theMEDICALSTUDENT
February 2014
The voice of London's Medical Students/www.themedicalstudent.co.uk
A&E Shortfall
A lack of doctors >> page 5
Lister
The pioneer of antiseptics >> page 21
Attendance
Does it improve grades? >> page 12
Biomedical Sciences
Just a route to medicine? > page 7
Socialising NHS Patient Data Krishna Dayalji This spring will see changes to the way in which health professionals working within the National Health Service (NHS) will handle our confidential medical records. This is because from March, the care.data project will have begun. Led by NHS England, the care.data project will entail gathering information regarding the care patients have received in order to improve the future quality of care provided by health and social services. This will be achieved by creating a dataset stretching over the whole patient care pathway, which will be made available to clinicians, commissioners and researchers. The new system aims to provide joined-up information about the care received from all of the different parts of the health service, including hospitals and GP practices. Only the date of birth, full postcode, NHS number and gender will be used to link your records in a secure system. Once this information has been linked, a new record will be created. This new record will not contain information that identifies a particular individual. It is believed that through this programme of work, the best possible evidence will become available to improve the quality of care for all, whilst also creating a clear and complete picture of what is happening across health and social care, and plan services according to what works best as well as reducing inequalities in the care received. Interestingly, the new system will also provide information that will enable the public to hold the NHS to account and
ensure that any unacceptable standards of care are identified as quickly as possible. We also know that these types of collaborative schemes have proven successful in the past. For example, the analysis of NHS records first revealed the dangers of thalidomide and helped track the impact of the smoking ban. Future medical treatment we will receive and provide will be based on the largest evidence base yet. Indeed, ‘the new era of socialised big NHS data’ holds great power and potential for medical researchers and future clinicians alike. However, would socialising NHS patient data be a good idea overall? Some have argued that this health policy has more to do with economic value and financial benefits, with a social good and multiple health value as a ‘pleasant side-effect’. As Alice Bell, Guardian correspondent, wrote: “It’s about boosting the UK life sciences industry, not patient care.” She goes further to add that socialising health data is counter-productive when we are breaking up the core of a socialised healthcare system. The care.data project is “merely transforming us into a financial asset” The cost to quantify and market patients is estimated at over £50m by The Health Service Journal. Another argument that has been put forward surrounds the issues of data security. It is the role of the Health and Social Care Information Centre to ensure that high quality information is used appropriately to improve patient care. However, the critics of data security add that with the constant cuts and out-sourcing of the NHS, fears regarding ownership of data heightened...[cont’n on page 2]
Plaid Cymru to wipe debt of doctors who move to Wales Chris Smith Junior doctors who decide to work in Wales could get their student debts paid off under proposals unveiled by Plaid Cymru, the Party of Wales. The debts, about £75,000 on average, would be wiped in exchange for a commitment to work in Wales for a number of years. The party said 1,000 extra doctors were needed to boost what it called a “creaking Welsh health service”. The party said their policy would solve a problem that has led to Wales having one of the lowest doctor per patient ratios in Europe, 26.4 doc-
tors per 10,000 people, ahead of only Romania and Poland. They claim that there is a GP ‘time bomb’ in certain parts of Wales with many on the verge of retirement and a lack of new recruits ready to replace them. By paying off debts, student doctors would have to spend a portion of their training and early employment in an underserved area. However, the policies were dismissed by the Labour party as “fantasy politics” and the head of medical education in Wales said that the policy would be expensive, urging politicians to focus on improving the working experience
of doctors in Wales to attract more recruits. Before completing medical school, students rank the UK’s medical training areas by order of preference. Betterperforming students have an increased chance of being allocated their preferred area, leading to concerns that the best young doctors are becoming concentrated in the parts of the country perceived to have the best career opportunities and quality of life. Dr Andrew Collier, co-chair of the British Medical Association’s Junior Doctor Committee, said that striking off student debt...[cont’n on page 2]
theMEDICALSTUDENT / February 2014
News Editor: Chris Smith and Krishna Dayalji news@themedicalstudent.co.uk
J
[Editor's Letter]
anuary seemed to fly by and we are already into the second month. Without wishing to cause undue stree to the pre-clinical students, end of term exams are only a three months away. I have been lulled into what I imagine will be a false sense of security with a 1st August exam. Far enough away not to panic, however I don’t have a 6 week Easter to fall back on to revise in. As soon as our last module ends, we have a week of intensive study leave before we do our end-of-year SBA and OSCE. Then, before August ends, we are back to start another year at university. I implore those with generous three month summers to make the most of it!
[Editorial Team] Editor-in-Chief/Peter Woodward-Court News Editors/Chris Smith & Krishna Dayalji Features Editor/James Wong Comment Editor/Robert Cleaver Culture Editor/John Park Doctor's Mess Editor/Zara Zeb Education Editor/Sarah Freeston Sports Editor/Mitul Patel Images Editor/Upi Sandhu Treasurer/Jen Mae Low Online Editor/Anhya Griffiths Illustrators/ Edward Wong, James Wong
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In my first year I was not nearly as nonchalant about impending examinations. A seemingly universal keeness surrounds us at the beginning of our studies. We feel compelled to attend all lectures and extra sessions. As we become older and werier of the same old lecture theatre, we begin to question what we actually get out of going, and our attendance tends to wane. We are, after all, adult learners - so surely we should be able to decide the best way for us to learn. In Education, we consider the pros and cons of sticking it out day in, day out, and whether it actually makes any difference to our final result (p.12). News about an oversub-
scrubed foundation program is becoming all too regular, and with the advent of new, private medical schools accepting their first set of students, it doesn’t look like the issue will go away. We take a brief look (p.5). A&E, on the other hand, is suffering from a lack of applicants. The field is receiving good funding but doesn’t have the doctors to carry out an appropriate service, read more on page 5. Biomedical science receives a bad rep as simply a degree to do before you get started on medicine if you didn’t get in first time round. Anhya Griffiths argues this is an undue and improper view to take (p.7). Also in Features this month we take a look at the
challenge of multi drug resistant TB and the risks it poses (p.8). In sport we look at RUMS’ main rugby match of the year the Bill Smith’s cup. One of the things that I think is so good about university sport is the ability to try something completely new. In third year I got involved in Ultimate Frisbee, something I had scarcely heard of before I joined the university. We take a look at a similarly niche sport - Kabbadi. The dreary weather seems to be endless, I hope when I write next month I can report on a bit more sunshine and signs of Spring! The early evenings and cold weather have gone on far too long. Enjoy the issue!
[cont’n from Socialising NHS article] with the potential of personal health data falling in to the hands of employers, advertisers, insurance providers and even drug manufacturers. There are worries that the movement of confidential data around the NHS will be significantly impacted. A survey by Pulse Today with 400 GP respondents conducted in January 2014 found the profession was split over whether to support the care.data scheme, with 41% saying they intend to opt-out, 43% saying they would not opt-out and 16% undecided. However, an ‘opt out’ option is available should an individual chooses not to disclose their personal health data. This can be achieved by contacting a member of staff at your GP who will make a note in your medical records, thereby preventing the information being used other than where necessary by law, such as in the case of a public health emergency. The individual can also restrict the use of information held by other places you
receive care from. NHS England added that this decision would not affect the care one would receive. It seems difficult to answer the question regarding whether socialising NHS patient data is a good idea because unfortunately this policy is being pushed through with very little debate. In turn, this will affect our working careers as health professionals as well as our use of the NHS as its consumer. From March 2014, the information centre leading the care. data project will begin extracting data from patient’s GP records.
revamp training for postgraduate doctors to improve the skills that currently exist and; recruit doctors from foreign countries as a short term solution to specific staffing shortages. Plaid Cymru health spokeswoman, Elin Jones, said “This document is not meant to be the final word in solving the recruitment problems in the Welsh NHS; we do not pretend to have all the answers to our health service problems. The document is meant to stimulate a lively debate and exchange of ideas that will bring about a brighter future for our NHS and its hardworking and dedicated staff and, of course, the many thousands of people who rely on it each and every year.”
[cont’n from Plaid Cymru article] would be an “incredibly attractive proposal” for new graduates but needed to be part of “a package of measures” including giving young doctors more choice about where in the country they practised. The consultation document includes proposals to: pay off student debt; make Wales a more attractive place for doctors to develop their careers;
[NEWS]
theMEDICALSTUDENT / February 2014
News Editor: Chris Smith and Krishna Dayalji news@themedicalstudent.co.uk
Medgroup Chairs Dheeraj Khiatani & Mark Gregory January is over! The medical student year rolls on and I’ve already started writing erotic poetry for my valentines day cards. For most of our prestigious medical schools RAG week is fast approaching. Abandon all work, find some scrubs and do something genuinely productive for once; there’s a fine tradition to uphold! Almost as importantly as RAG week, scoring a massive 9.9 out of 10 on the medical student importance list, is the start of UH sporting battle. UH Rugby and Football kick off this month and both will no doubt be fiercely fought events. It’s important to note that the UH Rugby event is the oldest rugby competition in the world and since 1875 has been halted only due to war. This year Barts will be going for a third successive victory. The UH Football has famously been dominated by GKT of late and much like its rugby equivalent has an astonishingly long history of competition. To conclude, there are far more important things to be thinking of than work this month, so leave the finalists to the library and concentrate on doing what medics do best...
RUMS President Swathi Rajagopal
ICSM President Steve Tran
As the new term unfolds, everyone at RUMS has been settling back into the rhythm of university. January kicked off with the infamous Bill Smiths tournament in Regents park, where we saw the first and second years battle it out on the pitch, to claim the 2014 title and of course, the eternal glory that comes with it. Looking ahead, Taboo week is all set to run from February 3rd to 13th - look out for the elephants is all I shall say for now! In addition, the elections for next year’s RUMS exec will be kicking off shortly. If you want to know more about any positions or standing in elections, just get in touch by e-mailing swathi.rajagopal.10@ucl.ac.uk. Next on our calendar is the NEW charity event – ‘RUMS has got talent’. If you possess any crazy skills be it singing, dancing or juggling, make sure to get involved. We’ll be announcing audition dates and our top judges soon, so dust off those instruments and get practising. RUMS exec are also working on a fantastic sports ball so make sure to watch this space!
GKT President Juliet Laycock
February marks the start of our undergraduate admission interview cycle at Imperial, so we wish all those applying to medicine the best of luck this year; wherever you are applying to (we’ll forgive you if you pick Imperial over the others). We’ve all been there and somehow managed to get through it, so will you! At ICSM, February starts off rather slowly due to impending come down after our annual Circle Line and RAG Week. We’d like to thank Erika and her team for organising such an amazing array of events. Fear not though, as love is in the air with our annual black-tie RAG Valentine’s Ball on the 10th February, followed shortly by our epic RAG Dash to Antwerp on the weekend of 21-23rd February. The Dash starts with a night out in Brighton… This month also sees the start of our BIG election, where nominations will be open for all of our 17 executive officer positions. So anyone at ICSM who is interested in running, please get touch! Good luck to all students that are taking the Prescribing Safety Assessment this month. The countdown to finals has started… #finalscountdown
BLSA President Ali Jawad
February time at GKT means only one thing: RAG WEEK. After a hugely successful Jingle RAG in December, and a RAG raid that sold out in a mere 11 minutes, this year is set to be better than ever! Keep up to date with all that’s going on at http://shortify. us/dK3MJ
Hi all,
Entering into February also brings the GKT Dry January endeavour to an end; a milestone that will do wonders for Guy’s Bar profits! Thank you to all those who got involved and congratulations to all who successfully completed it, for each of you The MSA will donate £10 to RAG.
RAG week is coming up from the 7th-14th of February. The RAG team have got a whole host of events lined up, and we’re sure to raise a great amount for our list of charities this year. Our Neurosoc and Surgsoc have both got their annual conferences this February, the 12th and 15th respectively. I’m sure they’ll follow the pattern set by our other outstanding societies and their conferences so far this year. And of course, everyone is looking forward to the notorious Dental Beer Race on the 28th!
Highlights from January have included: MSA Musical Theatre delivering an outstanding performance of Rent (raising a hefty sum of money that will be donated directly to RAG) GKT’s Got Talent (disclaimer: the name of this event debatably oxymoronic) The KCLSU AGM, at which Medics most certainly came out on top with motions relating to wifi, cycling and finances being passed
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Hope everyone is enjoying their 2014 so far, and sticking to those resolutions! Things have been ticking along smoothly over here, and things will soon get very busy.
Lastly, good luck to all the medical finalists, who’ll be hearing back about their FPAS applications and SJTs soon, and of course preparing for the almighty task that is finals towards the end of the term.
theMEDICALSTUDENT / February 2014
News Editors: Chris Smith and Krishna Dayaji news@themedicalstudent.co.uk
[NEWS]
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GMC clarification: disabled trainees and medical students unable to perform CPR Krishna Dayalji News Editor The General Medical Council (GMC) issued a statement in December to clarify its position regarding disabled medical trainees and students who are unable to perform cardiopulmonary resuscitation (CPR). This came after the GMC was informed by the Medical Schools Council that a recent survey identified ten disabled medical students who are expected to graduate from medical school but may encounter difficulties at later stages of their medical training, including a wheelchair user who is able to direct but not perform CPR. The statement also added that the current “regulatory requirements around CPR – which provide for a greater level of flexibility than other learning outcomes – are not always well understood” and therefore believed that clarification was needed. The statement highlighted that “[The GMC’s] view is that all disabled students and doctors in training should have a reasonable expectation that they can progress through their education and training,
subject to meeting their outcomes required and having the appropriate reasonable adjustments to help them.” The requirement for gaining competence in CPR for medical students, foundation year doctors and speciality training doctors, is that the individual can direct others to undertake resuscitation if they are unable to do so. This is clearly stated in the Tomorrow’s Doctors (for medical students) and Trainee Doctors (for FY1) documents. Furthermore, “If a doctor in training cannot physically perform tasks included in the ILS or ALS as a result of a disability, the Resuscitation Council allows them to direct others to undertake resuscitation and complete that element of training.” The statement goes further to question whether “the flexibility to direct and manage CPR achieves an appropriate balance between the needs and legitimate expectations of students and trainees…and the needs and safety of patients” And it goes without saying, the statement did identify concerns regarding the difficulties in achieving the skills to direct others as well as the varying competences between individuals. They also high-
lighted concerns about delivering CPR in General Practice or A&E settings during night shifts. Several suggestions from key stakeholders were also included about how any risks could be mitigated, in particular how to improve the transfer of information when disabled students move into the foundation programme and
between training rotations. The statement read: “For those with health or disability issues it is particularly important that transition is planned effectively and that information that the receiving organisation needs to have is shared in good time”. “Otherwise, the relevant foundation school and NHS employing organisation will not be in a position to
ensure a safe and appropriate working environment for the disabled new doctor.” The GMC will conduct a review in 2015 of the practical procedures stated in Tomorrow’s Doctors and Trainee Doctor to determine whether they remain fit for purpose, including the reassessment of CPR requirements.
‘Drunk Tanks’ for the Intoxicated Krishna Dayalji News Editor Yes, you read it here! ‘Drunk tanks’ may be the new alternative for those of you who become obliterated after Sports Night or casual Monday. First introduced in the USA, ‘drunk tanks’ are traditionally a cell or separate facility accommodating those who are intoxicated, especially through alcohol, and now they have made their way over to the UK. Last Christmas saw Bristol open the first ‘drunk tank’ outside of London. Put more
eloquently, Alcohol Recovery Centres (ARCs) will aim to provide a safe environment for intoxicated revellers to sober up and/or receive medical care, thereby reducing the burden on the limited resources of the emergency services. Run as a multi-agency partnership between the police force, the ambulance service, health organisations and the National Licensed Trade Association, it is hoped that the scheme will tackle the problems surrounding overconsumption such that there will be an improvement in safety for those enjoying nights out
in the city. Those individuals who are seen as putting themselves in danger will be taken to an ARC to recover from the effects of alcohol. The Bristol ARC remains in a secret location such that paramedics or the police can only refer individuals to the centre. A non-emergency ambulance staffed by care assistants will transfer those in need of help. Chief Inspector Catherine Johnstone, of Avon and Somerset Police said: “We want to ensure people are safe and don’t become victims of crime as a result of being vulnerable through drinking excessive
amounts of alcohol. It is about responsible drinking whilst enjoying yourself in a fantastic city such as Bristol. The ARC demonstrated how partnership working can deliver quality integrated services”. It is, however, important to note that those held at an ARC would be liable to pay up to £400 for security and medical staff to care for them overnight. Peter Brown, from the South Western Ambulance Service NHS Foundation Trust, added: “The ARC is not a hotel or a B&B – you cannot check in for the night. This is really
a place of safety until we can get somebody back to a position where they can look after themselves or indeed there is a relative or friend who can look after them… It is a primitive facility as it is not set up to an A&E department. This is for those that should not be in A&E department because they are not necessarily ill or injured, they are just vulnerable because they have consumed too much alcohol.” Whilst this scheme was piloted last autumn, the hope is that this multi-agency partnership will be rolled out nationally on a permanent basis.
theMEDICALSTUDENT / February 2014
News Editors: Chris Smith and Krishna Dayalji news@themedicalstudent.co.uk
CEM to streamline Emergency Medicine training to tackle impending shortfall Chris Smith News Editor Britain is facing a shortage of A&E doctors because many medical students are choosing not to pursue careers in such a pressurised environment, instead switching to easier specialities that let them take on more lucrative private work, such as general practice or anaesthetics, or even moving abroad. In an attempt to create a lucrative specialty that reduces attrition, the College of Emergency Medicine (CEM) are commencing a Run Through Training pilot in 2014. The pilot would allow trainees to progress from core training (CT) to speciality training (ST) without interruption. This would hopefully
allow for longer predictions of future doctors, with reduced loss between CT and ST as doctors currently have to interview to progress. All Deaneries in the United Kingdom are participating in the pilot. Dr Cliff Mann, the president of the CEM, said: “There’s plenty of money currently being spent on acute care. The problem is that we don’t have the doctors in training and fully trained to fill all the posts. At the moment all they can do is try and fill these gaps with locums and by getting staff to work overtime.” Figures released by the Worcestershire Acute Hospitals NHS Trust, following a Freedom of Information request by Labour, show it spent £535,000 on locum and agency doctors in
2009/10, 15 per cent of the total A&E medical budget. That has now increased to over £1.5m and accounts for 32 per cent of the same fund. In January, Belfast had to call in extra staff to tackle a huge backlog of patients seeking help in the Royal Victoria Hospital where, at one point, 42 people were waiting on trolleys and where tearful nurses likened their department to a war-zone. In the same month, South Eastern Health Trust was forced to close two A&E departments at the weekend, due to a shortage of middlegrade doctors. These dilemmas facing emergency departments aren’t peculiar to Northern Ireland. Across the UK, there’s a 50% shortage of medical staff in A&E units.
FP oversubscription in numbers Krishna Dayalji News Editor On 21 January 2014, the UKFPO confirmed that there are 293 more applicants than places available for the Foundation Programme due to begin in August 2014. All fully eligible applicants will be ranked in score order and the top 7,589 applicants will be allocated to a foundation school on 10 March 2014; the remaining students
will be placed on the reserve list, which will be published shortly. However, it is expected that there will be fewer applicants placed on the reserve list as a result of candidates either failing finals or withdrawing from the process entirely. Professor Derek Gallen, UKFPO National Director, added: “Despite the programme being oversubscribed again, I would like to reassure applicants that we are in a bet-
ter position at this stage in the process than last year. I am confident that has been the case since the programme was first oversubscribed, all eligible applicants will be placed in jobs by the start of the programme in August.” The 2013 Foundation Programme was oversubscribed by 295 applicants, of which the remaining 33 applicants on the reserve list were allocated a foundation school by 8th July 2013.
[NEWS]
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Research In Brief IMPERIAL COLLEGE LONDON Brain imaging experiments have revealed for the first time how ecstasy produces feelings of euphoria in users of MDMA. The results of the study conducted at Imperial College London were televised on Drugs Live on Channel 4 in 2012. It is hoped that the findings will hint at ways that ecstasy/MDMA might be useful in the treatment of anxiety and post-traumatic stress disorder (PTSD). UNIVERSITY COLLEGE LONDON Research carried out at the Farr Institute of Health Informatics Research and the National Institute for Cardiovascular Outcomes Research at UCL have discovered that the chance of surviving a heart attack is far lower in the UK than Sweden. The major new study published in The Lancet, suggested that more than 11,000 lives could have been saved over the past seven years had UK patients experienced the same care as their Swedish counterparts. It is believed that a key reasoning behind this is faster uptake and use of new technologies and recommendations in Sweden. This has contributed to large differences in the management and outcomes of patients. KINGS COLLEGE LONDON Ingredients found in tea and berries could offer protection against developing developing type two diabetes, according to research from King’s College London and the University of East Anglia. Findings published today in the Journal of Nutrition reveal that high intakes of flavonoids including anthocyanins and other compounds are associated with lower insulin resistance.
and better blood glucose regulation. Comprising of almost 2,000 people, the study also found that these food groups lower chronic inflammation, which is associated with diabetes, obesity, cardiovascular disease, and cancer. BARTS AND THE LONDON Researchers from Queen Mary University of London have found that large-scale HPV self-testing proves effective for screening cervical cancer. In a pilot study, comprising 100,242 Mexican women – the largest study of its kind, around 11% of women tested positive for HPV (10,863 women). This study, published in the International journal of Cancer, shows self-testing works as an alternative to smear testing when rolled out in a large scale and could be particularly beneficial in countries shown where smear testing programmes are poor. In addition, self-testing is desirable because it poses fewer barriers to access for women living in areas with little access to health services. ST GEORGES A recent study carried out by researchers at St George’s, University of London and Kingston University have found that patients with learning disabilities become ‘invisible’ in hospitals. Hospital patients with learning disabilities face longer waits and mismanaged treatment due to a failure to understand them by nursing staff, says the new report. The study found many examples of good practice, but also many examples where the safety of people with learning disabilities in hospitals was at risk, with the most common safety issues including delays and omissions of care and treatment.
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theMEDICALSTUDENT/February 2014
Features Editor: James Wong features@themedicalstudent.co.uk
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Biomedical Sciences: The Graduate Entry Route into Medicine? Anhya Griffiths Online Editor As the application process for Medicine becomes increasingly popular and competitive (UCAS applications are up 3% on last year) it’s no wonder that what is being increasingly seen as Medicine’s sister/preparatory course, ‘Biomedical sciences’ and other variants, becomes a progressively more popular alternative for those who plan to advance onto the Undergraduate or Graduate entry courses for Medicine. Unsurprisingly, perhaps there is a stigma surrounding a Biomedical Sciences or related degree, that it is merely a preparatory course for Medicine; rather than an individual degree in its own right that prepares applicants for occupations outside of practising medicine such as research, immunology and toxicology. And in reality, it doesn’t sound overly persuasive to the Lead of Biomedical Science degree, on a personal statement, when listing reasons why you’re passionate about their course, you happen to slip in ‘this course provides the perfect stepping stone for my actual passion in life...Medicine!’ However it cannot be denied that Medical schools appreciate the experience offered by a post grad undertaking a second degree in Medicine. This is reflected in the fact that 15 medical schools in the UK offer the accelerated 4 year Graduate entry program for Medicine. Clearly, there are benefits to having completed a previous degree before entering the medicine
pathway, especially a related degree like Biomedical Sciences. For example in asking the Graduates on my 5 year course, universally they agreed that a major benefit of having completed a previous degree meant they were much more prepared for the intensity of a medical degree as having gained a solid understanding of the basic science and principles that are necessary for a career in Medicine. Additionally, other beneficial aspects of being a Graduate on a Medical degree I found included: allowing students a greater time period to mature and to have had time to gain insight into the type of person you are, identifying your own strengths and weaknesses as well as having a better understanding of what is expected of yourself as a student and the nature of the work involved. Obviously, however, there are certain drawbacks to this route into Medicine. Most blatantly, the extra expenditure of undertaking a second degree. Graduate entry students have to contribute significantly to their medical training and contend with the idea that after having completed 3 years of higher education, they still won’t be earning for at least another 4 years. Furthermore, one Graduate on the A100 program at Barts and the London talked of the potential of feeling “not necessarily in the right place” as perhaps being one of the eldest in the year; causing feelings of isolation from some peers who could be nearly 5 years younger and have much less life experience. In the UK it is less commonplace (though on the rise) to have com-
pleted a previous degree before entering into medicine. However in America, the PreMed system stipulates that applicants are usually expected to have completed at least 3 years of ‘Pre Med courses’ as a medical degree in America is considered a second entry degree. Therefore it perhaps should not be viewed so unconventional in the UK. However, if the idea of a Biomedical Sciences degree is offputting for the simple fact that at the end of the degree you’re not a Medical graduate, in the UK there seems to be a broadening of several alternative pathways into Medicine. The widening access into Medicine, 6 year course at Southampton is an example of this. Currently the Southampton
6 year course requires that applicants have A levels of BCC including Biology and Chemistry (or equivalents) as well as satisfying 3 out 6 criteria in order to be eligible. These criteria include: being a first generation applicant to higher education; living in an area with a postcode which falls within the lowest 20 per cent of the Index of Multiple Deprivation or being a member of a travelling family and parents/guardian or self are in receipt of a means tested benefit. Furthermore, the Medical Sciences program at the University of Exeter gives the opportunity of 10% of the first year to enter year 1 of the MBBS program after performing to a higher standard in the 1st year of the Medical Science course. This performance in-
cludes: being on track to achieve a first or at least a 2:1 in the degree; having already obtained AAB at A level or equivalent; and performing satisfactorily at the interview stage. However, let’s not forget the prospect that you might actually enjoy a Biomedical Science degree and want to pursue a career afforded by said degree...it might happen! There are several careers related to the NHS and healthcare that appreciate and need Biomedical Sciences graduates, for example, in Pharmaceuticals and Forensics, so maybe it’s not just a simple equation of: Biomedical Sciences degree + keen student = Post Graduate Medicine applicant ...but to be fair, it’s not the worst career option out there!
Write for Us! The Medical Student is always looking for keen writers to get involved with the paper, if you have an idea for an article, big or small, don’t hesitate to contact us: editor@themedicalstudent.co.uk
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theMEDICALSTUDENT/February 2014
Features Editor: James Wong features@themedicalstudent.co.uk
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The challenges multi-drug resistant TB strains Narmadha Kali Vanan Features Subeditor Almost one-third of the world’s population is infected with the latent form of tuberculosis (TB), but most people are blissfully unaware about the disease that caused the Great White Plague in Europe during the 17th and 18th centuries. Tuberculosis has dipped in terms of its public perception of danger, leading to complacency of policy makers, health services and the general public. However, with the rise of drugresistant strains of TB (DR-TB) in the form of multidrug-resistant TB and extensively drug-resistant TB, efforts must be taken to diagnose and treat both non-DR and DR-TB effectively to prevent the escalation of this disease into a global pandemic. The major challenge faced in these efforts is the lack of funding for research related to drug-resistant tuberculosis; which seems like a repeat of the events in the 1980s in which declining TB budgets led to the resurgence of TB in the 1990s. In May last year, the budget of the Tuberculosis Trials Consortium
(TBTC) was immediately reduced by 25-30 percent, with a similar cut in the following financial year due to the sequestration of the US Federal Budget. This will lead to a significant decrease in the studies that the TBTC will be able to undertake, slowing progress in clinical, laboratory and epidemiologic research. The motivation behind TB budget cuts can be attributed to the long course of illness. The treatment of DR-TB is a lengthy process therefore the immediate effect of statistics and figures tend to die down since it is not perceived as a particularly alarming issue. This lack of urgency translated into a state’s or country’s budget for health spending, as policy makers seek to solve the more prominent issues first. This causes a knock on effect, resulting in a limited pool of diagnostics, strategies for clinical management and prevention of this disease. Sputum microscopy is the most widely used diagnostic method to confirm the presence of Mycobacterium tuberculosis, however its sensitivity is compromised when the patient is co-infected with HIV and it cannot be used to determine if the
strain is drug resistant. Current drug susceptibility tests are elaborate, leaving a long duration between the actual sample taking and the detection of TB. This extended period of time may lead to the inappropriate administration of treatment and further increases the chances of an infected person spreading the disease. Serodiagnostic tests have been shown to have variable sensitivity and specificity (leading to the first negative policy recommendation related to TB by WHO). In terms of drug development, only two new anti-TB drugs have been released within the last 40 years, which highlights the apparent reluctance of the drug industry to drive progress in this area. This may be due to several reasons, including the extended period for drug development, the difficulty in demonstrating the effectiveness of new drugs over pre-existing drugs as clinical treatment usually involves multidrug therapy and the perceived lack of commercial return as over 95% of TB cases occur in developing countries. Weak monitoring and surveillance systems in developing coun-
tries cause the collection of inaccurate data, regarding prevalence rates, treatment outcomes and disease relapse, which leads to wrongly tailored anti-TB programs for the country. If the number of people affected is underestimated, this results in a program which is unable to deal with the reality of more TB and DR-TB patients than the projected numbers, which could causes increased chances of disease relapse as drugs may be distributed sparsely. A general lack of public awareness is another major challenge faced in the eradication of this disease. People may tend to brush off their symptoms until they worsen as the disease progresses and this greatly increases the number of individuals the patient could have infected. The long duration of TB treatment, with many drugs and associated side effects, does no favours for patient compliance and this could contribute to the development of drug-resistant strains. An increasing number of antiTB projects being approved as the incidence of TB and DR-TB spikes within the population causes an
increase in the demand for secondline drugs used in the treatment of DR-TB. This opens the door for the entry of unregulated drugs into the market. The effectiveness of these drugs may be compromised and their use may lead to the development of resistance against them too, resulting in the increased prevalence of XDR-TB, which is extremely difficult to treat. But it’s all not doom and gloom! An undertaking of this nature will take a long time to bear fruit, however, it is great to see that policy makers and the general public are sitting up and paying attention to the threat that DR-TB poses to their citizens. For example, over US$ 12 billion was pledged in contributions by 25 countries, the European Union, private foundations and corporations and faith-based organisations to The Global Fund to Fight AIDS, Tuberculosis and Malaria (which funds more than half of anti-TB programs around the world), allowing programs aimed at managing and preventing these diseases to be funded for the years before the next replenishment of the fund.
MEDTECH AND SMART LIVING INNOVATION AND NETWORKING EVENING AT THE ROYAL SOCIETY OF MEDICINE 24th March 2014 6.00pm – 9.30pm, Royal Society of Medicine Calling innovators, entrepreneurs, businesses in the MedTech sector, funders, students, academics and clinicians with an interest in medical innovation. This is an evening where like-minded individuals can come together, exchange ideas, make new contacts, learn from each other, and find funding and new research/business opportunities. Whether your interest is in big data, digital health, wearable sensors or medical technology this is the networking event for you. As well as the networking opportunity, there will also be talks from:
Miles Ayling, Director of Innovation at NHS England on how the NHS can support you in delivering your idea.
Dr Jack Kreindler, founder of the Centre for Health and Human Performance and a number of MedTech Startups on his journey, from start-up to exit and beyond. There will also be a ‘Show and Tell’ session where you can take the stage for 5 minutes to tell others about your idea To register your attendance, visit meetup.com/med-tech-campus. Places are free of charge and refreshments will be provided. If you have any queries regarding this event, please contact us on info@ medtechcampus.com The Anglia Ruskin MedTech Campus brings together all of the essential components of the innovation process, provide one of the world’s largest health innovation spaces and drive business growth in the UK MedTech sector. Learn more about us at medtechcampus.com
[FEATURES]
theMEDICALSTUDENT/February 2014
Features Editor: James Wong features@themedicalstudent.co.uk
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Keep on Truckin’ James Wong Features Editor Shattered. Third consecutive day of on-calls at the birth centre. I’m afraid I have little to show for it. The logbook hangs limply at my side, the pages where my name is printed await signatures; surrogate markers of new found skills. Half asleep I slump against the wall and cast my mind back to the peripheral attachment from which I have not long returned. The oldschool consultant’s mutterings are still fresh: “Medical education was different back then you see....you are dealt a tough hand nowadays”. I quite agree, it is Saturday. Might it be said the clinical apprenticeship we know today is a shadow of its former self? Medical school was more a way of life, students lived in the hospital, they even had their laundry done for them. Incredulous, I could scarcely restrain a chuckle at the consultant’s stories of delivering babies while merely a student and how the dishing out of “character building” grillings by their seniors was de rigeur. Seldom am I plied with any such questions. Teaching is a rare commodity at times. Hours on a busy ward can bear little return. Frequently do I hear students barely a rotation into their clinical years, bemoan a woeful lack of attention. All recollection of the starry-eyed second year, romanced by anything remotely clinical, has evaporated like the morning dew. “Make way, make way!...” cries a thin voice from the far reaches of the centre. A squeel of bed wheels. The newly crowned obs & gynae reg drives past the midwife station executing an impressive Tokyo drift into the corridor where I stand. Through the theatre doors opposite me he vanishes. I follow. Major postpartum haemorrhage. A bevy of scrubs flit across the room in a live performance of the RCOG guidelines for obstetric haemorrhage. They resuscitate the women on the table, her clammy body flat across the carmine blotched sheets. ABC, intravenous access and a rapid two litres of Hartmann’s later, the bleeding can not be arrested by rubbing up contraction. Pharmacological measures: syntocinon and ergometrine preparations do not staunch the flow.
Blood pressure still falling, I watch the consciousness slowly ebb from the woman’s eyes. Then in a tone of voice, seemingly beyond his years, the reversely gowned anaesthetist clocks my badge and says, “Fetch me the carboprost.” I could feel an exercise in futility sprout as I gave an empty but ingratiating nod. “It’s hemabate....in the fridge” he continues. In the anaesthetic room I find the fridge and rummage blindly through. Thirty seconds later having discovered nothing but my general inadequacy, I crawl back into theatre. I was as good as useless though to my surprise the anaesthetist disappeared and re-
The Medical Stuwriters to get inan idea for an
turned with a vial. Handing me both it and a prepped syringe, he instructs me to inject intramuscularly into the woman’s thigh. The most common cause of postpartum haemorrhage is uterine atony. Prostaglandin analogues like carboprost promote coordinated contractions of the body of the pregnant uterus. Constriction of the vessels by myometrial fibres within the uterine walls achieves postpartum haemostasis. This textbook definition does not quite echo my thoughts as I gingerly approach the operating table. Alarmingly I am unaware that aside from the usual side effects of the drug in my syringe; the nausea and vom-
iting, should the needle stray into a nearby vessel and its contents escape into the circulation, cardiovascular collapse might be the unfortunate result. Suddenly the anaesthetist’s dour expression as I inject now assumes some meaning. What a relief to see the woman’s vitals begin to stabilise. As we wheel her into the recovery bay, the anaesthetist unleashes an onslaught of questions. Keen to redeem some lost pride, I can to varying degrees, resurrect long buried preclinical knowledge: basic pharmacology, transfusionrelated complications, the importance of fresh frozen plasma. Although, the final threat of drawing
the clotting cascade from memory is a challenge too far. Before long I am already being demonstrated the techniques of regional analgesia, why you should always aspirate before injecting lidocaine and thrust headlong into managing the most common adverse effects of epidurals. To have thought I had been ready to retire home early on this Saturday morning had serendipity not played its part. A little persistence would have been just as effective. It’s the quality so easily overlooked in these apparently austere times of medical education. And not a single logbook signature gained. Oh the shame!
dent is always looking for keen volved with the paper, if you have article, big or small, don’t hesitate
[COMMENT] /10 The Hotel of the Damned theMEDICALSTUDENT / February 2014
Comment Editor: Rob Cleaver comment@themedicalstudent.co.uk
Rob Cleaver Comment Editor
There is a certain type of person who is able to, who is obliged to, spend time at Broadmoor Hospital. They are there because they are not well, they are there because they need treatment for ongoing severe psychiatric illness not because they need a vacation. Lately, the hospital itself has been undergoing treatment, a facelift of sorts, one that strips it of the victorian corridors, the winding staircases and the spectacular views over the Berkshire countryside. As new buildings spring up, aimed at providing high quality and modern care facilities to some of society’s most vulnerable, some of the old buildings cannot be torn down. These are grade I listed antiques, not to be touched without white gloves, and most certainly not to be stroked by the face of a wrecking ball. What on earth can they do with a building so notorious? Sutcliffe may have stalked the corridors, Brady and Bronson too. There is history in those dark, derelict spaces, the kind of history that isn’t so easily scrubbed out. There are ru-
mours though, plans afoot, to see the old buildings undergo a renaissance. The fences and the walls will be moved to separate it from the new facilities. The old buildings will house only those insane enough to spend a weekend there - The Grand Broadmoor Hotel.
[The old buildings will house only those insane enough to spend a weekend there - The Grand Broadmoor Hotel.] The building overlooks a valley that, like Blake’s Jerusalem, is very green and very pleasant, one where a cushion of mist gently rolls over. The same view afforded to the patients, like the one who escaped through the bathroom window to that very valley in 1997. It’s a beautiful vista, of that there is no doubt, but it is one that has a thorn in its side. There must be questions asked of the safety of situating a hotel so close to a high security psychiatric unit. Although there hasn’t been an escape since 1997, there is no reason to suspect that it will never happen again. To place tourists on such a site next to a population that is undoubtedly unpredictable and potentially volatile is a
decision that would be brave to make and even braver to stand by if the unthinkable were to transpire. Of course the attractions are endless, there is a certain type of person who is able to, who is obliged to, learn more and become fascinated with the idea and the history of such a place. Notoriety lends itself to legend and legend lends itself to visitation rights. There are people who would love the idea of having stayed, with the key to the door and if only for two nights, behind lock and key at Broadmoor. In that respect, it may be a money-spinner and could lay out a veritable feast of historical events - murder mystery tours, haunted house nights, ghost storytelling. It would attract locals and those from further away. However, we must, if we are to allow the hotel to be opened, ensure steps are taken to avoid the days of Bedlam, back in the 19th century, when people would pay tuppence to see the inmates, to look at them and make fun of them, to point and to laugh at their illness. If money is to be made out of Broadmoor it must not be at the expense of the current patient population.
[We must ensure steps are taken to avoid the days of Bedlam, when people would pay tuppence to see the inmates, to look at them and make fun of them, to point and to laugh at their illness.] While I was there recently, I saw the woodwork and the art that the patients make and we were told that they cannot generate money from the works even if, as some of it was, the quality was superb. Art gets exhibited in London sometimes, the woodwork often gets placed in the grounds. These are positive steps and a positive portrayal of the work that goes on behind those series of closed
doors and security checks. Broadmoor has been, and will always be, a name that everyone recalls, a he-who-shallnot-be-named of medical facilities and therefore it should be a modern and world leading centre for the treatment of severely dysfunctional patients. Equally, we must preserve its heritage, its stories as examples of both good and bad treatment of psychotic disorder. Whether the prognosis for a spa hotel, where people lounge overlooking a southern idyll, looking forward to their evening of wonderment on the other side of the perimeter fence to the subject matter, is ever going to be a positive one is as inconclusive as the prognoses of the inpatients themselves.
ing. All of my room is taken up by us. We are in everything I think, everything I do, everything I envision transpiring in the future. Sometimes I wonder what it would be like to be single again – I hardly remember a time without us. Before we got together we’d known each other well for three years, but we’d always hovered around each other long before that. I guess you could say that this is a childhood relationship. They say when your partner walks into your life that your life is turned upside down. That’s exactly what happened and bit by bit we’ve been building an upside down palace of our own. I often wonder if one day my world will ever turn the right way up or if that would mean losing us. I’d truly be lost without us. I’d have no
constant, nothing to rely on, nothing I know. I’d have to find someone else and get to know how they think and how they work. Relationships require time and effort and, if this one is ok, why should I rock the boat? We have our good days, full of joy, gratitude and happiness. We also have our bad days, full of anger, stress and confusion. Relationships are hard, even after three years. I always dream of being with my partner for eighty years – the same person there for the whole of my life. It’s just a dream, but three years isn’t a bad start. Three years. Maybe one day on our anniversary, I’ll look back and realise it’s been over a year since we last met. Maybe I’ll say that we are officially over. Maybe I’ll say goodbye to you, my depression.
Happy Anniversary Zara Zeb Doctors’ Mess Editor January 31st 2014. Three years and counting. The longest relationship I’ve ever had. The longest anything I’ve ever committed to. I’ve never kept a diet longer than a week, never kept a hobby longer than six months and never kept a pet longer than eight months. I’m not a quitter, I just get bored (or in case of the pet, I move away – I’m not heartless). But for some reason, this one has stuck. Three years. We’ve settled into that routine now, where we can spend many days in a comfortable silence. We text every now and again, just so we don’t forget the other. We can go many weeks, many months not seeing each other, and then
when we do meet again, it’s like no time has elapsed. Every once in a while, those emotions from three years ago come rushing back but they too pass into that comfortable amicable companionship. After three years together, I am compelled to look back. We’ve definitely evolved. We’ve had our bumps but we’re used to each other now. We’ve shared some highs and lows. We’ve been judged, we’ve lost a few friends and we’ve been labelled. People see us together and think they understand how we think because they read about it in some book (because feelings are that simple). People give us that look - the one they reserve for the muttering homeless man on the bus- because we’re different; we’ve started things together, and we’ve got
to know each other very well. People see us together and are amazed at what we can do. They know they don’t understand and never will understand, but they support us. But no one will know all of us, and I don’t know all of you. We’re still learning about one another, still shaping one another, still going strong. Don’t get me wrong, after three years I do get tired. I do want change. But we’re all I know. And no matter how hard I try, I cannot shake us. When my single friends ask me what it’s like, even now after three years, I don’t know how to describe it. When you’re single, you have room for what life has to throw at you. When you’re in a relationship, like us, the little things that life throws in your way become overwhelm-
[COMMENT]
theMEDICALSTUDENT / February 2014
Comment Editor: Rob Cleaver comment@themedicalstudent.co.uk
YAY! As is always the case with politics, something is only announced to the public as an idea if it has had a thorough report written on it first by someone who’s opinion is considered as fundamentally right. Once this idea is announced, another report has to be written by someone whose opinion will match that of the first report and this will take another 6 months. It is no surprise then that the two-tier A&E systems is something which most people are already aware of and have lost interest in, because the process for anything to happen is so slow. What many people don’t realise is that the process has already begun, it’s a process that could work, but it’s being managed atrociously. The latest report published at the end of 2013 stated the pressure on A&E can be alleviated in a number of ways. Firstly, creating specialist units for certain conditions - King’s College Hospital now has a specialist A&E for trauma. Second, there is a new telephone system, 111, for advice on which service is most suitable for a patient’s needs. Finally, the report says minor cases can be delegated to paramedics or pharmacists. Sometime last year my local pharmacist got a consultation room in his little shop, the idea being patients get treated for common non-prescriptive ailments. Paramedics are also receiving specialist training to offer complete treatment at the scene. These suggestions are already happening; the report doesn’t bring anything groundbreaking to the table or any insights into how to make the current system better, other than to say there needs to be more co-operation between healthcare specialists. The two tier system already exists but patients don’t know how to use it because those running it are not very good at managing it. The confusion over which services to access has led to patients simply turn-
ing up to A&E as a default. Handily in health centres, splashed across buses, and on billboards are posters telling you not to go to A&E but when your GP can’t see you for more than two weeks and your local walk in centre is not only 2 bus rides away but also only open Mon-Fri 9am-5:30pm (i.e. when the majority of the population are at work or school), where do you go? It’s more convenient to spend four hours one evening sat in A&E reading a text book or checking emails to get treatment for a minor in-
Accident and Emergency forms a key part of the NHS. It represents a specialised clinical team that serves the purpose of responding to patients that require immediate and critical attention. However headlines have recently shown failures in this service, with many departments failing on their targets for waiting times. The re-organisation to a two tier A&E is based on interpretations of a report by Sir Bruce Keogh. Whilst headlines have focused on this declaration of a twotier system, this appears to almost entirely miss the point of the report. Shockingly, the report states that 40% of A&E patients have no need to actually be there. Re-organising A&E will likely have little effect on this. Instead, as the report recommends, A&E needs to be transformed from a static building
ACCIDENT AND EMERGENCY SHOULD BE A TWO-TIER SYSTEM. FOR - ZARA ZEB (GKT) -VSAGAINST - OSCAR TO (QMUL] jury than to find time during the day when you need to be elsewhere to access the right service. The two-tier system makes sense, can theoretically work and I’m all for it. But the people designing it see the NHS as a market and often don’t put the needs of the patient first. The two-tier system can provide faster, more appropriate access to healthcare but serious work is needed to improve what already have with patients as the focus. We must improve the image of the number 111. We must have longer opening hours. We must have specialist centres so that the patient gets the right treatment from the right people at the right time.
department to a flexible, mobile service that allows patients to understand whether or not they require medical attention. NHS 111 has the potential to provide this, but like many other NHS initiatives, remains critically underfunded with a lack of trained medical professionals to deliver the service. A&E targets are being missed precisely due to this excess of unwarranted visits. Establishing a two tier service would also likely result in all patients moving towards higher tier
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centres regardless of their condition. Particularly as most patients have no idea of how severe their conditions actually are; assessment requires a professional. This will simply divert A&E patients from 2nd tier to 1st tier centres, somewhat defeating the point of this reorganisation. If anything, a patient going to any A&E can at minimum be stabilised prior to movement to a more suitable centre. In fact, what is really necessary is greater central organisation of services so that the logistics of moving patients to the correct hospitals can be co-ordinated rather than patients throwing themselves at top tier centres. Furthermore, the specialisation of hospitals has been occurring throughout the past few decades, it is no surprise that some hospitals cater more for specific areas than others, for example, Great Ormond Street. Does this meet we should segregate all hospitals into tiers as well? Furthermore, the government promises that this reorganisation will not actually affect services in any A&Es departments, leading to a key question: what is the point? This will simply amount to a pointless renaming exercise. Specialisation of services occurs naturally based on the populations that surround a hospital, with artificial enforcement only leading to an expensive and wasteful service that does not cater for the local area. Overall, the report simply reflects many changes and innovations that are already happening in the NHS. The movement towards telecommunications has already taken off in some GP practices, extending this towards other services is a natural next step. The specialisation of certain hospitals specialising in trauma or other areas has also already happened. This leaves the question of why we need to specifically label A&E as a two tiered system; another expensive renaming exercise?
NAY!
[EDUCATION] /12
theMEDICALSTUDENT / February 2014
Education Editor: Sarah Freeston education@themedicalstudent.co.uk
A is for… attendance Sarah Freeston Education Editor We’ve all been there – the friend who you’ve barely seen attend lectures all month aces a formative. All those early rises suddenly feel wasted and a justified feeling of frustration ensues. There is a small literature on the issue of attendance, but very little, if any, on medical students specifically: a highly motivated and already high achieving student population. Several studies in higher education have found a positive correlation between attendance and attainment; however, it’s hard to dissect whether attendance or attitude is the root cause of this relationship. There has also been rising interest in the concept of ‘the socialisation of learning:’ the less tangible effects of being with other learners and learning with and from them. I want to compare these concepts and conclusions with what current London medical students think in this technological era when definitions of ‘attendance’ and ‘engagement’ are not so clear cut and their relationship to doing well is not so apparent. Most medical schools have a relatively strict policy on attendance. But how should we
define attendance? How can we define engagement? Is it actually more engagement that medical schools are looking for? Is watching a lecture back online a week later engaging on the course? Does it count as attending if you watch the lectures at some point from various locations or is your physical presence in the lecture theatre required? What if you turn up but spend the hour browsing Tinder and don’t listen to a word? I think for true engagement you need a certain level of motivation; you need to enjoy learning and actively search for more knowledge. In tutorials, this may be getting involved in the discussion, but it can equally mean reading a physiology textbook on the sofa with a cuppa. To categorise absenteeism as wrong or bad, does it depend on the reason why you missed the original lecture?
[Does it count as attending if you watch the lectures at some point from various locations or is your physical presence in the lecture theatre required?] “One thing we have learnt from surveying our students is that when they are not there they are often doing something else that can be consid-
ered learning. We spend a lot of time emphasising to students the importance of talking about, reflecting on and taking part in medical learning, particularly work-based learning. We recognise, however, that the big hurdle of exams colours students’ thinking about how and where they should be learning but we need to look at ways of getting this message through,” explains Deborah Gill, undergraduate lead at UCL Medical School who is part of a working group of students and faculty at UCLMS who are looking at attendance and engagement following student requests to better define ‘compulsory teaching.’
[What is clear is that compulsion is not helpful in increasing attainment.] Another largely unexplored question is whether good attendance is a professional duty or simply a course requirement. In almost any other degree, as adult, independent learners, if students don’t want to attend sessions they’re paying a lot for then fair enough. However, medical schools are under strict regulation and need to deliver fit-to-practice final year students who have fully engaged with all teaching and indirect learning experi-
ences – a well-rounded doctor demonstrating professionalism, motivation and clinical skills. Therefore, the situation is different. It’s not just the medical schools’ responsibility though; students themselves also need to respect their seniors by turning up and being as attentive as possible and of course show their patients respect by fully engaging. As medicine is a vocation, you’re not just paying to get a certificate; graduating is only the beginning and embarking on this road is a life choice. “Turning up to teaching sessions on time and participating fully is expected of medical students and is a key professional expectation that predicts professional behaviour as doctors,” clarifies Dr Anne Stephenson, Head of Professionalism at King’s College London School of Medicine in correspondence with The Medical Student.
How to enforce? So how far should medical schools go to enforce attendance? Checking attendance at most medical schools seems to be patchy at best; college cards are occasionally swiped when coming into lectures, practicals and workshops (with someone lumbered with a stack of 10 cards to swipe from their more organised and smart ab-
sent peers). Signatures can also be forged and some students may arrive but only stay for 10 minutes. Whether this information is actually checked is not apparent. I’m pretty sure I could have been in a different country since September and I wouldn’t have been chased up. Is this dangerous? For some naïve freshers who think they’d have been chased up if it mattered, it may well be. However, it is explained at the start of the year that attendance is mandatory and most medical schools have clear guidelines online about what is expected – letting them know about illness and getting permission to miss teaching for musical or sporting commitments. But, as already discussed, these rules are easily broken.
[...if some activities are deemed compulsory then...other sessions may become backgrounded or considered ‘optional’.] “What is clear is that compulsion is not helpful in increasing attainment,” explains Dr Gill, who refers to a literature review conducted by final year UCL medical students. Furthermore, if some activities are deemed compulsory then an unintended consequence could be that other sessions may become backgrounded or
[EDUCATION]
theMEDICALSTUDENT / February 2014
Education Editor: Sarah Freeston education@themedicalstudent.co.uk
considered ‘optional’. Perhaps measures such as taking marks off for lack of attendance would motivate students to attend more. But Dr Gill highlights significant difficulties with these sorts of approaches: “practically, how do you accurately measure attendance of over 1,000 students in an integrated curriculum when they could be doing shift work, visiting a specialist clinic or attending their GP sessions?”
Be there square
or
be
After a lazy day in bed, overtired from too much sleep and under nourished in social interaction it’s easy to regret putting snooze on for the third time – what had everyone learnt today? How was everyone’s weekend? Even if it’s just to talk about the essentials such as bemoaning occupational health charges, finding out who else clammed up on ward round and who vomited on who during sports night, you can’t deny that seeing friends is a top reason to come to lectures. “Not only does attendance contribute to acquiring knowledge and skills (and passing examinations), it also fosters collaboration with and support of peers and the support and development of the School, the curriculum and its teachers,” explains Dr Stephenson. Medical students arguably need close peer relationships more than other students, as the course is long and tough.
[Not only does attendance contribute to acquiring knowledge and skills (and passing examinations), it also fos-
ters collaboration with and support of peers and the support and development of the School, the curriculum and its teachers .] “Learning is of course a social event and we have an increasing body of data arising from research from Woolf and colleagues at UCL Medical School that social contacts are important in attainment at UCLMS. Professional knowledge and know-how is learnt from doing and belonging and becoming like, not from books and lectures. Furthermore, the practice of medicine is a social practice and learning for, and from, patient care cannot be done without patients!” says Dr Gill.
B is for… balance From discussing attendance with students, it seems that most would rather opt for a ‘B’ for balance. As the two case studies demonstrate, there are valid reasons and arguments for both frequently missing lectures and 100% attendance. Although students rarely fall into these extremes, I’m sure most of you can relate to parts in both of them. Attendance is a really individual thing. Perhaps it’s other skills such as time management and characteristics like motivation, thirst for learning and conscientiousness that underlie the link between attendance and attainment and not physically being in lectures. I personally believe that although engagement is hard to measure it may be a more important consideration than attendance when judging a student’s grades and professionalism.
Case 1: Blah blah blah The alarm goes off at some unearthly hour (around 10am), you roll over, weigh up the benefits of 2 more hours in bed against whether going into lectures will be any more useful than watching them back later after a leisurely breakfast. Don’t pretend you’ve not been there! Medical schools can be quick to say that if you don’t attend your marks are likely to slip but this simply hasn’t been reflected in my friendship group. I for one regularly use Lecturecast: some lecturers talk way too quickly meaning I need to re-watch the lecture anyway. I make a note of the time they lost me or I zoned out. With the fees we’re paying I think this is the kind of facility we are entitled to. People also talk in lectures and this is distracting. From home, I can pause the recording, look something up online and have my textbook open; I can better engage with the content because I’m not too busy scribbling everything down. I also live quite far from uni so I need to consider the length of time I’m spending on the tube there and back. If we have 9am and 5pm lectures, for example, I’m highly likely to opt for studying at home. Other times I need to nip out of lectures to go to work, volunteering placement or to a meeting. I’m making the most of all opportunities available to me as a medical student and developing key skills, which are perfectly good reasons to delay watching lectures to when it’s convenient. I also know graduate students who need to do the school run! Prioritising and managing your time are critical to becoming a good doctor. Having managed a team myself I certainly wouldn’t automatically employ the student who sits at the front of every lecture without fail, asks questions before fully digesting the material and completes online quizzes on the day they open. I would much prefer a student who’s fully engaged in other aspects of the medical school who misses the odd lecture to earn money, attend a mentoring session or spend time reading up on that concept covered weeks ago they hadn’t quite got their head round. Of course, this is overly simplified and it’s rarely this black and white but there are certainly reasons why not attending can be valid.
2nd year, UCL
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Case 2: Attendance = opportunity Some absentees say they can just watch the lecture online later but many confess that they rarely find time to do this. The recording quality is often very questionable and good luck knowing what’s going on if they use a laser pen to point out features of a slide or don’t use a microphone or overrun past the hour! I think students rely on this facility too heavily. Some lecturers don’t want their lectures recorded and attendance at these is noticeably higher with much more frantic note taking! There is certainly something to be said for watching a lecturer talk in the flesh; after all we’re not at all programmed to find a moving figure on a screen more captivating than in real life. Also, if I don’t get round to revising that lecture, I hope that I’ll remember some of the material (you know, the information going in by osmosis); maybe the lecturer told a joke or a story or their mannerisms were unforgettable but utterly lost in the recording. You also can’t contribute anything to more interactive lectures if you’re not there. And perhaps more importantly you can’t ask the lecturer questions while the material is still fresh in your mind. I attend lectures as I get all the relevant information packed into a concise format instead of spending hours reading up around the subject and trawling through YouTube videos. Spending time in hospital on placement and getting bedside tutorials are essential for good clinical knowledge and practice. If you don’t become familiar with seeing sick patients and certain clinical signs first hand you’re going to be in a lot of trouble dealing with it when you’re the only one on the ward as an FY1! In the clinic, with attendance and showing your face comes opportunity. You won’t hear about that really interesting case and be in a position to write a case report on it if you’ve not been there to discuss the possibility with your consultant and you won’t learn the dos and don’ts of being an FY1 if you’ve not helped them out.
4th year, Kings
theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
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2014 Academy Aw 2014 Golden Globe Award Winners Best Film (Drama): 12 Years a Slave Best Film (Comedy): American Hustle Best Actor (Drama): Matthew McConaughey (Dallas Buyers Club) Best Actor (Comedy): Leonardo DiCaprio (The Wolf of Wall Street) Best Actress (Drama): Cate Blanchett (Blue Jasmine) Best Actress (Comedy): Amy Adams (American Hustle) Best Supporting Actor: Jared Leto (Dallas Buyers Club) Best Supporting Actress: Jennifer Lawrence (American Hustle) Best Director: Alfonso Cuaron (Gravity) Best Screenplay: Spike Jonze (Her) Best Animated Film: Frozen Best Foreign Language Film: The Great Beauty Best Score: Alex Ebert (All is Lost) Best Song: Ordinary Love (Mandela: Long Walk to Freedom) 2014 Screen Actors Guild Award Winners Outstanding performance by a Cast in a Motion Picture: American Hustle
12 Years a Slave One of the obvious front-runners in the race for Best Picture, Steve McQueen’s new slavery drama is filled with unforgettable performances from Chiwetel Ejiofor, Michael Fassbender and Lupita Nyong’o (all nominated), McQueen’s unflinching direction, and a beautiful score. All in all, it’s the whole package, ticking all the boxes necessary for a clean sweep at the Oscars. With nine nominations overall, it’s off to a very good start. American Hustle
Outstanding Performance by a Female Actor in a Supporting Role: Lupita Nyong’o (12 Years a Slave)
The second David O. Russell film in two years (after Silver Linings Playbook) in which four cast members were nominated for each acting category, Davd O. Russell’s smart, sexy, sassy offering is a well-crafted, fastpaced heist drama that makes great use of its star-studded ensemble. Ten nominations overall, including Best Director and Best Original Screenplay, both of which are handy when it comes to winning Best Picture.
2014 Critics’ Choice Award Winners
The Wolf of Wall Street
Best Film: 12 Years a Slave Best Director: Alfonso Cuaron (Gravity) Best Actor: Matthew McConaughey (Dallas Buyers Club) Best Actress: Cate Blanchett (Blue Jasmine) Best Supporting Actor: Jared Leto (Dallas Buyers Club) Best Supporting Actress: Lupita Nyong’o (12 Years a Slave) Best Young Actor/Actress: Adele Exarchopoulos (Blue is the Warmest Colour) Best Acting Ensemble: American Hustle Best Adapted Screenplay: John Ridley (12 Years a Slave) Best Original Screenplay: Spike Jonze (Her) Best Animated Film: Frozen Best Action Film: Lone Survivor Best Actor in an Action Film: Mark Wahlberg (Lone Survivor) Best Actress in an Action Film: Sandra Bullock (Gravity) Best Comedy: American Hustle Best Actor in a Comedy Film: Leonardo DiCaprio (The Wolf of Wall Street) Best Actress in a Comedy Film: Amy Adams (American Hustle) Best Sci-Fi/Horror Film: Gravity Best Foreign Language Film: Blue is the Warmest Colour Best Documentary: 20 Feet From Stardom Best Art Direction: Catherine Martin, Beverley Dunn (The Great Gatsby) Best Cinematography: Emmanuel Lubezki (Gravity) Best Costume Design: Catherine Martin (The Great Gatsby) Best Editing: Alfonso Cuaron (Gravity) Best Makeup: American Hustle Best Score: Steven Price (Gravity) Best Song: Let it Go (Frozen) Best Visual Effects: Gravity
Some are praising this as being Martin Scorsese’s best since Raging Bull or Goodfellas, others disagree. While the three-hourlong drug-fuelled, sex-filled story of greed and excess turned off many, Leonardo DiCpario is a force to be reckoned with, and could be a real strong contender to win his very first Best Actor trophy. Scorsese’s very deserving Best Director nod comes as no big surprise, even though he was ignored at the Globes.
Outstanding Performance by a Male Actor in a Leading Role: Matthew McConaughey (Dallas Buyers Club) Outstanding Performance by a Female Actor in a Leading Role: Cate Blanchett (Blue Jasmine) Outstanding Performance by a Male Actor in a Supporting Role: Jared Leto (Dallas Buyers Club)
Gravity Alfonso Cuaron’s space drama has been a massive hit, and most, if not all, technical achievement awards should be going to the variuos departments that worked as a part of this film (production design, sound editing, sound mixing, visual effects, cinematography, film editing). Sandra Bullock also made the shortlist for Best Actress, whereas Cuaron himself is up for Best Director. Ten overall, tied with American Hustle.
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theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
ward nominations Dallas Buyers Club
Her
Although sadly snubbed by the BAFTAs, across the pond both Matthew McConaughey and Jared Leto are winning rave reviews for their exceptional performances, and Leto is almost certainly walking away with that Best Supporting Actor trophy. McConaughey has been transitioning successfully to more serious roles, and a possible Best Actor win this year will further cement his credibility as a more versatile, defined actor.
Yet another film that was entirely ignored in the U.K. BAFTAs, but there is enough love for Spike Jonze’s new quirky romanticcomedy as evidenced by the five nominatinos it did receive at the Oscars. A wonderful blend of science-fiction and rom-com, Joaquin Phoenix excels as he falls in love with a computer operating system sweetly and elegantly voiced by Scarlett Johansson. It’s thought-provoking and undeniably moving.
Philomena
Blue Jasmine
The big surprise at the announcement of the Oscar nominations was just how many awards the film was nominated for. Four in total including one for Best Picture, the Harvey-Weinsteinbacked film was clearly a hit with the voters and Dame Judi Dench is in the mix for Best Actress. Steve Coogan also has a reason to celebrate with his Best Adapted Screenplay nod, whereas Alexander Desplat’s wonderful score also got in.
Cate Blanchett would be wise to start preparing her acceptance speech, as many agree that she is almost the dead-certain winner for the Best Actress category, for her towering performance in Woody Allen’s new film. Sally Hawkins bagging a Best Supporting Actress nomination was a surprise, but a good one, and the ever-so talented Woody Allen making an appearance in the Best Original Screenplay category is no longer a big surprise.
Nebraska
August: Osage County
Alexander Payne’s black-andwhite father-son roadtrip movie has largely been sidelined of late, but has certainly racked up nominations here, for Best Picture, Best Actor (Bruce Dern, also a winner at Cannes), Best Screenplay, plus a worthy nod for June Squibb in the Best Supporting Actress category as the best scene-stealer of the year. It’s a gentle, funny, nostalgic journey to the state of Nebraska and back that needs to be seen.
Meryl Streep has now been nominated 18 times over her career, more than any other actor. She is clearly showing no signs of slowing down and her phenomenal performance does indeed deserve praise. Julia Roberts is just as good, which explains her presence in the Best Supporting Actress race, although the other aspets of the film have fared less well. Two acting nominations, and nothing else, not even a Best Adapted Screenplay mention.
Captain Phillips
Snubbed
Although Tom Hanks missed out on his nomination as Best Actor (see “snubbed” section on the right), Barkhad Abdi’s Best Supporting Actor nomination is well earned for sure. Although Paul Greengrass’ thriller squeezed into the tight Best Picture space, the director himself wasn’t so lucky, although the writing, film editing sound mixing and sound editing departments made the cut, giving this still impressive six nominations.
Some were nominated, others were inexplicably left out: Tom Hanks, Robert Redford were both shut out of the Best Actor category, Emma Thompson missing out on Best Actress (Saving Mr Banks) is an absolute travesty, The Butler, quite the Oscar-bait, walked away with no nominations whatsoever, and Inside Llewyn Davis, the Coen brothers’ well-liked music drama only gained two nominations in technical categories.
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theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
He is a no one, a zero, zero John Park Culture Editor January for Hollywood is traditionally the cinematic dumping ground where all the trash goes to rot and waste away because there is no other suitable place for it all to go. The Texas Chainsaw Massacre 3D ended up here last year, and so did The Devil Inside in 2012, and Season of the Witch (remember that with
Nicolas Cage?) the year before. So it makes sense The Legend of Hercules made its way to the January release date, where it opened to abysmal numbers because clearly, no one was interested in watching a less than adequate, lazy rehash of a mythical hero. Thankfully the U.K. has a different system where award contenders are slowly released throughout December, January and all the way throughout February. Nevertheless, the film that is supposed to convince us that Kellan Lutz of the Twilight franchise (where he played a supporting character who barely registered) can carry a film on his own, is laughable at best and their efforts, poor. In an attempt to reimagine and reinvent the hero, the film brings in and badly copies elements from memorable hits Gladiator and 300. The trouble is, those films did it much better than the poor execution that is given here. The grand CGI-designed audience we got in Gladiator as Russell Crowe stepped into the ring to fight? It’s looks like a cheap, pirated knock-off as Hercules prepares to draw some blood. The worst kind of visual effects is seen at the very beginning, where the film can’t seem to decide whether this is a live-action
film or a poorly drawn animated one. It’s that bad. Sudden slow-motion choreography technique in its action sequences that director Zack Snyder is so fond of? Here, it’s an embarrassing ploy to make something out of its monotonous, interchangeable action scenes. The slow-mo also captures Lutz in his more embarrassing facial expressions, those that generate laughs rather than convey intensity. Plus it looks extra ridiculous in its desperation to not show any blood ever, something that was done to lower the age restriction imposed. As if that helped with drawing in the crowd. Even teenagers have standards these days. When something looks this tacky, not even fanboys can get excited. Plot-wise, Hercules (Lutz), the demi-god son of Zeus and a human mother, is betrayed by his human stepfather and looks for revenge and on the way he meets good guys and bad, tries to make some clunky, inspiring speeches, makes us laugh instead (at him of course), and yes he meets a pretty girl to keep him company in the most PG-13 way possible. He also has a jealous brother who means trouble and starts flirting with the girl Hercules wants.
Led by Lutz who has the right physique but wrong everything else, everytime he speaks and tries to sound serious it’s difficult to take him as a genuine, convincing leading man. Where’s the grit? Where’s the rage? Where’s the heroic stance every sword-and-sandal epic needs? The very thing that makes an ancient action/adventure is missing, and the grandeur and gravitas that go with leading characters are nowhere to be seen. But it’s not fair to only pick on Lutz. The rest of the cast is just as atrocious, if not worse. The love interest created here is embodied by the bland Gaia Weiss who shares no chemistry with the leading man, the villains have very little to show for themselves which make the many showdowns very disappointing to watch. Luckily/unluckily (delete as appropriate), there’s another Hercules film coming, this time led by the mighty Dwayne “The Rock” Johnson. Perhaps his time served as the Scorpion King will do him some good. It’s been designed as a summer blockbuster and flashes a better cast and bigger budget. Whatever the case, it cannot be worse than what was dumped in the cinemas at the very beginning of 2014.
Rocky Balboa and Jake LaMotta have sure aged John Park Culture Editor There is an alarming trend in recent years where older actors who have done much better are put in thankless roles where the main source of attempted humour stems from everyone pointing out just how old they are. When the Lethal Weapon franchise tossed the line “I’m too old for this shit”, imitators soon followed and 2013 alone saw Red 2 (meh), Stand Up Guys (terrible) and Last Vegas (bad) that tried to make something funny out of aged actors. 2014 kicks off with yet another tiresome example of legends doing less than mediocre work in Grudge Match, with its
leading stars taking jabs at one another for their lack of youthful skills and fitness. When two retired boxing legends with stalling careers who have a score to settle, are placed in the ring for a final showdown that will determine once and for all who the ultimate champion is, Henry “Razor” Sharp (Sylvester Stallone) and Billy “The Kid” McDonnen(Robert DeNiro) put
their gloves on for the first time in many, many years. There are insults, trash-talk, and a lot of verbal comeback, but frankly very few of these actually manage to stick and what’s disappointing is the sporadic nature of the comedy aspect of the film. Alan Arkin has played so many snarky, old, grumpy, straight-talking men in the past that he’s been in similar, much
better roles in the likes of Argo and Little Miss Sunshine, whereas the generic words he has to spew out are both unfunny and frustratingly unsatisfactory. But when it comes to being grumpy, no one has repeatedly played the same type more than De Niro who seems to be getting cast in every single shade of grouchy old retired men reluctantly trying to recapture their youth and glory days. The casting doesn’t get any more generic and predictable than this. The plot is meandering to say the least until they actually come to the final fight, as there appears to be some personal drama between the two boxers. Sally Rose (Kim Basinger) is the woman who came between the two of them, which makes them
hate each other even more, although given how thoroughly wasted Basinger is here, the little sub-plot again fails to add any appealing material to the worryingly thin script. When the film decides to give its flimsy humour a rest and actually get down to have a true heart-to-heart with the veterans, that’s when it finds some peak moments. Its quieter, more sombre moments bring out the more thought-provoking sides to the two rivals that allow the two actors to have their brief moments to shine. Small scenes however cannot make up for the rest of the film that is clearly misjudged and badly planned out. Plus, seeing the two of them with their shirts off? Oh it’s not a pretty sight.
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theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
Every man has his secret sorrows Zara Zeb Doctors Mess Editor Depresso, a graphic novel by Tom Freeman, takes us on a journey with Brick as he battles his demons, the welfare office, and the NHS. Brick, a graphic artist creating satirical images for tabloids, wakes up one day with excruciating pain in his testicles. The pain is unbearable, he loses his libido, he can’t sleep, he loses motivation and becomes a couch potato, he gets angry easily, he alienates his friends, and starts seeing a giant talking lizard following him around. Convinced he has cancer, he avoids visiting the Doctor or telling his partner. Eventually, making his way to the Doctor, Brick is diagnosed with depression and prescribed medication. Despite being diagnosed and medicated, Brick hides away unable to work, and accurately depicts his inner turmoil. With a supportive partner who’s been through a rough patch in her college years, Brick has some
support, yet feels isolated. Deciding to go away with his longterm partner, Brick experiments with alternative treatments such as the balance of the mind and body being achieved through foot massages or meditating to achieve an enlightened self. Neither the Western medications (of which he’s tried more than four by the end of the novel) nor the Eastern therapies work. Freeman (a.k.a Brick) dots statistics and facts about depression and the NHS system throughout the novel. Did you know GPs in the UK cannot access mental health services directly? Throughout all this, Brick joins
NHS waiting lists for therapy, gets assessed and joins another waiting list. By this point it’s been a year or so since he was diagnosed and he has yet to receive any therapy. Brick dedicates a few pages to explaining the chemical processes of Serotonin and what the anti-depressants hope to achieve in layman terms. At one point, Brick talks about the current anti-depressants on the market not being any more effective than placebos: this message I found unjust. Anti-depressants do not work for everyone, and current guidelines advise against prescribing anti-depressants to those
mildly depressed. But for those who are moderately to severely depressed, medication can and does help. Medication does not “cure” but it allows a patient to manage their symptoms and try to recreate a life. Through the downs, and the lower-than-downs, Brick accurately depicts the feelings of helplessness, isolation and vicious cycle that depresso’s go through. Then one day, bit by bit, Brick starts doing things again: he manages to step out the front door, he manages to mow the lawn, and he manages to talk to people. He’s still experiencing his lows, he’s not bet-
ter, but something has changed. Spanning several years, the novel follows Brick as he tries to go back to some normality. By the end, Brick is on the road to recovery and content with being ‘Bonkers’. Having been there, and still being there, Depresso is the first piece of work where I’ve thought the artist has managed to capture what depression is like yet still inspire hope that it will be ok even if we depresso’s are bonkers. Of course depression is different for each patient, but the lack of motivation, the alienation of friends, the isolation, the lizard that hangs around, the good days and the bad days are all common themes. As a patient this novel accurately depicts how depression can affect everyday life, and for those who have to worry about work, money, NHS waiting lists, and doctor’s over-eager to prescribe, this book is a great insight. I strongly recommend everyone to read this as we will all know someone, if not treat someone, who has depression.
The Other Hand - Chris Cleave Ashra Omr Guest Writer The whole point of a blurb is to provide a short description about the book. The blurb for The Other Hand doesn’t. However, it does leave you stumped and eager to discover the story within. You are only aware of two facts: “it is extremely funny, but the African beach scene is horrific.” In my opinion, only half of that statement is accurate. The story is written in dualnarrative by a 16-year-old Nigerian refugee called Little Bee, and Sarah, a magazine editor from Surrey. Their two worlds collide one fateful day on a beach and from there begins this emotional and heart-rending journey. What should have been a romantic walk with Sarah and her husband Andrew turns into a moment of fear and fright with the appearance of Little Bee, her sister, blood-thirsty soldiers and
a machete. And in this instant, a link is formed and their lives change forever. Two years later, Little Bee is on her own little journey in England. Having travelled halfway across the world in a cargo ship, with just the memories of the past to haunt her, Little Bee finds Sarah. That microscopic link between them will gradually grow and strengthen as they seek solace in each other. Little Bee has hopes for globalisation and freedom for a country where every day is a blessing to live. While Sarah faces a daily battle with her troubled marriage, her young child and haunting recollections of the past. At a time when all hope is lost and the odds are against you, Little Bee and Sarah need each other more than ever. She may have escaped the harsh and brutal environment of her homeland, but can Little Bee truly ever be safe? She has fled a country from malicious
people who want her dead, only to find herself in a place where she legally does not belong. You will find yourself gripping onto this book tightly until the very end. Each chapter brings about new conflict that will desperately keep you reading on until it resolves. But you will soon find out that true peace is only sought at the end. Cleave effortlessly combines two very distinct ethnicities and entwines their lives into one. His way of integrating vital issues such as globalisation and immigration within a story allows you to understand the struggles faced by millions across the world. The sheer innocence of Little Bee fused with the determination of Sarah is enough to form an instant attachment with these two. By reading both perspectives you get a deeper understanding of their lives and struggles. One hopes to erase the pain of the past while the other yearns to create a better future.
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theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
How the mighty have fallen: Simon Boyd Special Guest Writer As everyone clamours to give their opinion on the Oscar race, another smaller event takes place the day after celebrating the worst of cinema from the past year. The Razzies are The Joker to the Oscars’ Batman. It is in its 34th year now and whilst I disagree with some of the Oscar nominations (No hair and makeup nomination for American Hustle?!?!?! That was the best part of the film!) I generally find the Razzies to be pretty spot on. So settle down, have a nice cold pint, and join me in discussing the worst and wait for all this Oscar stuff to blow over.
Worst person in film of the year Shia LaBeouf There is just so much to hate about this guy that it almost feels like he’s doing a Joaquin Phoenix and this dickheadedness is part of a secret documentary he intends to release. Alas, it probably isn’t His career just stumbles from one piss-poor decision to the other. Helping Michael Bay make action films dull, ruining the Indiana Jones franchise (it still
hurts), making Keanu Reeves seem energetic and exciting next to his no-note performance in Constantine. Not just comfortable to commit these crimes, he now commits plagiarism on just a grand scale that scientists are working to use his conceited grandiose feelings of self importance as a new form of clean energy. To paraphrase what happened, he showed a short film at Cannes Film Festival which he had directly lifted from a comic by David Clowes. It wasn’t just that there were similarities, the shots and direct text were used, and he didn’t even credit the author, let alone pay him. He did make two changes, he changed the word “muffins” to
“cookies” and a reference to the French film Le Mepris to Shakespeare in Love. Do the cookies give some hidden symbolism? Do they highlight a nuanced side to the character that we would have otherwise missed? No, of course they don’t, but at least he made the film reference less obscure to help the philistines at Cannes Film Festival, you know, one of the most respected film festivals in the world. So what happened next? Did he apologise? No, his use of double-speak and convoluted language in his “apology” would give Malcolm Tucker a wet dream. The apology itself was directly lifted from a post on yahoo answers!!! (I think the question was - “How can I make
myself look like an utter tool”). Later he hired a skywriter to post a message of apology over LA, which for the record, isn’t where the author lives. Things are bad when you can afford to pay someone to literally carve a message into the skies but you STILL won’t pay the creative force of your latest project. I won’t even go into his interview where he claimed “authorship is censorship” or his repeated posting of apology tweets copied from other famous people. I think the best way to solve this problem would be for the Razzies to now use a golden statuette of a naked under-endowed Shia as their new award, and have his name legally changed to Shia LeTw*t.
Worst actress/Worst director/Worst picture/Worst Screenplay/ Worst Screen combo (shared with that worn out and wig and dress) Tyler Perry A Madea Christmas Tyler Perry is one of those special cases where he gains some real box office success, despite an utterly dire back catalogue of terrible comedies. His hackneyed and tiresome jokes only serve to provide ammo to closet racists – the type of people who will clutch their wallets when they walk past a black person, whilst claiming “I’m not racist, I’ve got black friends” referring to that one guy they chatted to in a pub because they thought he was a drug dealer and wanted a cheap deal on coke. He’s of the school of filmmaking, championed by the Wayan brothers and Eddie Murphy, that seems to believe actor + fat suit = comedy gold. It doesn’t; the “jolly fat man” cliché only worked because of the air of self depreciation the character had. If it was that simple, then Airplane! would comprise entirely of Leslie Nielson frolicking in the aisle as his large gut bounces against the annoyed faces of passengers. Every version of the Madea franchise rehashes the same jokes in increasingly rubbish scenarios. Perry is the kind of director that almost aims to be on the Razzies hit list, and I will be hugely surprised if he doesn’t pick up at least a couple.
Worst Supporting Actor Chris Brown Battle of the year. Chris Brown is a detestable individual in need of a smack in his smug annoying face. However he is just too much of an easy target, so anyone writing with any self-respect should just leave such a joke of a person alone, luckily that doesn’t include me. His terrible music sounds like a Flight of the Conchords pastiche but without any of the wit, he’s a woman-beater without any remorse, and he’s arrogant without any discernible talent. The film is another dance flick, and in all honestly, I really like dance films (the Step Up series is great). The plot is dull, the dialogue is at best - crap, and Chris Brown is as good at acting as he is at feminism. Dirty Dancing, it is not. If the Houseman family were in it, they shouldn’t just put baby in the corner, they should take her outside and do the only humane thing by putting a bullet through her head so she doesn’t have to witness the appalling combination of a ropey script with a man who makes Tyler Perry look like Hitchcock.
theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
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: the worst offenders of 2013 Worst Picture/Worst Actress (Halle Berry)/Worst screen combo (entire cast)/ Worst Directors (all 13 of them)/Worst Screenplay Movie 43 I really, really like anthology films, partly due to my short attention span but mainly due to the endless opportunity they give the writers. Try an idea with a strange premise, run with it as far as you can, then wrap it up and move to the next one. Much like grapes they are the food of endless opportunity, don’t like the current one? Its fine! Just move onto the next. So I was really excited at the prospect of a comedy by the Farrelly brothers, crammed with major Hollywood elite – Richard Gere, Kate Winslet, Dennis Quaid etc. One reviewer succinctly described it as “The Citizen Kane of bad movies”. What is so fascinating is how it was made and signed off. I don’t know what dirt The Farrellys’ have on half of Hollywood but it must be some truly degrading stuff involving cattle and sex toys if the performers would rather be associated with this hokum. It’s a gross-out comedy but without the comedy, and it’s mainly upsetting – Hugh Jackman licks soup off a pair of testicles that he was born with attached to his chin, Anna Farris is a coprophiliac, Chloe Moretz is terrified by her first period and trails it around a kitchen. Twice through the whole 90-minute running time I thought in my head “OK, I guess that’s kind of funny” but that was it. I’ll admit it is kind of fascinating to watch, but it was a large effort to watch all of it in one sitting so I split it over three viewings. This HAS to win worst directors at the Razzies because it’s almost quite an achievement to waste this much potential.
Worst Prequel, Remake, Rip-off or Sequel Scary Movie 5 Who is still funding this franchise? Or more importantly, who is still going to see these films? It annoys me that this has become the norm for spoof films. Blazing Saddles, The Naked Gun series, and more recently Shaun of the Dead are REALLY funny. They are good because the writers really understand the original genre, they know the tropes, what we love about the classics and how to poke fun at the plot holes. This new breed of “(insert genre) Movie” don’t actually contain any jokes, which isn’t really good for a comedy. I haven’t seen all of them because I’m not a masochist, but all of the scenes are the same, the script usually goes “Oh no is that the ghost of Charlie Sheen?” “I am Charlie Sheen, watch me recreate a scene from Paranormal Activity whilst farting” “Is that one of the Kardashians?” “This is crazy, mega lolz!!!!!!” One of the previous films actually had a scene where they referenced Little Miss Sunshine by having a character where a t-shirt with the film name on, AND THAT’S IT! It wasn’t mentioned, the character had nothing to do with the film, and then they disappeared. I watched that scene three times, desperately trying to find the satirical point before my flatmates found me in the foetal position surrounded by scrawled notes with various conspiracy theories demanding they hand me the Zapruder footage.
Biggest hypocrite of the year Spike Lee Oldboy Spike Lee has done some incredible work, his portrayals of black culture are the antidote to Tyler Perry’s tripe, and I have a lot of respect for him. He is quite vocal about his belief that white directors don’t always “get” black culture and there are many mainstream films with barely concealed racist stereotypes (I’m looking at you Star Wars prequels). However if you are going to put personal ownership on culture (which again, I can definitely respect) then don’t painfully force one of the finest works of Korean cinema into an American setting. Oldboy is my single favourite film of all time and, quite simply, it just doesn’t work as an American film. The cultural cornerstones that make the original so rich and affecting just simply don’t translate to a Western setting. Large parts of the remake are set in Chinatown which doesn’t really make sense, if you want to remake a film in another language then the film needs to be infused with the setting. Instead it’s just a cop-out of trying to do a halfway house of Asian and Western culture. Worse still, the title card says the film is “based on a South Korean film”. Not “based on the original manga” or even “based on the work of Park ChanWook” just a vague indication that it’s from some foreign thing but subtitles are like totally lame so we took out all the funny speaking and made it English.
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theMEDICALSTUDENT /February 2014
Culture Editor: John Park/culture.medicalstudent@gmail.com
Do you hear the people sing? Zara Zeb Doctors Mess Editor If you haven’t seen Les Misérables (Les Mis) in theatre, go see it. If you’ve seen it already, watch it again. A review cannot do this amazing production justice. By far one of the best WestEnd shows I’ve seen, it’s clear to see why it’s been running for far longer than I’ve been on this Earth. The story on the surface is far more complex than an average show, but delve a little deeper and anyone who enjoys thinking will be overcome with the messages about identity, society, and redemption that are portrayed. Every word is sung, and the movie released not so long ago is exactly like the theatre show, but with a smaller cast, fewer props, and a tinier budget, the theatre production is better than the movie. The show starts in early 19th century France, in a prison camp, where Jean Valjean has served nineteen years for stealing a loaf of bread for his starving sister’s child and consequently trying to escape. He’s handed his parole by policeman Javert (remember the name) whereby he has to check in with the authorities every so often. Valjean soon finds that being an ex-convict on parole means no one wants to employ him, and when he does find work, he is often underpaid. Unable to find a place in society, he steals from a Bishop and is caught red-handed by the police. The Bishop lies and saves him from imprisonment. Inspired by this act of mercy, Jean vows to be redeem himself. He breaks parole and disappears from the authorities. Fast forward eight years, Valjean is a wealthy mayor with a new identity. With his power, and with his new identity, Valjean has managed to carve a new life for himself, and is clearly one of the few people in 19th Century France who gives people a chance. The play then switches to focus on Fantine, one of the workers in Valjean’s factory. Fantine draws sexual attention from the foreman, denying his advances, much to the jealousy of the other workers. When a co-worker discovers
Fantine has an illegitimate child who is cared for by an innkeeper and his wife, they demand she be dismissed, much to the foreman’s pleasure. Fantine is unable to find work and having sold what she can, turns to prostitution. One day Fantine refuses a customer, and when she strikes him, a policeman, Javert, comes running and arrests Fantine. Javert sees prostitutes and convicts as scum, a product of his society. Thinking he is upholding the right way, Javert is the perfect policeman. The Mayor so happens to be walking past, sees the commotion and finds out Fantine was his employee until she was unfairly dismissed. Feeling responsible, Valjean orders Javert to release Fantine and take her to hospital. Valjean has now been bought to Javert’s attention, and Javert begins to suspect Valjean may be the prisoner from so long ago who broke parole. At the same time, another man has been arrested accused of being Valjean; unable to live with the guilt of letting an innocent man go to prison on his behalf, Valjean confesses his real identity at the trial. Anyone would think it was a no-brainer, letting someone else take the rap so he could live in peace, but Valjean is torment-
ed by who he would be, what sort of person he’d be, if he saw an injustice that involved him, and stayed quiet. This is one of the songs that really makes me think about who I am and what I stand for. Meanwhile, Fantine is at death’s door, and after Valjean promises to take care of her darling Cosette, Fantine dies. Javert now wants Valjean back in prison, believing convicts can never be reformed and society will never be safe with unhonest men on the streets, and so begins hunting Valjean down. Fast forward another nine years, Paris is experiencing unrest with students plotting a revolution. Valjean has been raising Cosette hidden from the authorities. On his usual rounds of giving to the poor, he is identified by the old innkeeper who used to look after Cosette. Having lost his inn, the keeper, his wife, and their daughter Éponine are on the streets trying to con rich men like Valjean. Éponine has a thing for one of the students called Marius, but on this day, Marius bumps into Cosette and falls in love with her. When the innkeeper tries to rob Valjean, the policeman Javert turns up and breaks up the kerfuffle. Valjean and Cosette sneak away, and the
innkeeper tells Javert of Valjean’s true identity. Javert now aware Valjean is back decides to hunt him down. Meanwhile Marius asks Éponine to help him find Cosette. The story has so far touched on identity, reformation, societies’ duty to the poor, and is now bringing in the typical love story, as if it wasn’t complex enough! Although Valjean has had the opportunity to start again, there are countless others like Éponine born into a poor home with a terrible upbringing and no escape. We soon learn about a bunch of students planning a revolution – ordinary people like us (albeit very wealthy living in a time when they could flirt with radical principles or idealise a concept they didn’t truly commit to), planning on challenging the societal norms. Marius meets Cosette with the help of Éponine and they confess their love for one another. Éponine, heartbroken, stops Cosette’s home being robbed by screaming, causing Valjean to think they are being robbed which leads to Valjean packing to flee the country with Cosette. In Act II, we start with the revolution the students had been planning. Éponine has disguised herself as a boy to join, and Marius asks her to deliver a farewell letter to Cosette. Valjean reads the letter and learns of Cosette’s and Marius’ love, causing Valjean to go to the barricades to meet Marius. Meanwhile Javert enters the barricades as an informer and says the police are not planning on raiding that night, but when his identity is revealed, the students tie him up. The first loss of life at the barricades is a touching affair – I won’t reveal who, but many people die that ‘night’ in a dramatic shoot out. With gunshots, lighting effects, and excellent slow motion action, the scene is chaotic and harrowing, as it no doubt would have been in a real revolution. But I get ahead of myself. Valjean arrives after Javert has been detained and after proving he is not a spy, the revolutionary students allow him to dispose of Javert as he will. This is Valjean’s chance to finally be rid of the demon Javert who won’t let him live in
peace. Javert symbolises the society expectations and thinking, not making him a bad person, but making life incredibly difficult when society’s standards are not met. Valjean helps Javert to escape even though Javert vows to hunt him down. Valjean simply lets him go and praises him for doing his duty, accepting society is society, for better or for worse. After the shootout, Valjean carries Marius’ body through the sewers. Whilst Valjean sleeps, a robber (the innkeeper who is where he belongs, the real dirt who is embraced by society while Valjean is rejected) steals Marius’ ring. When Valjean and Marius reach the sewer exit, Javert is waiting. Valjean begs Javert to allow him to take Marius to a doctor, and Javert agrees, but Javert cannot match Valjean’s mercy and kindness with the image of the convict he has in his head. Shaken by the principles he’s lived with his whole life and his duty to bring Valjean to justice, Javert makes a choice (SPOILER!). If society were ever to ask itself the same probing questions Javert faces, it too would realise that it has to make a choice, and will probably make the same choice as Javert. Back in real life, Marius has no idea who saved him. Valjean confesses he is a convict to Marius but Cosette must never know, gives the love birds his blessing and disappears back to the convent where he vowed to be a good person many years ago. Marius and Cosette go on to marry, but at the wedding ceremony the innkeeper turns up with his wife. The innkeeper intends to blackmail Marius, but it backfires and Marius realises it was Valjean who saved his life on the night of the revolution. The newlyweds race to Valjean in the convent who is on his deathbed. If the audience wasn’t crying by now, the final scene could wring a tear out of a stone (except for me as I can keep my composure; silly theatre go-ers). Valjean is finally absolved and finds peace. A truly remarkable show which should be on top of everyone’s must-see list!
The Doctors’ Mess
Scavenging in London - Hidden City Evening Trail
London has a lot to offer, and it doesn’t have to be pricey. HiddenCity have no way asked us to review their business, but having lived in London for 3 years now, finding student friendly bargains always makes me praise any business. HiddenCity offers a scavenger hunt around London for the bargain of £16 PER TEAM. They have nine hunts situated in various parts of London with flexible starting times. For most hunts you don’t need anything except your eyes, good company, and a camera. They also recommend a map of some sort, but with those London maps every 100m
or so, you could be plonked here from Mars and still complete a trail. Don’t get me wrong – it is not necessarily easy – the clues require good ol’ brains and observation. I did the City Lights Scavenger Hunt with a group of four. The way it works is you register online, and then when you’re ready to play you simply send them a text saying START. They ping you your first clue immediately. All the clues were easily solvable after much thinking. When you have worked out the answer/ reached your destination, you simply text them
your answer, and they text you the next clue assuming you are correct. For every incorrect answer there is a 10 minute penalty (first one being free). You can also ask for hints if you get stuck, with hints costing 10 minutes penalty as well (first one being free).
it’s a nice way to spend a few dencity.com. hours, or a good portion of the day if you want to take a break Happy Hunting! and go shopping or come back to it the next day. If you’ve seen a London bargain, get in touch and let us For friendly fun, you too can know! hunt by visiting www.inthehid-
The trail took me to parts of London I’ve raced through and made me slow down and appreciate the history around me. It also took me to parts of London I never knew even existed. The scavenger hunt was a great way to test my riddle skills, my observational skills, my London knowledge, and bring out the competitive edge! You don’t win anything but every team who takes part is ranked on the website and simply being number one is motivating enough. Regardless of where you come,
History Corner - Lister, the pioneer of antiseptics It’s hard to imagine a ward, let alone an entire hospital without a sink to wash your hands in. Such was the environment into which Joseph Lister entered when he started as a houseman. Lister studied medicine at UCL, not only because it is a fine medical school, but because he was automatically excluded from Oxford, Cambridge and KCL since he was a Quaker. He completed his first house job in 1853 at what is now UCL’s Cruciform building, but was then known as University
College Hospital. He soon moved up to Scotland and began work at the Glasgow Royal Infirmary to begin his surgical career. Here he had first hand experience of the traumatic nature of even the most basic surgical procedures. Amputations carried a 60% survival rate, and abdominal operations were seldom attempted since a catastrophic sepsis was almost guaranteed. With Glasgow being an industrial city, compound fractures were commonplace, which provided an ideal en-
vironment for Lister to carry out a primitive trial of repeated experiments. He was greatly influenced by his contemporay, Pasteur, who was one of the key figures in dispelling the idea that infection was due to wound oxidation or ‘spontaneous generation’. One of the first compounds he used as an antiseptic was carbolic acid - a coal tar derivate. This was placed on the instruments and put on the patients wounds. After some initial failures, gangrene rates in patients declined steeply, even though chemical could
damage the body’s own repair mechanisms. This success resulted in Lister instructing all the surgeons under him to wear gloves for the first time, and they were required to wash their hands with 5% carbolic acid prior to operations. The move resulted in a sharp decline in post-op mortality and results were subsequently published in The Lancet. From this point onwards the ‘germ theory of disease’ took off and has since then formed the basis of our understanding of microbiology.
Comics
theMEDICALSTUDENT /February 2014
Prize Crossword Causes of Joint Pain
Doctors’ Mess Editor: Zara Zeb/ mess.medicalstudent@gmail.com
Diagnostic Corner 1. Which hypoadrenalism symptom below distinguishes between primary adrenal failure and secondary pituitary adrenal insufficiency? a. Weight loss b. Fatigue c. Skin pigmentation d. Hypoglycaemia 2. Which hormone deficiency causes most of the symptoms of adrenal insufficiecncy, such as weight loss and hypotension? a. Cortisol b. ADH c. ACTH d. MSH 3. A 32 year old male presents with a headache lasting 3 days. CT scans showed a normal brain. A lumbar puncture performed showed a very high CSF opening pressure. RBC is high in the first tap and normal in the second. What is the most likely diagnosis?
ACROSS 2 Chronic disease characterised by stiffness and polyarthralgia which worsens when waking up in the morning along with finger deformities, e.g. zshaped thumb (10, 9) 4 Possible diagnosis where there are signs of polyarthritis in children (6, 7) 5 Cause of hot, painful knee following an injury more common in children (6, 9)
DOWN 1 Inflammatory disease with sacroilitis as a complication (6, 7) 3 Chronic disease characterised by stiffness and polyarthralgia mostly worse at the end of the day, relieved by rest (14) 6 Cause of pain and swelling in the knee and wrist of elderly female patients; X-ray reveals calcium deposits (10)
7 Pain and stiffness in lower back radiating to lower limbs, especially in the morning with characteristic lack of lumbar lordosis and accentuated kyphotic spine (10, 11) 8 Bleeding into a joint following an injury (13) 9 Drugs that precipitate an attack of gout (9) 10 A likely cause of painful, red, hot, swollen big toe (4) 11 A patient with a history of painful distal interphalangeal joints of the hand and also skin rasj with salmon-pink plaques (9, 9)
a. Tension headache with traumatic lumbar puncture b. Sub arachnoid haemmorhage c. Stroke d. Benign intracranial hypertension e. TB meningitis 4. A patient is suspected of having an unknown primary malignancy. Which three tumour markers would you initially test for? a. Beta HCG b. CA 19-9 c. AFP d. CA 125 e. Thyroglobulin f. PSA 5. Which cancer does AFP test for a. Prostate cancer b. Choriocarcinoma c. Hepatoma d. Cervical cancer 6. An 83 year old female presents at A&E with her first epileptic seizure while watching TV at home. She is not currently on any medication. Her BP is 182/102. A blood test reveals a low sodium count at 129 mmol/l. An X-ray shows an ill-defined lesion in the left midzone. What is the most likely aetiology of her seizure? a. Brain metastases b. Hypercalcaemia c. Inappropriate ADH secretion d. Idiopathic epilepsy
Questions adopted from http://www.medicaleducator.co.uk/ Answers: 1 C. 2 A. 3 D. 4 A C F. 5 C. 6 A.
Congratulations to Kezia Smith from King’s College London for winning our Prize Crossword: Causes of Rashes ans Lesions in our January issue! For your chance to win a copy of Clinical Skills Explained (currently costing over £28 from Amazon) provided by Scion Publishing Ltd, simply send a photo of your completed crossword to doctorsmess@themedicalstudent.co.uk
It’s already February! Only 4 months left of the academic term! So why not contact me and get some of your work in our remaining issues? Doctors’ Mess would love your elective photos, your articles, or to answer any questions you may have. Please drop me a hello, ask me questions, or send all your contributions to doctorsmess@themedicalstudent.co.uk.
[SPORT]
theMEDICALSTUDENT / February 2014 Sports Editor: Mitul Patel
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“Bro, do you even Kabbadi?” Govindpal Singh-Kooner Guest Writer Many readers of The Medical Student will have a sketchy or non-existent knowledge of the sport called Kabbadi. Even some of those of Indian descent may have a knowledge limited to glimpses of the game in Bollywood films. Kabbadi is fast growing as a sport in the UK and in West London, Imperial College Kabbadi Club (ICKC) celebrates the first anniversary of its competitive debut this month. ICKC was founded at the close of the 2012-13 academic year. The driving force behind the team, Keshav Gupta, was a second year medical student at ICSM at the time and is now president of the club. The club started as an un-
mil for ‘holding hands’, and the sport is popular within Tamil speaking states of India as well as being the national sport of Bangladesh. In additon, the sport is gaining popularity in the UK. The England Women’s team has been well established for some years, and the sport is regularly played in the British Army. Last year also saw the development of the England Men’s Kabaddi team. Kabbadi received its first international exposure during the 1936 Berlin Olympics and the sport has not looked back since. Various federations are considering making Kabbadi a more permanent fixture in Olympic Sport as part of the
England national womens team in action
official group within the IC Hindu Society, but in order to broaden the appeal and satisfy the accelerating demand for opportunities to learn, participate and play Kabbadi, it was developed into an independent club. Significantly, independence from the cultural society opened the club up to members regardless of race, ethnicity or religious belief, to play for the small team in what is becoming a rapidly growing sport. The precise inauguration of Kabbadi is unclear but it originated from India. The word itself is derived from the Ta-
Olympics new policy to introduce a new sport at each subsequent games. The beneficiaries of such a decision are highly likely to be federations in Asia. The Asian games is the main platform for exposure where Kabbadi has been played since 1992. As one might expect, India won both the Men’s and Women’s tournaments in Guangzhou, China in 2010. The sport itself requires no equipment; 7 players per side compete in two twenty-minute halves. Teams occupy two halves of a small area, and take it in turns to send one team
member into the opponents half. The aim is to score most points by stepping into the opponents half and tagging or wrestling as many players as possible and make it back into your own half in one breath, which is proven to officials by chanting the word “Kabaddi”. The opposition can tackle you to stop you crossing half way line at any point. Tagged players are temporarily removed from the game, and if a player is removed then the opposing team scores a point. Simple. The underlying philosophies of the sport are as physical as they are tactical, and Gupta is not surprised at the way the club has grown at Imperial. “I’m really happy with the way Kabaddi has taken off at Imperial. Currently, we have squad of 18 with regular matches and socials. [We] hope to expand and develop the club into something even bigger and better known next year; and into a sport people know about in years to come.” ICKC boasts an impressive list of accolades which underline the work Gupta and his committee have achieved. They were crowned best Kabaddi Team in London at the NHSF London Zone Sports Competition in November 2013 defeating Portsmouth, LSE, Hertfordshire and King’s College. It is an impressive feat for a side that only debuted twelve months ago in the NHSF National Sports Competition, where they finished 2nd. Expectations are higher this year with the club now fielding two regular teams, both with impressive track records in the National Universities Kabaddi League (NUKL); the first team have won four out of five matches and the seconds have a 100% winning record. The NUKL itself is newly formed and is looking to expand to include more Kabaddi teams who often play un-
ICKC 1sts celebrate winning the NHSF London Trophy 2013 derneath culture or religious student bodies at their parent universities, and encourage them to follow in ICKC footsteps and become independent. The NUKL state that participation in the league as independent clubs would increase the popularity of the sport and provide financial incentive for the clubs concerned, Together with the work of the NUKL, the recent formation of the England’s Men Kabaddi team has brought about a surge in UK interest and the prospect of students graduating from their University Teams into a National Squad is not too farfetched. Gupta himself was contacted by the England Men’s Captain with the promise that ICKC members would be eligible for entering selection for the National Team. Moreover, their season has recently featured training sessions with England players and the club are also hoping to invite Ashok Das, England Coach, to host a session and potentially scout some players. The rise of ICKC could and should serve as an example not only for the cultural societies within UH, but medical
students all over the capital who would otherwise disband ideas of playing sport through lack of technical prowess in more popular fields such as football, netball, hockey or rugby. Furthermore, sports are only as popular as the players who take interest in it. All sports have to start somewhere, and whilst the short term future of the sport may continue to be dominated by players from the subcontinent, do not be surprised if your children or grandchildren come home mentioning the word “Kabbadi”.
[SPORT] /24
theMEDICALSTUDENT / February 2014 Sports Editor: Mitul Patel
RUMS Second Years Power to Smith’s Triumph Jacob Wilson Staff Writer
The Bill Smith’s Cup is an annual game of rugby played between the RUMS freshers and second years, and is steeped in history. Professor Bill Smith who taught at RUMS, was a huge supporter of medical school rugby, and was infamous for his bias in favour of rugby boys. He attended the annual match for many years before he sadly passed away. Wednesday 15th January saw the belated return of the traditional battle, and, as per tradition, the pre-game build up centred around terrible chat utilising social media sites. However, this author feels the freshers took an early lead through producing video propaganda entitled “show down.”
Thankfully, all the badinage was not thrown to waste thanks to RUMS Rugby President Kwame Asante, whose art of negotiating allowed the match go ahead at Regents Park despite groundsman deeming it unplayable on the morning of kick-off. A cheery crowd gathered eagerly for the start of the action at precisely 2.03pm. The bigger second years quickly settled and began throwing crash ball after crash ball at the nervous freshers. It took 15 minutes before their efforts were rewarded with a well worked try through the backs. The freshers, not to be deterred, admirably started countering with ferocious tackling as well as challenging the breakdown. A
series of infringements put the first years in good territory and ultimately they converted though Will “the pirate” Johnson. The remainder of the half saw the second years play a tight game, sucking in the less experienced freshers, and then utilising their pace on the outside to close the half on 12-5 after Sam Cullen converted. As half time beckoned, the usual port refreshments were dispensed along with worldly advice from those who have done their Bill Smith’s time. The second half begun with Moody being sin binned off the back of repeated infringements. The freshers however squandered the opportunity to take the lead and let in an-
other score unanswered, once more through fatigue. As time frittered by, injuries began to mount on both sides. In a momentary lapse of second year competence, the dogged freshers managed a score a wellengineered try, but this
was futile as second year Lawrence quickly darted through a seemingly tiny gap to score the final try; leaving the score at 29-10 and leaving the delighted second years to lift the cup.
ICSM Men blow UH away
Mitul Patel Sports Editor
The 2014 UH Winter Regatta is the first rowing event of the calendar year and a fresh opportunity for London’s medical schools to lay down a platform for the rest of the year. The headlines of this year’s instalment will be dominated by ICSM Men’s squad, who convincingly won both senior and in-
termediate categories on a blisteringly cold day in Mortlake, where the only thing that appeared to bring smiles to the competitors faces were the bizzare posts from the day’s Twitter master (@UHSprints). The regatta opened as always with the novice heats. Ultimate winners of the boys category, UCL, started
proceedings with a close fought victory over holders ICSM. They followed this up with a comprehensive thrashing over Georges in the semi-final, and a one length triumph against Vets in the final. Vets were given an honorary mention by virtue of being the top UH crew. Vets girls did brought
more New Years cheer by winning their novice division, after a one-length defeat of RUMS. Elsewhere, RUMS took the title off Georges by winning the Senior Women’s Category, whilst the South Londoners impressively won a three way final in the women’s fours category against both GKT and ICSM. The day however belonged to ICSM Men. Their intermediate crew held off Georges and RUMS en route to an audacious and borderline arrogant receipt of medals in the post-race ceremony, whilst their seniors underlined the dominance of UH in 2013-14 with comfortable victories over RUMS, GKT, and Georges.
Write for Sport! The Sport section is always looking for more writers to contribute to the paper, whether it’s match reports, important results, or just a sporting issue, if you’re an avid sportsperson email us at sport.medicalstudent@gmail.com