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The MedSceNe!

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Easter Special Hey MedSceNers… yes I went there... So the year is flying by and we’re finally at the joys of our easter hols… well, most of us are… Sadly we’re also getting closer to exams too, so if there’s any help you need please feel free to message us at themedscene@gmail.com and we’ll do our best to provide you with some of the newest, more or less reliable :P, but genuinely helpful textbooks, articles and websites that are out there! We also promise to do our best to make you laugh, think (a little) and keep you up to date on all things medical within the medschool. As an early warning the next issue may be a tad late so we can report on MedSoc Elections but one thing is guaranteed we’ll see you next month! Regards, Christopher Taylor 5th Year Intercalating Student

pg 2-3: LFTE & Contents pg 4-5: Medical Stereotypes pg 6-7: Metroline Special pg 8: Lecture Doodles pg9: “A Dangerous Method” Review pg 10: New SSCs pg 11: Ion Event pg 12-13: Calendar / Listings pg 14-15: Bright Club Review pg 16: Medics Review Teaser pg 17: Mental Health Review pg 18-19: Fun Stuff pg 20-21: Book Review pg 22-32: Textbook & Website Review


How do you view them as? The clinical years of medical school constantly provide us with fresh insights into how doctors from different specialties are, or at least how they are supposed to be like. The typical orthopaedic surgeon is as strong as an ox but half as bright, the typical A&E doctor has the attention span of a goldfish, radiologists have a strange form of allergy to normal light, anaesthetists are responsible for half the tea/coffee budget of the NHS, the neurosurgeon is never happy in the operating theatre because it is never big enough to accommodate his/her ego...the list is endless and never fail to make us smile. Yet, how far are these stereotypes from reality? After all, the main reason stereotypes exist is because a certain group of people display characteristics which may not be as common in other groups of people. The commonest rift that becomes apparent is the one between doctors and surgeons. Doctors generally consider themselves to be the final erudite barrier between their patients and those surgeons who know nothing apart from scalpel and sutures. They pride themselves on being able to read x-rays and ECG’s as opposed to their surgical colleagues. Unlike surgeons, they are rarely baffled by strange names on kardexes and are always on the look-out for an offending drug which, if found, is always celebrated with much glee. Doctors have polished their communication skills through years of training and never fail to point out how these as far superior to their surgical counterparts who are most at ease when their patients are asleep. As for surgeons, they tend to scoff at the daily 8-hour ward round which is hailed as the hallmark of medicine. They firmly believe that they are the ones doing all the hard work, coming to hospital amongst the earliest and leaving hospital later than medics. While they might pretend to have lost much of their medical knowledge drilled into them, they have a unique source of pride which they never fail to showcase to us ignorant medical students. That of course is their knowledge of anatomy. “Is anatomy still taught in medical school?� must certainly rank among their most popular questions. General Practitioners are a much envied bunch of people. They have a 9-5 schedule, are amongst the highest average earners and can play as much golf as they wish during weekends. They tend to be well liked by their patients and most GP practices have very supportive staff to help with the massive excitement represented by paperwork. Strangely enough then, few medical students at the beginning of their clinical years are willing to let themselves tempted by such a package. General practice is viewed as having little or none of the thrill associated with hospital medicine. However, if we are to go by the figures about half of us will eventually end up being GPs. Psychiatrists are an unfortunate lot who tend to be at the receiving end of much sarcasm. They are considered to thrive on the final frontier of what is considered to be medicine and what is voodoo-land. Some consider them to have simply overstepped that mark. Considering the kind of patients that they have to deal with, it is no wonder that they give the impression of living in a world of their own. They also tend to be the ones most commonly misunderstood .For common mortals like us, it can be especially difficult to tell between when they are joking to when they actually telling the truth when talking about their patients or some of the more exotic psychiatric conditions.


Obstetricians are a temperamental lot who have scarred many medical students for life. They tend to have the longest working hours and seem to derive pleasure from making the life of others around them as miserable as possible. This is not helped by midwives who find it difficult to hide their contempt for medical students silently observing from a corner, while they are doing all the hard work. If you cannot push hard, you better not cross the path of obstetricians or else they will section you, this certainly applies for patients and medical students alike. Paediatricians are instantly recognisable parading around with their miniature stethoscopes hanging around their necks. They seem to have never fully recovered from the trauma of leaving childhood and might often carry funny looking toys around. These can sometimes mysteriously appear in the middle of a ward round to distract an unwilling patient. A situation which can potentially become embarrassing when a toddler suddenly develops affection for a particular toy and a tug-of-war has to ensue to retrieve that precious object. Priceless when it happens. Besides, most paediatricians seem to have missed a promising career as ventriloquist; such is the array of voices that they can potentially display to communicate with children. Overall though, they are a very accommodating lot, which is probably why paediatrics is so appealing to many medical students. I am sure most of us have made similar observations, whatever the specialties we have spent some time in. The fact is that all of them are associated with their own set of quirks. This is perhaps why most of us end up finding somewhere we can fit in, doing something we like. Disclaimer: The above work is intended to be fictitious and bears no resemblance to anyone alive or dead. Written by Kamlesh Sreekisson


LECTURE DOODLES

Now this is technically taking lecture doodles to a new extreme but I guess it still counts. Look at the beautifully shaded liver, the perfectly placed kidneys, the liver sneaking round the corner & the signature colon… Its actually a fun way to revise; we Durham Medics actually had a lot of this and managed to while away the hours “learning” anatomy this way. Hopefully it’ll manage to work its way into the Newcastle Curriculum at some point. But its lots of fun anyway - Doodle Away! :P


What a film! It was a powerful film from the word go. Anyone with an interest in Mental Health, how the field struggled to come into its own in a world where physical illness was characterised as the only true pathology. Captivating your attention from the very beginning, the story unfolds and continues to build and grow and turn into a real hard hitter. As long as you get past Keira Knightly and her terrible, terrible Russian Accent… We are introduced to Carl Jung and his wife, his experimental techniques and his patients. Next we meet Sabina Spielrein, a young Russian girl suffering from Hysteria. We follow Jung, the founder of Analytical Psychology, as he attempts to “cure” this young lady before becoming deeply entwined in each others future. By lending Sigmund Freud’s techniques of Psychoanalysis, he learns a lot about Psychology and its use. This sparks his interest in Freud and after one letter their friends blooms. We follow their careful footsteps along this tricky path and learn the true meaning of ‘A Dangerous Method’. Why should you watch this film? It’s a good film which can inspire you about Mental Health and see more of Keira Knightly, if you’re into that sort of thing… Why shouldn’t you watch this film? It does feel a little long and the pace is a little slow, but as long as you can struggle through the poor accent, its actually a really strong film. Written by Christopher Taylor


Choosing an SSC How things have changed By Dave Eastwood The SSC part of the undergraduate curriculum is unique in that it provides you with 18 weeks where you choose topics you wish to study, taking place in the back end of 4th year. This is in line with the General Medical Councils (GMC) recommendations in the document To m o r r ow ’s Doctors, which suggested that all undergraduate medical curricula should comprise both the ‘Core Curriculum’ and SSCs. You may choose to explore a new subject, which you have not previously studied (this may be medical or non medical), or to consolidate an area of learning that you have already encountered, or explore a topic in greater depth. It may be that you wish to sample a branch of medicine that attracts you as a future career. Many of the topics offered are designed to expose you to specialist areas of Medicine, which are not dealt with in great detail in the Core Curriculum; others however, are much broader, general topics. Nonmedical topics, including foreign languages and literature, are also available. Irrespective of the topic chosen however, the medical school

expects you to spend some of your time in self-directed learning. This ‘guided discovery learning’ is very much part of the GMC philosophy and is something which is embedded in the overall aims and objectives of the Newcastle curriculum. Surprisingly, It actually is important, as throughout the SSCs you are responsible for your own education and this will continue to be for the rest of your career. The way the system has worked over the past few years has permitted students to select either SSCs that are part of a database, or their own private SSCs. Arranging a Private SSC is perfectly feasible, and indeed over the last few years an increasing number of students have done so. In fact, from what I’ve gathered from my own friends in 4th year, I would highly recommend it. A private SSC must be a special arrangement between yourself and a supervisor who, if already offering an SSC, is prepared to take you over and above the students indicated on the Web. The EJRs in third year are a perfect opportunity to build a good rapport with consultants and consequently organize your own private SSC. In the past, the SSCs on the web database have been collated onto a secret page and then on a specified morning, made public to the 4th year domain. As you may expect, the result is typically carnage. Every single fourth year finds themselves avidly waiting at a computer screen with a trigger-happy finger and rarely does a student actually acquire the SSCs that would be most useful. In fact last


year, a group of techno-wizards in 4th year actually managed to beat the system, arranging their own SSCs in the comfort of their armchairs, beers in hand, the night before the specified “live date.” As you might expect, from the fact that I tell this very tale, the said students were caught, but the medical school were aware that things could not carry on in this way. Things had to change. As a result, the third years of 20112012 will have a very different system to work with – and one that I believe works much better. The same rules apply for organising private SSCs, yet the online system has a radical new look. Students will have three, 6-day periods (one for each SSC) in which, they will mark a 1-10 preference on the SSCs they are interested in. The medical school will then randomly assign SSCs, weighted by the given preferences. The random nature of this selection does have its flaws, but I believe it to be a much more fair, and much less frantic method of assigning SSCs. Despite the new system, my advice would be to sort things privately. Although there is no rush, if you have specialties that you’re interested in, you may as well go out of your way to guarantee your place early.

- with the Institute of Neuroscience This Month saw Brain Awareness Week hit and as part of the fun and games, myself, a handful of other MRes and PhD Students travelled to a school in Durham to show some Year 9s just how amazing their brains can be while doing something as straight forward as taking a penalty kick. I felt fairly prepared during the taxi ride over but as anyone else will confess, when you work with that year group it is really hard work. Between the punching contests, texting, day dreaming and general lack of enthusiasm my work was cut out for me - however, it was actually loads of fun and quite rewarding! So there is one thing you can be sure of when you start to get to grips with your brain - don’t underestimate Year 9s! Written by Christopher Taylor


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Now there’s a lot you can get for £3:  

A Pint A Subway Lunch

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The Bus Home An Easter Egg

If there is one thing I would recommend you spend your student loan on its Bright Club. Billed as “Where brains meet funny” this is not only an intellectuals comedy night, this is a night where local scientists, medics, comics, museum curators, or performers of all kinds can come together to give a show like no other. This was the second Bright Club that I have attended and will definitely be going back for more! As part of Science and Engineering Week / Brain Awareness Week , Bright Club was the opening event for organisers where we saw several local researchers and performers put on a show that kept us on the edge of our seats for the full 3hours. Some of the topics that were covered over the course of the night included:     

Balding Badgers and how to make a career from Road Kill Why Donald Duck should wear pants and why you can speak so passionately about duck sex How much fun things like rubber can be and how stretchy things can help you understand the wear and tear of horses knees Exploring the Myths and Science Fiction that is the strange world of Science Finally we got see up close just how crazy and bendy the human body can be, with a little magic thrown in to remind us that even with all our science and research we can still be tricked easily thanks to the crazy Chris Cross (right).

It was really a fun evening and I would ask for nothing more; cheap comedy and a pint… well, maybe the opportunity to get on the stage myself. Sadly time won’t permit for fun things like that, but I’m sure most of you will agree - Medicine in strange and you can definitely find humour if you look at things the right way. How many of you have been chatting casually in a nice pub, coffee shop, or even on the bus and suddenly realised you are discussing something quite unusual; say the anatomy of a hand or some great pus / abscess like structure in theatre… Then perspective sets in and you realise if anyone around you was listening to the conversation it would probably be quite disturbing!


So - not wanting to anyone to miss out I thought I’d enlighten you to some of the content I eluded to earlier - it was actually funnier to me at the time because 5years ago, when this story came out I found it in New Scientist and chose to save it as a Note on Facebook to share with my friends. And here I am, 80% through Medicine and 75% of the way through an MRes and here is the story coming back full circle to tickle my funny bone once again!

The Twists and Turns of Duck Sex Ducks and geese are not the most gentle of lovers. Males of some species, such as the mallard, have a notorious habit of "raping" females. They and other wildfowl are among 3 per cent of bird species whose males have phalluses big enough to insert into the vaginas of females whether or not the female is willing. However, females don't take it lying down. A study of 16 species shows the females have evolved vaginal features that thwart the males' advances. The longer and more elaborate the male member of the species, the longer and more elaborate the female counterpart. Some birds have vaginas with spiral channels that impede sex by twisting clockwise, the opposite direction to that of the male phallus. Others had as many as eight "cul-de-sacs" in the reproductive tract, pouches that could prevent fertilisation by capturing sperm. These features were only found in species where forced sex occurs, demonstrating the existence of an evolutionary "arms race" between males and females. All other species had simple genitalia. "These structures are wonderfully devious to send sperm down the wrong road or impede penetration," ... "it shows that females are not passive in averting exploitation"! Written by Christopher Taylor


MY EXPERIENCES OF: Getting through the Mental Health Rotation Mental health isn’t covered very much in stages 1 and 2 at Newcastle, so going into my Mental Health rotation, I had many mixed emotions: apprehension, anticipation, uncertainty, and others I couldn’t pin point. I had no idea what to expect and psychiatry wasn’t exactly one of the fields I was interested in. Would I be intimidated by the patients? How will I talk to someone who has psychiatric disorders? What do I do when patients tell me intimate details? These were all thoughts repeatedly running through my head. I wanted to share some of my experiences for those of you also terrified of this unfamiliar territory in medicine.

The psychiatric history The psychiatric history is something completely different from your normal medical history. Often patients don’t realize they have problems, and as the medical student it isn’t our place to try and ‘enlighten’ them. We are there to determine for ourselves whether there is a problem, and if there is, what this problem is. For example, in a Schizophrenic patient with no insight (where the patient does not recognize there is a problem and doesn’t accept treatment), most of the history involves asking the patient about the hallucinations and delusions they have while keeping a neutral standpoint. The process of getting a psychiatric history is also an exercise of multi-tasking. While we speak to the patient, we also need to complete the mental state exam, by making observations on behavior, appearance, speech, mood, thought contents, and cognition. I found observations on behavior to be the hardest since the content of the patient’s speech can influence how I view their behavior. As in learning all new things, the key is to practice, practice, and more practice. Without practice, it is easy to get distracted and miss important observations.

The biopsychosocial model and pleasing your supervisors Unfortunately, if you are sick and tired of hearing about bio-psycho-social models of health, psychiatry is one of the biggest advocates of this. Therefore, make biopsychosocial your new best friend if you want to impress your consultants and do well in your MiniCex. However, I found that this was one of those things which is easier said than done. In between memorizing lists of personality disorders which all sound frustratingly similar, and the blurry line of distinction between different thought disorders, I found it difficult to relate in other aspects of the patient’s history into my differentials. Going to this rotation, my ideas of what psychiatry has shifted slightly. Psychiatrists aren’t all pschoanalysts, but they are deep thinkers and highly intelligent and have the special ability to relate all aspects of the patient into their current mental health state. I know many people who have also found it difficult to gauge psychiatrists; either their mood or their expectations from us. Unfortunately I still haven’t found a method to be comfortable around some of these highly intelligent doctors. The best way to impress is by knowing your disorders, and remember that not everyone with hallucinations and delusions have schizophrenia.

Talk with your group Make use of your colleagues to discuss and reflect on clinical problems. This seemed silly to me at the beginning. However you will soon realize that sometimes everyone comes out with a different story, sometimes an entirely different history from speaking to the same patient, at different times. How this happens I have no idea. I have even gotten entirely different histories from speaking to one patient on two consecutive days. Psychiatry requires reflection and formulation, which were some of the hardest things I found. Before presenting histories, I found it helpful to discuss my patients with fellow students, and getting their view point. Often you find that there are many aspects of the patient you haven’t considered until you speak with someone else.

In summary Psychiatry is a very different experience to other rotations and aspects of medicine. It is important to go in with an open mind and make sure you get lots of practice with histories. Who knows, you may even enjoy it. By Angela Tang


Have you enjoyed reading our articles? We’ve really enjoyed writing them! No really! Do you see yourself doing the same? Or Better? Over the next month or two we will be recruiting NEW MEMBERS to carry on the great work this newspaper does. Can you spare 2 - 3 hours a month? Do you enjoy writing or want to share your achievements with your peers? Want to be involved in a fun society which gives you the creative freedom to write about and critique almost anything? Then get in touch @ themedscene@gmail.com!


Three Cups of Tea A keen American mountaineer lands himself into trouble after a failed ascent of K2, the second highest mountain in the world. Lost and exhausted, he is rescued by villagers living in one of the most inhospitable areas of the world, near the border between Pakistan and Afghanistan. This misadventure kindles a friendship between the Balti village chief Haji Ali and Greg Mortenson, the American mountain climber, who promises to return and thank them in his own way for saving his life. His promise takes the form of a daunting challenge; building schools for girls in a region where female literacy is one of the lowest in the world, a matter which is not helped by conservative Islamic beliefs about women’s education. Three cups of tea is the first book written by Greg Mortenson in collaboration with the writer David Oliver Relin. The title of the book is inspired from a popular Balti proverb “the first time you share a cup of tea with a Balti you are a stranger, the second time you become an honoured guest and the third time you become a family member.” The title fits the book perfectly considering the numerous meetings that Mortenson has with village chiefs, mostly over cups of tea, to win their trust and outline his vision. His rationale for laying more emphasis on education for girls is that most educated boys tend to leave their villages to look for jobs in the city, perpetuating the cycle of poverty and illiteracy in their villages. Women tend to stay behind and form their families, so educating them will help lay the foundation of better educated future generations. He however, underestimates the scale of his challenge as he struggles to raise money and convince people with his plans. He nearly gives up when his first lot of building material meant for a school is instead used to erect a bridge. Luckily Mortenson learns from his lessons and a life spent challenging himself to climb the most difficult of peaks, means that he does not give up easily. Living the life of a destitute in America, he repeatedly uses all his savings from his job as a nurse to travel to Pakistan to continue his project. A generous benefactor comes along and helps him set the Central Asia Institute (CAI) which helps to give a new dimension to his work. With the help of local contacts and keen volunteers he expands his network of schools under construction together with the number of girls schooled. The reader is then taken through tales of a man determined to do his very best sometimes at great personal costs. At one point he is even kidnapped by the Taliban. The book follows the style of an autobiography. Critics have argued that some of the events described in the book have been grossly exaggerated, for example his claims of being kidnapped. Some people have claimed that not all the money raised went into building schools as some was alleged to have been diverted to Mortenson’s personal business interests. Some went further by arguing that the profit from the sale of his book, which amounts to about $5 million till date, should have gone to the CAI.


While these criticisms might be true, I believe that for all that Mortenson had to endure and overcome together with the scale of his achievements from very modest beginnings, this book is outstanding. A must read for fans of this genre. By Kamlesh Sreekisson Recommended Retail Price - ÂŁ6.99 Amazon:

Used - from ÂŁ0.01

New - from ÂŁ3.69


Medical Ethics: A Very Short Introduction Tony Hope Finding Ethics tricky? Keep getting caught out by NonMalifecence, Autonomy, Beneficence and Judgement? This beautiful little book will open your mind. It draws out difficult questions to really make you think, while carefully exploring difficult concepts. A very short introduction indeed, chunking in at 128 pages, this handy pocketbook will keep you straight through the difficult times of Gillick Competency and even Euthanasia. I could go on further but as a quick read there really is no reason for you not to buy it, or at least pick it up, as it will improve your professional attitudes and help with any trick questions or assignments you may face - particularly for that final year essay! Written by Christopher Taylor


Website Review Almost a Doctor has been running for a while now and has an extensive catalogue of notes, providing dynamic and accessible documents across various formats. You can register to help blog, create a profile and even contribute your own work to make your mark and add to a growing community. There is also a medivids section, perfect for anyone sick of reading notes and a nice and accessible form. As you can see below; blogs, flash cards, checklists and mind maps - tonnes of stuff to help you out with up coming exams!


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