A PUBLICATION OF THE T&T MEDICAL STUDENTS’ ASSOCIATION (2014-2015)
Student Life
The Chekhovian Doctor
Beyond Office Hours
Ward Rounds and much more!
TTMSA EXECUTIVE 2014-2015
Sheelu Ria Khaja (President) Isabella Griffith (Vice president) Aaliya Ali (Secretary) Tian Torress (Assistant Secretary) Mitra Maharaj (Treasurer) Mershawna Ramnath (PRO) Meagan Mohammed (Year 1 Rep) Keston Rattan (Year 2 Rep) Kevin Harris (Year 3 Rep) Kodi Lourenco (Year 4 Rep) Anesh Lalram (Year 5 Rep)
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THE PULSE TABLE OF CONTENTS T&T Medical Students’ Association THE PULSE TEAM Taureef Mohammed (Editor) Irfaan Ali (Graphic Artist) Nicole Maharaj Cimone Ramcharan Virender Mahabir Patrick Edward Chin-Kong Mateus Fernandes CONTACT US Email: ttmsapulse@gmail.com Tel: 735-1001/769-1865 Facebook: Trinidad & Tobago Medical Students’ Association ACKNOWLEDGMENTS Dr Premchand Ratan Prof Samuel Ramsewak Prof Christine Carrington Dr Lianne Conyette Dr Simone Chang Dr Srikanth Rao Dr Lennon Johnson Usamah Mohammed Kelli O’Brien Sofiya Barrow Stephen Beharry
A message from the Dean Greetings from the President A review of PECH The hockey champ A taste of Canadian medicine Beyond office hours The Chekhovian Doctor About the TTMA The art of succeeding in medical school Ward rounds Study tips The dreaded internship Valedictory speech 2014 A night to remember Etymology
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A MESSAGE FROM
THE DEAN towards this production. The Pulse is really what it is – measuring the heartbeat of our faculty. It reflects activities in the institution during the various steps of the programmes and includes electives, internships, academia and research . I am delighted to see that someone whom I am fortunate to count as one of my teachers and a formidable mentor, Dr. Premchand Ratan, has been honored so appropriately. Dr. Ratan’s sense of dedication to The UWI and by extension to
PROFESSOR SAMUEL RAMSEWAK
"Dr. Ratan’s sense of dedication to The UWI and by extension to the Caribbean is legendary.”
It gives me immense pleasure once more to see this edition of “The Pulse” ready for print. First, I must extend special congratulations to the editorial staff who, as students of the Faculty of Medical Sciences always have such demanding courses in their programmes of study, but yet have committed their valuable time and energy
the Caribbean is legendary. We are most fortunate to have had the benefit of his tutelage in the clinics and wards, providing our students with incisive and commanding detail. He is someone who showed masterly command of clinical signs and of sleuthing in one of the most challenging area of medicine – the nervous system. I am particularly pleased that
"I am also pleased to see the “Tips for the wards,” “Study tips” and “Etymology,” features which will help readers to improve their prowess in the course ...” he continued to serve the Faculty even after his retirement from active clinical pursuits, in order to demonstrate the humane and ethical heights to which those in this noble profession can attain. I am also pleased to see the “Tips for the wards,” “Study tips” and “Etymology,” features which will help readers to improve their prowess in the course as well as to impart some of the important attributes required of young clinicians and readers. I am proud to lead this faculty from which such an impressive publication emanates and I wish the committee even more successful projects in the future. Samuel Ramsewak Dean, Faculty of Medical Sciences
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Tel: 735-1001/769-1865
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GREETINGS FROM THE
PRESIDENT
"Do not give up. The beginning is always the hardest.” I trust that everyone is having an enjoyable and productive year. On behalf of the executive of the TTMSA and the wider student body, I’d like to extend a late but heartfelt congratulations to the newest additions to the Medical Sciences family: The Class of 2019. Dear students, you are the young sparks that will keep the light of medical practice in Trinidad and Tobago shining brightly. It is our hope that you keep focused and equally enjoy your time in and out of class. The TTMSA ensures that you find your niche and can still come together with the rest of your classmates as well as the other year groups in the events throughout the year. The TTMSA represents all the students of the Faculty of Medical Sciences. Our priority is you, the students. We aim to provide assistance in all aspects of student life—be it mental, social, psychological, academic and even financial—to ensure the holistic wellbeing of each and every student. Undoubtedly, the student body at the Mt Hope Campus of the University of the West Indies comprises the most hardworking and intelligent minds of the Caribbean. However, some may still feel inadequate when they compare themselves to the toppers in the class. To these students, remember that you have found yourself in
SHEELU RIA KHAJA Class of 2016 that seat in Amphitheatre A on the first day of orientation, and you will find yourself there on the last at The OathTaking Ceremony. I’ll like to take this opportunity to thank all students who work tirelessly on the various subcommittees of the TTMSA—without your help the TTMSA would not be what it is. I encourage everyone to adopt active roles on the various subcommittees. The skills you will acquire in spending time in those committees, whether it is the Environmental Committee or the Banquet Committee (or any of the others), will shape you into the all-rounded doctor who the world admires.
“We aim to provide assistance in all aspects of student life— be it mental, social, psychological, academic and even financial—to ensure the holistic wellbeing of each and every student.” Our time as medical students is very limited in the journey we take as doctors. So do make the most of it! In closing, I wish you all the success and happiness that goes with being a medical student. I am sure that you will all be hallmarks in our country, as well as the world. May God bless each and everyone one of you, and our organisation.
- Sheelu Ria Khaja TTMSA President
There is no short cut, nor “royal road,” to the attainment of medical knowledge. The path which we have to pursue is long, difficult, and unsafe. —JOHN ABERNETHY, Hunterian Oration (1819)
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Letter to the Editor :
A review of PECH Professionalism, Ethics and Communication in Health (PECH) is a new course introduced in September, 2013, to the Class of 2018. The objective of the course, as outlined in the foreword of its manual, is “to inculcate a strong sense of social and civic responsibility which will better prepare and enable you (the student) to serve your communities empathetically”. Based on such a premise, it’s hard to dispute the need for such an initiative in the training of medical professionals. With increasing numbers of complaints from the public about maltreatment in the nation’s hospitals, the implementation of such a course seems long overdue. Throughout the beginning of the first semester of first year, the course seemed quite straightforward. Tutorial sessions, for my group at least, comprised discussions about professionalism in health and relevant real-life scenarios. I must say, the lively conversations that ensued during tutorials were intriguing. These discussions were the highlight of PECH for me, mostly because it gave me the opportunity to articulate my own views and to hear those of my colleagues, allowing us to gain new perspectives on issues. Our first assignment was to complete a journal, comprising six to eight reflective pieces, by the end of the semester. Some students expressed concern about the tediousness of researching topics and writing a piece every week while trying to keep up with other courses, including PBLs and
labs. I had no problem with the additional workload since I accepted it as part of being a medical student. However, I did question myself as to how this particular assignment would
“These discussions were the highlight of PECH for me, mostly because it gave me the opportunity to articulate my own views and to hear those of my colleagues, allowing us to gain new perspectives on issues.” help achieve the objective of the course. Sure, it can be said that the reflective pieces could have helped us get in touch with our emotions and empathise with persons in different situations, but I felt that all of this would be overshadowed by being marked. I think that this impeded students from making a sincere effort to be more reflective or empathetic. In semester two, we had to do two PECH courses, simultaneously, which proved to be too much. There was a general air of frustration among students as
the end of semester two drew closer. Nearing the end of the second semester, our class learnt that PECH would span over three years. This raised more questions among students who expressed their concerns to the course coordinators. Fortunately, these concerns were not overlooked. After experiencing one semester of the second year PECH course, I can safely say that there is an observable difference in the way the course is implemented. There are hardly any out-of-class assignments and a greater focus on developing practical skills necessary for the clinical environment. Notwithstanding the legitimate concerns of students, credit must be given to Dr. Farid Youssef and Ms. Stella Williams for their foresight in developing a course with such an integral objective. After all, I am sure they had the best interest of the students and patients at heart when they developed and implemented PECH. Some level of dissatisfaction is always expected with change. The challenge is to come together, despite differing views, with open minds to push the change in a positive direction. I hope this letter is a step in that direction. -IRFAAN ALI Class of 2018
Do you have an opinion on anything related to medical school? We would like to know. Write a letter to the editor and send it via e-mail to: ttmsapulse@gmail.com
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A former national field hockey player, captain of the UWI hockey team, footballer, baker, and, last but not least, a third year medical student, Kelli O’Brien is a shining example of a balanced student. How does she do it? With proper planning and limitless passion, anything is possible, Kelli says. This is her story. AS TOLD TO NICOLE MAHARAJ I came from a family with a sporting background. My dad played rugby, and many of my cousins swam at a national level, played water polo and a variety of other sports. We were very active kids—we did ballet, we swam, played a little tennis. When I was about 11 years old, following in my older sister footsteps, I traded in my ballet shoes for a hockey stick. My parents are very supportive. I have two sisters so no boys for daddy. He was a big rugby player so I guess we did him proud. I started with a junior club called Futuristics and I also played while I was at Holy Name Convent, Port-of-Spain. But before I was at Holy Name, I used to tag along to my sister’s trainings while she was there. Eventually I joined a club which is now Shandy Carib Magnolias. My first tour, which was a club tour, was in 2007 in London, UK. It was a lot of fun and I was 14 at the time. The following year I made my first junior national side (Under 21). We went to Mexico City, Mexico, for the Junior Pan-American Games. In 2010, I went to warm up games in Chile and the Central American and and
Caribbean Games in Puerto Rico where we won gold. In October, 2010, we went to India for the Commonwealth Games. We were actually one of the first Caribbean teams that did not place last in that tournament and that was amazing. We played against top teams in the world and yes, we got some pretty big goal lines scored against us but it was some really good exposure. And I got to see to the Taj Mahal which was amazing! The following year we played in Panam games at senior level in Guadalajara, Mexico, and then the junior games the following year, in Cuba, and then that was the end of that. An injury from the Cuba tour took me out in 2012, my first year of med school. An X-ray revealed I had damaged my coccyx bone. I was unable to make it back to national team because I couldn’t rehabilitate myself to that level and I wasn’t able to figure out how to give that much of my time to make it back there and maintain med school at the same time. I’m captain of the UWI St Augustine hockey team. In 2013, we
won silver at the UWI games in Jamaica. But because I wasn’t totally fit, I strained my groin and I was down for a bit. Although I would love to be back on the national team, I know that it's unrealistic because medicine is becoming more and more demanding. My desire is to live a healthy lifestyle while actively pursuing a sport while I continue my studies. I may not be able to make it back to nationals but I can stay at a high local competitive level.
Kelli in action!
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Sports have taught me the importance of time management, team work, and discipline. As a team player, you learn to cooperate and delegate; everybody has their part to play in getting something done. In a team sport it’s never any one person’s fault that something happens. I have almost no free time. It is school, hockey/exercise and very little down time in between and that has made me a very busy person. I paint and draw a little and I like to bake. Sometimes I bake just out of stress, and I make really nice stuff. I think my friends really like that. As of recently I’ve taken up football. The boys have been teaching me and I’ve been one of the girls on our year group’s team for our little league in the faculty. I play volleyball as well on the beach when our faculty has its brain coolers. I like to take pictures; I wish I had a really fancy camera. Life is about just appreciating the small moments that make everything worthwhile.
I would like to specialise in sports medicine because it brings together my passions for sports and medicine. So I can see myself there in about ten years.
I have no secret on how to balance everything. You need to set goals and be realistic in giving yourself enough time to achieve them while being prepared for unexpected events in between.
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drawing up little calendars and writing in what I have to do on different days. But I always leave room for chaos. Balancing school and exercise has always been easy for me because the latter is my release. My advice to the current students is not to be afraid to aspire and dream to do things because we are all special in different ways and we are all capable of doing amazing things. Keep doing something that you enjoy as a stress reliever. All the best and good luck!
I have no secret on how to balance everything. You need to set goals and be realistic in giving yourself enough time to achieve them while being prepared for unexpected events in between. I’m constantly Kelli at UWI Mona
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The Victoria Children’s Hospital, LHSC,London, ON. My choice of Canada to do my elective was influenced by a personal encounter with the country’s healthcare system in 2006. After tearing the Anterior Cruciate Ligaments in both my knees, I had to undergo reconstructive surgery twice within three years at the University of Western Ontario (UWO) Hospital in London, Ontario. The standard of care that I received during this period left an indelible mark on me as a patient and so my decision on where to do my elective as a soon-to-bedoctor was made easy. I’ve always been quite fond of children and therefore, paediatrics was my specialty of choice. I spent the first two weeks of my elective at the Victoria Children’s Hospital at the London Health Sciences Complex and the final two weeks at the General Pediatrics Clinics at the St. Thomas Hospital, London, Ontario. The hospital system encountered was very new to me but nevertheless quite amazing. There were two clinical teaching units: CTU RED and CTU BLUE. The members of the BLUE unit consisted of a consultant (who everyone addressed as “staff”), a senior resident, junior residents, and two to three medical students (like myself) called clinical clerks. This is where I was rotated for the first two weeks. The RED unit comprised three or four full-time university paediatricians who attended to more complicated scenarios like childhood cancers and rare subspecialty cases. The consultants on the CTU BLUE attended to general paediatric cases and changed every week as they were continuously rotated among a group of twenty to thirty pediatricians in the community. This was very different from what takes place at
USAMAH MOHAMMED CLASS OF 2015
“Not only were the facilities outstanding, but so too was the admirable work ethic displayed by my colleagues.” home where the consultants are permanently stationed. Every day began at 7.30am with a thirty-minute teaching session conducted by junior or senior residents for the medical students. The daily rounds then began with a thirty to forty minute round-table meeting with the on-call team (including nurses). An updated patient list and worksheets would be printed and given to each unit member to keep everyone abreast of what was happening.
The facilities were stunning. I experienced my textbook theory in action as simple antiseptic techniques and infection control methods were strictly adhered to. We were outfitted with gowns, gloves and shield masks to enter rooms with patients who had any type of infection. Furthermore, advanced technological equipment and sub-specialty staff enabled up-to-date disease management. All records were computerised. The rounds trolley consisted of a computer from which all patient information was accessed from a database. There was therefore no chasing of lab results, no cases of lost patient notes or losing track of who had last attended to a patient. This was a highly efficient system built upon Electronic Medical Records (EMR) which has revolutionised patient records. Not only were the facilities outstanding, but so too was the admirable work ethic displayed by my colleagues. I believe that such an attitude to work in a people-centred profession plays a major role in the system’s efficiency. I encountered people who wanted to work, were happy to work, and who were very patient-friendly. To students who may be wondering where to do their elective, I would definitely recommend applying to a hospital in a developed country. I believe that this experience would help you to appreciate and emulate an efficient healthcare system, not only technology-wise, but from the point of view of the enviable work ethic. This would only serve to improve your standards as a doctor.
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with Prof. Christine Carrington Professor of Molecular Genetics & Virology, Biochemistry Unit Coordinator & former Deputy Dean of Graduate Studies & Research, Faculty of Medical Sciences, UWI, St. Augustine
BY NICOLE MAHARAJ
Q A
: Could you tell us about your life
before university?
: I was born in St. Augustine, Trini-
dad, the second of three girls. My father was a UWI academic and my mother taught biology at St. Augustine Girl’s High School (SAGHS). I attended St. Joseph’s Girls’ RC School and then SAGHS. I took part in many school activities and was in the steel orchestra but to be honest I spent most of my time liming with friends! I was always interested in science. In form one, I would read the sixth form Biology texts. I enjoyed nature programs, especially those by David Attenborough, and reading science fiction and books by James Herriot who wrote funny stories about being a vet. What did you study at university? I did a BSc in Biotechnology at the University of London, King’s College. I was always fascinated by viruses and the one virology course I did was my favorite so I went straight on to a PhD in Molecular Virology at the Institute of Cancer Research, University of London.
Could you elaborate on your PhD work? I studied the Human T cell Leukemia virus (HTLV-1), a retrovirus—same family as HIV. I worked in the laboratory of Professor Robin Weiss, who was one of my PhD supervisors. The lab was one of the earliest to work on HIV and was renowned for having identified CD4 as the receptor for HIV. Our focus was viral entry. The more you know about how viruses enter cells, the more you know about how to block that using vaccines and therapeutics. I worked on the viral protein that mediates attachment of HTLV-1 to its cellular receptor. Currently, what are your research interests? I’m interested in emerging viruses (viruses that have appeared in human populations for the first time, or that existed before but are increasing in incidence or geographic range). HIV, Dengue, Chikungunya and Ebola are good examples. My group works mainly on dengue and other mosquito-borne viruses (we are now starting work on chikungunya), rabies and other viruses carried by bats. We aim to understand the evolutionary and ecological factors that deter-
mine viral emergence, patterns of spread and mechanisms of maintenance. Most viral emergence has to do with human activity: habitat destruction, urbanisation, rapid global travel. The work involves fieldwork to collect virus samples, molecular genetics work in the lab, and bioinformatics analyses done on the computer. People sometimes underestimate the value of research, what impact does your research have in T&T, and the region? The impact of the type of research I do is not usually immediate, but it moves our understanding of the field forward and creates a platform of knowledge on which more tangible impacts are built. For example, if we can answer questions like: “Why do the dengue epidemics behave the way they do?’’ “What determines direction and intensity of spread?” “Are some countries putting out more viruses than others?” “Where are the viruses maintained between outbreaks?”, we can better target surveillance, monitoring and control efforts. We also sequence a lot of viruses so we produce data about the diversity of the Dengue virus in our region, which is needed to develop a good vaccine. I contribute to building intellectual and technical capacity in the Caribbean by
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training the next generation of researchers. Why did you choose academia? I love research, so academia was an obvious choice. I always wanted to know how things work. When I got four A’s at A’ levels everybody told my parents, “Oh, now she can do medicine.” My parents replied: "But, she doesn't want to do medicine." And people would say: “Well you must make her do medicine”. Thankfully my parents ignored them. Academia can be extremely frustrating and challenging but you are free to do what research you want to do – well as long as you can get funding! It’s very demanding but reasonably flexible which helps when you have children. A big plus is that in academia I’m constantly learning...without having to do exams!
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Unfortunately I don’t have that much one-on-one interaction with students, because the classes are so big. But I like that the students are eager to learn, very bright, pleasant and friendly. One of the problems we have on this campus as staff is we don’t have staff recreation areas so there’s no incentive for me to stay back after work and hang out with my colleagues or take in a show the students are doing or anything like that. It’s very much a place where you come, you work and you go home, and that could be improved.
“...the key to success in any university programme is consistency and striving to understand the underlying principles of what you are learning. You can never learn everything by heart but if you understand, you can work it out.”
Why did you choose the Faculty of Medical Sciences, UWI? When I finished my studies, because I was on a scholarship for my first degree I owed the T&T government three years of work. I remember once telling my parents that they were very lucky because they didn’t have to pay for my education. My mother responded, “I pay taxes!” That shut me up! I did feel like I owed the country. People pay money for you to go and study, so you should return and do something, and I was glad to come back. The original plan my husband and I What is your proudest achievement? had was to do the three years and then It is an on-going one. It is finding make a decision about whether to stay or balance. I am proud of managing to do go, but the conversation never came up. solid, internationally respected research while also looking after our two little Do you see a bright future for molecu- angels, Lukas and Mia. It isn’t easy but I lar genetics and virology in UWI/ think so far I’ve managed to have a successful career while at the same time T&T? maintaining a happy home and hopefully I think so. We now have quite a being a good mother. Having an exfew PhD Molecular Genetics graduates tremely supportive husband like Axel is whose work focused on viruses and a big help. Mind you, we’ll have to wait they’re all doing well. We have a legacy to see how well the children turn out! to build on. T&T has an important place Come back to me with that question in in the history of virology – a lot of semi20 years! nal virology work was done right here. One of the biggest problems today is a lack of funding; there is not enough in- What do you like about the current batch of medical students vestment in research.
Is there anything you don't like about us? Anything that gets on your nerves? I don’t like that the students’ approach to learning is often along the lines of “tell me what I have to know.” I don’t like when they ask what’s coming in exams, or if they have to know something I taught “for exams.” They are so bright and have so much capacity to explore and follow up on their interests. It’s a shame but it isn’t all their fault. They are products of our exam-focused education system. Secondly, (and this is not just medical students but throughout society), there is a lot of dishonesty—plagiarism and unethical behaviour. You all are going to hold positions of respect in society—jobs where ethics, morality, trust and general uprightness are paramount. I sometimes have to go to hearings for students accused of plagiarism and cheating. It’s very depressing to hear about students submitting work that is completely copied from somewhere else or research that is totally fabricated. What is the key to success in medical school? I never went to medical school but I think that the key to success in any university programme is consistency and striving to understand the underlying principles of what you are learning. You can never learn everything by heart but if you understand, you can work it out. Also looking beyond your textbooks or lecture notes. Reading—not just about medicine—but about the world, a novel, another field. Medical students need to try to be more all-rounded. All work and no play make Jack a very dull doctor.
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Lifework:
BY TAUREEF MOHAMMED When clinical teaching was first introduced in Trinidad in 1967, Dr Premchand Ratan started ward rounds with students. In April 2014, after pacing the wards for almost 50 years, the 86-year-old internist decided to hang up his shirt jack. For Dr Ratan, teaching, not just medicine but life, was his lifework. “I was very passionate about teaching. I loved it. I feel every doctor has a role to teach, whether he teaches juniors, medical students, nurses, or even patients,” Dr Ratan said in an interview at his Federation Park home. Most of Dr Ratan’s teaching years were spent on the wards of the Port-ofSpain General Hospital (POSGH) and, for a brief period, the Eric Williams Medical Sciences Complex. Ward rounds, he said, were more than just medicine. “There are so many opportunities to teach attitudes and to lead by example in showing how to deal with patients and how to talk to people.” The eclectic doctor did not stop there. Like Dr Anton Chekhov, the nineteenth century Russian physician and literary giant, he found a way to merge two seemingly parallel fields: medicine and literature. Using his vast clinical experience and collection of literary gems, Dr Ratan spruced up the scientific method with fine poetry. “‘Music that gentlier on the spirit lies than tired eye lids upon tired
eyes.’ I would tell them (the students), think. What medical condition does that bring to your mind? Myasthenia Gravis.” “‘There is sweet music here that softer falls than petals on blown roses on the grass.’ That talks about observation,” he explained. “I would ask the students: do you drive around the savannah and observe the Poui flowers on the ground? Observe, observe, observe.” “It wasn’t just showing off poetry but making the teaching enjoyable. When you’re teaching it must be an enjoyable occasion. I don’t know if the students had liked it but I thought it was my responsibility to introduce them to these things.” The students did enjoy it, especially those who wrote him a thank you card which read: “What a nice blend of philosophy, clinical medicine, and fun. Your wisdom was appreciated and valued.”
On the power of reading Maintaining his unconventional style of teaching, Dr Ratan encouraged students to read extensively, beyond the unlimited editions of medical textbooks. Among the books he recommended were A.J Cronin’s The Citadel and Desmond Morris’ Manwatching; the latter brought
DR PREMCHAND RATAN “...when you read a novel, you have the privilege of being with other people and seeing how they react and so it makes you a better person and doctor.” hearty giggles from the female students, he said jovially. For a doctor, reading is a powerful tool, he emphasised. “It makes you a better person. As a doctor, you would never be able to see everything in people’s lives, but when you read a novel, you have the privilege of being with other people and seeing how they react and so it makes you a better person and doctor.” Reading, he added, broadens one’s imagination, making one more capable of understanding a patient’s situation. “If you have a patient with a stroke, you have to imagine what is going on their life when they go home, and if you can imagine that, then you can think about other things that you could help them with.” And for these reasons, he repeatedly quoted to his students Chekov’s immortal words: “Medicine is my lawful wedded wife and literature is my mistress. When I’m tired of one, I spend the night with the other.”
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to develop self-confidence, saying this When it comes to learning on the generation was exceptionally bright and had a lot to offer. wards, Dr Ratan, with almost 50 years of clinical teaching, has seen it all. “...Students must act the “Sometimes you see a student comrole of pretending physiing in with a Coke bottle inside the cian. Pretend you are a wards. To me, that is not acceptable. doctor and behave as What would a patient think if a doctor though you are a doctor in comes in with a Coke bottle in his hand, the way you dress and the and his shirt is dirty? way you speak. Ask your“I think students must act the role of self: how would you like pretending physician. Pretend you are a your doctor to be?” doctor and behave as though you are a doctor in the way you dress and the way What better way to end this final you speak. Ask yourself: how would you round than with one of Dr Ratan’s favourlike your doctor to be?” ite lines of poetry? He urged students to maximise their ‘How dull it is to pause to make an time on the ward by getting as much end to rust unburnished not to shine in hands-on experience, even if it meant just use.’ “In other words, you have to have shaking a patient’s hand. “When you ambition. You don’t want to make an end, shake a patient’s hand, you’ve touched that patient and just by holding the hand, but you want to continue. And to rust unburnished, meaning you don’t want a you can get so much information.” “If you are on a ward for a few min- soppy kind of job with no challenges,” the utes, just go and do an ankle jerk. You Chekhovian doctor explained. should be doing it often enough so that when you are asked to do it you can say: About Dr. Ratan: ‘What stupidness they asking me to do? The last of six children, Dr Ratan I’ve done hundreds of these.’ That’s how was born in 1928 in Tunapuna. When he you must feel. And you could only do was eight, his father passed away and his that by actually doing it.” family moved to Couva. Most importantly, he added, was for In 1941, he enrolled at Naparima students to think critically and not to be College where he met and became lifetime afraid to challenge their superiors. “I tell friends with former T&T President Noor the students don’t be afraid to say ‘I don’t Hassanali who was a master at the college. agree with you,’ or to ask questions, but After winning the Jerningham Silver do it in a proper way.” Medal, an award similar in prestige to the He encouraged the current students President’s Medal, Dr Ratan transferred to St Mary’s College to complete the Higher School Certificate, placing fourth in the country in the sciences. Having lost his father at an early age, Dr Ratan’s dream of becoming a doctor was obscure and after graduating from CIC, he worked at the Government’s Chemist Department at the top of Frederick Street, Port-of-Spain. Nevertheless, Dr Ratan applied to University College of the West Indies
Words of advice
Dr Ratan with the Chancellor of the UWI, Sir George Alleyne.
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(UCWI, now UWI, Mona) to study medicine. He was surprised when he woke up one morning and saw his name published in the newspaper among those who were accepted. “I got in, but didn’t have the money to go. The family got together and decided I must go. They used to collect money and send it every three months. It was through their kindness that I was able to go to Mona in 1949.” Based on his excellent performance in the preclinical years, Dr Ratan received a grant which came as a great relief to him. He graduated in 1955 and completed his internship in Jamaica before returning to Trinidad in 1957 to work in the public service...and to get married! In 1961 he became a Member of the Royal College of Physicians Edinburgh (MRCP Ed.). Having gained some experience in neurology in the UK, he started a neurological clinic at the POSGH in 1967 which he ran until his retirement in 1988. In recalling his life history, Dr Ratan glowingly revealed the source of his passion for teaching: his teachers. From his early Naps days to his post-graduate days in the UK, Dr Ratan was always in awe of his teachers and mentors, including Mr Noor Hassanali, Dr Percival Harnarayan (Naparima), Dr Ramdath Ramkissoon (Naparima), Prof Eric Cruikshank (UCWI), and Sir Max Rosenhein (UK). As a physician, Dr Ratan mentored generations of students including Prof S. Ramsewak, Dean of the Faculty of Medical Sciences, and Prof. Surujpaul Teelucksingh, one of his fondest students. Among his many accolades is the Chaconia Gold Medal which he received in 1990 for his outstanding service to T&T. So now that he is retired, what is Dr Ratan up to? He writes in his album amicorum (latin for ‘book of friends’), a centuries-old tradition similar to an autograph book, “...I will continue as I am now, Laughing, loving, crying, sharing, caring, wondering, longing, Being part of humanity, Saddened by man’s inhumanity to man, By poverty in the midst of obscene abundance, Touched by the innocence of children, And kindness when you least expect it...”
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ABOUT THE T&T MEDICAL ASSOCIATION The T&TMA is the umbrella body for doctors in our twin-island republic. We represent interests of doctors according to our Constitution, The Act of 1974. We differ from The Medical Board of Trinidad and Tobago (MBTT) as they represent the statutory body of our medical fraternity and from The Medical Professionals Association of Trinidad and Tobago (MPATT), which functions as the de facto trade union for doctors. Our association has embarked on four fundamental principles to improve healthcare in our beloved nation:
TEACH: All healthcare professionals must strive to be on the cutting edge of knowledge, information and technology as it relates to our field. As a result, Continuing Medical Education (CME) is one of the T&TMA major thrusts. We host monthly CMEs throughout Trinidad and Tobago, all accredited by the American Academy of CME (AACME). We partner with local associations such as the ENT Society, Dermatological Society and Diabetic Association of Trinidad and Tobago in hosting these monthly meetings. In 2013 alone, we distributed over 1000 certificates. Our flagship CME is our Medical Research Update Conference (MRC), held annually in July. Last year we proudly hosted our 20th year of the MRC and celebrated it by placing the spotlight on the Faculty of Medical Sciences of the University of The West Indies, St. Augustine, as it was their 25th anniversary.
TREAT: In order to promote the public’s trust in our profession, clinicians must always keep the Medical Code of Ethics and the Declaration of Geneva (aka the Modern “Hippocratic Oath”) in mind. The T&TMA categorically supports this.
MENTOR: Through our Youth Committee we support and celebrate with our medical students. We are the proud sponsors of an Interns Dinner which occurs on graduation from the faculty. Our association gives advice on medical ethics, medical protection and financial management to name a few.
ADVOCATE: The T&TMA is aggressively involved in advocacy and we will continue to advocate for health care issues that affect us all. We had an outstanding executive last year and worked together with all our Standing Committees to keep the T&TMA committed to the constitutional mandate to serving our country. The T&TMA continues to work towards productive changes in healthcare in our country. DR LIANE CONYETTE (Former T&TMA President, 2014) For more info: visit www.tntmedical.com; Facebook: Trinidad and Tobago Medical Association; e-mail: medassoc@tntmedical.com; call 671-7378.
The Official Journal of Trinidad & Tobago Medical Association
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BY CIMONE RAMCHARAN Many believe art and medicine are on completely different wavelengths, but not Dr Srikanth Rao, 2013 valedictorian and founder of the Mt Hope Art Society. In an interview with The Pulse, Srikanth said the same passion, emotion, and dedication involved in creating art were similar to the qualities need to become a successful doctor. “Sickness is poetic in its own way…And medicine is about finding a passion in the art of saving lives,” he said. However, there is a point when one has to choose either sciences or the arts. Although an art lover, Srikanth had no difficulty in choosing. “Growing up as a child it was all I knew since both my mom and dad were doctors and it seemed only natural to continue to help people and touch their lives the way I saw my parents did.” Srikanth had some straightforward advice for the current students. He be-
lieves that a solid group of friends is capable of helping you through the public health projects, the cramming in the anatomy lab days before spotters and the mini mental break downs before phase when you are literally calculating the number of MCQ’s that you need correct to barely pass. “Friends are the ones that pull you back to reality and remind you there is a reason for all of it and that there is indeed a light at the end of the tunnel no matter how far it may seem.” The rawest piece of advice he gave me was: “Some mistakes you can’t fix.” So for every decision you make, ensure you prioritise and analyse the consequences of all involved, because being young and free would not save you forever. As the interview continued, he spoke about his favourite subjects and lecturers. Anatomical Pathology was always his calling so much so that he started referring to his Robbins’ Basic Pathology text as the “Raobbins,” which he carried around as his personal medical bible. This love of pathology may have been influenced by one of his favorite lectures, his dad Dr. Chalapathi Rao, head of the Para-Clinical Sciences Department. Other lecturers whom he admired included: Prof Harri Maraj and Dr Patrick Harnaryan.
The Rao Family at an art gala hosted by the Mt Hope Art Society
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He remembered when he approached the podium as valedictorian on graduation day he was swept away with a wave of relief and realisation that life was
“...for every decision you make, ensure you prioritise and analyse the consequences of all involved, because being young and free would not save you forever.” made up of a series of moments that leave impressions behind and this was going to be one to remember. Medicine, according Srikanth, is about people, and so is medical school. It’s about surrounding yourself with people you love and who support you through thick and thin. It’s about making the best out of every situation, learning from your mistakes and growing from your experiences.
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In T&T, medical school comprises two years of preclinical sciences, one year of para-clinical sciences followed by two clinical years. The most dramatic change in both teaching and learning occurs at the start of the fourth year when one is thrown into the hospital wards for clinical rotations. These fourth year rotations include Medicine, Surgery, Obstetrics and Gynaecology, Paediatrics, Psychiatry and Community Health. Some students can’t wait to begin these rotations while others feel overwhelmed by the sudden change. To help ease the transition into fourth year, The Pulse asked a few students of the Class of 2016 to share their experiences on the wards. They preferred to remain anonymous.
Discovering the truth about Mental Illness My first clinical rotation, Psychiatry, was an eye-opener as I came to realise that much of what I believed about mental illness was false. Prior to entering medical school, I became aware of the degree of stigma attached to the field of psychiatry. However, in many ways, psychiatry served as an appropriate springboard for my future rotations. This rotation allowed me to observe, firsthand, the challenges faced by people who suffer from anxiety, mood disorders
and the myriad of other mental illnesses. These were conveyed by tutors, lectures and most importantly interactions with these patients. The rotation increased my empathy toward these patients, especially those who had difficulty with controlling their symptoms for various reasons. While many of the patients I encountered might remain nameless and faceless, I had the privilege of interviewing and interacting with a few who enabled me to broaden my perception of psychiatry. This spectrum of patients represented a group of people in society who is generally shunned, relegated to whispers in conversations, but
with the aid of health care professionals and medication, could rise above their illness to integrate and become productive members of society. For me, the greatest aspect of this rotation was gaining insight into the lives of others, which allowed me to appreciate the challenges faced by the patient and their loved ones and understand that with some patience and outreach, I can assist in improving their quality of life.
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The Real Deal Prior to starting y e a r four, I had no idea what to expect. I was scared, not because I didn’t pass OSCE, but because mere acting would no longer cut it. I would be examining real patients and required to report real findings. After my first couple days on the wards I realised there was little to be afraid of. Although we were required to examine and do very minor procedures on patients, we had guidance. I started my first two months with obstetrics and gynaecology during which 20 per cent of my time was spent in the classroom and the remaining in two hospitals. At the hospital I, along with two of my classmates, was assigned to work with a team of doctors. We assisted with the management of patients as instructed by our unit doctors and were expected to take call. As an O/G student, call meant that I stayed in the hospital from 8am to 8pm, even on holidays and weekends, unless given permission to do otherwise.
Additionally, there was a check list of different procedures that had to be completed toward a coursework grade. This along with attendance and the end of rotation exam gave our final grade. My transition between years three and four was smooth. For the first time in medical school I felt like the quantity of work that I had to put in was doable. My only real difficulty was having to start this rotation in San Fernando, foreign territory. Within a week, however, I learned to travel to and from the south land and by the second week I had a place to call my temporary home, the student quarters on the hospital’s compound. For the most part I loved the hospital wards. They gave meaning to the words in Macleod’s and Robbins. Being able to see patients with pathologies which I had read about and take part in their management made concepts much clearer and easier to recall. Some days however were downright depressing generally from being ignored, scolded and/or made to feel like I was in
everyone’s way. Everyone’s experience on a particular unit will be different. You will hear rumors that some units are better than others which may or may not be true. Regardless of the unit you are placed on, show enthusiasm and be grateful for anyone who tries to teach you.
“For the most part I loved the hospital wards... Being able to see patients with pathologies which I had read about and take part in their management made concepts much clearer and easier to recall.
Navigating the Medicine Clerkship I started year four with the medicine clerkship, which lasted eight weeks. I was assigned to a unit at Port-ofSpain General Hospital (POSGH) for the first four weeks. The team comprised the consultant, the registrar, two house officers, two interns, two fifth-year medical students and a fourth-year student (me). I had to be present and punctual for all call days if I did not have a class and for postcall rounds sessions even though I had a class. I had to reach on the wards for 7.30am on call days and 6.30 am on postcall days. Regular ward rounds usually started at 8am. Notwithstanding, I had to be present on weekends but my house officer and intern would often let me
leave around 12pm if there was no call. I was grateful for this as other units had more rigid schedules My experience at POSGH was eventful. Six weeks into the clerkship, each student had to submit 17 case histories, so making full use of the time at the hospital was commonplace. Some patients were very engaging and cooperative and I got proper histories from them. For the second half of the clerkship, I was based at the EWMSC where I enjoyed more structured classes and conversations with lecturers on any topic or term that I thought needed clarification. However, at POSGH, unlike EWMSC, I got more experience in interviewing patients and history taking. Students also had the opportunity to work
jointly with the interns assigned to their unit. In so doing, I practised venepuncture, learned to set up IV lines, assisted with urinary catheterization, digital rectal examinations and blood transfusions and wrote up request forms, among other tasks.
“One thing I liked on the ward was seeing the way a patient's face would light up on hearing that he/she would be discharged.” I expected to be proficient in performing venepuncture and answering questions directed from the registrar, but I was disappointed. I learned that I did not
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know very much and began to worry. However, he often assured me that I will know much more in one year's time. I agreed so I eagerly kept on trying. I thought that I was not equipped for the ward in the least. I felt as though I was thrown in a lion's den for the first week in particular but afterward I got used to the feeling that there is no easy part of medi-
cine. I took each day at a time and I know that I may have annoyed my intern with my countless questions but at least I invested in some humor to lighten things up. One thing I liked on the ward was seeing the way a patient's face would light up on hearing that he/she would be discharged. I urge all incoming third-year stu-
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dents to master year three and revise MDSC 1002. These courses seemed compulsory for the Medicine Clerkship. They tend to ease the drastic transition period as long as they are studied in detail. Lastly, it is definitely required that students examine patients well and become proficient in history taking. Good Luck!
TIPS FOR THE WARDS
Be polite. Greet all doctors, nurses, other hospital personnel and patients who you come in contact with.
Be on time. Find out your unit’s schedule on the first day and try to get to the hospital before the unit doctors.
Dress professionally! If you don't know what that means, find out!
When in doubt, ask! Especially if your decision will affect the well-being of the patient.
Learn from your mistakes. If a doctor embarrasses you, don’t dwell on it—learn from it and never let it happen again.
Be willing to do procedures when your unit doctor asks. Even if you don’t know how to do it let one of your seniors show you how.
Complete your coursework checklist as early as possible so that you do not have to worry about it toward the end.
Eat a good breakfast especially on theatre days.
Keep good contacts with those in your group.
Be balanced in your readings and interactions with patients and doctors.
Keep a small book to record the different diseases you encounter and do further reading about them as soon as possible.
(From the Class of 2016)
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IVCF MT HOPE
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The Dreaded Internship Live a simple and a temperate life, that you may give all your powers to your profession. Medicine is a jealous mistress; she will be satisfied with no less.—Sir William Osler. The transition from student to intern was definitely more challenging than I expected. My first week was rough, I was asked to be on call till midnight on my first day of work. Those first few days proved to be much more physically tiring than I had imagined. I was accustomed to staying up and concentrating, as all students are while preparing for their final exams, but there is a difference when you are legally responsible for lives. Some rotations are much lighter and more enjoyable than others and your responsibilities will differ from rotation to rotation, as well as hospital to hospital. Your responsibilities will include running the ward rounds. It is important to have a list of all the patients, their summaries, locations, diagnoses and outstanding investigations. Some consultants actually like a printed copy of this list on a post call morning—it shows that you’re being proactive. Always reach early! (I can’t stress that enough). Of course, before rounds with your registrar or attending physician, you carry out your pre-rounds where you ‘SOAP’ patients and this helps you to have an idea of what’s going on with them. After rounds, you perform your ward work, chase results and organise scans or discharge summaries. Of course, when you are on call, you will clerk patients, begin initial management (in some rotations) and review with your house officers. Proper documentation is also essential. Always record the date and time you write in the notes whenever called to see a patient. The rotations that you may hate as a student, sometimes prove to be the most enjoyable ones. Surprisingly, I enjoyed working in the Obstetrics and Gynecology
DR SIMONE CHANG Class of 2013
“Humility and good communication skills are essential. It’s very easy to tell patients what medications to take but to get them to listen is totally different.” rotation despite my dislike for the specialty. You will probably understand and learn much more during this year than in your previous two years of studying! You begin to actually practice what you’ve learnt and experience is a great teacher. The year proved to confirm the importance of teamwork. If you have a good team, where everyone was willing to work hard, it makes the work not just lighter but happier. As in all jobs, you will encounter lazy and difficult coworkers or patients as well as those who will take advantage of you and you will be forced to learn to deal and work with them. Humility and good communication skills are essential. It’s very easy to tell a patient what medication to take but to get them to listen is totally different. Caring and being genuinely concerned for your
patient’s welfare may sometimes be what makes the difference. Be considerate and go out of your way to help your fellow staff members. This just doesn’t mean your fellow doctors, but the lab, pharmacy and nursing staff. In an emergency, they will be the ones to help you get results and blood for your patients. Don’t ever underestimate the role they play. During your rotations attend the grand rounds and genuinely be interested, read official guidelines on the initial management common conditions and be eager to get involved. It would be in your best interest to continue reading during the year so that you don’t get rusty. It would also help your team if you’ve read up on your patients. Despite all the long hours starving, having people quarrel with you, running from ward to ward and being frustrated, it is worthwhile to see your patients get better. Nothing will describe the feeling of seeing a patient who has had a difficult and complicated pregnancy or delivery go home with a healthy baby. In terms of postgraduate training, there are many Doctor of Medicine (DM) programs. It would be in your best interest to find out the entry requirements and the experiences of the residents in these fields. It would also be practical to work in the field for some time to get a good grasp on things before applying to the program. My interest is in Pediatrics or Family Medicine which have well established postgraduate programs at the university. Internship is an overall enjoyable experience. Friendships will be made and experiences gained. Give it your all and don’t waste the time. Make every opportunity a learning one. Make time for your family and try to exercise! All the best!
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Valedictory Speech 2014 The following is the transcript of the valedictory address delivered by Dr Lennon Johnson on 25 October, 2014, at the graduation ceremony of the Faculty of Medical Sciences, University of the West Indies, St Augustine. Chancellor of the University of the West Indies, Sir George Alleyne; Vice Chancellor, Professor Nigel E. Harris; Campus Principal and Pro-Vice Chancellor, Professor C l e me n t S a n k a t ; H o n o r ar y Graduand and Guest Speaker Dr. Subesh Ramjattan and other distinguished members of the platform; Dean of the Faculty of Medical Sciences, Professor Samuel Ramsewak; distinguished lecturers; specially invited guests; fellow graduates: Good afternoon. It is with great pleasure and honour to extend heartfelt congratulations to my peers, the graduating class of 2014. Countless late nights, hard work and dedication have finally come to fruition and we first give thanks to The Almighty God for granting us success. Graduation is one of those awkward times in our lives when we are torn between the joy of our memories and the apprehension and mystery of our future. Should we look back on what were the most dynamic years of our lives or instead should we focus on the next stage of this journey called life? We have been impatiently waiting for this day and now, we just want to hit pause. We want to slow it down, and relish the last fleeting moments. Let us reflect upon our time spent at
the University of the West Indies, St Augustine Campus. Our tenure at the UWI has made an indelible mark on our educational experience and developed a
strong foundation. Here, we have become more steadfast, disciplined and diligent individuals. The UWI experience has not only been an academic exercise but rather a journey; one which had taught us many invaluable life skills such as: perseverance, patience and the importance of hard-work and dedication. These five years spent at the UWI have taught us to push ourselves beyond our limits and to transform every opportunity into one where we can learn. The education which we have received has not only equipped us with the knowledge and skills we need for the challenges which lie ahead, but has stirred up a hunger in us for more and greater accomplishments. The goal of any educational institution should be to produce quality professionals who are equipped to take on the world and the unique challenges and opportunities which it presents. I believe the administrators of this noble institution can feel confident that yet again this has been accomplished. Here at the UWI, we have mastered the art of time management. There was always so much to learn, yet so little time. We were constantly challenged.
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Vivid memories of PDQ exams and PBL sessions come to mind. However, in trying times I would always recall what my father said to my siblings and I throughout the years while growing up, “If you fail to prepare, prepare to fail,” and trust me, failure was not an option. At this time, permit me to express gratitude to our parents who have journeyed with us—our guides, our support and our pillars of foundation. Words can never repay, but a special thank you goes out to my parents, my sisters and my friends for all their support, and especially sustenance. Friends we sit with today became additions to our family. To our lecturers, thank you for bearing with our countless questions. I know you will miss us dearly. As we move out of this esteemed learning institution, I say, “This is just the beginning.” As we the graduating class of 2014 enter this bold new world, it is important that we are continually reminded that our journey is not complete, it is merely continuing, onto a new and exciting path, onto novel experiences and openings. Socrates said that “education is the kindling of a flame, not the filling of a vessel.” I concur. Learning does not end here. The onus is on every one of us to build on our
“Never stop learning, never stop asking questions, and never forget that medicine is an art as well as a science practised by medical professionals who bring to the bedside not only technology and training, but also their humanity, care and compassion.” foundation which has been set to propel us into the world that awaits. Additionally, Brian Tracy once said “Those who develop the ability to continuously acquire new and better forms of knowledge to apply to their work, and to their lives, will be the movers and shakers in our society, for the indefinite future.” Undeniably in the medical profession, it is paramount that we remain cur-
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rent in order to provide the best service and care to our patients. Lifelong learning is necessary for continued success. Let us never settle for mediocrity. We must continue to strive for excellence, and look beyond our goals, boundaries and limitations. Never stop learning, never stop asking questions, and never forget that medicine is an art as well as a science practised by medical professionals who bring to the bedside not only technology and training, but also their humanity, care and compassion. In closing, let us reflect on the words of Charlie Munger, of the University of California Law School 2007: “You’re not going to get very far in life based on what you already know. You’re going to advance in life by what you’re going to learn after you leave here.” With this in mind let us be driven with faith, passion and determination for what lies ahead. As graduates of the esteemed UWI, let us indeed be “A light rising from the West.” I thank you.
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BY SOFIYA BARROW & STEPHEN BEHARRY ‘Unforgettable’ best describes the 2014 edition of the TTMSA’s Banquet and Awards Ceremony. Ten months of preparation culminated in TTMSA’s most memorable and marvelous event for the academic year. Guests were seaside at the Anchorage Beach Club, embraced by the fresh sea breeze and warmth of each other’s company. The night seamlessly waltzed through the award ceremony, impressive dining experience and electric afterparty. Last year, we opted to be different and really raise the bar. We made the decision to host the event at a new venue, the Anchorage Beach Club, and push the limit of the banquet experience. To achieve this, we knew that the entire committee had to work arduously to raise the necessary funds. Fundraising events ranged from BBQ sales to bake sales to the massively successful Miss Mount Hope Pageant. The banquet was hosted by two Mt. Hope veterans from the Class of 2014, Amit Ramrattan and Swasti Narine. They steered the program through the national anthem, prayer, awards—both academic and fun— performances and speeches with complimentary humour, personality and elegance. The graduates also voted on the winners of the Fun Awards, such as “Best Dressed” and “Class Clown”. We tried to spice things up by adding a few controversial titles, including “Mr. Thirstman” and “Queen of the
Friendzone”, which had everybody in stitches. Two fantastic performances complimented the evening: Adriel Rahman playing a lovely rendition of “All of Me” on his electric guitar, and RexxAnn Bobb blowing everyone away yet again with a powerful song. The night would not be complete without a speech by the TTMSA President, Erron Ramdass, and a Vote of Thanks. The dining experience was simply special, from the delicious hors d’oeurves that greeted guests on arrival to the splendid main course. To close, a dessert of cakes and a chocolate fountain extravaganza satisfied every sweet tooth. Then, in the blink of an eye, a party emerged. With lights dimmed down low, the luminescence of glow bands enhanced the electricity that flowed through the dance floor. The TTMSA Banquet and Awards Ceremony 2014 combined a beautiful venue, great food and an exhilarating party in perfect harmony with amazing people—a spectacular event that guests will always remember.
The Awardees Class of 2018 MDSC 1001: Ariel Knowles MDSC 1002: Ariel Knowles and Abhinav Karan MDSC 1101: Ariel Knowles MDSC 1102: Sarah Gobin Class of 2017 MDSC 2001: Damien Ramoutar MDSC 2002: Damien Ramoutar MDSC 2101: Chenelle Khan MDSC 2102: Kirin Rambaran Class of 2016 MDSC 3311: Diana Persaud MDSC 3312: Diana Persaud MDSC 3313: Diana Persaud MDSC 3314: Giovanni Maharaj
ACTIVITY
ETYMOLOGY INSTRUCTIONS: Match the latin/greek root word with its English equivalent and give a medical example. Answers on page 27! LATIN/GREEK 1. Leukos (D)
MEDICAL EXAMPLE Leukocyte
ENGLISH A. Mouth
2. Xeros
B. Sweet
3. Skleros
C. Sore
4. Rhag—
D. White
5. Psora
E. Corpse
6. Glykys
F. Pain
7. Malakos
G. Produce
8. Pyon
H. Finger, toe
9. Stoma
I. Burst forth
10. Dactylos
J. Crab
11. Nekros
K. Dry
12. Algos
L. Suppress
13. Ischein
M. Hard
14. Poiein
N. Pus
15. Cancer
O. Softening
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SPECIAL AWARDS: Most Oustanding of 2014: Isabella Griffith Leadership Award: Lennon Johnson Best Pre/paraclinical Lecturer: Dr. Shivanada Nayak Best Clinical Lecturer: Dr. Patrick Harnaryan Best Ancillary Staff Member: Mr. Gaston Francis
ETYMOLOGY ANSWERS
Tel: 735-1001/769-1865
1 (D) Leukocyte 2 (K) Xeroderma 3 (M) Atherosclerosis 4 (I) Haemorrhage 5 (C) Psoriasis 6 (B) Glycaemia 7 (O) Osteomalacia 8 (N) Empyema 9 (A) Stomatitis 10 (H) Dactylitis 11 (E) Necrosis 12 (F) Algesia 13 (L) Ischemia 14 (G) Erythropoiesis 15 (J) Cancer
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