DiveRCSIty - Spring 2022 by DiveRCSIty - RCSI Student run Newspaper and Publications

#DIVERCSI TY RCSI Student Run Newspaper and Publications

a professor’s personal experience during covid-19

pg 16-17

|SPRING | |Publication Year 2022, Vol. 7, Issue No. 1|

Cancer Society’s achievements this year

pg 6-7

Networking as a medical student

pg 19

DIRECTOR AND CO-EDITOR-IN-CHIEF

CO-EDITOR-IN-CHIEF « VIKNESWARAN RAJ

// Meet the team.

COURTNEY CHENG »

MANAGING EDITOR

SENIOR ADVISOR

YOHAN IRANI »

« LORI ISRAELIAN

CONTENT EDITOR AND ILLUSTRATOR

CONTENT EDITOR « MANVIR TAUNK

FIONA MCGOWAN »

CONTENT EDITOR

ANSHULA TIWARI »

« SOHRAB ZAND

SOCIAL MEDIA OFFICER AND ILLUSTRATOR

TREASURER AND CLUBS AND SOCIETIES COORDINATOR

MANSI POTLURI »

« MIR ALI

GENERAL COMMITTEE MEMBER AND CONTENT CURATOR

« KEESHA RAVINTHARAN

ANUSHA SHARMA »

GENERAL COMMITTEE MEMBER AND CONTENT CURATOR MALAIKA PETER

STAFF ASSOCIATES CORRIENA BRIEN & JACKIE KNOWLES - CONTENT REVIEW, STAFF CO-ORDINATORS

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Editors’ Notes

// At a glance... Editors’ Notes. Dear Reader, Welcome back to Divercsity’s spring issue! This year has been another testament to our resilience, ability to adapt, and strength in the face of uncertainty. Although there may have been some ups and downs along the way, I think there is something for each of us to be proud of in terms of the commitment and efforts we have contributed to overcome these obstacles as a community. It has been wonderful to see classmates, professors, and staff in-person again, and I am hopeful that we can continue connecting in-person with each other next semester. Thank you to everyone who contributed to this year’s paper, it would not have been possible without your ongoing support! Happy reading :) Sincerely, Courtney Cheng

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ello DiveRCSIty Readers

Thanks to the busy editorial team for the invitation to contribute to the Spring 2022 edition. After two years of a recurring focus on the everyday implications of COVID-19, it has been a refreshingly forward-looking semester. We have commenced development of two major education buildings that will enhance our core and clinical education activities. On the Connolly Hospital campus, two floors of a new building will be for clinical education and research – opening in Spring 2024, alongside the new ambulatory paediatric extension, it will benefit clinical medical, GEM and PA students in particular in the future. On Stephens Green, the largest ever RCSI building project has started and will be opened in May 2025. I’m sure you’ve seen the hoarding! Some of you in early years in all courses will benefit directly as undergraduates and many more may use the facilities for professional education in leadership, surgery and population health – or the events facilities – in the future, in what will be an iconic building on the Green. Also future oriented, the first group of over 100 students will receive their Certificate in Lifestyle Medicine in July. Congratulations to all who added this work to your already busy study schedules. We hope it give you firstly an evidence base to inform your own plans for healthy living; will be of CV value on your graduation transcripts; and may inspire some of you towards a career focus in what we expect will be an ever-increasing focus on Lifestyle Medicine. To address this societal move, we are establishing a new School of Population Health which will offer initially postgraduate education and research in the area. To the immediate summer – it has been wonderful to re-start in-person graduations in Dublin, Penang and Bahrain. For faculty, these days are joyous celebrations of the challenges faced and overcome by students to achieve your ambitions for a professional qualification – and a delight to see your families and friends proudly share the achievement with you. Here’s to future years of graduations in-person. For now, I wish you all a great summer, full of enjoyment and re-charging of energies for next year. We plan a much more on-site in-person programme from the autumn for students and staff. Healthcare delivery is a person-centred and team business, as is healthcare education. So I ask that you plan for an on-campus working week when you return. We will be pleased to see you back, in person, for busy academic programmes and fun social activities. Professor Hannah McGee Deputy Vice Chancellor for Academic Affairs, RCSI

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Clubs & Societies

//A Home Away From Home

« Ayomide Ogungbenro

“A

home away from home. I come with extraordinary vibes. I throw electrifying parties. I am made up of the most diverse and distinct group of people. Who am I? I am the Caribbean African Society (CAS). Although we make up a tiny percentage of the entire college, our impact is ground-breaking. We are what you call, ‘‘small but mighty’’. If there’s one environment that can be described as bubbly, energetic and just so full of life, it’s amid Africans and Caribbean people. The best part? No one is left out. You do not have to be from either region or culture to enjoy the full CAS experience. Our motto is, “You do not have to be from CAS to be in CAS.” The 2021/22 committee was made up of 19 spectacular members with Ayomide Ogungbenro (Mimi) and Sharnavi Sagramsingh leading the team. Together, we pulled off the impossible “White Party”, which was a mind-blowing event that was put together in five days! Being dormant for a year due to Covid filled us with determination to not throw in the towel despite being hit with so many obstacles for months on end. We were told a series of “no’s”, to quit, to postpone the event, to try again, but we persevered. It is not over till it is over, and in the end, we are glad we stood firm. The unique cultures present in the Caribbean and Africa are endless, and it is virtually impossible to explore them all, especially with the resources we have. The vastness of our culture also comes with its challenges. One of which is representation: it is very easy for the majority of CAS cultures represented in RCSI to overshadow those from minority backgrounds. It also paints a one-sided picture to the rest of the college, as they view our society through a single streamlined lens and attribute one aspect of a particular culture of a subset of people in the entire society. Another dilemma we face is the differences between African and Caribbean people and our culture. Yes, we are one, but we are not alike. Our food, clothing, music, movies, history, mannerisms, slangs and so much more are dissimilar. Over time, we have learned to accept and love one another, enjoying our distinctiveness as it brings us closer. Getting to the top is not easy and staying there is much more difficult. There is a standard expected from CAS, and with every event we are expected to maintain or supersede it. This tends to put strain on us, like the saying, “uneasy lies the head that wears a crown”. The hard work that goes into running and maintaining CAS is immense for everyone involved, including the college, the committee members, and even volunteers, which has been amplified due to the pandemic. This doesn’t just apply to CAS but to every club and society present at RCSI. Accolades to each committee member, teammate and volunteer in all clubs and societies. Your ability to balance it all alongside your demanding healthcare courses is truly inspiring. To the rest of the college – show support, show up and show out, and send love and encouragement, we truly need it. Covid restrictions have not held us back. Instead, they have made us more eager, imaginative and resilient. The sky is truly the limit with CAS. Ayomide Ogungbenro Outgoing CAS President

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Clubs & Societies

//RCSI Cancer Society 2021-2022:

« Jessica Lloyd

A Year in Review W year.

ith the end of the 2021-2022 academic year, societies have wrapped up their initiatives and reflected on all they have accomplished over the past

RCSI has one of the largest multicultural and diverse student bodies in the country, and because of this, a broad range of clubs and societies exist at RCSI. The RCSI Cancer Society is one of the few student societies that hosts both charitable and educational events, which are both well supported and welcomed by the RCSI community. We had a diverse, collaborative, and engaged organising committee composed of 15 wonderful RCSI students who were committed to fulfilling the society’s aims and objectives, increasing student participation, and providing interactive educational content and rewarding fundraising events. The aims of the RCSI Cancer Society are to connect students with similar interests and passions, provide resources to students about cancer and the field of oncology, and promote awareness and raise funds for various charities that support those affected by cancer. We have two main methods of promoting cancer awareness and fulfilling our objectives: education and fundraising events. Education: We worked closely with our academic advisor, Dr Adrian Murphy, a consultant medical oncologist at Beaumont Hospital, to ensure that all of our educational content was accurate and up-to-date. We also aimed to provide information and resources that were accessible to students of all levels at RCSI. We hosted our annual educational event, “A Day in the Life of an Oncologist”, where students were able to interact with six leading medical and surgical oncologists in various stages of their professional career, from registrars to consultants and professors. We were thrilled to have won the Board of Irish College Societies (BICS) 2022 national award for the ‘Best Virtual Event’ for this event! To supplement the educational component of the society, we also created monthly oncology case study quizzes that were verified by our oncology consultant academic mentor. Students were able to learn more about various types of cancers and answer quiz questions through our social media pages, and the top scoring student won a Network coffee voucher. We worked with Dr Jarushka Naidoo, a consultant medical oncologist at Beaumont Hospital, to host our first ever cancer patient-centred event, “Patient and Clinician Partnership in Cancer Care”. We had multiple cancer patients and advocacy speakers join us to speak about the cancer journey from the patient perspective. We also invited different healthcare professionals to speak about cancer medicine, as well as the importance of the multidisciplinary team management aspect of cancer care. As future medical professionals, understanding the patient perspective is integral in providing effective patient-centred care, so we hope students will take what they learn from the event and implement it in their future careers. Finally, we have been piloting an oncology mentor network program this year where students will be paired with clinicians and researchers in different subspecialties of oncology. We have worked with Dr Naidoo and Dr Murphy to develop this program, and we are all looking forward to seeing the outcome of this exciting partnership for everyone involved! Fundraising: We work closely with multiple cancer charity organisations to raise awareness and support for their causes, and 100% of the proceeds raised from our fundraising events are donated to the respective charities. This year, we have fundraised for Breast Cancer Ireland, the Irish Cancer Society, and the Movember Foundation. Collectively, we have raised over €3,000 for charity thanks to the generous donations and support from the RCSI community. Some of the events we have hosted for Breast Cancer Ireland include Breast Cancer Awareness Day, where students wore pink in solidarity to demonstrate their support for individuals who have been affected by breast cancer. We also hosted the Great Pink Run, where we collaborated with the RCSI Running Club to encourage students to run, jog or walk to raise funds for cancer research. We also hosted a Movember fundraiser for the month of November, where students formed teams and grew out their moustaches to gather support for men’s health, and this year we raised a total of €800 for the Movember Foundation. We had an amazing turnout and support from the multiple RCSI Clubs and Societies that collaborated and formed teams for Movember, including the Orthopaedics Society, GAA Club, Physiotherapy Society, CIMSA, Music Society, Volleyball Society, and the Student Medical Journal. In March, we hosted a bake sale and celebrated Daffodil Day, a day for us to give hope to those affected by cancer. The daffodil represents the first flower of spring and symbolises hope, cancer research and awareness. All the baked goods for the Daffodil Day bake sale were generously donated, subsidized, or

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Clubs & Societies

handmade for our event by amazing RCSI students, our committee members, and the local community. All the profits were donated to the Irish Cancer Society to support cancer patients through providing free advice and support, as well as funding for life-saving cancer research. Finally, we are also a part of an amazing initiative called Hugs for Cancer. This initiative was originally founded two years ago by Dr Claire Stenson, an RCSI alumni and current intern, while she was studying at RCSI. The main aim of the initiative is to provide a “hug” of comfort to those affected by cancer by providing carefully curated gift hampers for cancer patients receiving treatment or follow-up. This initiative not only gains publicity inside the college by impacting RCSI students and staff, but more importantly, it indirectly connects and directly supports individuals affected by cancer all over Ireland. We have received so much support and many donations from other RCSI clubs and societies, and we hope this initiative allows RCSI students to see the direct impact of their charitable actions! With the current statistics that 1 in 2 people will have cancer in their lifetime, most people at RCSI will be affected by cancer in their lifetime whether personally through loved ones, or in their future careers in healthcare. Students from all levels and backgrounds benefit from the educational content we share, the events that we hold, and have the opportunity to contribute to cancer awareness and fundraising initiatives that benefit the wider community. Thank you so much to everyone who helped make our events and initiatives successful this year. We could not have done it without the wonderful support of the RCSI community. If you have an interest in raising cancer awareness and learning more about the field of oncology, please consider joining us at our events next year!

Jessica Lloyd Outgoing Cancer Society President

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Clubs & Societies

//Cardiovascular Society

« Sarah Chiodo

he RCSI Cardiovascular Society is a collective group of students from various years that share a keen interest in cardiovascular medicine. Our aim is to furnish students with career-focused information and educational opportunities to reinforce their knowledge of cardiovascular health sciences and to help facilitate networking opportunities with experts in the field. The Outgoing 2021/2022 Cardiovascular Society members: President - Tiffany Yeretsian Vice President - Devika Dahiya Senior Advisor - Daniel Sherlock Secretary - Sharnavi Sagramsingh Education Officer - Craig Fernandes Deputy Education - Tim Vaughan-Ogunlusi Events Officer - Saad Hussain Deputy Events Officer - Savanna Naylor Communications Officer - Katia Yazji Deputy Communications - Sandra Abu-Khalaf Deputy Communications - Katrina D’Urzo

General Committee - Gerges Abdelsayed General Committee - Muhammed Ashfaque General Committee - Hannah Berman General Committee - Stephan Caruano General Committee - Sarah Chiodo General Committee - Journee Couture General Committee - Victor Florea General Committee - Wadeed Irfan General Committee - Aathmika Kirubaharan General Committee - Katrina Law General Committee - Julia Matwiejczuk General Committee - Nabil Merchant

This year was unforgettable as the lifting of Covid restrictions brought a nostalgic return to many exciting in-person Cardiovascular Society events. There were also an impressive number of collaborations with other societies both in our events and educational content. Some of our events featured: Day in the Life of a Cardiologist: In this online speaker event, distinguished Professor Jim O’Neil, consultant at Connolly Hospital Blanchardstown and Mater Hospital, spoke about his compelling work as a cardiologist highlighting his sub-specialities of interest including heart failure and interventional cardiology. 5th Annual Braveheart: The much-anticipated return of Braveheart to an in-person venue celebrated friendly competition as eight teams competed in an elimination-style tournament testing their knowledge in cardiovascular medicine on topics ranging from anatomy to physiology to clinical medicine. This is one of our most anticipated events every year, encouraging a healthy dose of competition and collaboration amongst participants! We welcomed esteemed judges: Professor Noel McElvaney (Head of Department and Professor of Medicine, Beaumont Hospital and Consultant of Pulmonary and General Internal Medicine), Professor Robert Byrne (Chair of Cardiovascular Research and Director of Cardiology at Mater Private Hospital), Dr Tom Farrell (Former Senior Lecturer in Anatomy and Past Deputy Director of the Graduate Entry Medical Program at RCSI) and Dr Michael Daly (Lecturer in Cardiology at RCSI). The top 3 teams received fun prizes from generous sponsors: Dunnes, Boojum, CramFighter, DiFontaine’s Pizzeria, BaoBun Street Food, Murphy’s Ice Cream, Bubble Waffle Factory and Insomnia.

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ECG Tutorial: This online tutorial which encouraged participation from all years covered the basics of ECG interpretation along with high yield ECG facts and included small group ECG practice workshops to reinforce concepts. Memorable initiatives enriched by collaborations with other societies included: Special Speaker Event - Paediatric Society: In this in-person event, we were grateful to host accomplished Paediatric Cardiologist and Electrophysiologist, Dr Shubhayan Sanatani, from British Columbia, Canada, as our guest speaker. He shared his insights on the benefit of providing subspecialty care for children with cardiac conditions and detailed how the sub-speciality has evolved over the span of his dynamic career. This lively interactive talk was an audience favourite! Lub Dub Pub Quiz Fundraiser - American Medical Student Association (AMSA): Dear to the hearts of trivia-savvy and spirited members, this cardiovascular-themed pub quiz at Harry’s On The Green raised funds for AMSA’s Heart Health Fair. Annual Student and Staff Cycle (Fundraiser for Irish Heart Foundation) - Cycling and Mountain Biking Club and RCSI Sports and Social Club: Befitting Health and Wellbeing Week, the Annual Student and Staff Cycle returned after a break due to Covid. Participants enjoyed heart-healthy exercise while taking in scenic views of Phoenix Park. Proceeds from the event were donated to the Irish Heart Foundation. Quiz Night In - Dublin Internal Medicine Student Society (DIMSS), UCD North-American Irish Medical Students Association (UCD NIMSA), TCD Paediatric Society: This Jeopardy-style quiz competition via Zoom served as an excellent opportunity to brush up on cardiovascular medicine amongst other topics while encouraging inter-collegiate networking for students from UCD, Trinity and RCSI. Educational content this year encompassed our Case-of-the-Week initiative which is a weekly quiz posted to our Instagram that presents a cardiology-related clinical vignette accompanied by four board-style questions. To provide students with more exposure to analysing results of various diagnostic tools, the cases involved relevant diagnostic tools such as ECGs and CTs. Each week’s winner received a fun prize! In addition to the Cases-of-the-Week, we collaborated with the Endocrinology Club to produce an infographic on hyperaldosteronism in which our contributions focused on ECG features and action potentials. The Cardiovascular Society looks forward to another vibrant year in 2023 building on its strengths of delivering a complement of fun interactive activities and learning opportunities on cardiovascular medicine. Be sure to sign up on Student Life HQ for membership and follow us on Facebook, YouTube and Instagram @rcsicardiosoc so you don’t miss out! Best, RCSI Cardiovascular Society Author: Sarah Chiodo Editor: Devika Dahiya Photographer: Niharika Rajesh

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Clubs & Societies

//Music Society Year in Review

Gabrielle Sanatani

he Music Society at RCSI plays an essential role in the extracurricular scene, functioning to showcase student talent through our events and to bring together music lovers alike. We pride ourselves on being inclusive and fostering creativity. This year, we had an incredible committee working tirelessly to put on exceptional events to serve the RCSI community. Outgoing 2021/2022 Music Society members: President: Gabrielle Sanatani Vice Presidents: Ross McGuinness and Makaela Jones Head of Events: Michael Labib Head of Music Room: Anjuli Chehil Head of Public Relations: Simrin Bains Public Relations Committee: Ahad Jassani Graphic Design: Naeha Lakshmanan Events Committee: Harriet Leahy and Luke Murphy Music Room Committee: Laura Rice and Nurul Maghfirah Jamel General Committee: Muhammad Usman Qureshi, Luke Farrell, and Ava Eusepi-Harris Senior Advisors: Liyana Kukkadi, Fraser Jang-Milligan, and Emmanuel Eguare Despite the uncertainty that this year held, given the everchanging Covid-19 restrictions, we had an undoubtedly successful year and transition back to in-person events. We started the year off with our final virtual event as part of Fresher’s week, Acoustic Night, and showcased performances from several students. Following this, we had our first in-person event since the beginning of the pandemic, in collaboration with the Pakistan, India, Bangladesh, and Sri Lanka (PIBS) Society. This was held at Bartley’s Lounge at the Grafton Hotel and included student performances followed by a PIBS night out hosted by DJ Frank Jez. Our final event of the year was our spring Acoustic Night, hosted in the board room at RCSI. We were fortunate to have an amazing turnout at all these events and numerous first-time performers! Throughout the year, we featured student-made playlists on our Instagram account, highlighting different themes each week. We are sad to be saying goodbye to many final year medical students who have been heavily involved in Music Society during their time at RCSI, particularly two previous presidents and many of our regular performers. We wish them all the best in their future careers, both medical and musical. To the remainder of the student body, we are very much looking forward to seeing you all back in the fall and can’t wait to show you what the next committee will have in store for Music Society! Gabrielle Sanatani Outgoing Music Society President 2021-2022

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Clubs & Societies

//Pharmacy Society

PharmSoc Committee

s we, the 2021/2022 committee, close the door on Pharmsoc, I would like to take a moment to reflect on the year.

Starting out in September as newbies on the block, we did feel as though we were in too deep. But myself and my amazing team have put our best foot forward and fought hard to prevent Covid from dampening our spirits. In the world of RCSI’s Clubs & Socs, being told, “No” is a common occurrence. The amount of minor and major details that can jeopardise an event is unimaginable. It is only when you are the one looking into the face of the Societies Team as they say “No”, for the fifth time (that week) that you realise just how much effort it takes to organize an event. If I have learned anything this year it is to be more appreciative of the work that societies do to make events possible. Pharmsoc itself had many setbacks, our famous (or infamous) Pharmball was postponed by 2 months with the ever looming threat of simply not happening at all. Despite this, we never gave up and continued to work to create a night no one would forget. In my humble and non-biased opinion, Pharmball proved to be one of the most successful nights of the year, selling out above and beyond its previous maximum capacity. In terms of improvements to Pharmsoc, our Education Officer, Elizabeth Joyce, succeeded in collaborating with Coloplast and the School of Pharmacy for an in-person workshop that allowed students to get hands-on experience with ostomy care. This was a huge achievement and had not been done before. It gave students an opportunity to take initiative and enhance their CV’s and professional development. Myself and our Welfare Officer, Ciara Melody, also successfully secured sponsorship for 2 STEP projects available only to pharmacy students. These projects are to be based around Welfare and Self Care within college and will be an incredible opportunity for pharmacy students and staff alike. While we unfortunately did not win any awards this year, I would like to take the opportunity to congratulate my team once more for truly making a difference to the lives of pharmacy students within RCSI. Without them the success we have had this year would not have been possible. Each member has taken time out of their days to go above and beyond my expectations of them. The most important thing I have learned is the value behind a strong team. There is only so much one person can achieve and without the correct support & diversity of skills a project is sure to fail. Each of us entered this year with a drive to achieve and I can proudly say we have done just that. Thank you to all who supported us and we hope that the new committee will continue to grow & develop in the way we most certainly did!

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Clubs & Societies

//PIBS Diwali Wins Best Event at BICS

Ahad Jassani and Mariam Sharfi

his year, PIBS was very successful in hosting many events and initiatives, as well as providing lots of engaging content through our social media platforms. Below is a review of our Diwali event which won the national award for Best Event In-Person from the Board of Irish College Societies (BICS). Diwali is an annual event thrown by PIBS occurring during the month of November in line with the actual religious date of Diwali, November 4th, 2021; however, during Covid we were unable to host any in-person events, and this year’s Diwali was to be RCSI’s first large person event since the pandemic. Diwali is a festival of lights and one of the major festivals celebrated by Hindus, Buddhists, Jains, and Sikhs. It usually lasts five days and is celebrated during the Hindu lunisolar month Kartika. In order to uphold these traditions, the PIBS Society hosts a ball event open to all students from all backgrounds and departments of the school. In addition, we are inclusive of all backgrounds and this year had a record number of performers from many different countries. Every year at this event, we put on a showcase of at least 5 different dances. These dances show off different styles of South Asian dance such as Bollywood, bhangra, classical, Bharatanatyam, and more. We aim to be inclusive of all the different cultures within South Asia, as well. Students will choreograph these dances and teach fellow performers. These dances are different every year to offer new students the opportunity to choreograph and represent different styles of dance if they’d like. This event also invites students to get creative with their cultural clothing and decor. The event was meant to take place on November 27th at the Radisson Blu Banquet Hall starting at 7PM and running until 10PM. The event was to include a full show with dinner, bar service, photo booth, henna hand painting, and a DJ. The show included performances such as dancing, singing, spoken word, trivia, and interactive games with prizes to keep the audience engaged throughout. Dances were also in collaboration with the RCSI Dance Team and vocalists were in collaboration with RCSI’s Music Society. Dinner was to include authentic food from many of the PIBS countries including tandoori chicken and samosas. The photo booth was in collaboration with RCSI’s Unicef Society, and each polaroid photo taken serves as a donation to the charity. Additionally, we collaborated with RCSI’s Photography Society to provide free digital photographs and to document the night. After the event was to end, we had made bookings for an after party including a private club and DJ to celebrate everyone’s hard work and success, as well as to continue on with the Diwali festivities. Unfortunately, due to the rising cases of COVID and RCSI’s student guidelines, we were asked to either postpone the event or continue it on campus with a smaller capacity. After much discussion with society members, we decided to continue the event in the Exam Hall of the RCSI campus for free. With only 5 days’ notice, our committee worked hard to achieve the same goals set for the original event. Furthermore, we were grateful to receive partial funding to hire a professional photographer and videographer to help capture the night’s performances, as well as make a recap video. While our numbers were reduced and we no longer served food, we still achieved a successful event, with 120 people, allowing those who celebrate Diwali to feel that sense of home and celebration, as well as share our culture with the remaining RCSI community. Diwali successfully fulfilled the aims and objectives of the society by ensuring all students felt included and that all students learned and cherished the traditions, culture, and performances displayed at the event. Our society aims to create a home away from home for students and a safe and loving environment for them to celebrate their traditions. For most students this is the first time they are celebrating a major holiday away from home and we strive to alleviate as much homesickness as possible, while generating a sense of family for everyone. For instance, dancers from any background were allowed to participate. This year we had dancers from the PIBS countries, as well as Canada, the United States, Nigeria, Trinidad and Tobago, Dubai, Saudi Arabia, Mauritius, Germany, Singapore, Malaysia, Thailand, and Ireland. Additionally, we made sure that all students had access to all the event information and promotion when advertising our ticket sales by sending our posters to different societies and programs including RCSI’s School of Medicine, School of Pharmacy & Biomolecular Sciences, and School of Physiotherapy. We also ensured to host live forums on our Instagram stories to allow all students to ask questions about the event and receive updates. Although there are plenty of challenges that come with organizing such a large-scale event, we believe our biggest challenge was having to adapt the event and make it more Covid-friendly within 5 days. This involved a change in venue, significantly reducing the capacity, and re-advertising. We had to get in touch with Radisson Blu to let them know about the change in our event, as well as figuring out if we could get our deposit (that we put down to secure the venue) back. We also had to contact the club and DJ to cancel, and contact the volunteers signed up to do henna and the UNICEF photo booth. All the performers had to be constantly contacted with updates regarding whether the show was still going on, if there were changes in venue and time, and about any modifications to the performance. We also had to organize a professional photographer and videographer to document the night. Throughout all of this, the PIBS committee was also communicating with the senior management team at RCSI and the Deputy Vice Chancellor about the new restrictions and how we could still safely hold the event. This also included hosting a Town Hall meeting for all members of the society to join and ask any questions regarding the changes and the new event. This involved readvertising our event on social media and the RCSI student life website. Finally, we had to contact all the attendees originally planning to come to the event and inform them about the changes as well as their next steps in terms of getting their refunds.

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Having to make major changes to the event was a big disappointment. So much time, hard work, and dedication was put into Diwali and so it was challenging to adapt to these unforeseen circumstances and work quickly to revamp the event, while maintaining the celebratory atmosphere. Furthermore, another big challenge was refunding all 300 students who bought tickets to attend the event. As all ticket sales were done in cash and had already been submitted to student services which was then lodged into the society’s bank account. This process was tedious. We decided to individually IBAN, which was acquired via a Google form, and provide each student their refund. Despite all these changes being made in the 5 days leading up to the show, our society maintained our rehearsal schedule and modified the performances to accommodate. We still managed to put on a successful event and give the student body an opportunity to celebrate and enjoy our hard work. We also managed to issue every student their refund as well as create a great recap video of the evening that is now on our social media pages. PIBS’ Diwali is an annual event at RCSI and has been for the past 9 years. This year was our most successful year in terms of student engagement with over 60 students signing up to perform and 20 students signing up to volunteer. We ensure the continuity of this event through the handover of our committee at the end of the year. The outgoing president and vice president documented the logistics of the event and will serve as senior advisors to the incoming committee, guiding them on how the event is run. The incoming president of the society will also be someone who is currently on the PIBS Committee, so they have seen some aspects of the event planning for next year. We hope to hold the event next year with the same vision as we had for this year including the henna booth, UNICEF polaroid booth, and performances. Written by: Ahad Jassani & Mariam Sharfi

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//CAS: Your Home Away From Home

« Sharnavi Sagramsingh

he Caribbean-African Society in RCSI, also known as CAS, comprises a diverse diaspora of students from the Caribbean islands and African continent. However, CAS openly accepts students of all backgrounds to be a part of our family. We like to describe ourselves as a home away from home – a community of genuine and “vibesy” people who become lifelong friends. CAS aims to not only throw some of the most extraordinary parties and events at RCSI, but to also raise awareness and remove the stereotypes and stigmas commonly associated with our culture. While being quite challenging given the ever-changing Covid-19 restrictions, 2021-2022 was indeed an exceptional year. We were able to host many incomparable events showcasing our vibrant culture and even establish great rapport with other Caribbean-African Societies in neighbouring colleges and universities. Additionally, a new initiative implemented this year was the addition of “Cultural Education Officers”. Before we say our goodbyes and wish the upcoming committee a heartfelt good luck, lets recount our amazing triumphs over the past year. CAS’ Meet and Greet is an annual tradition and an opportunity for all society members or those wishing to join CAS to get to know the committee and each other through a series of fun games, team building exercises, giveaways, and food (who doesn’t love free stuff after all?). Our event this year was spectacular, with over 70 attendees from many different countries at both our sessions. Some games included “two truths and a lie” and “balloon pop”. Guests were also treated to cupcakes, drinks, and more before the event ended. White Party is an exhibition of Trinbagonian culture, specifically Carnival, where attendees are asked to wear all white, where possible, to enhance the colours of the costumes worn by our models. As Carnival is a representation of freedom and culture, we aimed to create a similar environment at The Well, located at St. Stephen’s Green. The night was filled with music, laughter, and dance, which was indeed unforgettable. Models wore handmade costumes, and they paraded on stage and in the crowd, showcasing the vibrancy of CAS culture. Chocolate Ball is CAS’ “Event of the Year”. This year was directed at cultural exhibition. Thus, we chose the theme, ‘Enchanted Forest’ to emphasize CAS’ folklore, which stems from tales of forest creatures. We chose Anansi the Spider, Mama D’lo, Papa Bois, Impundulu and Aziza Fairy, which our dedicated committee members and volunteers fabulously portrayed. In addition, there was a variety of entertainment, such as dances by CAS and the Dance Team, musicals by talented volunteers, spoken word, and even drag. Prizes were awarded for best dressed and the scavenger hunt. Dinner and drinks were also served, followed by a night of incredible music. All profits from this event were donated to the SOS Children’s Villages (https://www.sos-childrensvillages. org/). Black History Month is celebrated in October (Ireland and the UK) and February (USA). As such, CAS posted various blurbs on our social media with important facts, persons, and dates in our history that have positively shaped our future. Multiple giveaways were also done via Instagram to engage the student body in celebrations. In October, we supported black-owned Irish business (Ekaya and Bees of Honey) and specially curated a gift basket filled with their products as the grand prize. In February, we did a CAS bingo which had various tasks pertaining to black culture to complete and submit for a €50 One4All voucher. Speed Friending was held to support our efforts to create a home away from home. We collaborated with the African-Caribbean Societies of Trinity College and the National College of Ireland to put a twist to the concept of speed-dating. At this event, which was held at RCSI, students sat in rows facing each other and were given five minutes to chat before switching chairs and meeting a new person. This allowed students to interact with members of all colleges and make new friends. Afro-Caribbean Zumba dance is an important part of CAS culture since it is used in celebration, praise, religious events, and as a means of self-expression. In line with our goal of cultural consciousness, we held an Afro-Caribbean Zumba session with dancer and choreographer, Lapree Lala at Liffey Trust Studios. Approximately 30 students attended and highly enjoyed the session. A small €2 donation was requested to donate to the SOS Children’s Villages. Refreshments were also provided after the energy-filled event. Our events were so spectacular that we were nominated for Society of the Year and Chocolate Ball -Event of the Year. This season was such a whirlwind of events filled with laughter, music, friendships and much more! As we bring CAS 2021-2022 to an end, we would like to thank everyone for their continuous support, as we truly could not have succeeded without it. CAS is ecstatic to welcome in our new committee and we look forward to an even better 2022-2023 (although, it will be tough to beat this past year). Please sign up on the Student Life HQ and follow us on all our social media pages (Facebook and Instagram @cas_rcsi) so you get first access to our events and never miss out on amazing opportunities! #CASCares

Spring 2022

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Clubs & Societies

Love, Caribbean-African Society Author: Sharnavi Sagramsingh Editor: Joella Simon Outgoing CAS Committee Members 2021/2022: President – Ayomide Ogungbenro Vice President – Sharnavi Sagramsingh Secretary – Kelliane Tambe Treasurer – Joella Simon Cultural Education Officers – Bianca-Marie Thompson, Oluwapelumi Ogunlowo Events Coordinators – Chelsea Rampersad, Vitallia Sooknarine Events Promoter – Danya James IT Officer – John Dahabreh Inventory Officer – Danielle Herbert Senior Advisors – Ansara Balgobin, Jesiah Meade, Olutayo Toriola General Committee – Blessing Bakae, Deeksha Sammy, Imogene Mohammed, Iluore Asekomhe, Siddiqah Shah

Spring 2022

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Personal Stories

Prof Fidelma Fitzpatrick

icture 1: Friday 8 May 2020

This picture was taken the night of my 21st wedding anniversary. We had originally planned to be in Co. Clare; however, we celebrated at home in Dublin. From the end of February, I had worked almost exclusively on COVID-19 in Beaumont Hospital. Work was incredibly busy, with new evidence emerging at an exponential rate on a daily basis. From an early stage in March 2020, Martin, my husband, and I agreed to physically distance at home. My benchmark at that time was terrible stories from Italy, hospitals were running out of ventilators and people were acquiring this new infection rapidly and sadly dying. There were so many unknown unknowns in addition to the known unknowns about transmission, that it was difficult for me to figure how best to protect myself and my family. What was clear was that of the two of us, I was the most likely to acquire COVID-19 in the hospital and potentially spread it to him. We were lucky that we could distance in our house, as many of my colleagues did not have additional rooms or enough space to do so. Each evening during the first COVID-19 wave and national lockdown, my friend Ruth Medjber, a music photographer, popped out with her camera at twilight. She visited neighbours and friends to capture their lives at home during this unique moment in time. These pictures are part of a book she published late last year called Twilight Together (www.ruthlessimagery.com). This picture marks a day of relief in a strange all-consuming few months – I took this day off work to celebrate our anniversary with my husband and step away from COVID-19 land for a while.

Spring 2022

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Personal Stories

icture 2: Friday 25th December 2020 (Christmas day)

Another wave, another lockdown. Over the last 20 or so years, I have worked many Christmas Days in hospitals. Christmas Day is an odd day to be working. There is zero traffic in the morning, shops are closed and most people are at home celebrating with their families. For those of us working, we make a special effort to take time with each other to have a Christmas chat, eat copious amounts of chocolates to fuel the day and take additional time with our patients. It is not much fun being in hospital as a patient anyway, but especially on Christmas Day. However, this year Christmas was different. Dublin had been in lockdown since October and the nation was due to be locked down after Christmas. There was a sense of urgency in the air – the need to celebrate with our families before we could not. COVID-19 cases were rising, though there was news of vaccinations on the way. Very few visitors were allowed in the hospital so it was a lonely time for our patients. Though some could facetime, it didn’t replace the personal visit. I took this photo after I had finished the critical care rounds and hospital COVID-19 patient flow meeting. I was returning to the clinical microbiology laboratory to discuss results that are more positive with our medical laboratory scientists. These scientists are often forgotten, yet their work is crucial to patient care. Without them we could not diagnose infections, rapidly implement infection control measures to protect patients or choose the correct antibiotics for patients with sepsis and bacterial infection.

uesday 5th January 2021 – We will dance again

This was an incredible day in Beaumont! First dose of my COVID-19 vaccine. I got a call the previous week with an early morning appointment that I jumped at. An army of Beaumont Hospital staff worked over the Christmas period to get the hospital vaccination programme up and running at record speed. This included administration, management, pharmacy, medical and nursing staff to count a few. Along with colleagues, we waited in line, many emotional, all of us hopeful and joyful. I had purchased this T-shirt to support an Irish nightclub. It was one of my many purchases to support the Irish music industry, which really was no longer in 2020. I now have a range of vinyl, T-shirts and hoodies that chart my story of the pandemic. The T-shirt message ‘we will dance again’ really resonated with me. It was one of hope, that this pandemic will pass at some stage, though I cannot see myself dancing in a nightclub now (and that is nothing to do with COVID!).

Spring 2022

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Personal Stories

//A Marathon Through the School Year

« Helen Huang

he first marathon I ran was in 2017. Our high school organized the “Run For Water” marathon, which was a fundraiser to raise money for children in Haiti who were recently affected by a hurricane and a flood. However, this marathon was one of the biggest challenges I ever faced. At that time, I was a very out of shape and I rarely participated in physical activity due to a major leg surgery I had to undergo a few years ago. It was a huge commitment to sign up for this marathon, and I was afraid of being the last one to cross the finish line. Despite this fear, I had one goal in mind: to raise money for the greater good. For personal reasons, I will not disclose whether I finished last or finished at all. Nonetheless, this experience made me realize how important it is to take breaks, stay hydrated, and have support from my family and friends. After this marathon experience, I never would have thought that I would be thrust into yet another marathon. This time, however, it was a mental marathon. Year 1 Medicine was a very challenging run that tested my fortitude and resilience in the face of the new “normal” due to the Covid-19 pandemic. It was a major adjustment to my study habits, as the programme transitioned to online teaching and physical access to the library was prohibited. The mental resilience needed to wake up for online lectures and establish a strict schedule was a new normal for me. Just like any marathon, I was filled with excitement and energy at the starting line. It had been almost half a year since RCSI made the decision to send students back home, when I came back to Dublin for the new academic year in 2020. I was beyond ecstatic to reunite with my friends from Foundation Year and to start a crucial component of my academic career: anatomy. Dissecting cadavers and understanding the human body as a whole is an enriching part of medical school. Unfortunately, I was not well-prepared for the heavy academic content and the fast-paced curriculum. Our system-based modules focused on different parts of the body. Some of the modules we studied in semester 1 included the fundamentals of biomedicine and pharmacology, cardiorespiratory biology, and musculoskeletal biology. The understanding of molecular pathways and different genetic disorders allowed us to further develop our understanding of why certain diseases occur in the musculoskeletal or cardiorespiratory system. The foundations of molecular medicine module was then interlaced with the intricate anatomy of the arms, legs, heart, and lungs. The content was mesmerizing, but online engagement was a personal difficulty I faced, and I had a hard time finding effective study habits, which was further compounded by the uncertainties brought on by the pandemic. The beginning of the run was difficult because I didn’t have a solid revision strategy to employ for a dense curriculum, and it didn’t help that I couldn’t study in the library due to Covid-19 restrictions. I had always been a firm believer in taking notes on paper, as I had little technological experience back in high school. This was proven to be inefficient when I entered Foundation Year. Taking hand-written lecture notes in a notebook could not keep up with the sheer volume of content that needed to be dissected and processed in our brains. As a result, I started using a spaced repetition program called Anki. It took time to adjust to the volume of cards I made for each lecture and to find time revising them over the weekends. Needless to say, I was beyond burnt out by the end of the semester. The pandemic left me feeling isolated from the general student body and exhausted from running a mental marathon against myself. I couldn’t afford to give myself breaks because I was eager to finish the year and ace my exams. I had the opportunity to go back to Canada and visit my family during the new year, which motivated me to finish my studies on a good note. Studying during the winter break was a huge road bump in it of itself, and I managed to cling onto my stamina to just cross the halfway point. However, I was unsure if I was mentally prepared to stand up again and finish the last half of the run. Our four-day winter break after semester 1 coupled with multiple lockdowns and restrictions from the pandemic made it not only difficult to recalibrate for the new year, but impacted many of my colleagues’ mental health. Just as runners feel the need to take a break while running a marathon, I needed a break from studying. Though I was mentally burnt out and stressed after finishing first semester, the last half was an easier race to run. Not only were Covid-19 cases declining and vaccines being rolled out, but I had also adjusted my studying habits and set a stricter schedule to meet the demands of the curriculum. Studying about the biology of the nervous system, gastrointestinal system, and understanding renal and endocrine function went more smoothly than the previous semester. I had become well-adapted to studying with flash cards throughout the semester, and I found myself excelling academically. The end of semester 2 was a breath of fresh air for me. I still remember finishing my last exam on renal and endocrine biology and letting out a huge sigh of relief. I finally finished the marathon. I may have not placed first, but I knew that I had put every ounce of my determination into the programme to not finish last. A celebratory summer ensued, as the COVID vaccination certificate enabled me to travel all around Europe (while adhering to COVID regulations) from France and Italy and all the way to Greece. Needless to say, I finally had time to relax and enjoy the moment. The pandemic has impacted everyone in different ways, from job lay-offs to being restricted from seeing family members. The mental marathon I participated in made me realize how important it is as medical students to take breaks for our mental health and understand the overwhelming academic and personal support we have access to. There were times I had failed to adhere to my study schedule and I had to adapt between multiple techniques to find what works for me. From a holistic view, the values and skills I had learnt from this journey has strengthened not only my mental resilience but my ability to overcome failure and to keep running. If the time ever comes again, I believe I am ready to run another marathon.

Spring 2022

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Personal Stories

//The Medical Student’s Research as a Form of Networking

« Olivia Jagiella-Lodise

y advice to students in their early years of medical school is to network whenever possible. Try to turn your hobbies and accomplishments into networking opportunities. Being a stellar student with publications and leadership experiences will not get you far if no one recognizes your successes. Be loud about them and use those moments to build your network. This will help your career down the road. I really enjoy research. I actually like running data analysis. It is an unusual trait, but it has served me well in joining teams for growing my research portfolio. However, I learned a bit too late that not highlighting your work so that you receive credit means no one will recognize your efforts. I did a lot of research in my undergraduate degree. I wrote an entire program to evaluate data, generate figures, and conduct statistical calculations such as confidence intervals. I literally designed and built by hand the equipment that was being used to collect data. I wrote the proposal that earned the funding. I also created all the diagrams for previous and future publications. I spent years in this lab and truly enjoyed my time there and learned a lot, but my name was not even on one publication, not even one acknowledgments section. Therefore, when I began working on research projects in medical school, I ensured the latest research lead investigators were aware of just how much I did for each project and what my expectations were. It felt aggressive at first, almost demanding, but it has served me well. A few of my current primary investigators agreed to have me listed as the first author because of my involvement. While the manuscripts have yet to be published, they have led to several poster presentations. In particular, I was the first author and presenter at a national conference this last fall. It was my first conference, and I was the only student presenter. I took advantage of every opportunity. I attended every panel and presentation I could, including a networking brunch. I met every research person I had spoken with virtually previously, to ensure they met me in-person. I shadowed one of the trauma surgeons for a night. I met their colleagues. I attended their own presentations. It was busy, but by the end, I was sure I had met as many people as I could, and that they knew who I was. I ensured I was no longer some random person running statistics and writing manuscripts on another continent, but someone they knew and would recognize. These are the same people I have reached out to for recommendation letters, mentorship, speaker events, etc. They have recommended me to their colleagues when other projects were starting, further expanding my research repertoire. They have also agreed to have me submit multiple abstracts to various conferences. What started off as small projects have potentially built me a backing for electives and residency applications. While I may not be applying for the match just yet, I strongly believe that the push for recognition and networking has paved a much steadier path than I could have by simply studying. Whatever you enjoy doing—even if it isn’t research—take advantage of all it has to offer. Push its reach. Meet people through your various hobbies and jobs, and build yourself a reputation. It will serve you in the long run.

Spring 2022

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Personal Stories

//Lions, Baboons and the Kenyan TwoStep, August 1995

« Prof Kevin McGuigan

’m hot, thirsty, sunburnt, sweaty, my feet ache but most of all I’m scared. I have a feeling that this is all going to end badly. I have a PhD in semiconductor spectroscopy. My natural habitat is a darkened optics lab surrounded by bath cryostats, transfer-siphons and argon-ion lasers. How on Earth did I end up here, hiking into the Kenyan Bush with four Maasai gentlemen looking for water holes? Two years previously I had just started in my first permanent academic post as a physics lecturer in RCSI, when a retired lecturer burst through my office door and asked who the new physics chappie was and if he knew anything about lamps. That was my first encounter with the legendary Dr Joseph Barnes. Even then at the age of 75 he was famous throughout the tropical medicine community for his dedication to combating diseases of the poor in developing countries. Joseph at that time was an emeritus lecturer in tropical medicine and was trying to see if bacterially contaminated water could be rendered potable using sunlight. That’s why he needed someone who knew about optics, lamps and irradiances. It was but a short stumble for me to go from that initial consultation, to being part of a field team travelling to Kenya prior to the start of field trials of solar disinfection among the Maasai communities. Today I’m travelling around the study area in the Kenyan Rift Valley to take samples from water sources used by the Maasai. I have already visited five other sources and there only remains one more in Nayukatuk before we are finished for the day. Unfortunately it is a 20 minute hike across rough terrain from where we have to leave the vehicle to this open water source. With only an hour remaining, sunset is uncomfortably close. The Programme Manager of our collaborating aid agency had warned me to avoid walking in the bush or driving on the roads after dark. This water hole in particular was dangerous because a pair of young male lions had recently moved into the area in the hope of taking a goat, a cow or a cow-herder as they moved their livestock along the trail. I’m accompanied by four Maasai gentlemen. Seruni is my interpreter and works for a local NGO, Wilson is the local government-appointed Chief, James is the local teacher (acting as guide to this water hole) and the fourth man is a young Maasai warrior (honestly, that is how he describes himself ) called Thomas that we met in the bush and seems to have joined us because he was bored and had nothing better to do. They are all in high spirits, talking loudly in Maasai and laughing frequently. None seem bothered about the lions. If we are confronted by a peckish lion we will have to rely on a spear (Thomas’) a machete (also Thomas’) and a rhungu (yep! You’ve guessed it) which is Maasai club supposedly fashioned from the femur of a rhino, but this one looks wooden to me. My take-away message here is not to annoy Thomas and, if push comes to shove, give him whatever he asks for. As I mentioned at the start, I am thirsty so I take my water bottle out of my rucksack. Being the polite Irish chap that I am, I offer it to my four Maasai companions first. Being the pragmatic Africans that they are, they assume no one would be so stupid as to offer their water around without satisfying their thirst first. My bottle is handed back to me empty. As I look at the rapidly descending sun, I ask James if we are nearing the water hole. He says it is “Just there!” I don’t get my hopes up because over the past week I have learned that the Maasai have quite an elastic interpretation of time and distance so “Just there” can mean anything from 20 meters to 20 kilometres. However, in this instance the water hole is just there – a pond about the size of a playground sand-pit, nestling at the bottom of a small cliff. There is a troupe of about 20 baboons drinking at the pond but Seruni soon sends them scampering up the cliff by throwing a stone at the alpha male. To my great amusement some of the baboons stop at the top of the cliff and hurl rocks back in our general direction. Nevertheless our sample bottles are soon filled and we tramp along the trail towards the jeep. We are walking in single file with me third in line when I see an impressively large black snake slither out from under a bush at the side of the trail. As he slithers in front of me I stop and ask Seruni if I need to worry about this snake. He takes one look and shouts “Two-Step” at the top of his voice. Immediately James, Thomas and Wilson drop their backpacks and run off in three different directions. Seruni places his arm on my shoulder and tells me not to move. The snake is unimpressed by these shenanigans and disappears into the bush on the opposite side from where he appeared without so much as a backwards glance. As I wait for the others to return Seruni explains what has just occurred. Kenyans call that snake a Two-Step. If he wants or is angry enough, he can move as fast as a man can run and can bite you in your face. If he bites you, you will take maybe two steps before you collapse and ultimately die a very painful death. Whenever we meet them, Maasai groups will always run off in opposite directions because the Two-Step can only chase one person at a time. Days later I discover that the Two-Step is the local name for the Black Mamba (Dendroaspis polylepis) which comes in at number 8 in the world-wide ten most venomous snakes’ Hall of Fame. Over the following 10 minutes Wilson, James and Thomas come skulking back. They clearly seem embarrassed at abandoning Seruni and his mzungu (white) charge to their fates, especially Thomas. Eventually we start off again but by now the sun had set and we are tramping in the dark without any lights. James seems sure of where he is going so we follow his lead. A short while later I hear a low rumble which I take to be the hungry tummy of one of my companions. Spring 2022

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Personal Stories

Seruni suggests that I swap places with him so that I am right in the middle of the group and we continue along our way. After the scariest 15 minutes of my life, stumbling through the moonless bush, we finally arrive at the jeep. As we load the water samples into the vehicle Seruni asks me if I heard the lions. It seems that he had switched places with me because he could hear two lions close by the trail. I was fascinated by his apparent calm and asked him why he wasn’t scared they would attack us. His response is burned into my memory. “Oh I wasn’t scared for myself. Male lions are very lazy. If they had attacked our group they would have taken the slowest, fattest person with the most meat”. He looked at me pointedly and smiled as he then gazed at our stick-thin companions. In future, I think I’ll stick to the optics lab. Lasers, high voltages and explosive gases somehow seem safer.

Spring 2022

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Personal Stories

//Functional Medicine

Yohan Porus Irani

unctional medicine is an emerging field that is focused on addressing the root cause of disease. The root cause may manifest itself in the symptoms that the patient presents with. Functional medicine stems from the belief that a symptom can be caused by multiple causes. Additionally, a single cause can manifest as multiple symptoms. Not only does this approach help look at all the systems of the body as a whole, but it also addresses the root cause rather than supressing symptoms, which can reappear. For example, consider a patient presenting with what a clinician may suspect as depression. This may have several causes ranging from hormone imbalances to chronic inflammation. These causes may then be due to a combination of the individual’s environment, lifestyle, and genes. Keeping this in mind, a functional medicine approach will assess the patient’s lifestyle/environmental/genetic factors to come up with a treatment plan that involves changes to their daily life and alternative therapies, as opposed to the prescription of antidepressants. Furthermore, for patients who have tried several antidepressants with no success, they have found great benefit from dietary changes. This stems from research indicating that deficiencies in nutrients like vitamin K, zinc, magnesium and even fatty acids can cause symptoms of depression, and the consumption of these nutrients can be protective against depression. This, coupled with the well-evidenced research showing that moderate exercise can help reduce depressive symptoms, indicates that there are several interventions that can be taken as opposed to the direct prescription of drugs. Furthermore, it is evident that functional medicine tools are tailored to the individual by taking a deep-dive into their life and behaviour. This emerging field is now being utilised in the management practices of conditions such as Crohn’s disease to type 2 diabetes. With the increase in metabolic illnesses, autoimmune conditions, and an array of mental health disorders, it is imperative to view a patient holistically and take a functional medicine approach to treating disease in order to prevent relapse and promote better patient outcomes. We acknowledge that life is a constant journey of discovery.

Spring 2022

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Education

//MSc Physician Associate Studies

« Dr Pauline Joyce

hysician Associates (PA’s) were first introduced in the United States (known as Physician Assistants) over 50 years ago and have now gained recognition globally. A PA is a healthcare professional who works to the medical model within the general medical and/or general practice team. The value of this internationally developed career role is to alleviate workforce pressure on the health service for the benefit of patients and doctors alike. The master’s programme in Physician Associate Studies, commenced at RCSI in January 2016, is modelled on the UK and US curricula. It is targeted at graduates with a biomedical or health sciences degree, and is a 2 calendar years’ full-time programme, consisting of a balance of theory and clinical rotations. PAs are trained in the generalist model and are known as advanced practice providers in much of the US literature. Clinical rotations span medicine, surgery, community medicine and specialties including mental health, obstetrics and gynaecology, paediatrics etc. The first year of the programme is mostly theory with clinical rotations at the latter part of the year. Students rotate across general medicine and surgery within the public and private sectors. Year 2 of the programme is given over to clinical rotations with scheduled tutorials in RCSI. Figure 1 summarises what a PA can do. PAs function under the supervision of a doctor and practice as semi-autonomous clinicians with roles that complement those of the doctor. Alongside the start of the master’s programme at RCSI, a two-year pilot project between the Department of Health, RCSI, and Beaumont Hospital was set up to evaluate the contribution that the role of the PA could make to service delivery in four surgical units at the hospital. Four PAs were recruited from North America during this time with a number of projects set to demonstrate the impact of the PA role on service delivery and patient care. While the evaluation of the role was positive, the Department of Health have yet to progress the regulation of this new profession in Ireland. In the meantime, the Irish Society of Physician Associates (ISPA), set up the PA graduates, holds a register of all PAs and PA students in Ireland and all employment opportunities are sent to the ISPA for distribution. RCSI PA graduates are now working in medicine and surgery and in primary and secondary care across public and private settings. The programme is growing year on year with some scholarships available for students towards their study fees. A number of studies have been carried out to evaluate the impact of the role in Ireland, including patient satisfaction, patient willingness to be seen by a PA, and willingness of medical students to refer patients to a PA or a doctor, when time is a trade-off. Some medical students have been involved in these studies as part of the RCSI Research Summer School. This is an exciting development for RCSI and the medical profession as the PA role can help to complement the workforce challenges, particularly at this time of long waiting lists for patients. With a generalist training background, PAs can be deployed across different sectors as was the case during Covid-19 when the PAs at Beaumont Hospital were instrumental in supporting the Covid-19 Hub. Studies across the globe have shown consistency in the potential positive contributions of PAs to the wider health system in terms of patient care, patient satisfaction and cost effectiveness.

Figure 1: What a PA can do Dr Pauline Joyce, Director of Quality and Clinical Engagement

SEPTEMBER Spring 2022 2015

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Education

//Race Equality at RCSI: Realistic Expectations?

Carmen Jeanette Stepek and Yohan Irani

he RCSI’s first Race Equality Action Plan (REAP) is an Equality, Diversity, and Inclusion (EDI) initiative developed by the Race Equality Forum. The Race Equality Forum complements the unique diversity at RCSI and brings racial and cultural equality to the forefront. This collaboration of students, staff, trainees, and the broader community began less than a year ago, in January 2021, but has already displayed rigour, dedication, and advocacy for every voice to be “heard, celebrated, and respected (RCSI Race Equality Statement).” Though most of us do not typically experience blatant discrimination, institutionalised and covert forms of prejudice, xenophobia, and racism are observed in our local communities, including on campus. The Higher Education Authority (HEA)’s recent research on race equality showed high levels of discrimination in the higher education sector, such as a pay gap for minority ethnic groups. By simply acknowledging that race inequality exists in several contexts within higher education, RCSI and the Race Equality Forum have already taken the first step in encouraging greater awareness and activism from students and staff. The efforts outlined in this three-year plan are expected to promote open discussions in inclusive and safe conditions. Such formal and casual conversations (whether about race equality, diversity, or otherwise) allow us to better understand and respect different groups of people. The result is a community whose educators, future healthcare leaders, and researchers are “culturally competent, socially conscious, and have a sense of civic responsibility.” As stated in the RCSI Statement on Race, these qualities are requisites for a more inclusive and fair society. The following questions were asked to RCSI undergraduates, postgraduates, and staff. Although we can understand the bothersome task of completing yet another survey, the answers (summarised below) provided insight into our community’s expectations of the new initiative. Down the line, this investigation could serve as a qualitative starting point to evaluate the results of the Race Equality Action Plan over the next three years. Question: What do you think race equality looks like in higher education or in general? Answer: Race equality in an academic setting yields equitable treatment and opportunities for all staff and students, in addition to the local and even global population. Each tier, whether undergraduate, postgraduate, lecturer, etc., should be representative of that population. Ideally, there would not be any discrimination, prejudice, or preference due to someone’s race, nationality, or skin tone. In the workplace, everything should be objective, and no one should experience or observe preferential bias. There should be an objective way to measure someone’s progress or rate of progress because, at the end of the day, the work or research we do is the only thing that matters. When someone speaks up about bias, discrimination, or other unjustified behaviours, the community, including the administration, should adequately acknowledge the concern and promote awareness. The fear of dismissal is often behind the lack of recognition and representation in the community. If race equality is achieved, every individual will feel comfortable and appreciated, allowing them to thrive in their academic or work environments. Question: What do you think are the core challenges to race equality? Answer: RCSI students and staff originate from many different backgrounds and cultures, from over 80 nationalities. There are so many nationalities and cultures within RCSI, and one action (or action plan) will not be interpreted the same way by all students and staff. However, RCSI’s diverse community is more of a strength than a challenge. Representation and inclusion are vital to facilitate equal opportunities. RCSI shows significant evidence of moving toward racial justice. This initiative is a relief for students and staff waiting for race equality to be taken seriously within RCSI and the local community. Also, the plan may be an eye-opener for those unconcerned about such topics, primarily because it benefits them whether they acknowledge it or not. Every member of RCSI’s diverse, international community should challenge fixed mindsets and start conversations surrounding uncomfortable topics despite fear of dismissal. One student mentions the fine line between banter and inappropriate commentary, rarely treated lightly, but a common breeding ground for microaggressions and even arrogance. Still, the upcoming obstacles remain unseen until the RCSI community takes a deeper dive into race equality and discrimination. Question: What actions do you think REAP should include to promote equality? Answer: RCSI should also increase promotion and show more enthusiasm surrounding activities such as the Cultural Awareness Club. The club is open to everyone and meets once a month to speak about their cultures, i.e. what similarities and differences exist among people from different backgrounds. The individual who offered this information noted that participants learn about unexpected similarities among their races and cultures more often than differences. Another individual suggested allowing additional leave for staff to celebrate their culture’s holidays since Ireland does not celebrate every holiday of Spring 2022

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the 80+ nations that comprise RCSI. This change would celebrate diversity and inclusivity among staff. According to one student’s perspective, the Racial Equality Action Plan ideally includes a means to have open discussions about race in a welcoming environment. This would allow students and staff to educate themselves about other cultures and ethnicities or even feel comfortable raising concerns if necessary. For example, the recent occurrence at Connolly Hospital suggests there are many people in academic and medical environments unaware of which terms are appropriate when referring to regions or ethnic groups in terms of disease epidemiology and which ones are outdated and offensive. RCSI could reiterate their dedication to cultural awareness and reduce unconscious bias by mandating more than one online HR training. These could perhaps take place once a year and in person if possible. Question: Have you ever experienced racial or cultural inequality at RCSI? Answer: Out of the sample, only a couple of people observed and/or experienced racial or cultural inequality at RCSI. Not many specifics were shared, but according to one individual, minoritised students receive preferential treatment so the university can avoid accusations of racism. Students should never use their race, skin tone, or origin to excuse failing exams or doing poorly in their modules, but this individual’s answer begs a critical point. Perspectives on race equality and how the Race Equality Action Plan are implemented will vary greatly. It is equally as important to mention that racial inequality does not only affect non-white communities. Class and culture also play a role in acts of discrimination. This article was written in memory of Lee Maracle, revolutionary Indigenous writer & academic of the Stó:lō nation, who recently passed on at 71 years of age. “Where do you begin telling someone their world is not the only one?”

Spring 2022 2015 SEPTEMBER

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//New Opportunities for the Management of Stroke

« Prof David Williams

ntroduction Internationally, stroke is a major cause of death, and the commonest cause of adult-acquired disability. 1 in 6 people worldwide will have a stroke in their lifetime. It is estimated that there will be a 34% increase in total stroke events in the European Union between 2015 and 2035. This number is projected to increase by 50% in the next 8 years as the population ages. Stroke can be classified into two main types, ischemic and haemorrhagic. Ischemic strokes are by far the most common cause of stroke accounting for over 80% of cases. Approximately 10,000 people in Ireland are admitted to hospital annually with a stroke. There are approximately 30,000 survivors of stroke, many of whom have significant residual disability including hemiparesis, inability to walk, need for help with activities of daily living (ADLs), clinical depression and cognitive impairment. Risk factors for ischaemic stroke include a raised BMI, lack of exercise, high blood pressure, raised cholesterol and atrial fibrillation. Recognition of Stroke The typical patient loses 1.9 million neurons for every minute a stroke is untreated. Therefore, it is imperative that patients suspected of suffering a stroke are treated in a timely manner. There are a number of campaigns which have increased the public’s awareness of stroke. One such campaign is the FAST campaign which assesses a person suspected of suffering a stroke for Facial weakness, Arm weakness, Speech problems and prompts the person making the assessment to call the emergency services in a Timely manner. Advances in Stroke Care Over the past 20 years there have been a number of advances in stroke care. Evidence for the benefit of stroke unit care was demonstrated in the early 1990’s. A stroke unit is an organized system of care including medical management and multidisciplinary assessment by a nurse, physiotherapist, occupational therapist and speech and language specialist. Stroke units have been shown to reduce death and dependency by 25% and length of stay in hospital. This was followed swiftly by evidence for the benefit of carotid endarterectomy, outpatient therapy services, and early supported discharge for patients requiring rehabilitation and hemicraniectomy for patients with malignant middle cerebral artery (mCA) infarction. However, the most significant advance in the acute management of ischemic stroke came in 2003 when Alteplase (i.e., thrombolysis) was licensed for the treatment of acute ischemic stroke. This meant that stroke became a medical emergency necessitating early treatment within 3 hours of symptom onset. 2015 saw the publication of five studies demonstrating the benefit of a new treatment, Endovascular Thrombectomy (EVT) for the management of Large Vessel Occlusion (LVO) stroke. Thrombectomy is the process by which a thrombus is removed from an artery supplying a region of the brain, typically the middle cerebral artery. The Stroke Centre at RCSI/Beaumont Hospital recruited patients into one of these studies called ESCAPE. Professor John Thornton leads a group of interventional neuroradiologists who perform this procedure at Beaumont Hospital. The ESCAPE trial demonstrated a significant reduction in death and disability in patients receiving this treatment, with a number needed to treat (NNT) of 4 to demonstrate efficacy. There are currently two thrombectomy centres in Ireland, one is based at Beaumont Hospital, Dublin and a second has recently opened at Cork University Hospital. Rehabilitation Despite the recent advances in acute stroke care, a significant number of patients will still require ongoing rehabilitation following a stroke. Rehabilitation begins in the acute stroke unit. Physiotherapy helps the stroke patient regain as much mobility and muscle control as possible, so as to achieve the fullest degree of independence and mobility. Occupational therapy explores ways for the patient to carry out tasks which may have become more difficult following the stroke such as washing and dressing. Speech and Language therapy addresses swallowing and communication difficulties caused by a stroke. Psychology services assess and treat the psychological effects of stroke including cognitive impairment following stroke. Future options for acute stroke care There are a number of future options for the management of stroke patients. With better imaging modalities, we may be able to better select patients who will benefit from acute treatment. We may also be able to increase the time window for treating patients presenting with acute stroke, thereby increasing the number of patients who may benefit from both thrombolysis and thrombectomy. Improving our systems of care will also allow more patients to be transported to stroke centres to receive acute treatment. The Beaumont Stroke centre has recently been accredited as a European Stroke Organisation (ESO) comprehensive stroke centre. It is the only such centre to receive such accreditation in Ireland. iPASTAR. Prof David Wiliams and Prof Frances Horgan (Dept of Physiotherapy) are leading a HRB funded iPASTAR (Improving Pathways for acute Stroke and Rehabilitation) research programme. This interdisciplinary programme will generate a cohort of post-doctoral researchers with transferable skills who can make significant future impact across a range of settings with the necessary expertise to generate research evidence that will support cost-effective, patient focused stroke care. This consortium of national and international experienced interdisciplinary stroke academic researchers, clinicians, stroke patients and PhD educators are all focused on improving stroke recovery and rehabilitation. iPASTAR is a collaboration between RCSI and UCD. Prof Anne Hickey Spring 2022

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(Department of Psychology RCSI) and Prof Jan Sorenson (RCSI) are core partners on this project. RCSI collaborators on the programme include Professor Kathleen Bennett, Dr Fiona Boland and Dr Lisa Mellon. In conclusion, there have been a number of recent exciting developments in the acute treatment of stroke which will offer new opportunities for the treatment of this potentially devastating illness. Prof David Williams, Professor of Stroke Medicine RCSI University of Medicine and Health Sciences

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//COVID-19 and the Rise of Maskne

Brian Li

he end of 2019 marked the beginning of a year like no other. What began as a mysterious respiratory virus rapidly descended into the COVID-19 pandemic. Flattening the curve, contact tracing, and lockdown joined our everyday vernacular as we adjusted to the new normals of social distancing and virtual gatherings. Despite government restrictions and public health measures, communities around the world continued to struggle under the weight of the pandemic, anxious for the delivery of vaccines and the return to life before. In the midst of the chaos, mask-wearing emerged as a highly contentious political issue, dominating news cycles worldwide. This shouldn’t come as a surprise considering that mask-wearing is not common practice in Western countries. Even in Eastern countries, masks only gained widespread popularity after the 2003 SARS outbreak, becoming associated with civic responsibility and support for healthcare workers.1 In contrast, Western society’s perception of masks seemed limited to illness and hospital settings – less about contributing to the greater good and more about individual rights and freedoms.2 The tone shifted dramatically in the past year, as governing agencies attempted to unify their message on public face coverings. Subsequently, a full year after the emergence of COVID19, one would be hard pressed to find people in public, particularly in enclosed spaces, without wearing a mask. Face coverings may become far more mainstream than ever before, but its protection comes double-edged. This frequent, physical contact on our faces, albeit protective, may soon be the driving force behind the resurgence of a certain, pesky skin condition that, for so many of us, marked our teenage years. Acne is a chronic inflammatory disease involving sebaceous follicles leading to open or closed comedones or pustules, potentially forming scar tissue during the healing process.3 Follicular hyperkeratosis, hormonally induced sebum overproduction, immunological influences, and local environment are all hypothesized to be involved in the pathogenesis of acne.4,5,6 Though typically thought of as a way of passage through adolescence, with some reports citing prevalence as high as 90%, acne can persist into adulthood, largely influenced by genetics and lifestyle.7 Local acne outbreaks in the vicinity of personal protective equipment (PPE) such as masks, commonly referred to as “maskne”, is a growing phenomenon as more individuals increase their frequency and duration of mask-wearing.8 More than 22,000 images with the hashtag “maskne” have been posted on Instagram over the course of the pandemic.9 Although the term may have only recently trended, healthcare workers are likely already well-acquainted.10 Incidents of acne flare-ups due to PPE have been reported since the SARS crisis, often in a perioral distribution, tracing the contact border of N95 masks.10,11,12 Heat and humidity are the primary suspects for maskne development, which can block pilosebaceous glands by increasing sebum production and inducing hypertrophy of the keratinocyte lining.13,14 Mechanical shearing may also contribute to maskne by way of pressure and follicular occlusion.15 Not to be mistaken for adult acne, maskne is unique in that it may present de novo in patients without any prior history.9 What does this mean for the field of dermatology, now that medical specialties must adapt more rigorously to telemedicine or virtual services in the midst and aftermath of the pandemic? Compared to cases of serious infections or malignancies, maskne is far less urgent and can be managed virtually without much difficulty. After all, maskne management focuses primarily on conservative measures to maintain healthy skin microbiome, such as using well-fitted masks, non-comedogenic moisturizing creams, and gentle cleansers.9,16 The pervasiveness of smartphones and annual improvements to their built-in cameras allow patients to send high-definition photos of acne outbreaks for diagnosis, so long as a secure line is available. This transition away from in-person consultations offers greater convenience and cost-effectiveness, but will require the implementation of appropriate infrastructure and triage algorithms, especially with the rise in volume of nonurgent cases such as maskne.17 Countries have already observed up to a 15-fold increase in teledermatology consultations as a result of the pandemic.18 Even Google search trends have suggested a growing public interest in the past year in general skin conditions such as acne, dry skin, and atopic dermatitis, which can all be aggravated by extensive mask-wearing.19 But as some clinical practices have reported, the visual nature of dermatology is highly conducive to telemedicine without compromising patient satisfaction, though extra attention should be given to the potential for missed diagnoses or complications.20 A rise in maskne cases, all things considered, is hardly a reason for panic; however, we would be remiss to think that acne only affects the skin. Our appearances are so often tied to our self-esteem and our day-to-day living. The impacts of acne on our self-image, together with subsequent scarring and hyperpigmentation, can threaten to derail our confidence, our social lives, and in some instances, fuel depression and suicidal thoughts.21,22 Despite its physiologically benign nature and relatively straightforward treatment, maskne should be considered a skin condition with significant psychological sequelae, one where treatment should be based less on the severity of acne but aligned with patients’ perceptions of how greatly their quality of life is impacted.23 12 long months have passed since humanity was first introduced to COVID-19. Masks have become de facto symbols for the pandemic, literally in front of our faces the moment we step outside. In the same way that all aspects of society were disrupted by the pandemic, so too were all medical specialties, even those that seem far removed from an acute respiratory illness. With mask-wearing becoming more omnipresent, dermatologists would be prudent to prepare for the imminent wave of maskne cases, especially knowing that some conditions, however benign, are more than just skin-deep.

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References 1. Siu, J. Y. M. (2016). Qualitative study on the shifting sociocultural meanings of the facemask in Hong Kong since the severe acute respiratory syndrome (SARS) outbreak: implications for infection control in the post-SARS era. International Journal for Equity in Health, 15(1), 1-16. 2. Ma, Y., & Zhan, N. (2020). To mask or not to mask amid the COVID-19 pandemic: how Chinese students in America experience and cope with stigma. Chinese Sociological Review, 1-26. 3. Williams, H. C., Dellavalle, R. P., & Garner, S. (2012). Acne vulgaris. The Lancet, 379(9813), 361-372. 4. Collier, C. N., Harper, J. C., Cantrell, W. C., Wang, W., Foster, K. W., & Elewski, B. E. (2008). The prevalence of acne in adults 20 years and older. Journal of the American Academy of Dermatology, 58(1), 56-59. 5. Juhl, C. R., Bergholdt, H. K., Miller, I. M., Jemec, G. B., Kanters, J. K., & Ellervik, C. (2018). Dairy intake and acne vulgaris: a systematic review and meta-analysis of 78,529 children, adolescents, and young adults. Nutrients, 10(8), 1049. 6. Dursun, R., Daye, M., & Durmaz, K. (2019). Acne and rosacea: What’s new for treatment?. Dermatologic therapy, 32(5), e13020. 7. Wolkenstein, P., Machovcová, A., Szepietowski, J. C., Tennstedt, D., Veraldi, S., & Delarue, A. (2018). Acne prevalence and associations with lifestyle: a cross‐sectional online survey of adolescents/young adults in 7 European countries. Journal of the European Academy of Dermatology and Venereology, 32(2), 298-306. 8. Kosasih, L. P. (2020). MASKNE: Mask-Induced Acne Flare During Coronavirus Disease-19. What is it and How to Manage it?. Open Access Macedonian Journal of Medical Sciences, 8(T1), 411-415. 9. Gomolin, T. A., Cline, A., & Russo, M. (2020). Maskne: exacerbation or eruption of acne during the COVID-19 pandemic. SKIN The Journal of Cutaneous Medicine, 4(5), 438-439. 10. Foo, C. C. I., Goon, A. T. J., Leow, Y. H., & Goh, C. L. (2006). Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome–a descriptive study in Singapore. Contact dermatitis, 55(5), 291-294. 11. Tan, K. T., & Greaves, M. W. (2004). N95 acne. International Journal of Dermatology, 43(7), 522-523. 12. Rosner, E. (2020). Adverse effects of prolonged mask use among health care professionals during COVID-19. J Infect Dis Epidemiol, 6, 130. 13. Sardana, K., Sharma, R. C., & Sarkar, R. (2002). Seasonal variation in acne vulgaris—myth or reality. The Journal of Dermatology, 29(8), 484-488. 14. Narang, I., Sardana, K., Bajpai, R., & Garg, V. K. (2019). Seasonal aggravation of acne in summers and the effect of temperature and humidity in a study in a tropical setting. Journal of Cosmetic Dermatology, 18(4), 1098-1104. 15. Boer, J., Nazary, M., & Riis, P. T. (2016). The role of mechanical stress in hidradenitis suppurativa. Dermatologic Clinics, 34(1), 37-43. 16. Teo, W. L. (2020). Diagnostic and Management Considerations for ‘Maskne’ in the Era of COVID-19. Journal of the American Academy of Dermatology. 17. Trinidad, J., Kroshinsky, D., Kaffenberger, B. H., & Rojek, N. W. (2020). Telemedicine for inpatient dermatology consultations in response to the COVID-19 pandemic. Journal of the American Academy of Dermatology, 83(1), e69-e71. 18. Sharma, A., Jindal, V., Singla, P., Goldust, M., & Mhatre, M. (2020). Will Teledermatology be the silver lining during and after COVID‐19?. Dermatologic Therapy, e13643. 19. Guzman, A. K., & Barbieri, J. S. (2020). Analysis of dermatology-related search engine trends during the COVID-19 pandemic: Implications for patient demand for outpatient services and telehealth. Journal of the American Academy of Dermatology, 83(3), 963-965. 20. Mostafa, P. I., & Hegazy, A. A. (2020). Dermatological consultations in the COVID-19 era: is teledermatology the key to social distancing? An Egyptian experience. Journal of Dermatological Treatment, 1-6. 21. Tan, J. K. (2004). Psychosocial impact of acne vulgaris: evaluating the evidence. Skin Therapy Lett, 9(7), 1-3. 22. Dreno, B., Bagatin, E., Blume‐Peytavi, U., Rocha, M., & Gollnick, H. (2018). Female type of adult acne: Physiological and psychological considerations and management. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 16(10), 1185-1194. 23. Wang, C., Chudzicka-Czupała, A., Grabowski, D., Pan, R., Adamus, K., Wan, X., ... & McIntyre, R. S. (2020). The association between physical and mental health and face mask use during the COVID-19 pandemic: a comparison of two countries with different views and practices. Frontiers in Psychiatry, 11, 901.

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//Switching Back the Clocks: Why Daylight Saving Time is No Longer Needed

Tiffany Yeretsian, Gabrielle Sanatani, and Komal Marwaha

ntroduction Prior to the invention of electricity, humans depended on the sun to organize their daily routines. (1) Circadian rhythms have evolved around a 24-hour cycle which determines biological process and activities, all of which are heavily dependent on light from the environment. (2, 3) As many people now live in cities, work in buildings, and use electric light, there has been a dramatic shift in our social and biological clocks. (1) These clocks are rarely in sync with the sun, which has led to significant effects on our health and well-being. (1) The challenges that our circadian clocks face worsen during daylight saving time (DST). (1) The initial reasoning behind introducing DST, including maximizing the duration of workdays, is no longer relevant. In effect, the implications of these biannual clock changes are causing more harm than good to human health, and are resulting in sleep deprivation, cardiovascular disease, and metabolic disorders. Background Daylight saving time has been used in the Republic of Ireland since 1961. In 2001, DST became mandatory for all European member states. (4) Typically, DST lasts from spring to fall and consists of a one-hour time change, affecting work and lifestyle. DST determines the social clock, such that social activities and the typical workday start one hour earlier relative to the clock set by the sun. (1) People typically live according to the same social clock within a time zone, but so long as natural light is still visible, our internal clocks follow the time of the sun, as defined by the sun’s path from east to west throughout the day. (1) Light is a dynamic signal that is influenced by season and by individual behaviours. (3) This internal clock influences our biological needs, including when we sleep, eat, and are at maximal cognitive function. (1) DST was originally introduced decades ago by politicians to allow employees to work for longer hours with sunlight, something that was of particular benefit before the invention of electricity. (1, 5) Once electric lighting became widely available, DST proved to be useful in reducing electricity expenditures in the evening. (1) DST was useful for artificially increasing the amount of sunlight in a day, enticing employers with a way to save money. However, this rationale is no longer valid since most energy expenditure occurs during the daytime. (1, 5) DST is still used in some areas of the world today based on an outdated notion that it is beneficial to the workforce. However, the negative effects of DST are increasingly evident. As DST directly alters the relationship between the social clock and the natural clock set by daylight, this twice-a-year shift disrupts work, sleeping, and socializing schedules. (5) In recent years, the effects of artificial light has been a growing research topic, particularly with the introduction of devices that emit light waves capable of altering the circadian rhythm. (6) With the growth of artificial lighting, natural light is playing a smaller role in everyday life. People now live by a combination of natural and artificial light exposure and set their schedules to follow this, rather than the sun. (6) In assessing whether or not DST is still necessary, the importance of artificial versus natural lighting and how much the body depends on sunlight is a key consideration. (6) In March 2019, European Parliament approved the termination of the mandatory use of DST effective as of May 2021 in order to enable member states to make their own decisions regarding DST implementation. (4) Debates surrounding this ensued, with many scientists emphasizing the impact of the biannual clock change on overall health. (6) Health effects of daylight saving time Although most problems arise from the transition from standard time to DST, the conversion from either time zone may cause detrimental health complications. These include disrupted sleep schedules, dramatic fluctuations in mood, risk of cardiovascular death (CVD), increased emergency room visits, sleep deprivation, circadian misalignment, and increased inflammation. (2) In regards to CVD, myocardial infarctions also become more common after the time change due to downstream effects of increased inflammatory cytokines, elevated heart rate and blood pressure due to a decrease in vagal tone, and sleep deprivation. (2) During DST, individuals must wake up an hour earlier, which results in an abrupt change in sleep pattern, lack of sleep, and ultimately, a change in gene expression due to cellular derangements. The presence of darkness upon waking up and daylight in the evening causes a shift in the circadian rhythm, but the internal clock does not ever fully adjust to this change even after many months. (1) Another detrimental effect is accidental trauma, with a 6% rise in traffic accidents in the United States. (7) Alongside these short-term effects, there are also long-term sequelae of DST on health. (1) Waking up earlier disrupts the natural wake cycle and causes a persistent discrepancy between the internal clock and the social clock called social jet lag (SJL). SJL is the difference between work days and free days, and between social and biological time. (8) SJL has been linked to an increased risk of morbidity, including obesity, cardiovascular disease, metabolic syndrome, and depressive symptoms, with the worse effects being in the western-most regions of a time zone. (1) Physiologists push for permanent wintertime to prevent this excess stress on the natural sleep-wake cycle. (6, 10) Although more daylight later in the day results in a slight decrease in the risk of car crashes, there were increased deaths in the morning associated with children going to school when DST was implemented for a year (in response to an Organization of the Petroleum Exporting Countries (OPEC)). (1, 7) Spring 2022

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Termination of daylight saving time While the disruption caused by a one-hour time shift may seem insignificant to otherwise healthy individuals, the negative effects associated with the transition to daylight savings time have been widely reported. (2) DST disrupts genetic mechanisms involved in the circadian clock that help regulate the sleep-wake cycle in humans. (2) These effects may be even more commonly seen in individuals with extreme manifestations of chronotype or circadian rhythm sleep-wake disorders, neurological disorders, or children and adolescents whose developing brains are more susceptible to the adverse health effects that occur following the transition to DST. (2) There has been a longstanding debate on whether DST should be abolished, though evidence shows that switching the clocks every 6 months is doing more harm than good. To improve health, Ireland should abandon DST and remain in standard time (ST) year-round. Standard time is when the social clock most closely matches the clock set by the sun. This solution would alleviate both the acute and chronic problems caused by DST. (1) A survey performed in the EU found that of those who participated, 84% voted for the clock change to be abolished. Of those respondents, 56% would keep DST, 36% would favour ST, and 8% would have no preference between the two. Most respondents in favour of ST emphasized general health as a priority, and those in favour of DST prioritized evening leisure activities the most. (6) Conclusion The initial reasoning behind the implementation of daylight saving time is no longer relevant given the developments in electricity and the shift in the modern-day workforce. Recent studies have shown the clinical implications of biannual DST shifts on human health, and the potential for negative consequences to outweigh the benefits of continuing the use of this outdated system. We suggest abolishing DST to improve the connection between our internal, social, and sun clocks, which will result in overall improved health and less disruption to daily life. References 1. Roenneberg T, Wirz-Justice A, Skene DJ, Ancoli-Israel S, Wright KP, Dijk DJ, et al. Why Should We Abolish Daylight Saving Time? J Biol Rhythms. 2019;34(3):227-30. 2. Malow BA, Veatch OJ, Bagai K. Are Daylight Saving Time Changes Bad for the Brain? JAMA Neurol. 2020;77(1):9-10. 3. Zerbini G, Winnebeck EC, Merrow M. Weekly, seasonal, and chronotype-dependent variation of dim-light melatonin onset. J Pineal Res. 2021;70(3):e12723. 4. Derks L, Houterman S, Geuzebroek GSC, van der Harst P, Smits PC, Registration PRCotNH. Daylight saving time does not seem to be associated with number of percutaneous coronary interventions for acute myocardial infarction in the Netherlands. Neth Heart J. 2021;29(9):427-32. 5. Zhang H, Dahlén T, Khan A, Edgren G, Rzhetsky A. Measurable health effects associated with the daylight saving time shift. PLoS Comput Biol. 2020;16(6):e1007927. 6. Blume C, Schabus M. Perspective: Daylight Saving Time-An Advocacy for a Balanced View and against Fanning Fear. Clocks Sleep. 2020;2(1):19-25. 7. Rishi MA, Ahmed O, Barrantes Perez JH, Berneking M, Dombrowsky J, Flynn-Evans EE, et al. Daylight saving time: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2020;16(10):1781-4. 8. Wittmann M, Dinich J, Merrow M, Roenneberg T. Social jetlag: misalignment of biological and social time. Chronobiol Int. 2006;23(1-2):497-509. 9. Hafner M, Stepanek M, Taylor J, Troxel WM, van Stolk C. Why Sleep Matters-The Economic Costs of Insufficient Sleep: A Cross-Country Comparative Analysis. Rand Health Q. 2017;6(4):11. 10. Martín-Olalla JM. The long term impact of Daylight Saving Time regulations in daily life at several circles of latitude. Sci Rep. 2019;9(1):18466.

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RCSI STUDENT SERVICES ACCOMMODATION ON CAMPUS  Mercer Court & Millin House  Mill Street Accommodation

PERIPHERAL  300+ students accommodated weekly  Accommodation/ Travel support for students when out on rotations throughout Ireland

OFF CAMPUS  RCSEYE and Moodle Accommodation Message Boards  Various Off Campus and private accommodation options

50+ SOCIETIES

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Climbing, Cycling, Equestrian, Kickboxing, Rowing, Running, Sailing, Ultimate Frisbee, and more!  Responsible for allocating the prestigious Prof. Moira O’Brien Sports Scholarship

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Disclaimer The views expressed in this issue and student newspaper are the views and ideas of said individual/s only. They do not necessarily represent the views, beliefs or attitudes of the Royal College of Surgeons in Ireland (RCSI). In addition, the referral to any products, services, directions or advice by any parties at this event does not necessarily constitute an endorsement of any kind by RCSI.

Spring 2022

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