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URMUR Lent 2016, Edition 2

Photo credit: Maria Seago

www.cambridgemedsoc.com/murmur


Contents Opinion

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The Junior Doctors’ Contract Dispute – A Dissenting Voice

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The Junior Doctors’ Contract Dispute – What Can we do as Students?

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Adapting to a Life in Space

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Interview

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A Student Perspective on Mental Health

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A Guide to Choosing the Right Part II

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To BBS or Not to BBS, That is the Question

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Subject Responses

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Editors’ Note Dear readers, Welcome to our second edition of Murmur! We hope you all had a productive and enjoyable Lent term and are looking forward to the Easter holidays. Good luck to those of you sitting exams at the moment. This edition begins with two independent articles looking at different aspects of the junior doctors’ contracts dispute. On a more scientific theme, we have an interesting piece exploring the physiological challenges faced during life in space. Our interview section focuses on the mental health issues faced by medical students at Cambridge. Our next edition will expand on this important topic. Finally, with Part II choices looming, Murmur has compiled the thoughts of current third years into our Guide to Choosing the Right Part II. We hope you find this useful when making your decision.

The Editorial Team Petros Fessas, Maria Seago and Luke Bibby

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OPINION The Junior Doctors’ Contract Dispute – A Dissenting Voice

compromise patient safety. A more limited definition of normal working hours might be welcomed, though I think concerns about basic pay would overwhelm this small gain.

Jeremy Hunt may be wrong and we medics have a right to be angry, but we ought to be cautious not to create an echo chamber where misinformation can proliferate

A follow-up question asked in my interview was on whether I agreed with the specific decision made to suspend some emergency care in future strikes, given another emergency service (the police) cannot legally do this. Withholding labour is a particularly effective form of industrial action in the private sector, given that the revenue of the company in question is usually linked inextricably to its workers doing their jobs. However, the same cannot be said for a public body like the NHS. If doctors strike Jeremy Hunt, and the government more generally, is not harmed because the NHS is not their ‘business’ as such and they do not derive any direct benefits from it functioning smoothly. Most high-ranking ministers of the Tory government are very wealthy, so likely have private health cover and hence need not even worry that they or their loved ones might be harmed directly by a strike. The only group that can be harmed is patients and, though junior doctors have the noblest intentions to avoid future harm by taking part in strikes, there is no evidence that these actions give them any leverage whatsoever over the machinations of government.

At my interview for Cambridge’s Clinical School I was asked for my views on the BMA’s decision to hold strike action in protest of proposed changes to junior doctor contracts. Like everyone else with interviews for clinical school this year, I had tried to brush up on my knowledge of the situation the day before in anticipation of the question. Unless you’ve been living in a cave (or library) for the past few months and have just emerged, you are likely to be familiar with these so I won’t bore you with the details again. I would, however, like to share some heretical thoughts I had whilst mulling it over before and after my interview. My first thought was to do a ‘reversal test’, imagining what the reaction would be if the changes were made in the opposite direction. That is to say, what would people say if the new contracts were already the status quo and the changes would bring us to our present state? I don’t think it is controversial to state that an 11% reduction to basic pay would be met with fierce resistance. The compensatory rise in overtime pay would likely be viewed as a bribe for junior doctors to work unsociable hours. We might predict this would force doctors out of their normal work schedule just so they can make ends meet, and therefore

I believe that Jeremy Hunt, along with many ministers of the current government, are a danger to the NHS because of their explicit support for privatisation and worrisome legislation like TTIP. How-

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OPINION cal practice in the UK as a sinking ship entirely because of the spectacle of contract changes. Even if the proposals are brought in without further modification, the vast majority of doctors will find their pay unchanged or raised. From those I speak to little has changed in the field and the idea that doctors are in some sense ‘not appreciated’ by the government doesn’t seem to be well founded. Threats to leave for other Anglosphere nations are creating a culture of anxiety that drives others to do the same in a vicious cycle. I for one will not be pushed out so easily whilst I can contribute to building a better NHS.

Jeremy Hunt (Picture: PA Wire)

ever, I do not believe that the tendency towards character assassination of the health secretary is a constructive strategy for dissent. Much of the rhetoric directed at Jeremy Hunt implies that he is incompetent, which is unlikely to be true. A favourite point for mocking the health secretary has been his call for a ‘7-day NHS’, taken by too many as evidence that he believes the health service simply stops looking after patients during the weekend. Taken in context it should be clear that this is not what was meant, and he raises a legitimate concern held by many (myself included) that equal service should be provided all week round. Whether the changes he is trying to push through will achieve that is the only thing that should be controversial. In reality Jeremy Hunt seems to fully grasp the present situation, and to underestimate his ability is the real danger.

None of this is to say that the proposed changes should not be opposed - there is a great deal that is clearly bad, not least the reduction in time set aside for breaks during shifts - but merely that we should be more critical of both sides in a debate that is far from simple. It is easy to fall victim to status quo bias where any change is automatically viewed as negative, particularly if made by an unpopular politician, without considering it on its own merits. I’ve played devil’s advocate in this piece, but if I was a few years further on in my career it’s likely that I too would have joined the strikes. The best way to preserve and improve the NHS is to be constantly sceptical of what others tell you about it, and to reject sound-bites empty of any real content. With this in mind, I hope you apply that same standard to this opinion piece as well!

My final and most pressing concern is that the fatalism surrounding this situation will produce a self-fulfilling prophecy that truly threatens the NHS. Many friends, both medics and non-medics, now view medi-

Daniel Hurt, 3rd Year, Clare College

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OPINION The Junior Doctors’ Contract Dispute – What Can we do as Students? After months of negotiations, strikes, and legal disputes Jeremy Hunt has opted for the so-called ‘nuclear option’, vowing to impose the new junior doctors’ contract against the united will of the profession. The BMA has promised more industrial action, but it looks likely that junior doctors will soon be working under a contract that will prove unfair for doctors and unsafe for patients. What role can we as medical students play in this debacle? As we are not yet NHS employees, we have no paid labour to withdraw, but we can still play a crucial role in the ongoing crisis.

out controversy. In a letter sent to British medical schools, the Medical Schools Council reminded students to retain a “professional attitude” when using social media sites, a move which some took as a caution against protest. Though the exact wording of the letter was debated and later clarified, it is clear that the issue of professional image is on the mind of students wishing to protest the contract changes.

So much of the outcome rests on public opinion; Hunt has to balance his agenda against wavering public support. With so much misinformation being peddled by the press and politicians, it is our job to set out our criticisms of the new contract in a clear and reasoned manner. As a medical student my newsfeed is awash with statuses, videos and images setting out the flaws of the contract. It feels like a current and pressing issue, with almost all commentators rallying behind the junior doctor cause. Yet much of this is an artefact of the way social media works.

Similar tensions arise in clinical situations. As medical students we occupy a strange space between student and young professional, gradually developing into the demanding role of a junior doctor. To the public eye, the line between ‘student doctor’ and ‘junior doctor’ is often blurred, and many patients will quite understandably mistake us for qualified doctors. Whatever our perceived role, we undoubtedly have a responsibility to uphold professional values. On multiple occasions I have had these values thrown into confusion when patients have asked me about my position on the strikes. These situations present a conundrum. On one hand we might wish to generate public engagement with an

Social media sites act as an echo chamber, presenting us with views similar to our own while masking the true opinions of a general public who may have a more ambivalent attitude toward the issue. However, this online activism is not with-

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OPINION issue that affects members of our profession and puts patients at risk, but in doing so we can threaten the impartiality that is so central to professional conduct. This can be a balancing act. Medical care should always be provided to a high standard, irrespective of a patient’s political or religious beliefs, and those delivering the care should do so in a manner uninfluenced their own opinions. This is surely the central tenant of treatment under the NHS - free at the point of delivery, delivered without regard to a patient’s worldview or life choices. Yet it is these core values that can be threatened by structural changes that we have a duty to oppose.

paid work under the new contract, while being saddled with even greater debt than our predecessors due to increased tuition fees. Current doctors and teaching staff often tell us to think of our first day as a junior doctor. On that day we will continue using the skills and knowledge that we have honed during medical school, but we will suddenly gain a great deal of responsibility. With the threat of poorly regulated and unsafe working hours, this looming horizon can only appear more intimidating. There are, however, silver linings. As a group, medics often take their impartiality out of the hospital, remaining apolitical and quiet on controversial matters. The issue of junior doctor contracts has ignited debate within the profession, making us better aware of our rights and responsibilities, and more politically aware. There is a feeling that the disputes have fostered a sense of camaraderie amongst junior doctors and medical students alike, which will surely put us in good stead for any future challenges we might face working within an embattled NHS.

Despite these concerns about public support, it seems that the British public are resolutely on our side, with a recent poll showing that 83% of those questioned placed the blame for the crisis squarely on government action. But this does little to allay the situation; the NHS currently faces one of its greatest financial and staffing challenges, leaving many junior doctors demoralised and tempted by promises of better working conditions and higher pay abroad. Our generation of will be the first to enter

Tom Ronan, 4th Year, Trinity Hall

Adapting to a Life in Space apparent however that they are all in themselves scientific experiments just by being there and just as much when they come home.

Major Tim Peake is the only British astronaut currently on the International Space Station (ISS), orbiting the Earth 250 miles above our heads. The ISS is home to up to six astronauts at a time whose mission is to undertake a number of scientific investigations. It may not be immediately

All life on Earth has spent the last few billion years evolving with gravity as a fun-

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OPINION damental influence on physiology. It was only in 1961 that Yuri Gagarin became the first human in space and since the inception of the ISS in 1998, humans have spent continuous periods of well over a year in microgravity conditions. Never has evolution had to contend with rapid changes in gravity and so we are poorly suited to a life of being shuttled to and from space. In fact, the fluid changes, nausea and dizziness astronauts first experience in microgravity are collectively called “space sickness”.

Time Peake on the ISS – research doesn’t have to be at a lab bench! Credit: Tim Peake/flickr.com

life. We know that other sensory systems can adapt to chronic changes in input because they are plastic. It seems likely therefore that a similar “rewiring” occurs in the processing centres of the vestibular system which sets the new input as the new normal. Indeed, as astronauts return to Earth they experience dizziness and nausea again because their new model of interpreting vestibular inputs is wrong again.

On arrival at the ISS, astronauts experience a shift in extracellular fluids towards the head as the gravity, which ordinarily pulls body fluid towards the feet, becomes negligible. This causes initial facial oedema as capillary pressure in the face increases. Venous blood in the legs is shifted towards the heart and creates extra right atrial stretch, releasing ANP which causes a diuresis of around 15% of the total body fluid volume and red blood cell counts drop rapidly over the first hours and days. Returning astronauts are anaemic and dehydrated and often need salt supplements to replace the electrolytes lost by the diuresis they experienced on the ISS.

Changes to the musculoskeletal system are perhaps the best known changes astronauts experience in microgravity. Without having to support the weight of the body, the anti-gravity muscles (the legs and back in particular) atrophy. Some astronauts find coordination a challenge back on Earth, not because of the vestibular changes above, but because they are now experiencing the weight of their body again and have “forgotten” how to act against gravity. Some returning astronauts find it hard to speak normally and so perhaps the neural models which control patterned motor function have been remodelled to remove the anti-gravity

Microgravity also causes changes in the vestibular system as the cupulae do not experience buoyancy like they do on Earth. A disparity therefore is created between the vestibular and other systems assisting balance (e.g. vision and proprioception) and so nausea and dizziness are common on the ISS until after a few days, astronauts have adapted to weightless

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OPINION component which was not needed in space. In time, normal coordination and speech return however. Bone density decreases throughout the body after prolonged exposure to microgravity too (especially in the legs) because there is very little stress caused by supporting the body and walking. Astronauts exercise for around two hours per day on the ISS in an effort to mitigate these changes, although bone density still drops by one percent or more for each month spent in microgravity. A number of drugs exist to treat osteoporosis on Earth (e.g. bisphosphonates and denosumab) and perhaps a modification of the treatment regimen could be used to prevent reduction in bone density in microgravity. Vitamin D supplements are also given to astronauts because the ISS is heavily shielded against UV radiation. UV is needed for the endogenous production of vitamin D3 without which bone density would fall even faster. Pictures of astronauts who have just returned from the ISS often show them in wheelchairs because they are unable to support themselves, so exercise and physiotherapy are needed to get back into shape.

come much of a concern although any oncogenic mutations might take decades to manifest themselves. As the number of astronauts increases, we might gain some insight into patterns of common space-specific diseases, including psychological challenges which will probably become more pronounced as we venture further from Earth. But why is this important? For one thing, low Earth orbit space stations like the ISS are the only place that we have access to a microgravity environment. By conducting experiments without gravity, we can pick apart the contribution gravity makes to normal physiology. Because of this, we get “spill over� of knowledge that initially seems very space-specific into medicine on Earth as we better understand human physiology. But perhaps most relevant is that we are getting better at putting people into space. Space travel is becoming increasingly widespread (China launched their Tiangong-1 space station in 2011) and commercialised (see SpaceX) and plans are being made to return to the Moon, put people on Mars and start commercially mining in space. We need to be ready to put people in space even more quickly and efficiently and if we can learn to mitigate the health problems we now face in space, we will reduce the need for lengthy and expensive treatments for returning astronauts. Let’s become a species at home in space.

The ISS has not existed for long and few astronauts have ever been aboard. High quality longitudinal studies on the long term effects of prolonged space flight and microgravity have not been possible therefore, although one potential concern is that because the number of cosmic particles reaching astronauts on the ISS is much higher than on Earth, there is a danger of genetic mutation and cancer. This increased exposure has not yet be-

Keep up the good work, Major Peake!

Sam Webb, 3rd Year, Selwyn College

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INTERVIEW

A Student Perspective on Mental Health As medical students, we have a huge balancing task on our hands. Juggling hobbies, social events, coping with no longer being the ‘smartest kid in the class’ amidst a sea of never-ending, seemingly-impossible work at any university is tough. But here at Cambridge with all of our pre-clinical studies squished into 2 years, the pressure is even greater. Throughout my time here at Cambridge I have encountered many students with mental illnesses and of these, a large proportion were medics. The problem is that many students, and especially medical students, don’t want to admit to having a problem and even when they do they don’t

feel like they have the time or the know-how to do something about it. As Cambridge medics we want to be invincible and in control of everything, but this is not always possible. Many students here feel too ashamed to address such problems, seeing it as a character flaw with some students even worrying that it will hamper their future career. This myth-mongering needs to end and medics need to feel able to open up about when they are struggling rather than feeling forced into silence due to the competitive atmosphere surrounding the medical Tripos.

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INTERVIEW plummet in second year as work picked up and I became very anxious and depressed. The only thing I felt I could successfully control and achieve was restricting my diet and losing weight. I used my eating to maintain some control over my life and to give me the sense of self-worth and gratification which I could no longer gain from my work. How did these issues first present themselves? Was there an identifiable trigger? It was the combination of the intensity of the course, the constant competition and lying between students, and never receiving any positive feedback or recognition. None of the supervisors really seemed to care about who I was or what I was or wasn’t good at and I never felt any satisfaction from my work as there were never constructive yet positive comments for essays etc. It just seemed like a never-ending cycle of work with no reward at the end. This was especially frustrating as in second year our mocks and essays were often left unmarked and so I couldn’t track my progress at all. Losing weight was the only thing I actually felt I was actually good at and the only thing in which I could see clear results and gauge my progress.

This interview is a compilation of views stated by different Cambridge medical students who have suffered from mental illness during their time here at Cambridge and how they dealt with this challenge as well as what advice they would give to those in a similar situation. Most of the students interviewed suffered from anxiety, depression, anorexia and bulimia. Can you give a brief description of the mental health issues which you faced here at Cambridge? I had been struggling in first year to maintain my sense of self-worth which had for so long focused upon my work. When I worked my hardest and still wasn’t achieving as much as I wanted to and as much as my peers, I started feeling very low about myself. I stopped my hobbies to focus more upon my work and my only relaxation was going out for nights out when I’d get really drunk so I could forget about how crap I felt about myself. My confidence started to

How did these issues manifest themselves? How did these stresses impact upon your life as a medical student at Cambridge? I became anorexic and lost interest in everything. I no longer felt like socializing and was constantly having mood swings and angry. This meant that I isolated myself further from my friends which only made me feel worse. They did try to help but I was always used to being in control and did not want anyone to have that power over me. I was still work-

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INTERVIEW ing hard but I became so tired and weak that it was a challenge to accomplish much. My physical health deteriorated such that I was barely able to sit the exams.

GP who referred me to the Adult Eating Disorder service at Addenbrooke’s. The GP also started me on an antidepressant and anxiolytic and advised me to contact the University Counselling Service. I was quite alarmed at the prospect of having to take medication as I felt like that was admitting that there was a problem. However, on speaking to my friends and realizing how worried they were about me I decided to take them. In addition, I realized that I would not be scared to take antibiotics because I had a throat infection and therefore, it made little sense as to why I wouldn’t take antidepressants and anxiolytics to ameliorate a chemical imbalance in my brain.

Did you seek help from anyone? How long did it take for you to recognise that there was a problem? Who did you contact for help? It took me a while, with much convincing from friends and family, that I had a problem and then even longer for me to want to seek help. That is a problem with many mental health disorders – you yourself need to want to be helped and let yourself be helped before any progress can be made. If you’re not going to do it for yourself you need to do it for the people that care about you and are worried for you. I saw my

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INTERVIEW Was the assistance/advice/care which you received helpful?

could be altered to aid students more effectively?

The Counselling Service told me that I couldn’t apply to both them and be receiving help from Addenbrooke’s as this is ‘unfair’ even though it would be weeks before Addenbrooke’s saw me. I lost a lot more weight during this time, so arguably they could have stopped this and they didn’t. I know that there are a lot of students with mental health issues here at Cambridge and that they can’t really prioritise one student’s health but it seems ridiculous that they did not take my case more seriously when it was clear that my health was seriously deteriorating. The most useful help I received was from my college tutor who organised for me to be able to take taxis to the exams as I was too weak to walk to them. Not everyone finds counselling helpful and sometimes if you are given different counsellors this can be very disruptive as you end up explaining every painful detail to each person which is horrible. Sometimes doctors especially seem to put you into the box of ‘neurotic girl/boy’ and think they know ‘your type’ after a consultation. This was very frustrating and made me wish that I hadn’t sought help in the first place. These hurdles made it easy to walk away from treatment and not pursue the problem any further. However, other people have a very positive experience of counselling and found that talking through their problems really helped them to make sense of their feelings and face up to the underlying issues at play in their mental illness.

Waiting lists need to be dealt with more effectively. If the service is at full capacity it should be expanded. There is a huge demand for eating disorder treatment as well as for counselling services. It is often a big step for someone to seek help and so turning people away or making them wait ages for an appointment can have a significant negative impact upon the student’s mental health problem. No-one should feel that their problem is being belittled and is unimportant. Everyone deserves the right of access to mental health services. In addition, I think that colleges should pick up upon these issues more readily. If a student appears withdrawn, continually on edge, often in tears or has evidently lost a lot of weight, someone in college should notice. If a DoS, supervisor or tutor does not pick up on this it is important that college MedSocs engage with their welfare system to ensure that students who are struggling are identified and helped. A friendly, supportive college system is so important in preventing this pervasive competitive atmosphere amongst students and a self-denial of needing help, from festering. How did these issues get resolved? How long did this take? I was put on a meal plan with weekly monitoring of my weight and blood until I was no longer in a critical state. I was only discharged from the Addenbrooke’s service last December and so it took two years of CBT to fully emerge from anorexia. I still take anxiolytics. This process has been long and painful and I still am not free from my anxie-

Can you think of any ways services which help students with mental health problems

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INTERVIEW ty and depression and eating normally can still be a struggle especially when I’m feeling lonely or stressed. However, I am so glad I took control over the situation in seeking help. If I had not sought help I am not sure what could have happened. My family and friends have been so supportive throughout the entire process, however, it is difficult to find others who really understand my situation which can be difficult. I did connect with some other students in a similar situation although sometimes this had quite a negative effect upon myself – serving to drag me down further and making me view the situation in a slightly competitive way, which was extremely counter-productive for my health. On occasions, however, this contact helped me to see that I wasn’t alone and that such issues are more common than you think and that it could happen to anyone. Seeing other people in a similar situation stopped me from viewing my mental illness as being somehow my fault and offering other people advice and encouragement helped me take control over my illness as well.

can’t look after yourself. Whilst for some students not enough work is being done and so discipline is strictly enforced by supervisors, if you are working hard you should make sure you do not take their advice onboard for yourself as well. You need to find a balance. Exercise, eat properly, sleep at least 7 hours a night and keep on top of work but don’t be excessive. By definition as a medic at Cambridge you cannot be completely in control – it isn’t possible and in the end who really cares if you miss a deadline? It is all for your benefit. If you think you have a problem, seek help early and never be ashamed of struggling. A way to help tackle these issues in college is to try to help build up a supportive welfare system – we need to see medicine as a collaborative effort both within and between colleges rather than as a plight for personal glory to be achieved at any cost.

Can you offer any advice for medical students in a similar situation?

If you have been personally affected by this interview and would like to talk to someone then please feel free to contact one of the people/ groups below:

Rebecca Jordon, 3rd Year, Sidney Sussex College

Your mental health is too important to risk. Whilst many students can suffer to varying degrees from mental health issues, for some students it can reach a very serious level. It is so important to put life into perspective. If you are so miserable here that things get serious there is no shame in intermitting, switching course or even changing university if needs be. Your university years should be the best time of your life and your happiness is of paramount importance. As a doctor you can’t expect to help anyone if you

Medsoc Welfare Officer, Sarah Adams welfare@cambridgemedsoc.com Cambridge Peer2Peer http://ptp.soc.srcf.net/supporters/ Linkline 01223 744444, email@linkline.org.uk Student Minds Cambridge studentmindscambridge@gmail.com

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A GUIDE TO... A Guide to Choosing the Right Part II

Contents

Our guide mainly consists of the subjective experiences of third year students doing different Part II subjects. However, there are several factors that you need to consider on your own. Firstly, take some time to find out the specific topics covered in each subject. These will give you a great indication of whether you will enjoy the course. Admittedly it is quite hard to find a subject in which all topics seem interesting to you; fortunately, at Part II you can choose what you spend your time on. Of course, this is a great opportunity to pursue an Arts subject if you don’t feel like you want another year of biomedical science. Considering the specifics of the different subjects will be useful if you feel split between two topics that you find equally interesting. Would you rather do a subject that offers a BBS option? Is the idea of a one-term project more appealing to you than a two-term project?

To BBS or not to BBS, that is the question

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PDN

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Pathology

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Genetics

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Pharmacology

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Psychology

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Biochemistry

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Zoology

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Biological Anthropology

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Part II - A Brief Timeline

This is where our Guide comes in. There are aspects of different subjects that are impossible to find out about until you have been through them. To circumvent this, we put together a series of personal accounts by third year students, which will hopefully provide you with a sneak peek of what different courses are like.

10th March

Subjects’ Fair

14th March

CamSIS Opens

2nd May

Although the decision may be tough, ultimately you should choose a subject that you enjoy and want to learn about!

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Deadline for Choices

17th June

Round 1 Allocations

21st June

Round 2 Allocations

27th June

Final Subject Selection


A GUIDE TO... To BBS or not to BBS, that is the question For those of you opting to stay in the field of science for your Part II, one of the biggest questions you will face (other than choosing your subject) is the choice of doing the single subject or the BBS course. The core teaching for both is generally the same but there are some differences. For the single subject, you will be expected to complete a research project alongside your studies while for the Biological and Biomedical Sciences (BBS) route, you will be expected to write a dissertation and study a ’minor’ subject alongside your ’major’ studies.

outside of science without fully committing to a humanities subject. This does mean that you will need to adapt to a different style of thinking and essay writing, which for some people, can be tricky!

Research projects typically last for either one or two terms and will require you to work in wither a lab or on a computer to answer a scientific question. You will have help during the project on how best to design, perform and interpret experiments . However, the hours can be long and experiments will not always work. For those of you considering entering the field of academia or if you want to find out more about the scientific process, this is a perfect opportunity to experience research first hand. Who knows, you may even get a publication out of it!

To use an analogy, a research project could be seen as an obstacle course, with some easier sections and other more challenging problems or hurdles to overcome. On the other hand, a dissertation can be seen as a marathon; although longer than an obstacle course, it requires a slow and steady commitment to finish. Of course, just like obstacle courses and marathons, both are equally challenging in unique ways and different people will be suited to each. My advice would be to choose what you think you will enjoy the most: Part II is supposed to be an opportunity for your to explore your interests, not be forced into doing something you don’t want to do - so make the most of your choice!

With dissertations on the other hand, you will have a lot more independence meaning you are in control of the hours you work. This does mean however that you will have less day-to-day supervision meaning you need to motivate yourself to do well. It will also allow you to explore a topic that really interests you in a lot of detail. The minor subjects also allow you to explore topics

Luke Bibby, 3rd Year, Gonville and Caius College

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A GUIDE TO... Physiology, Development and Neuroscience (PDN) Katy Crooks, Murray Edwards

was suitably broad and therefore not boring!

Anonymous

KS - I enjoyed neuroscience 1b and I wanted a two term project.

Sam Webb, Selwyn Isabelle Terry, Pembroke Keerthi Senthil, Jesus

Approximately how many lectures do you have a week?

Why did you pick this subject?

S - 6 + 1 two hour journal club.

A - I really enjoyed embryology in FAB and HNA, and HR. I found it fascinating and wanted to study it more, in particular the areas about fetal and maternal physiology and the development of the early embryo.

What are you enjoying most about your subject? KC - Really interesting clinical physiology, and the department is great. A - The lectures on fetal and placental physiology. There were some really cool lecture series on developmental programming. I also had the opportunity to do an amazing practical in which we cultured and observed 9-day old rat embryos.

S - Found its subjects most interesting and has clinically relevant modules. I - I wasn't sure what I wanted to choose for Part II, but knew that I was reluctant to specialise too much. I decided that revision & deepening of my understanding about how the body works 'normally' would put me in good stead for clinical school, whilst it was also a subject that

S - My project, which is clinically relevant (meniscal damage). I - The breadth of topics we study, the low number of lectures, the freedom. KS - I love that we are learning at the highest level and have access to knowing what the current understanding of a field is. What are you enjoying least about your subject? KC - The library could be better, and the department aren't always that supportive although my lab is fantastic, with my lab supervisor (Prof Huang) being very involved and supportive.

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A GUIDE TO... A - Some of the embryology bits can get a bit heavy in genes and signalling pathways (which are my least favourite bit), and occasionally a lot of time is spent on Drosophila and fish or frog details.

tre and see real patient records. I - Spending time in theatre (my project is a clinical anatomy project) reminds me why I chose to study medicine! KS - The independence: it is nice to take the project in whatever direction I want (however, this really depends on your project supervisor). If I find an interesting phenomenon, I can pursue it further.

S - So much drosophila in development! I - Pretty much no hand-outs. KS - You choose modules as a whole despite there being some lecture courses which may not interest you.

What are you least enjoying about your project?

Why did you decide to do a project?

KC - It takes up a lot of time, and when things go wrong it can be stressful. The write up is also quite a lot of work.

A - I haven't ever really done lab research and wanted to try it. I also think I don't really want to do research in the future so now is a good time to give it a go!

A - Sometimes repeating the same experiments can get a bit tedious.

S - Chance to build research skills which might be useful later in my career.

I - The write up is SO long (8500 words), and it's easy to get 'stuck in a rut', and achieve 50 words an hour - if that!

KS - I wanted to experience research more and find out something that nobody else has ever researched before (whether it yielded a positive result or not).

KS - Carrying out repeats and number crunching can get a bit dull sometimes. Do you have any other comments or advice?

What are you most enjoying about your project?

KC - PDN Projects are worth 30% of your final grade, which takes the pressure off the summer a bit. You also only have 4 exams, and they are all in one week.

KC - Really getting into one particular research area, and potentially contributing to it!

A - Pick what you think you'll enjoy, not what you think will be easy - at the end of the day you have to spend the whole year on it so you might as well pick something you want to do!

A - The thought that you are carrying out investigations that nobody or not many people have done before. Your project will be a question that people don't necessarily know the answer to, and it's exciting to think that it's yours to try to start discovering the answer.

I - The PDN tea room does the BEST chocolate chip cookie-scone-mountain of deliciousness for ÂŁ1, and it's a pretty good self-treat, each time you manage to stay

S - Clinically relevant; get to go into thea-

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A GUIDE TO... awake through two lectures in a row!

are feeling particularly keen, read a few reviews on each lecture beforehand. Find a partner/group to discuss some key papers once a week.

KS - Read each lecture again that same day (you definitely have the time) and at least make very brief notes on the computer which you can add to later. If you

Pathology Luke Bibby, Gonville and Caius Emma, Clare Why did you pick this subject? L - For me, Pathology looked like a really interesting discipline combining both molecular biology with epidemiology, global health and conceptual information. It also looked to be one of the most clinically relevant Part II choices, as the department mostly work on human pathogens.

What are you enjoying least about your subject? L - If you do either the Immunology or CGD option, you will have Saturday lectures. This is something you will get used to quickly though and they can be avoided if you study M&P/Virology/DID.

E - Because I thought the subject was the most interesting part of second year and relevant to medicine. Approximately how many lectures do you have a week?

E - I had to go to Addenbrooke’s for my lab project a lot which could take a lot of time in the day.

L - 6 one hour lectures. What are you enjoying most about your subject?

Why did you decide to do a project?

L - I am really enjoying all of my lectures so far and I have found the course content fascinating. The course is very varied and builds upon your knowledge from BOD perfectly. I have also been enjoying the freedom to explore areas of pathology that interest me and not having to learn all of the little details for MCQs.

L - I am interested in going into research in the future so wanted to get experience carrying out some independent research. E - I wanted to get some lab experience and thought it would be much more interesting than a dissertation. What are you most enjoying about your project?

E - The content. I like the topics we cover and think it is all very interesting.

L - Having a two term project means that you have the chance to carry out a good

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A GUIDE TO... chunk research into an area that interests you. I am really enjoying the freedom to do my own research and design experiments independently. My supervisor is also lovely and offers me lots of support and guidance when I needed it.

quite frustrating but this is (unfortunately) an inherent part of scientific research. Also, the project write-up is due at the end of Lent term which means the end of Lent can be quite stressful. However, this does mean that you can dedicate the Easter vacation for revision.

E - The independence and getting to do some of your own experiments.

E - Not much worked so having to write up the project with little conclusions was fairly difficult.

What are you least enjoying about your project? L - When your experiments fail, it can be

Genetics Hannah Vandersluis, Peterhouse

way medicine will be practised in the future.

Why did you pick this subject?

Approximately how many lectures do you have a week?

H - A genuinely interesting course that is broad and has a lot of relevance to the

H - 10. What are you enjoying most about your subject? H - Incredibly friendly department, brilliant atmosphere. What are you enjoying least about your subject? H - That I'm only here for one year. Why did you decide to do a project? H - Wanted lab work, did not want to do a minor subject. What are you most enjoying about your project? H - The experience of doing real science. What are you least enjoying about your project? H - It takes up a lot of time.

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A GUIDE TO... Pharmacology Louise Rockall, Christ's

organised department in this respect.

Huw Garlans, Christ's

What are you enjoying least about your subject?

Anonymous

L - Some lectures are very molecular (though I quite like this). Having to cite papers in essays is quite a daunting task, and to be honest, I'm terrible at making decisions, so having to be selective with which topics I cover is a bit tricky.

Why did you pick this subject? L - MODA was probably my favourite subject at 1B, but more than this, the idea of a smallish close-knit department appealed to me, as did the idea of a 1 term rather than 2 term research project.

H - Too many structural/biochemical studies that are a very long way from anything that is vaguely clinical.

A - Good mix of topics (including bits of pathology, neuroscience and physiology). Opportunity for a 1 term project.

A - Still less structure than in previous years, no one asking for essays to be handed in! This is not unique to pharmacology though....

Approximately how many lectures do you have a week? L - 1-2 per day in Michaelmas (5-10 per week), 1 or fewer lectures per day in Lent (<5 per week).

Why did you decide to do a project? L - I wanted to experience firsthand the techniques I'd read about in papers, and understand where all the information we have learnt about in the first 3 years has come from.

What are you enjoying most about your subject? L - Pharmacology is a very sociable subject, everything centres around the tea room, and we have free wine and nibbles every Friday after the tea talk.

H - Would consider doing research alongside clinical work. Might like to do a PhD.

H - Interesting to be able to read about specific areas that interest me.

A - Opportunity to work in a world leading lab for 8 weeks. Enough time to get an idea of whether you enjoy lab work (but not too long if you realise you don't) - very useful to know for future reference!

A - The clinical relevance of a lot of thetopics (e.g. cystic fibrosis, asthma, rheumatoid arthritis, blood, diabetes). Even the topics that aren't clinically relevant are interesting! Fortnightly discussion groups give us a chance to talk about scientific papers and learn how to approach critically analysing them. As well as this, we also get an essay writing and referencing workshop. Definitely a well-

What are you most enjoying about your project? L - I've been very lucky with my project (Dr. Cath Lindon, Cell cycle and aurora kinases). It's very rewarding starting an

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A GUIDE TO... experiment completely from scratch and carrying it all the way through i.e. subcloning the DNA, electroporating cells, and imaging these cells to make discoveries about Aurora A kinase (a cell cycle protein). My project supervisor makes you think for yourself, so I feel I've learnt an awful lot, and it's fun to finally be doing something practical.

H - Frustrating when experiments don't work and you only have 8 weeks to generate enough data for the write up. Do you have any other comments or advice? L - Do make the most of the opportunity to read papers. They seem daunting at first, and a bit of a waste of time, but it's a nice feeling understanding exactly where a theory has come from, and also understanding the uncertainty behind some of the dogmas we're taught at part 1!

H - Interesting to be finding out something that nobody knew previously. A - The flexible hours, opportunity to plan the experiments myself and thinking of new ways of doing the experiments if there are problems the first time.

H - Pharmacology is more like MIMS than MODA in many respects.

What are you least enjoying about your project?

A - Part II pharmacology is nothing like MODA, so don't let your enjoyment/lack of it be a deciding factor for pharmacology!

L - It is pretty time consuming, so I have to be a bit more selective about what I do with the rest of my time. However, my project is usually 10am-5pm, so doesn't really impact social life.

Psychology Maria Seago, Gonville and Caius Why did you pick this subject? M - I've always found the brain interesting and I loved the lectures at Part 1B. I wanted to do something clinically relevant and not too molecular. Approximately how many lectures do you have a week?

What are you enjoying most about your subject?

M - It varies (and depends on how many lecture courses you decide to attend) but about seven (plus two hours for my minor subject).

M - Part II Psychology is great because of the breadth of what you can study - lecture courses vary from neuroscience, through 'standard' psychology, to social

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A GUIDE TO... What are you least enjoying about your dissertation?

psychology, and you can pick and choose those which are of most interest to you (you only have to attend about half to two thirds of the lectures). I have had no 'bad' lecturers and most of them have been fantastic. One of the things I love about Psychology is that it is not particularly molecular, unlike most of the other Part II subjects - but of course, it depends on what is of interest to you. The staff are lovely and helpful, and there is a great 'Part II room' on the first floor of the Psychology building, which has comfy seats and coffee and snack machines.

M - Mostly I've really enjoyed my dissertation. However, one minor thing is that it can be a bit frustrating when you're on your third or fourth draft... you put a lot of time in but at this stage you're only making minor changes. What is your minor subject, how did you chose it and how are you finding it? M - I picked the 'Psychology of Education' as my minor as I thought it complemented my major nicely, and medical education is something I would like to do in the future. It was also one of the few subjects that was guaranteed to not clash with my major subject, which massively helped me narrow down my choices. I've really enjoyed the subject but it is more abstract than I'm used to, and adapting to that, and the style of essaywriting, has been challenging.

What are you enjoying least about your subject? M - I'm not particularly enjoying the statistics that we have to do (and I think the same can be said for nearly everyone) but it only constitutes a third of one of our four papers, so it's not very much. Why did you decide to do a dissertation?

Do you have any other comments or advice?

M - I have always loved writing and wanted to do some scientific writing that was a bit more creative than our standard Part II essays. I wanted to do something very clinically-relevant, so I chose to write about 'The distinction between autism and childhood schizophrenia'.

M - In my opinion, unless you leave it to the last minute, dissertations are much less stressful than projects. Projects are often time-consuming and things frequently go wrong! A lot of my friends have had some stressful days and nights from project mishaps. That being said, if you really want to do a project - go for it! But don't do one just because you think it will 'look better' on your CV, or some such reason. This is the one year of your degree where you have some freedom and choice - so pick something that interests you and have a fantastic year!

What are you most enjoying about your dissertation? M - I have thoroughly enjoyed writing about my topic, and I believe it has taught me a lot that will be useful for clinical practice.

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A GUIDE TO... Biochemistry What are you enjoying most about your subject?

Petros Fessas, Gonville and Caius Anonymous

P - The heavily evidence-centred nature of the content and its breadth. We've learnt stuff from structural biology techniques to mouse models of cancer and the biochemistry of Pseudomonas and Plasmodium.

Why did you pick this subject? P - In short, I really liked the content. By the time I chose my Part II, I hadn't really decided on my favourite topic; instead, I wanted something that would provide me with some in depth knowledge without specializing too much. Biochemistry provides you with knowledge about the basic regulatory mechanisms of gene expression in the cell, that I can apply to anything I choose in the future. Plus, it is pretty sweet to only have a one term project.

A - Departmental supervisions (~six part IIs, three part IIIs, ~four faculty members journal group and various discussions, really engaging), genetics module, lab experience. What are you enjoying least about your subject?

A - Enjoyed MIMS and wanted some lab experience.

P - The breadth kind of makes it feel like I could been learning something more specialized some times, but this is definitely mostly an advantage. Overall, my least favourite aspect of Biochemistry is how some lecturers tend to assume knowledge that only the NatScis have, but this is only a very very very minor issue.

Approximately how many lectures do you have a week? P - 6-8 in Michaelmas, 3-5 in Lent, 0 in Easter. 2.5 modules are covered in Michaelmas and 1.5 in Lent, leaving time for lab work.

A - Lots of structural analysis of proteins (X -ray crystallography, NMR) which can be quite dry. Lent modules on cancer and infectious diseases cover a lot of familiar ground from MIMS and Pathology, so the first few lectures aren't very interesting. Why did you decide to do a project? P - Wanted the lab experience; chance to get published. A - Wanted lab experience (good for future research).

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A GUIDE TO... What are you most enjoying about your project?

5 job. Still, I suppose this is good preparation for clinical school.

P - Getting to finally be at ease and confident to work independently in a lab setting.

Do you have any other comments or advice? P - Base your decision mostly on whether the topics covered genuinely interest you; everything else will follow.

A - Lent, you go to the lab every day whenever you don't have lectures/ supervisions.

A - Only choose Biochem if you liked MIMS! Be prepared for extra reading about experimental methods and relevant evidence: papers are often recommended alongside lecture series.

What are you least enjoying about your project? P - The LONG LONG LONG hours. A - Quite time-consuming - basically a 9-

Zoology Gerard Martin, Christ's

N - The project.

Neil Cunningham, Trinity

What are you enjoying least about your subject?

Why did you pick this subject?

G - Some of the lectures can rely too much on research evidence and may miss out the key concepts.

G - Fantastic variety of modules and a really friendly department. N - It allowed me to do Biochem modules as well as developmental modules, as well as doing a project. I didn't want to narrow down my options too much so I still have a little variety in what I'm studying and it all comes together surprisingly nicely.

N - Also the project! Haha. Are you doing a project or dissertation? G - Dissertation. N - Project. Why did you decide to do a project/ dissertation?

Approximately how many lectures do you have a week?

G - No projects left.

G - 6.

N - Because I wanted lab experience and didn't like the idea of doing all the reading and library work for a dissertation.

What are you enjoying most about your subject? G - Taking up modules that aren't really covered by MVST, which gives a broader overview of biology in general. (Also studying dinosaurs is awesome!)

What are you most enjoying about your project/dissertation? N - Getting actual results, lab trip to ox-

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A GUIDE TO... ford, and lab dinners.

G - Evolutionary Genetics. It is really interesting and complements the modules that we do in Zoology. It takes a different approach to evolution than Zoology.

What are you least enjoying about your project/dissertation? G - Can be difficult to get supervisor support at times.

Do you have any other comments or advice?

N - The amount of time it takes and it is frustrating when you don't get the results you want.

G - Pick the Part II that you want to do, not the one you feel you should do. Part II is meant to be fun!

If you are doing a minor subject, what is it, how did you chose it and how are you finding it?

N - Don't pick something just because your friends are doing it.

Biological Anthropology Zofia Gibbins, Churchill Why did you pick this subject? Z - I've been interested in human evolution for some time and I thought it would be great to study something a bit different before going back to medicine in clinical school. Approximately how many lectures do you have a week?

Z - The lecture material is so interesting!

just enjoy the course content and focus on exams rather than anything else. There is an option to do a dissertation, however, and one can also do some lab/research work as part of that.

What are you enjoying least about your subject?

Do you have any other comments or advice?

Z - Quite a lot of essays.

Z - Biological anthropology is really brilliant for anyone who would like a more 'arts student' experience. The course topics are really interesting, you get to study loads of stuff from primate communication to health and disease in ancient times. It brings together loads of fascinating topics.

Z - 8. What are you enjoying most about your subject?

Are you doing a project or dissertation? Z - Neither (just exams). Why did you decide to not do a project or dissertation? Z - I didn't want to do either as I prefer to

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Profile for Murmur

Lent 2016, edition 2  

Lent 2016, edition 2  

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