School and some of its most famous contributions to medical science. The story of penicillin has been a particular focus, and Sidebottom has been able to enhance his meticulous research with personal memories of the major contributors, including Howard Florey and Norman Heatley.

Florey was the professor when Sidebottom was a student at Oxford, and he remembers his ‘conscientious’ lectures and dour personality.

He acknowledges that Florey must have had a

certain charisma, though, due to the loyalty that he inspired among his students and within his lab. Norman Heatley was Sidebottom’s teacher and friend and it has been a personal mission of Sidebottom’s to ensure that Heatley receives the recognition that he deserves for his integral role in the production of penicillin. Sidebottom has done this in various ways, contributing a chapter on the ‘Discovery of Penicillin’ in the book Nobel Prizes that Changed Medicine, giving lectures, and writing Heatley’s biography in the Oxford Dictionary of National Biography.

Sidebottom is currently working on a book on Heatley, co-authored by David Cranston, and is also writing a biography of his supervisor and mentor Sir Henry Harris.

Walking through the History of Medicine Sidebottom’s interest in the history of medicine has taken him far outside the walls of the Dunn School, however. He has also written a book, Oxford Medicine: A Walk Through Nine Centuries, which provides a walking tour of the medical landmarks of Oxford. He is currently working on a second edition of the book and is looking forward to adding some new locations and interesting stories to it. Oxford medical alumni often benefit from Sidebottom’s dedication to telling the stories of Oxford’s medical discoveries, and he has been known to provide walking tours as part of medical alumni events. When he is not researching medical history, writing, or giving talks, Eric enjoys spending time with his family, including his seven grandchildren, the oldest of whom has just won a place for medicine at UC London!

Dr. Eric Sidebottom, ‘the boy from nowhere’, has made a great impact on Oxford since coming up nearly fifty-eight years ago. His dedication to his students, to the pathology department, and to the institution as a whole, is truly admirable. Above all, Dr. Sidebottom’s warmth and humility shines in his work, as he now dedicates himself to sharing the stories of the people and the places that he has come to know and love.

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From the archives…

Eric Sidebottom playing rugby in Hospital Cup February 1963

With sadness…

Terence McQueen Collins (“Terry”) Former general practitioner (b 1943; q Oxford 1972; FRCGP), died from acute myocardial infarction on 4 March 2015.

Initially qualified as a vet in 1966, switching to medicine soon after qualifying but working as a vet during holidays to support his medical studies. Most of his working life was spent as a general practitioner in Maryport group practice in Cumbria.

He was instrumental in helping the practice develop from a traditional family doctor service to a modern multidisciplinary practice, embracing change where it was for the benefit of patients. This was exemplified by the practice being a first wave PMS (personal medical services) practice, having first been a PCAP (primary care asthma programme) pilot. Terry started a dedicated diabetes clinic in the practice in 1988. He established training in the practice, and many current GPs will be grateful for the thorough grounding he gave them. His colleagues and patients acknowledged his professionalism and compassion. He was appointed an examiner for the MRCGP, and his contribution to general practice was acknowledged by his attaining the fellowship of the RCGP in 1997.

Terry was very aware of the importance of the institutions that administered and supported general practice and was a member of the Cumbria family practitioners’ committee and the local medical committee for many years.

In the latter years of practice he became a member of the General Medical Council’s professional conduct committee, which he continued even after retiring from general practice in August 2007. Not finished with medicine, he then took an active role as a trustee for the local Hospice at Home charity, whose chairman he was from 2007 to 2013. He was highly regarded by both staff and volunteers in the organisation for his wise counsel and leadership, attending and supporting fundraising events whenever he could.

He married Rosemary in 1972, and they had two daughters (and, currently, four grandchildren). His life outside medicine was his family and gardening; he had a passion for classical studies, working towards an Open University degree. He always had a love of dogs and latterly got much pleasure out of watching and helping his grandchildren grow.

Terry was a dedicated doctor, who was conscientious and professional in every job that he did. He contributed enormously to

May Morning 1958, Osler punt in foreground

the development of general practice in west Cumbria, and his sudden death was a great loss to his many colleagues and friends.

Leslie Clifford Cowley Retired general practitioner (b 1932; q Oxford/St Mary’s Hospital, London, 1963), died from dementia on 23 October 2014.

After his house jobs in the London area, Leslie Clifford Cowley returned to his birth place to join a general practice in Ramsey on the Isle of Man. In his early days he gave anaesthetics for minor operations, and always maintained an interest in coronary care and medical politics.

For relaxation he enjoyed sailing in the Irish Sea and further afield, and farming on the family farm where he grew up.

He was married to Diana, a nurse at St Mary’s Hospital, for 50 years, and the couple had three children: a daughter, Sarah, a general practitioner in north London; two sons; and seven grandchildren.

Adrian Maxw ell Grant (b 1948; q London 1975; FRCOG, DM, MFPH UK, FRRCP), died from secondary spread from ocular melanoma 16 August 2015.

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Grant was born in Shrewsbury in 1948. After leaving Eton, he made a 13 000 mile trip round North America on a Greyhound bus before going to Trinity College, in 1967, aged 19, to study medicine, and then to St Thomas’ Hospital for his clinical training. Adrian Grant was embarking on a career in obstetrics at Queen Charlotte’s Hospital when a course in medical demography at the London School of Hygiene and Tropical Medicine changed the course of his life. “I was not a natural surgeon and tended to panic in crises,” said Grant, who was affected by progressive external ophthalmoplegia much of his life. But he found that he loved randomised controlled trials.

In 1980 he took up a post in Oxford as epidemiologist at the National Perinatal Epidemiology Unit (NPEU), under its founding director, Iain Chalmers, with the task of establishing a trials centre.

He died at his home in Oxford and leaves his wife, Frances, and their two children.

Gareth O. M. Jones 1928 - 2015 Matric 1950 BM BCh. D.A. F.R.C.A. London, Gareth Jones passed away in Southampton after a brief illness on Sunday, June 14. He was born in Barry, Wales, on Sept. 19, 1928. He completed his primary education in Wales, served in the British Army, and then completed his education in England culminating in B.M B.Ch. Oxford and Doctor of Anaesthesia from London R.C.S. After beginning his career in London, at the Cleveland Clinic, he moved his family to Maine. He held numerous positions at Augusta General Hospital (future KVMC), including Chief of Medical Staff, Chairman of ICU, President of Kennebec County Medical Society, and retired in 1996. He was very dedicated to the science of medicine and helping to heal his patients.

Gareth kept busy with many hobbies, including designing, building and sailing his beloved catamarans, photography, gardening, fishing, flying, golf, diving, and traveling. He particularly enjoyed his family, grandchildren and great-grandchildren.

Kenneth Harold Lew is Former private general practitioner (b 1928; q Oxford -St Mary’s Hospital, 1954; MA (Oxon), d 19 May 2015, aged 86.

Kenneth Harold Lewis was the son of Henry and Winifred; he had a brother, Neville.

Educated at Epsom College, St John’s College Oxford (1946-50), and St Mary’s Hospital Medical School (1951-54), he joined the Royal Navy as medical officer on board HMS

Mountsbay (1955-58). Afterwards he became a general practitioner and worked with his father in private practice, until Henry’s death in 1960, when he inherited the practice. Dr Lewis, like his father before him, was in general medical practice in Hampstead and Central London for more than 45 years. His distinguished medical career encompassed involvement with many illustrious organisations, fostering interest in medicine in the arts. He was a member of the founding committee of BAPAM, and personally involved with the Musicians Benevolent Fund.

But as a keen musician himself, he was honorary medical adviser to the LSO. He was a man of great compassion and kindness, always interested in the lives and concerns of others and taking endless care to help and support where he could beyond personal gain.

John Harmar Mott, Regional medical officer Department of Health and Social Security (b 1922; q Oxford/Middlesex Hospital, London, 1952; MRCGP), d 15 May 2015.

Known as a quiet and modest man, intellectual, classical, and knowledgeable, but still a private man with old fashioned courtesy, always rising to greet you with a smile.

He was born in 1922 in Oxford into a family who deeply valued knowledge and intellect, and received a classical education, at the Dragon School and Radley College, then changed in his teens to study medicine at New College, Oxford.

The war came, and he chose to join the Royal Air Force, training on Tiger Moths and graduating to Liberator bombers in Canada and Ceylon.

After the war he returned to his medical studies. After qualifying he was offered a position in a general practice in Southport: he had a reputation as a good diagnostician and was well respected in the practice. He became secretary of Southport local medical committee and medical officer at Sunnyside Hospital, also to the British Legion, the Home for the Blind, and the Children’s Home in Southport, and he was a founder member of the Royal College of General Practitioners.

He also took part in medical research, a study on physique and morbidity, and Professor Richard Doll’s study on the effect of aspirin in preventing heart disease, which involved taking small doses of aspirin for much of his life.

In 1969 he left general practice and became regional medical officer at the DHSS, advising GPs, and tribunals for assessing health benefits.

Finally he retired at the age of 71, which allowed him to go back to his classical interests, taking an Open University course in classical Greek history and becoming a member of the Anglo Hellenic League and the Society for the Promotion of Hellenic Studies He is fondly remembered by his wife, Elizabeth, after 64 years of marriage; three children, David, Jennifer, and Alison; six grandchildren; and two great grandchildren.

Kenneth Alfred Kingsley North (“Ken”), Consultant physician, endocrinologist, and medical unit director Wellington Hospital, New Zealand, and Royal Berkshire Hospital, Reading (b 1930; q Otago 1954; DPhil Oxon 1957, FRCP Lon 1960, FRACP 1964), died from Alzheimer’s disease on 22 January 2015 A keen sportsman at Otago University and president of the students’ union, worked with Sir John Eccles, Nobel laureate, to obtain his BMedSc. Three years later at Oxford as a Rhodes Scholar, he studied under Sir Howard Florey and obtained an athletics blue. He spent eight years in the UK, at the Radcliffe Infirmary and later at the Hammersmith Hospital, before returning to New Zealand in 1962, to take up the appointment of medical tutor and later consultant physician at Wellington Hospital.

When the New Zealand government would not accept his report advocating a full medical school at Wellington he returned to the UK in 1972 with a wife, four children, and no secure job. His first post was as locum registrar at Hampstead General Hospital. He quickly obtained a consultant appointment at the Royal Berkshire Hospital, where he made his name as a friendly, skilled and accessible opinion. He firmly established the weekly medical grand round and was one of the first consultants at a district general hospital to be made an MRCP examiner. Ken was outstandingly supportive of his colleagues and juniors.

His early retirement was a loss to the medical community, but Ken, always somewhat of a polymath, took up farming in North Devon in the 1980s. In 1999 his family drew him back to Nelson, New Zealand. He leaves his wife, Katherine, whom he met in Oxford; four children; and nine grandchildren.

Jennifer Leslie Pugh (nee Murray) was born in Exmouth, Devon, on 26 May 1931. Died September 2015. Married Michael Pugh.

Robertson, Clive C., Hanford, Calif.; Oxford University, 1971; internal medicine; FRCPC; former staff, Royal Alexandra Hospitals; assistant clinical professor, University of Alberta. Died June 25, 2004, aged 58.

Michael Patrick Ry an Former general practitioner Livingston, medical director of primary care Computing Systems Scotland (b 1935; q Oxford 1968; MBE, DRCOG, FRCGP, MFCM, MFPHM), d 1 January 2015. (“Mike”) studied at the London School of Economics and graduated BSc in economics with first class honours in 1959. Many of us will consider it our good fortune that he did not long pursue what could have been a promising career in economics Instead he started all over again as a medical student,

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graduating at Oxford in 1968. After junior hospital appointments, he went into general medical practice in Oxfordshire and then in Lincolnshire.

In 1974 he boldly moved north with his family to take up a conjoint appointment in Livingston. At that time, the Scottish Home and Health Department was actively promoting the Livingston scheme to bring the various parts of the NHS closer together. We were all enthusiastic and mostly quite young.

Joining our group in Howden, Mike combined general practice with what used to be called public health and had already by then been renamed as community medicine. As a general practitioner, he was a valued, mature, reliable colleague. Everyone appreciated his ability, his genuine charm, and his social skills.

As a man of active, athletic tendencies himself, he developed an interest in sports medicine, and for some time he ran a sports medicine clinic in the practice. Such was his own athleticism that on one snowy day he decided to travel from his home in Edinburgh to his work in Livingston on cross country skis—a journey of 17 miles. His physical capacities were amply adequate for this expedition, but he had not anticipated that in many places along the route, the snow had been cleared and skiing was impossible. He arrived several hours late, to find that his colleagues had attended to his patients, and he graciously accepted a lift home.

Another fond memory is of the excellent coffee he used to brew in his room and share with colleagues after all the patients had been seen but the paperwork remained to be done.

Recognising the limitations of paperwork as a means of recording and coordinating complex data, Mike developed a major interest in medical records. Sending sheets of data to be keyed into a remote, mainframe computer that worked rather like a tape recorder on steroids had already been shown to be of limited use.

With help from secretarial staff, Mike pioneered the use of punched cards, on site in the practice. These required a skilled operator, but they functioned well as a multirelational database.

In the meantime, the technological revolution was progressing, both in our own silicon valley and beyond. Mike started working part time with GPASS, General Practice Administration System Scotland. This was a computer system developed by and for GPs. In the early days it did not have all the bells and whistles found on modern systems, but it was built up and developed gradually and realistically, and it worked.

It worked so well, in fact, that in 1990 Mike was able to cut back on his frantic commuting between Edinburgh, Livingston, and Hillington in Glasgow, when he became medical director of primary care computing systems, full time.

We were sorry to lose him from Howden, but we recognised the contribution that he could make to general practice and public health throughout Scotland, and we felt privileged to have taken part in these exciting developments.

His work was also recognised in 1986 by the award of an MBE for services to medicine.

Mike later held other senior posts, including medical adviser to HM Inspectorate of Prisons.

He never lost his concern for individual patients and even after he retired, he worked a few sessions per week in a practice in Muirhouse in Edinburgh, an able and caring doctor and a valued colleague.

Oliver Sacks (b 1933; q Oxford 1958), died from cancer on 30 August 2015.

Strictly speaking, Oliver Sacks was a physician who took up writing. But his authorial impact was such that it makes equal sense to think of him as a writer who happened to have a broad knowledge of medicine. He mined that knowledge for insights into what it is to be human, whether in sickness or in health. His most celebrated medical achievement was the use of L-dopa in the treatment of a group of patients affected by the epidemic of encephalitis lethargica in the 1920s. It was also this, chronicled in his 1973 book Awakenings and the subsequent film that brought him to public attention.

Readers of his many books unfamiliar with the medical literature of years gone by may have thought Sacks had created a new genre in his writing about illness. He hadn’t, of course.

What he had done was resurrect an approach that once characterised much of the content of medical journals: the case history. He modernised it, enlivened it with his literary skills, and embellished it with his own humanity.

A century or more ago—when medicine’s grasp of disease was still rudimentary—the physician’s principal investigative tool was a thorough observation of the patient and their circumstances, followed by a careful account of everything that might be relevant to an explanation. As it was hard to identify what might be relevant, much detail was necessary.

The rise of science brought not only a better understanding of disease but the possibility of reducing an overview of the patient’s physical condition to a list of descriptors, an image or two, and set of numerical values for various

physiological parameters. Hardly the stuff of literature.

Despite attempts to deploy such an approach in mental illnesses, trying to explain aberrations of behaviour solely in terms of serum this or that or neurotransmitters X and Y was a hopeless enterprise. It did not take account of the experiential aspect of psychiatric disease. Many of the behavioural eccentricities that make up the greater part of Sacks’s raw material still remain to be explained—which is why his case histories are so detailed, covering anything that might eventually reveal itself as having causal significance.

The strangeness of so many of the people Sacks wrote about makes compelling reading.

Hence the much quoted New York Times epithet “poet laureate of medicine.” For my money that’s a bit too highfalutin. “Balladeer of medicine” might be more apt—almost literally so in the case of The Man Who Mistook His Wife For A Hat, the case history that became an opera.

Fascinated by science as a child, Sacks studied physiology at Oxford before joining the Laboratory of Human Nutrition. Bench science was a task at which he proved disastrously inept; he returned to the university, this time to read medicine. A couple of years after graduating he moved to California—partly, he suggests in his autobiography, to escape the mismanaged schizophrenia of his brother, but also to explore such illnesses in his own way. In San Francisco and Los Angeles he got to grips with neuropathology and neurochemistry, then moved to New York’s Albert Einstein College of Medicine to refine them. It was at the nearby Beth Abraham Hospital that he worked with patients with encephalitis lethargica.

New York became his permanent home, the setting for his clinical work, his teaching, and above all, his writing. Two New Yorkers— whose friendships with him go back over 20 years—take similar views of his influence. “The general public learned from him about neurology and brain science as it did from no one else,” says Erik Kandel, Fred Kavli Professor in the department of neuroscience at Columbia University. “He could make the front page of the New York Times.” The impact on the profession of his illuminatingly romantic view of illness has been less pronounced, Kandel adds.

“But in his writing he brought patients alive.

He saw new dimensions in their characters, and showed in his magical way how illness brought out new strengths in individuals suffering from them.”

Orrin Devinsky, professor of neurology, neurosurgery, and psychiatry at the New York University School of Medicine, echoes that view. When Sacks started out, only a small number of behavioural neurologists and psychiatrists appreciated how remarkable he was. But he believes that over time his

18 / OXFORD MEDICINE . NOVEMBER 2015

influence has grown. “He invigorated interest in the meticulous study of individual patients, and in understanding them not just from the medical perspective, but from their perspective, and in a much more vivid and fuller sense.

When I was a student at Harvard, doing a paper on Tourette’s syndrome, I was told I must read Awakenings. I did, and that’s what sold me on a career in neurology.”

Sacks’s autobiography—presciently published earlier this year and titled On The Move—tells of an emotional rollercoaster of a life. He realised as a teenager that he was gay, but a profoundly negative response from his mother condemned him to years of sexual guilt.

“He was a fabulous swimmer,” says Kandel.

“He had a Russian trainer who helped him. And he’d been in analysis for the past 46 years with the same person. He once told me there were certain things in life you needed to have a tutor for: swimming, piano lessons, and your mind.”

Not all Sacks’s pleasures were intellectual. They ranged from weightlifting to drug taking (prescription and otherwise), and included a lifelong fascination with motorbikes. He met his final and most fulfilling love when he was 75.

He died in a self-proclaimed state of contentment.

Jean Alero Thomas Senior clinical lecturer (b 1945; q St Mary’s Hospital Medical School, London, 1970; MSc, FRCPath), died from cancer of the lung on 3 January 2015.

(Known to her friends and colleagues as Alero) worked as a house officer at the University Hospital, Ibadan, Nigeria. In 1971 she moved to Lagos University Teaching Hospital, where her father, Horatio Orishejolomi Thomas, was professor of surgery and dean of the College of Medicine. She trained in pathology and haematology before returning to the UK in 1973. Alero won a Commonwealth scholarship to study at the department of pathology at the John Radcliffe Hospital, Oxford, and gained an MSc from the University of Oxford in 1976. Subsequently she held clinical research posts in immunopathology at the Royal Free and Royal Marsden hospitals and at the Imperial Cancer Research Fund Laboratories in London. She was appointed to a senior clinical lectureship in the department of infection and tropical diseases at the London School of Hygiene and Tropical Medicine in 1992, from which she retired in 2006.

Alero’s research centred on applying immunopathological techniques to diseases caused by viruses. She was a key member of the team at the Royal Free Hospital that identified Epstein-Barr virus as a cause of post-transplant lymphoma in 1985. She continued to work on this tumour at LSHTM, where she was also involved in training MSc and PhD students from around the world. She published many papers

on post-transplant lymphoma, defining the characteristics of the tumour cells. This work formed the basis for a successful multicentre trial of T cell immunotherapy to treat patients with the disease.

Alero was a keen student of art and architecture, and, while still working at LSHTM, she undertook a part time degree in history of art at Birkbeck College, London.

After retiring she indulged her love of the arts by becoming a docent for London Open House and at the Royal Academy of Arts, where she gave regular public tours of, and talks on, the building, the exhibitions and art collection it houses.

John Brian Walker Ophthalmic specialist (b 1924; q Oxford/London Hospital 1947), died from congestive cardiac failure on 15 October 2014.

He was born in Catford, London, and studied medicine at New College, Oxford before completing his studies at the Royal London.

As a final year medical student during the Second World War, Brian and some colleagues were asked to go to Holland in 1945. He was immediately diverted to help manage the liberation of the Belsen concentration camp.

Brian was one of the first to witness the shocking scenes there, which displayed inhumanity at its most bestial.

Drafted into the army on qualifying, he was sent to east Africa, where he became the army’s eye surgeon for the region. Here he married Mary, a nurse from the Royal London Hospital. After demobilisation they returned to London and, with the support of Mary, took on his father’s general practice, rather than continuing his specialist career as an ophthalmic surgeon.

One of his main passions in life was sailing.

He was one of three helmsmen to dominate the “Hornet” dinghy fleet in the 1950s, 60s, and 70s and became commodore of the class.

He and Mary were great supporters of young people learning to sail and, for many years, ran “cadet week” at Burnham on Crouch, Essex.

Later Brian commissioned the construction of an Alan Buchanan 44 foot yacht. Arrogant launched in 1991 and he and Mary cruised around the Mediterranean for many summers.

They would welcome many friends and more young sailors, often junior doctors, with their great hospitality. Brian died at home in Cornwall.

A celebration of his life was held on 1 November 2014 at the Harbour Club in Porthscatho, Cornwall, where he had been a longstanding member. There was no funeral as Brian had decided to donate his body to a medical school, to allow students to benefit from the study of anatomy, as he himself had done, so many years before.

Sylvia Madeleine Watkins Consultant physician and oncologist Lister Hospital, Stevenage (b 1938; q Oxford/London 1961; DM Oxon, FRCP), d 22 March 2015.

Sylvie had a reputation as an exceptionally kind and caring physician, qualities much valued by her patients. In her retirement, she committed her energies to postgraduate development in several African medical schools.

She was also an accomplished violinist, involved with chamber and orchestral music throughout her life.

Sylvia was born into a family of doctors—the 12th in six generations, ranging from Timothy Watkins, surgeon apothecary in the 18th century, to her father, Kenneth Harold Watkins (1903-38), a urological surgeon at the Manchester Royal Infirmary, and her brother,. Peter Watkins (FRCP).

She always excelled academically, was determined to be a doctor, and gained a place at Lady Margaret Hall in Oxford, followed by clinical studies at St Bartholomew’s Hospital in London. She undertook junior posts at St Bartholomew’s Hospital and in Leicester, passed the MRCP just three years later (1964), and was elected FRCP in 1980. She was at this stage determined to pursue a career in neurology. To this end, and using her linguistic skills (fluent in German and French), she worked as a registrar at the University Nervenklinik in Heidelberg, before returning to England. Subsequently she persevered with general internal medicine as senior registrar at the Royal Free Hospital in London. During this period she was undertaking research into lymphocyte function in patients with cancer, and was awarded the DM (Oxon) in 1973.

Sylvia was appointed consultant physician at the Lister Hospital in Stevenage in 1973, in acute general medicine, for a period undertaking responsibility for diabetes too, until appropriate arrangements were in place following reorganisation within the hospital.

She was then able to take over the care of cancer patients for which she had received special training at London’s Royal Free Hospital.

The oncology unit which she established acquired a high reputation both among patients and their relatives, as well as recognition by her hospital colleagues for its thorough application of current practice. Sylvia maintained her interest in research resulting in several published papers.

Her gift as a teacher at the bedside was well recognised. In due course she was appointed as examiner for both the Cambridge University Medical School and for the Royal College of Physicians.

Sylvia had always been interested in the medicine of the poor world, and it was logical in her retirement for her to offer her services to the Tropical Health and Education Trust (THET) which had been founded by Sir Eldryd Parry. She came to work in one room with a

OXFORD MEDICINE . NOVEMBER 2015 / 19

team of talented and dedicated young women, and negotiated the transition from the Lister Hospital with humour and humility, throwing herself with great enthusiasm into managing the Royal College of Physicians’ generous grant to THET for postgraduate development in African medical schools at Kumasi and Mbarara, Uganda. Working closely with her friend, the vice chancellor, she helped to establish a programme that has already trained current staff members.

Sylvia never married, but she loved, and was loved by, her nephews and nieces and her many godchildren. She entertained them, offered advice, and was always extremely generous.

John Trev illian Wright Consultant physician and gastroenterologist, London Hospital (b 1921; q Oxford 1944; DM Oxon, FRCP), died from acute myocardial infarction on 3 July 2014.

He spent much of his childhood in South America, where his father was a manager for an oil company. He attended Shrewsbury School and spent the holidays in South America and in the English countryside. These times, when he was often unaccompanied, fostered his independent spirit and sense of adventure from an early age: on one occasion, he jumped from the deck of one transatlantic liner to another. In addition to showing academic prowess, he was an excellent cross country runner and was taught to row by his father, with family trips in a camping skiff on the Thames.

He went up to Worcester College, Oxford, in 1940, crediting his place, characteristically modestly, to the correct identification at interview of a hornbeam tree in the quad. He won a Price university scholarship in anatomy and physiology, and after being admitted to the London Hospital Medical College in 1942, won prizes there in surgery, pathology, and chemical pathology. He undertook war service in and around London, and graduated in December 1944. On 20 January 1945 he married Kate Elliott, who was to be his wife for 56 years.

His house officer posts were at the London Hospital and his national service in the Royal Army Medical Corps between 1946 and 1948. He was senior registrar at St George’s Hospital in 1949-50, and lecturer and senior lecturer at the London Hospital Medical College from 1950 to 1958. During this time, he was awarded DM (Oxon) for his thesis on the management of barbiturate poisoning.

Periods as appointed assistant physician to Whipps Cross Hospital in 1956 and the London in 1958 were followed by his becoming general physician to St John’s Hospital for Diseases of the Skin in 1960. The London appointed him consultant physician

in 1964, and he remained there until he retired in 1986. In 1974 he was appointed the first physician to the gastroenterology department, and was also the London’s senior physician for many years. An instinctive clinician, he was able to determine rapidly how unwell a patient was and how best to proceed. This instinct extended to sensing when the senior registrar could be left to manage a situation, conferring maximal experience, and instilling self-confidence by allowing the appropriate degree of autonomy.

He took great pride in his appearance, daily sporting a home-grown rose as a buttonhole. Out of season, he drew on a supply of these, which he had harvested in full summer and stored in the freezer. These were just one element of the considerable produce of his large garden and greenhouses, which also included plentiful fruit, vegetables, orchids, freesias, and even the odd barrel of home brewed cider. Kate and he were stalwarts of local horticultural shows, and in later years, under her instruction, he even turned his hand to baking and jam making.

He was author of more than 40 articles over more than four decades, spanning a breadth of subjects befitting a true general physician and specialist gastroenterologist.

He could be considered an early exponent of translational medicine, leading randomised controlled trials, and the early exploration of biomarkers of gastrointestinal disease. His large practice at the London lent itself to investigation of disease associations, such as the prevalence of other autoimmune conditions in patients with coeliac disease.

He published on the efficacy of alginates in relieving symptoms of gastro-oesophageal reflux and on the scope of endoscopy to manage clinical problems, and how this important tool could best be employed for patients’ benefit. His characteristic candour and keenness that all should learn from mishaps was evident in his letter to the Lancet, about a family dog that he had treated for diabetes for some months with good effect until New Year’s Eve 1956, when she did not eat her dinner.

His ability to enthuse students was remarkable, and he is remembered as a consummately gentlemanly, courteous boss who would greet them with a wry grin. As a result, they both liked him and learned from him. The fact that he was admired despite the ward round starting in the sluice with a round of the gastroenterology bedpans speaks volumes for his personal charm and passion for enthusing successive generations of doctors. A contrasting but no less passionate performance could be observed on the river bank, when he coached the hospital boat club.

At home he was similarly enthusiastic, supporting his children’s various ambitions.

Anthony (Tony) followed in his footsteps into medicine at the London and became a general practitioner; Michael read physics at Oxford and became an expert on early mechanical instruments and curator at the Science Museum; and Charles read classics at Cambridge and became a schoolmaster. He continued to support his youngest son, David, whose special needs were met at home and then in residential care. His daughter, Sarah, went into nursing, training and practising in the East End, like her father.

His retirement was active, with dog walks in the Essex countryside, daily swimming, and compulsive gardening offsetting his lifelong fondness for good food. He continued to work for medical tribunals and cover occasional on calls for the GP practice of his daughter in law, Judy (now Wigfield), until he was 70. He was a devoted carer for Kate after a major stroke in 1997 until her death from cancer in 2001. After this, he rediscovered enthusiasms including driving all over the country to catch up with friends, family, and favourite places. This independence of mind was nearly his undoing, however, when a fall from the top of a ladder led to a hospital admission. He informed the admitting doctor that he had fractured ribs, and having been told that this was not so from the chest x ray film, was then vindicated by the subsequent computed tomography scan, but none the less went on to make a good recovery.

Fifty years a fellow, he continued to enjoy proceedings of the Royal College of Physicians and medical current affairs, and a copy of the week’s issue of The BMJ was never far from the top of the pile on the dining room table. In his last years, he lived close to his daughter, Sarah, who with her family supported him in maintaining an independent life, despite increasing frailty and a fractured neck of femur in January 2014. His death was sudden but not unexpected, and, as he would have wished, at home. Predeceased by his wife, Kate, in 2001, he leaves their children.

20 / OXFORD MEDICINE . NOVEMBER 2015

Contacting OMA

Oxford Medical Alumni, University of Oxford, Dept of Physiology, Anatomy and Genetics, Le Gros Clark Building, South Parks Road, Oxford OX1 3QS +44 (0)1865 282346 oma@medsci.ox.ac.uk

OMA Events

Wednesday 18 November 2015 at the John Radcliffe Hospital 2015 Radcliffe Lecture

Continuing David Weatherall's Vision for the Application of Molecular Biology to Medicine

Professor Doug Higgs FRS Director of the Medical Research Council Weatherall Institute of Molecular Medicine at the University of Oxford will give the 2015 Radcliffe Lecture on the work of David Weatherall and the Weatherall Institute of Molecular Medicine which he founded at the John Radcliffe Hospital in Oxford.

Margaret River, Australia 11th – 13th March 2016.

Oxford Medical Reunion and meeting — Australia

The 3rd Oxford Medical Alumni Reunion meeting follows on from successful meetings held at Cradle Mountain in 2012 and in Adelaide in 2014.

Programme for the weekend – The tentative plan is to gather for a welcome function on Friday 11th March (which may be wine tasting and canapés at the Voyager Estate vineyard). Presentation sessions will take place in the mornings of Saturday 12th and Sunday 13th March, and there will be a conference dinner in the evening on Saturday 12th March.

Presentations – Please consider giving a short (10 to 15 min) presentation on a topic (medical or non-medical) that might be of general interest to the group - this has been a feature of preceding meetings and they have always been interesting, often amusing, and thoroughly well received. To express an interest, or to find out more please email us.

Spread the word – We would be very grateful if you would pass this announcement on to others who may be interested in attending (and presenting).

Accommodation – The beautiful Margaret River area is a very popular destination for tourists and weddings so we have had to move quickly to book the Quality Inn. Situated just over 1 km from the town centre it not only offers comfortable and affordable 4 star accommodation, but also has excellent conference facilities that will accommodate our needs.

Travel – Margaret River is approximately 300 km south of Perth. The easiest way to get there is to hire a car at Perth Airport and drive down (about 3 hours). Having use of a car means that you will have easy access to the many attractions in the area (including vineyards, restaurants, beaches, forests and caves).

We very much hope to welcome you to one of the most attractive parts of Australia on 11th March 2016.

Saturday 16th April 2016 at the Medical Sciences Teaching Centre, Oxford.

2016 Weatherall Lecture Professor Sir Gordon Duff, Principle of St Hilda's College, Oxford will give the 2016 Weatherall Lecture. "Looking Ahead in Medicine: Making the Most of Biological Advances" (new concepts meet old principles). The lecture will be followed by a dinner at The Queen's College.

Saturday 16 April 2016 at The Queen’s College 20th Anniversary Oxford Medical School Reunion Oxford medical school graduates of 1996 are invited to their 20th anniversary reunion dinner on Saturday 16 April 2016 at The Queen's College starting at 7pm. Meet up with friends and share your life stories since you graduated. Alumni are most welcome to bring a guest. We would be very grateful if you would pass this announcement on to others from the year.

Saturday 21st May 2016 Osler House, Tingewick and Gazette Grand Reunion We are planning a celebration for all those who have been: • Members of the Osler House committee, • Directors and Producers of Tingewick • Editors of the Oxford Medical School Gazette An opportunity to come back all together, see the new Osler House and have fun!

Please make sure OMA has your contact details, and do tell anyone else who you know was involved in any of the above groups.

Saturday 11th June 2016 at Osler House 10th Anniversary Oxford Medical School Reunion Oxford medical school graduates of 2006 are invited to their 10th anniversary reunion. Professor John Morris and Tim Lancaster look forward to welcoming you to Osler House – for an informal, family, summer garden party. Guests and children most welcome. Meet up with friends and share your life stories since you graduated. We would be very grateful if you would pass this announcement on to others from the year.

Please contact OMA for more information on any of the reunions and events mentioned above or go to the website ww w.medsci.ox.ac.uk/oma

Please note that information and opinions expressed in this publication are those of the contributors, and do not necessarily represent those of the editorial team, OMA, the Medical Sciences Division or the University of Oxford, or of any of its constituent Colleges. Reference to specific commercial products or services should not be taken to imply endorsement or recommendation of such products or services by the University of Oxford or of any of its constituent Colleges. The University of Oxford and its constituent Colleges assumes no legal liability or responsibility for the accuracy, completeness, or usefulness of any information presented.

Oxford Medicine is produced by the Medical Informatics Unit, NDCLS, University of Oxford. Telephone +44 (0)1865 222746.

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