Page 1

r

u

m

s V

r O

L

.

1

e N

v O

.

3

i

e

w


EDITORS-IN-CHIEF Rebecca Mackenzie Sophie Bracke SUB EDITORS Rebecca Kells Tara Carlin TREASURER Carol Chan NEWS EDITORS Anamika Kunnumpurath Emma Lewin Rebecca Kells RESEARCH EDITORS Andrew Cole Eng O-charoenrat Richard Bartlett ALUMNUS INTERVIEW EDITORS Adesh Sundaresan Bill Boucher Charlotte Leigh ARTICLE EDITORS Lucy Refell Melika Moghim Otso Pelkonen Rebecca Fisher SPORTS AND SOCIETIES EDITOR Lucy Porter BOOK REVIEW EDITOR Katie Hodgkinson EVENT REVIEW EDITOR Yul Kahn Pascual DESIGN EDITORS + COVER Joanna Lucy Gabrielle Hobbs Elliot Clifford Nash WATERCOLOURS Emilie Claire Marguerite Hobbs ARTWORK Alvin Lim Elva Choi Kate Alice Mackenzie ONLINE EDITOR Joe Hearle

rums-review@ucl.ac.uk www.rumsreview.co.uk

DISCLAIMER: The views and opinions expressed in this magazine are those of the authors, and do not reflect those of the editors, UCL Medical School or RUMS Medical Students’ Association.


4 Editorials

32

From the Editors

Sports + Societies

Predident’s Letter

Round Up

Director’s Letter

Farewell Stu

RUMS Reports

Q+A In Focus: Varsity

10 42

News Bulletins

Comment + Review 15

Find Your Vocation

RUMS Research

Book Reviews

UCL MBPhD Programme

Event Reviews

Research Round Up

20 Articles Alumnus Interview ZIKA Dr. Dan Broman Dr. Patrice Baptiste Prescribing Prevention Demystifying Medical School

3

vol.

I,

no.

III


2 mbbs year

editor-in-chief

sophie bracke

2 mbbs year

editor-in-chief

rebecca mackenzie

editorials

A

s we write this, the weather is changing; as you step outside, you are tickled by a brief hint - a slight warmth and sweet smell to the air - that indicates summer is finally on the way. This summer will see thousands of athletes, support teams, officials, and spectators make the quadrennial ‘pilgrimage’ to Rio De Janeiro, Brazil, to partake in the 2016 Olympic Games. Like most things, sport has become increasingly medicalised, and there is a larger role played by doctors and medical research in athlete performance. Is this information to be afforded only to the elite, or can the average person benefit too? Whilst we all know that exercise is good for us, we may not know to what extent and in which scenarios this benefit can be ‘cashed’. Throughout this sports and exercise medicine special, we examine the wide spectrum of applications of exercise in health and medicine, from the powerful health benefits of exercise in preventive care, to its role in treating patients who are severely hypoxic in ITU. We also look at what a career in sports and exercise medicine entails in greater depth, and view the public health implications of this year’s Olympics in light of the recent emergence of the Zika virus. As always, medical students are leading by example, and have been taking part in and excelling at sport themselves. Term 2 always sees the conclusion to the sporting season, celebrated by the annual sports ball. In addition to this, we waved goodbye to final year students, battled it out in varsity, were victorious in Quality Improvement and voted in next year’s RUMS committee - it’s been a busy term! This issue features the first of a new section, Demystifying Medical School, which seems well overdue considering the many rumours that tend to fly around. Ravi Mistry, RUMS Education VP for years 4-6, will be trailblazing by setting the record straight on how our exams are really marked (perfect to reassure pre clins through the hefty revision period). As we publish our third and final issue of the year, it seems strange to consider that only a year ago the magazine was simply an idea. From that very first meeting in Warren Street Cafe Nero, Alex Maidwell-Smith (RUMS President) has been nothing but supportive and we would like to say a special thank you. During his time in office, he has put a tremendous amount of work into strengthening the RUMS MSA identity, maintained strong relations with the medical school to ensure students’ concerns are addressed and stepped up to the mark during a very difficult period externally (junior doctor contract), while ensuring the RUMS community was well informed and represented throughout. The RUMS Review editorial team looks forward to continuing this strong working relationship with next year’s committee. In the same light, we would like to thank the hard work and commitment of our editorial team, contributors and staff, both at the medical school, and at UCL. We look forward to further improving the magazine in the year to come, with the help of our new editorial team. But lastly, we would like to say thank you to you, our readers. Thank you for picking up the magazine, reading it, talking about it, integrating it into medical school life and hopefully enjoying it!

rums

review

4


editorials

5 mbbs year

rums medical student association president

alex maidwell-smith

In February, the whole RUMS Exec attended the first ever United Hospitals Conference. This allowed the committees from all five London Medical Student Associations to meet and share ideas. This was a hugely valuable experience for everyone involved as we learnt how best to improve our respective organisations and serve the students we represent. Hopefully some of what we learnt will be translated into real benefits for you!

Dear All, Welcome to the third edition of the RUMS Review! Once again I would like to congratulate Rebecca and Sophie on another stellar edition and for all their hard work this year to make the magazine a success. The last term has been fantastically busy and I would like to thank my team on the RUMS Executive for all their hard work! Furthermore, I would like to wish the newly elected Executive led by Raj Pradhan the very best of luck when they take over at the end of this year!

Our sports clubs and societies continue to go from strength to strength. Whilst RUMS were unlucky in the London Varsity Series and the United Hospitals Challenge Cup, the level of support was incredible and demonstrates the depth of feeling that underpins our sports clubs. Indeed, success was eventually achieved at the United Hospitals Head of the River, as RUMS BC picked up wins in 5 of 8 categories. As ever, The MDs demonstrated their wide array of talent in wiping the floor of the other London Medical Schools at the United Hospitals Revue with a unanimous decision reached by the judges. It’s all becoming too easy for them! As AGM season comes to an end, I would like to wish all the new committees the very best of luck as they look to the fast approaching 2016/17 season! Since January, RUMS MSA has hosted a vast array of events ranging from RUMS Dine with Me to the incredible Sports Ball held at the Royal National Hotel. With over 460 guests, it was the biggest and best Sports Ball we have ever put on. Its success was due in large part to Andy Webb (Sports and Societies Vice-President) and the huge amount of effort he put into it. Numerous awards were given on the night, the highlights of which were Sports Personality of the Year (Rob Tuckwell) and Team of the Year (Men’s Tennis 1st Team). In the coming term there are already grand plans for a Summer Ball, tickets are currently on sale for Finalists’ Ball and we have the Fifth Year Show to look forward to, which promises to

5

be side-splittingly funny. The fun never ends! This term has also seen some quite large academic issues raise their heads. RUMS has worked hard to make sure that students are well represented at the highest levels of medical school bureaucracy and that the best outcome for us is achieved. Both Ravi and Ozzy (RUMS Vice-Presidents for Education) and the module representatives have been working closely with the medical school to make the changes that you want. Please keep filling in the feedback forms that get sent out - they are hugely valuable when we look to try and propose changes. Most notably was the disruption caused to final year OSCEs as a result of the BMA Industrial Action. This posed a huge challenge for the medical school but RUMS MSA were in near daily contact to ensure that final years were not disadvantaged by the changes. Thankfully everything ran smoothly and I would like to congratulate the finalists who will be graduating in July! We are all going to miss you but wish you well in the future! Sadly, the next term sees more exams on the horizon - especially for pre-clinical students. If anyone has any major concerns and would like to chat to someone who has been through it all before, please don’t hesitate to contact Vignesh Gopalan (Welfare Vice-President) who will be able to point you in the right direction. If you would like to get in contact with me with any suggestion or concerns my email is zchahx0@ucl. ac.uk. As this is my last update in the RUMS Review, I would also like to say thank you to you all for making my year in charge of RUMS MSA as enjoyable as it has been! Thank you to all, Alex Maidwell-Smith

vol.

I,

no.

III


scanning the horizon

When Issue 2 went to print, the medical education and healthcare fields were buzzing with new activity and announcements: they have been just as buzzing in the last few months. The GMC has recently confirmed their plans to introduce a new national Medical Licensing Exam (MLA). Developing and implementing a large scale national examination is not a speedy process, and although activity is well underway it is unlikely to affect our final year students until about 2022. The GMC team came to visit UCLMS last month to listen to our views and ideas about the assessment and to meet with some of our current students. They plan to visit all of the English medical schools before announcing the format and structure of the assessment. UCLMS has significant assessment expertise and the GMC have asked us to stay involved in the design. We hope this will mean a robust but proportionate method of assessing final year students, and will keep students updated as more information is forthcoming. Reassuringly UCLMS students do very well in national assessments: all bar one of our finalists passed the national Prescribing Safety Assessment earlier this year at their first sitting so our students should not get too vexed about the MLA. As I write this the BMA has just announced a significant increase in scale of the planned industrial action by junior doctors. The proposed junior contract, and the industrial action taken in response, impacts on our students in many ways. Some students have been in contact about planned changes to teaching and assessments during the industrial action and we

rums

review

an improved medical school building

It can’t have escaped students’ notice that UCL is working furiously to improve the quality of the estate – particularly on the Bloomsbury campus. It is looking like the Medical School will benefit from some of this activity with improvements to the Rockefeller and Huntley Street buildings. Plans are in the early stages but are likely to focus on the skills centre (at last) and the student reception and social areas. The Postgraduate Dental School (the Eastman Dental Institute) will be moving into parts of the Rockefeller building and we hope they will make good bedfellows. Who knows, in a couple of years we might have a building that says ‘UCL Medical School’ over the door with a corresponding interior! In the meantime, we are pushing hard to improve what is already there. I will keep fighting until LT1 has a clock and a microphone that works!

meeting people

The Medical School is a big and complex organisation and as Director it is easy to become removed from the very thing that makes us special: our students. This term I have been making a concerted effort to get out and see more of our students and what they are up to. I was delighted to see so many of you at the UH Rugby final and the boys’ and girls’ varsity hockey. I even met some of your parents! Whilst we did not bring

6

NEW SCHOOL

I am delighted to be providing an update about Medical School news in the third edition of what has turned out to be a really excellent publication (well done Eds). I hope you find this update useful and would, as always, welcome your views and comments.

MEDICAL

Deborah Gill, Prof. Peter Delves

have given some general advice. Because of local variation and unpredictability of teaching, attendance has not been formally measured on these days. The junior doctors we have spoken to have been clear that they do not wish to disrupt your learning and so if teaching is taking place we have urged students to attend. There have been picket lines at the entrances to some clinical sites. These picket lines are clearly not there to dissuade students from entering but we understand students may feel uneasy about crossing them. We, as a school, have not issued any guidance or an official stance concerning the industrial action. At UCL we respect a range of views and will not tend to tell people what to do or think. We have suggested students and staff may wish to show their support (or disagreement) with the industrial action in a range of ways: signing a petition, wearing a badge, taking part in demonstrations, etc. We are proud to say that the manner in which our students (and former students) have expressed their views have been professional and thoughtful. On a personal level my concerns are that the suggested changes to junior doctor contracts have the potential to impact on the morale of our students as they enter practice at the very time that new doctors should be hopeful and full of enthusiasm. Like you, I very much hope that the situation can be resolved quickly in a way that doctors in training, and future doctors in training, can feel valued and supported in their work and careers.


editorials

home any trophies no one could say the players did not give their all and their supporters gave some pretty vocal support too! We had more success in the Be the Change Challenge: a national project to get healthcare students centrally involved in quality improvement in the NHS. ‘Team UCL’ were huge, well-coordinated, slick, and produced some fantastic work. Their victory was well deserved and we now have a trophy for the empty plinth in the cruciform hub. I have also met some delightful first years during the Monday Mixers who have been getting involved in all manner of UCL activities and events. Although I did not meet students face-to-face, I have also fielded all of the finalist’s queries about the emergency changes to finals. These e-mails have reminded of what concerns students about how we run the School, how resourceful and resilient our students are by year 6, but also how respectful and professional they are. I even discovered how funny they can be, even in the face of adversity*.

retirements

Finally, the medical school will say goodbye to a number of key individuals in the summer. After many years of service Brenda Cross, the Faculty Tutor, Irving Taylor the Vice Dean for Professional Affairs and stalwart of UCLH ward based surgery teaching, Peter Delves the Infection and Defence guru and Anthony Silverstone, one of our longstanding support tutors will all be taking well-earned retirement. We wish them well and hope they will stay in touch with us at UCLMS. If they have helped you in some way or you have good memories of their teaching and support of learning, please do send them a card, email or note to say thank you. It really means something to our excellent staff when they know they have made a difference. *A special message for finalists We are very proud of you and your performance in the PSA and the rapidly modified finals. Enjoy your SSCs and electives. Don’t forget to send those postcards and PLEASE COMPLETE THE NSS!

What this has reminded me of is that I don’t get to speak to or see students enough. My experience is that it is face-to-face conversations (or if all else fails, e-mails) that most effectively let us know what you are enjoying and want more of, what you want us to pay attention to or try to change and what makes being at UCLMS fulfilling and fun. So when you see me walking about in College, around Bloomsbury or one of the clinical campuses (or even in Sainsburys) – come and say hello, tell me how it is going and tell me what we need to do better. I look forward to it.

Follow us on twitter @doctordeborah @UCL_MBBS

Deborah Gill, Director, UCLMS

7

vol.

I,

no.

III


i. You said:   You  would like to have an increased number of small group tutorials, to allow for more interactive learning. We listened:    Overall, small group tutorials increased from 5 to 8 for this year (2015-16). ii. You said:  There is too much lecture-based teaching in CPP.  We listened:    In response to this, two new small group work sessions have been added in year 2. iii. You said:  You would like a

Some other accomplishments include the Cruciform Hub being open continuously for 10 weeks from Thursday 24 March through to Saturday 4 June. Additionally, there was the introduction of ‘Monday Mixers’, a series of informal social events for all first year students to meet with academic staff and converse about issues pertaining to both the course and university life in general. The main ongoing issues have been problems to do with audiovisual systems in LT1, and trying to increase both attendance and feedback response rates. With the time I have left, I will continue to work with the reps to tackle these issues as well as trying to ensure a smooth hand over to my successor.

i. Better communication to incoming Y4s Done. Students will receive an attachment with top tips about starting 4th year based on information we wish we’d known. ii. DGH Information In progress. Liaising with administration to ensure standardised information on provisions are circulated next year. iii. E-timetables Done. This has been a roaring success this year, surpassing my ambition of ‘common elements’; It is already implemented in 8 placements across Y4&5, with a view to keep expanding each term! iv. Lecturecast Not done. I gave focusing on formative/summative assessments (below) precedent given it was more high-yield and critical. v. Study spaces Done. Working closely with library staff, we’ve pushed for longer library opening hours at multiple sites, including DGHs. vi. Dispelling myths Done. I’ve worked with MedSoc Education (Y1&2 + Y4-6) to communicate that exams are blueprinted and that pass/fail quotas don’t exist. Other successes include: Year 5 IOM - is now dramatically reduced to 2 days and is more concentrated. Y5 CTWs will be less didactic and include more stimulating, interactive teaching. OSCE feedback - I led work looking at our OSCE feedback and am now working with the academic lead for assessment to implement changes for this year’s summatives. Formatives – given regular complaints that formatives questions don’t reflect the summatives’ difficulty or style. Y4s now have an end-of-module revision day with practice SBAs and later on, for the first time, a mock OSCE. Both Y4&5 have revised their formatives to better reflect summatives. Cases of the Month has been revised to involve less backtracking and repetition. Still have 5 months to go!

Ravi Mistry, MBBS Year 5, RUMS Education Y4-6 VP

fixed time for the release of examination results. We listened: We’re proposing to release all examination results at the fixed time of 10.00am the day after Examination Boards have made their decisions. The provisional date for this is the 8th of June 2016. iv. You said: You felt the FHMP module was disjointed and asked if there was a more systematic way of delivering the material. We listened:  To tackle the ‘disjointed’ nature of the module, more linking themes on key diseases have been introduced for 2015-16. We have introduced more signposts to changes in topics and highlighted their context within lecture introductions throughout the module.

Years 4-6 Education

The last few months have seen many issues around the MBBS Year 1 and 2 curriculum arising, and the module reps and myself have been working with the medical school to ensure they are tackled effectively. Here are some of the accomplishments we’ve been able to achieve on your behalf.

Ozzy Eboreime, MBBS Year 2 , RUMS Years 1-2 Education VP

Years 1-2 Education

R U R

It’s been a busy six months for myself and the Y4-6 reps. In spirit of accountability, here’s a brief outline of what I promised when campaigning and how the last 6 months have gone.


editorials

M S E P O R T S

Looking ahead to our Summer Ball still in the making! It will be held in the UCL quad on the 7th June, tickets will be cheaper than ever before and I hope to see lots of you there! More details, including the theme, will be released via the RUMS Bulletin and Facebook, so keep your eyes peeled! That’s it from me folks! Thank you all for supporting RUMS Events this year and making my job the best there is! I can’t wait to see what Ozzy will be getting up to next year!

9

Welfare

I’ve had the great pleasure to be the RUMS VP for Welfare this year, and while it’s been tough negotiating the medical school administration at times, I know it’s been an incredibly rewarding year for myself and the rest of the team! It all kicked off with Transfer’s Mum’s and Dad’s in August, welcoming the new Oxbridge transfers into our RUMS family. This was quickly followed up by the largestever attended Mum’s and Dad’s event for the incoming fresher’s (hence we ran out of pizza very quickly, sorry!). This year saw the launch of the RUMS site and the new welfare section offers a succinct summary of all the services on offer, hopefully clearing things up for those of you confused about what the medical school offers in terms of student support. Over the course of the year we’ve dealt with welfare issues on an individual basis, and have noticed an increased awareness of welfare services, which was one of our aims this year. We’ve written a welfare spread, with pointers for how to cope with first and second year from students in the inaugural issue of the RUMS Review. The Medics4Medics scheme (set up by Becki Clarke last year) has continued to flourish, with students being trained up by the charity Rethink to provide peer-support and welfare services. This year, RUMS clubs have also been encouraged to sign the LGBT+ pledge, and in conjunction with UCLU, a very successful and well-attended talk was held last month with members of UCLU and RUMS clubs to raise awareness of LGBT+ issues in sport. Looking forward, there will be a housing talk for freshers, and a drop-in de-stress session before pre-clinical and clinical exams, so make sure to keep a look out on the RUMS page! vol.

Vignesh Gopalan , MBBS Year 3 , RUMS Welfare VP

Term 1 ended on a high at our Bondthemed Winter Ball. Dubbed the event of the year by many of the freshers, everyone scrubbed up (not like that!) pretty well and danced the night away in Leicester Square. 007’s donned feather boas and Christmas specs in our photo booth - a great night had by all! A brand new event was launched in second term. RUMS Dine With Me was a roaring success, so thank you to everyone who headed down to our paired curries on Brick Lane and made it such a massive RUMS - wide social! We hope to be extending it next year to involve even more RUMS members - who doesn’t like completely filling up ULU on a Friday night?

Frankie Cackett, MBBS Year 3, RUMS Events VP

It’s been an incredible year for RUMS socially, from a sellout fresher’s Boat Party to the biggest ever Sports Ball (great job Andy!), we’ve come together like never before. RUMS welcomed its new freshers with open arms. A massive fortnight of events included the traditional scavenger hunt (some fantastic public break-ups featuring Buckingham Palace’s biggest drama), a typically messy pub crawl (thank you second years) and a similarly messy scrubs party (it was fake blood, okay) to top it all off!

Events

From a financial point of view, this has been a relatively successful year for RUMS. After a smooth finance handover (thanks to Stef Kouts), our first goals were sponsorship. After multiple negotiations we were able to gain sizeable contributions over the summer, allowing us to subsidise Freshers’ Fortnight, hold one of the cheapest Winter Balls on record, and fund other events throughout the year. Furthermore, through working closely with the union and careful management of resources, we have managed to put aside a proportion of our grant over the course of the year, which can now be invested longterm for RUMS. We also incorporated the RUMS Review into our financial structure this year. Its huge success is a testament to the determination and perseverance of the chief editors. In recent weeks, finalists ball has been a priority. For those in younger years, this is a big send off party for the final years. Thanks to the phenomenal work of the organising committee of 6th years, this is set to be bigger and better than ever before; with over £50,000 expenditure I would urge any finalists reading this to make sure they attend. Most work of the Finance and Operations officer is projections and negotiations, and I believe our successes in these fields are evident. This year, the Finance and Operations role has also incorporated PR. We streamlined our social media presence and set up our first successful website. After some perseverance (and a lot of youtube tutorials) we now have a professional online presence that will offer a solid foundation for development in subsequent years, offering information to prospective and current students as well as alumni. As next year’s President, I would like to thank the rest of this year’s committee (and in particular Alex Maidwell-Smith) for putting together a solid foundation from which we can build. Without their efforts, RUMS would not be the organisation it is today. That said, there are many areas where improvement is necessary, and this is what next years’ committee is tasked with - we look forward to the challenge.

Raj Pradhan, MBBS Year 3, RUMS Finance & Operations VP

Finance + Operations

it can sometimes be difficult to remember that rums is so much more than simply sports and societies, but also the students’ association which protects our interests and welfare. as the current committee embark on their final term in office, rums review catches up on the work that has gone on both, in front of, and behind the scenes.

I,

no.

III


Emma Lewin

news

inspire medicine conference

In its third year, the student-organised Inspire MEdicine conference was, once again, a big success. This year the conference was much more career driven, with a theme of “what does medicine mean to you/ where will medicine take you?”. It consisted of talks by speakers from various backgrounds, specialty workshops run by doctors and students in 17 different fields, a poster competition, a careers fair and a “Dragon’s Den” competition in medical innovation. Highlights of the day include the anaesthesia workshop, in which the attendees had the opportunity to learn basic skills required for anaesthetists such as intubation, the exciting talks on Wilderness Medicine and Battlefield Medicine and, of course, the MDs’ performance at the evening social. Congratulations to the inspireMEdicine committee for pulling off such an inspiring, entertaining and educational conference. We look forward to attending again next year!

sports ball

On the 23rd of March, the 460 strong RUMS sports community congregated, once again, for the annual sports ball. The evening, which was held at the Royal National Hotel, was a perfect way to celebrate the successful year of sport, featuring a 3 course meal, award ceremony and plenty of dancing. Team of the year was awarded to tennis men’s 1st team, whilst the coveted freshers of the year went to Josie Baker (women’s hockey and squash) and Josh Bryan (men’s football). Robert Tuckwell was the deserving winner of this years sports personalty of the year. Honorary life membership went to the following: Doris Chan, Karen Erskine, James Gladwin, Cleo Huang, Isabelle Goldrick, Katie Westbrook, Rishiraj Banerjee, Akash Maniam, James Oldman, Sunil Parthiban, Nicholas Makins, Tom Nash, Eleanor Croft, Karen Erskine, Natasha Graham, Christopher Bu, Harry Gross, Anya Borissova, Victoria Chelliah, Garima Govind, Robyn Brown, Charles Holden, William Rea, Jacob Wilson, Timothy Wagner and Matt Cox.

lumsden cup

On the 22nd of March, RUMS Netball held their annual charity event, the Lumsden Cup (a netball tournament held between each RUMS sport). The money raised this year went to Children’s House of Hope, which sends clothes, toys and medical supplies out to several communities in Ghana. The atmosphere was enjoyable and became particularly heightened when the MDs started to show great promise! The final involved MDs vs Rugby competing for 3rd place and a match of netball 1s vs 2s for 2nd and 1st place, with netball 2s ultimately winning the tournament. The money raised from the Lumsden event will be used to set up a room in the health centre.

NEWS

BULLETINS

finalists

rums

review

A huge congratulations to the finalists, who finished their exams on 15th March and have now received their results. However, their time at UCL is not quite over as they are currently having an exciting time on their various electives and “preparation for practice” SSCs. Their graduation on 7th July will be celebrated with a ball- dinner, dance and overnight stay- a few days later at the Beaumont Estate in Windsor. After a well-deserved break they will then start their first jobs as doctors on 3rd August. It is going to be an exciting few months for the finalists and we would like to wish them luck for starting their new jobs. Well done on completing medical school!

rums dine with me

On 26th February, an unprecedented event took place in which there was some rare mingling between the various RUMS sports teams (and MDs). Each team was grouped with at least two others and together they ventured to the Indian Restaurants of Brick Lane. The event was a huge success and there are plans for it to take place again in subsequent years.

rums summer ball

It has just been announced that the RUMS Summer Ball will take place on 11th June this year. The theme will be “A Midsummer Night’s Dream” and it will take place in the UCL Quad Marquee. It is bound to be an enchanting event so get your tickets soon!

nugsc

The National Undergraduate and Foundation Surgery Conference (NUGSC) 2016, organised by UCLU Surgical Society, took place on 19th March. The first undergraduate surgical conference officially endorsed by more than one surgical college, it was a professional and inspiring conference with a particular focus on the future of surgery in the UK. The conference was composed of a series of surgical skills workshops and talks from some very high profile surgeons as well as an academic research competition. The NUGSC was an exciting event and the perfect opportunity for anyone potentially interested in a career in surgery to gain an insight into such a varied field.

10


news

ucl medical student commended emergency care

for

exemplary

Asma Ashraf

ucl medical students taught of forced marriage

Anamika Kunnumpurath

Ms Williams, a 5th year medical student, was recently commended on her “Willingness to help, for ensuring the patient’s safety with an ABC approach and for her calmness in the circumstances”, whilst attending to a gentlemen who had collapsed in a busy tube station during rush hour. Dr Lucy Bemand-Qureshi, a palliative medicine registrar who was also passing by, was impressed when Ms Williams ensured he was in the recovery position, checked his ABC, and gave a calm, brief handover. Ms Williams proceeded to assist Dr Bemand-Qureshi until paramedics arrived.

uclh institute of sport, exercise and health recognised as an international olympic committee research centre

to

spot signs

UCLMS has recently featured in the BBC news because of their emphasis on educating medical students about recognising the signs of forced marriage. NICE has recently called on healthcare to do more in terms of ways to tackle the issue. The BBC news report talks to a victim of forced marriage and then highlights what is being done at UCLMS and features Year 5 medical students talking about why it is important they learn about it. Watch this link: http://www.bbc.co.uk/programmes/p03pd5rp

The UCLH Institute of Sport, Exercise and Health (ISEH) has been recognised as one of nine International Olympic Committee (IOC) Research Centres for Prevention of Injury and Protection of Athlete Health from across the world. The newly appointed IOC status commends their eminence in the field of Sports and Exercise Medicine. The IOC’s partnership with this endeavour will facilitate financial support and collaborative links to a global team of clinicians and scientists working towards optimising care in elite sport.

free online dementia course In March 2016, UCL launched a new, open online course “The Many Faces of Dementia”. Created and led by Dr Tim Shakespeare of the UCL Institute of Neurology, this free four-week course is designed for anyone with an interest in learning more about dementia and its impact. It is also suitable for those who interact regularly with people living with dementia, such as healthcare professionals, students, families and carers. The course commenced on the 14th of March 2016. However you can still sign up by going to www.ucl.ac.uk/lifelearning/courses/dementia-many-faces. The course will also run again in autumn 2016. George Wall

uh match

report

“13-12 to George’s.

The final whistle blows. The reaction of the crowd was felt instantaneously, elation from St George’s, and commiserations from RUMS. The disappointment for the team after all the hard work and training they had put in over the year was evident. Nevertheless, the RUMS supporters stood proudly by their team, knowing they had represented RUMS to the upmost standard on this night and all year; cries of ‘Middle middle middle’ went out to be echoed back by all with ‘sex, sex, sex’.” For the full match report by George Wall, MBBS Year 2, please visit: www.rumsreview.co.uk

11

vol.

I,

no.

III


news

uclms victorious

in

first

ever

nhs

quality improvement university

article by dina radenkovic

championship

Established in September 2015, UCL Be the Change (BTC) is a large student-led quality improvement initiative consisting of medical and pharmacy students. Medicine typically has a hierarchy which is detrimental to innovation, but UCL BTC aims to make full use of motivated medical trainees at all career stages, including students, in order to improve the efficiency of the NHS. This initiative proposes a model of how medical and pharmacy students can work (for free) with experienced healthcare professionals and carry out audit and quality improvement projects. Using Slack, a team collaboration tool used by leading global tech companies, UCL BTC functions as a small healthcare start up. Thus far, this student collaborative has developed unique digital solutions, customised for healthcare professionals, for project matching and efficient communication. The red book and implementing policy changes to improve the usage of Patient’s Own Drugs scheme and reduce medicinal waste. Other pursuits include testing virtual reality for clinical skills teaching and tackling issues such as patient nutrition and safeguarding patient property in a hospital setting. In March 2016 UCL BTC won the first ever NHS Quality Improvement University Championship. The competition was among all five London Medical Schools and took place in the BMA house. The judging panel comprised of representatives from the Health Foundation, Department of Health, NHS England, McKinsey, Institute for Healthcare Improvement and Directors of all five London Medical Schools. Winning the NHS Championship shows that this student-led model can be successful, but the mission does not end here; the team want to see a change in culture. UCL BTC wants a system that will support and nourish the innovative ideas of students and where quality improvement, not solely biomedical research, will be required for career progression. All healthcare professionals are also leaders and managers, and this leadership role starts now!

rums

review

12

More information is available on the UCL BTC website: http://btc-ucl.me.

projects are very diverse and include designing a new checklist for the


news

t

e

e

d

c

o

i

n

a u

n

t

l

c f

g

a e

t

t r

o

i e

n

n h

o

n

c

e

UCL students recently

child born with Treach-

together medical and

environment will be

played a major role in

er Collins syndrome.

pharmacy

students

familiar to UCL Med-

the recent Whitting-

Urvi and Alex have

for hands-on practical

ical students and the

ton Health Education

recently completed the

paediatric prescribing.

introduction of it for

Conference, held on

iBSc in Paediatrics and

This was evaluated as

NHS staff will ensure

the 23rd of March. The

Child Health.

a success, particularly

continuity in e learning

Conference

de-

It was then time for role

with breaking down

for Medical Students

signed to showcase in-

play, with final year stu-

the barriers of incorrect

moving to the Founda-

novation in education,

dents Dev Chatterjee

pre-conceived negative

tion Programme with

learning and training at

and Ciaran Megoran

views and stereotypes.

Whittington Health.

the Trust.

taking method acting

The afternoon began

During the conference

The morning plenary

to new extremes. They

with Megan Clear-Hill,

the visiting artist Lance

session was launched

played

themselves,

a 5th year Medical stu-

Bell

by Caroline Fertleman,

re-enacting a scenario

dent, describing the

the event. Lance im-

who is a Consultant

where a teenage patient

exciting UCL pre-hos-

provised cartoons to

Paediatrician

the

with asthma talks about

pital care programme.

illustrate some of the

Hospital, as well as the

why her smoking cessa-

This sees students gain-

educational innovations

UCL site Sub-Dean.

tion consultation had

ing invaluable insight

being presented.

Caroline

failed to change her

and experience in a

Ian Probert, novelist

habit.

range of settings, in-

and father of a recent

The general theme of

cluding days with am-

adolescent patient, who

the conference con-

bulance crews, dealing

gave a poignant and

cerned integrated edu-

with incidents ranging

eloquent speech about

cation and this was well

from cuts and bruises

his daughter’s recent

illustrated by paediatric

to cardiac arrests. The

illness. UCL medical

trainee

Birley,

programme is entirely

students, Urvi Patel

who described a teach-

student run and stu-

and Alex Harvey, then

ing initiative bringing

dent devised - a won-

was

at

introduced

Kate

read moving patient

derful step into inte-

journeys that are being

grated education. It has

published in a book

been carefully planned

due out this year. Urvi

to continue through

read out Ashoka’s story,

new

who received a kidney

uses Moodle as a vital

from her mother. Alex

education and admin-

read

istrative platform.

about

Wendy’s

experience of having a

leadership

caroline fertleman

h

t

&

i

illustration by lance bell

h

article by richard peacock

w

“live-scribed”

and

The conference concluded with the launch of

the

Whittington

Moodle. The Trusts’ new virtual learning

13

vol.

I,

no.

III


words by constance wraith

news

UCLMS Student Gains Pledges for the Housing of 20 Camden Refugees One of the clichés that many of us used when writing our personal statements to get into medical school was that we wanted to ‘make a difference’ to the world. However, with the intense workload, busy social and sport commitments and a need to fit in sleep somewhere, many of us may feel that we have not yet made a significant difference during our time in RUMS. Issy Good, a second year student, wanted to start making this difference, so joined a charity called Citizens UK who are currently running a campaign to find homes for 5,000 refugees displaced by the Syrian conflict. She took on a major role and organised a large event in Camden Town Hall on 14th March, in a bid to raise awareness and get MPs to pledge to make an actual difference in the local area. Among those in attendnet (leader of the Green (QC and Labour MP for and Tim Farron (leader crats) as well as members Also

speaking

were

soldier who has done in Calais and Dunkirk. insightful as he has re-

PLE DGE

for trying to smuggle a

ance were Natalie BenParty),

Keir

Starmer

Holborn and St Pancras) of the Liberal Demoof

Camden

Council.

Rob Lawrie, a former huge amounts of work This

was

particularly

cently been prosecuted four year old girl who is

living in The Jungle, and reunite her with her family in the UK. Ahmad Al Rashid, a Syrian refugee himself who has lived in The Jungle and now lives in the UK, also spoke. Issy was responsible for organising and chairing the meeting as part of the Citizens UK charity. She took a leading role in asking these influential politicians to pledge to ensure that at least 20 refugee families are rehoused in Camden by 2020, as well as to try to raise the government targets. All the attendees, apart from Starmer, agreed wholeheartedly to this task. The event was a huge success, with a turnout of over 60 Camden residents all pledging to do their part towards finding refugees a home here in Camden. They intend to do this by talking to landlords and encouraging them to rent their houses to the government for refugees as well as attending Citizens UK rallies later in April.

rums

review

14


faqs and misconceptions myths,

cal and surgical conditions to help keep

UCL is currently only one of two uni-

your ‘book work’ knowledge up to date.

versities in the UK to offer a formal

New for this year, there are tutorials

MBPhD programme. This unique

with Dr Marks every few weeks, where

programme offers research-inclined stu-

we each get given a real-life case in ad-

dents the opportunity to take time out

vance. We then discuss how we would

of full-time clinical studies to pursue an

like to proceed with specific questions

extended period of research in the form

in the history, clinical examination,

of a PhD. This means students follow-

investigations, work-up, and short and

ing the programme will graduate with

long-term management. There is also

MBBS, iBSc and PhD degrees.

the opportunity to get involved with

rums research

p r o g r a m m e m b p h d u c l

WHAT IS THE MBPHD PROGRAMME?

the on-call team at UCH whenever you WHEN DO STUDENTS UNDERTAKE THE

want, and this offers a great opportunity

PHD PHASE OF THE PROGRAMME AND

to keep your independent clerking up to

HOW LONG DOES IT TAKE?

scratch. The clinical teaching delivered

There have recently been some changes

as part of the programme is certainly in

to the structure of the programme, and

line with - if not better than - the best

all students are now expected to enter

teaching which I received as part of 4th

the PhD part of the programme after

year. Besides a couple of random SBA

year 4 of the MBBS course. This means

facts which I may have forgotten, I do

that they will have already completed

not feel that my clinical knowledge has

pre-clinical years 1 and 2, along with

suffered as a result of pursuing the MB-

their iBSc year and first clinical year.

PhD. In fact, if anything, the excellent

The PhD phase then typically takes 3

clinical teaching is one of the best as-

years to complete, before students re-

pects of the programme!

turn to complete MBBS years 5 and 6. In total, the programme is therefore ex-

ALL THIS EXTRA TIME SOUNDS EX-

pected to take 9 years to complete.

PENSIVE, HOW IS IT THE PROGRAMME

DO I HAVE TO DO MY PROJECT IN THE

There are 3 aspects to the funding of

SAME LAB AS MY IBSC?

any PhD.

FUNDED?

Absolutely not! You do not need to choose your project until after you have been accepted onto the programme.

t h e

article by richard bartlett

Ever considered taking an MBPhD, or even know what it is? RUMS Review research editor and MBPhD student Richard Bartlett explores the programme, dispelling myths and explaining potential career benefits along the way.

Some people do indeed choose to con-

1

Bench fees – the money that goes your lab to pay for materials to allow you to conduct your research,

tinue projects from their iBSc, however, this is by no means expected. In fact, where the programme funds you personally - rather than a specific project as

2

Tuition fees – the money that goes to UCL to pay for the services provided by the Doctoral School.

with other PhDs - you are pretty much free to apply to any supervisor within

Stipend – the money that gets

UCL. This gives you great flexibility and

paid to you directly for living

choice in selecting your supervisors and project, since you can apply for projects

3

costs (akin to student finance e.g. a wage).

across all the UCL laboratories and specialist hospitals, in addition to affiliated

Although the programme organisers

organisations such as the NIHR and

cannot guarantee funding per se, to date

Cancer Research UK (both hosted at

there have been no instances where the

The Francis Crick Institute).

programme has not managed to fund MBPhD students in their entirety. This

WILL I FORGET ALL MY CLINICAL

means that pursuing the MBPhD pro-

KNOWLEDGE DURING THE 3 YEARS OF

gramme will not cost you a penny, nor

THE PHD PHASE?

will you have to repay any of it once

Unlikely! In recent years the programme

you graduate (as you would do with a

has really ramped up the amount of

student loan). All in all, this means that

clinical teaching which is on offer. Typ-

the programme should be financially

ically, there are 2-3 bedside teaching

accessible to anyone and financial wor-

sessions per week with consultants or

ries should certainly not be a barrier to

registrars - including the legendary Dr

applying.

Daniel Marks! In addition, there are also sit-down seminars covering core medi-

15

vol.

I,

no.

III


“students

o

o n c e p t i o n scored top i the mbphd?

The programme puts you ahead of the game in terms

You will be-

of academic career progression – it means you are

come out of

able to apply for post-doctoral positions and re-

sync with your

search fellowships at an earlier stage than your

year

peers in the clinical academic training pathway.

group.

This was initially something I wor-

It offers 3 years to consolidate clinical knowl-

ried about, howev-

edge in an intimate and personable teaching

er, after seeing the

environment with some of the best clinicians

strong cohort spirit

at UCL.

amongst

current

MBPhD students, I You will re-enter clinical medicine highly

became much less wor-

research literate, meaning that you are

ried.

more likely to be asked to help ward

Maintaining

teams in performing research/audit.

phase comes at a cost – this

A number of specialties now require

can mean evening teaching

post-graduate qualifications such as

and early starts.

PhDs/MDs to progress to consultant level, and so undertaking a

An early PhD is not a ‘golden

PhD now as part of the well-sup-

ticket’ to securing clinical ac-

ported, integrated, and fully

ademic jobs – you will still have

funded programme is a very

to do all the other things required

appealing prospect.

for a training number. Nevertheless, 3 years of full-time research under

Doing a PhD now means

your belt will certainly help you to se-

that you do not have other commitments such as family/mortgages

and

so you are more likely

cure a competitive portfolio of peer-reviewed publications and conference presentations.

to be able to concentrate on producing high-quality research without other pragmatic barriers.

rums

review

clinical

knowledge during the PhD

16

disadvantages

advantages

what are the advantages and disadvantages of the

program


ften

have

the

misc

-

that they need to have n their year to apply to me

.”

should lower results automatically exclude you.

There is typically an information open day in

Rather, it would seem that the programme or-

mid-January and applications must then be

ganisers are looking for those students with a

submitted by mid-February. The application

genuine enthusiasm in their subject area, a good

requires you to submit a CV, application form,

all-round understanding of the scientific meth-

and two academic references. The application

od, and an honest desire to inform and improve

form is quite comprehensive and often includes

clinical practice through translational research.

a reiteration of what might be included on your

Of course, it is impossible to say with certainty

CV. There are specific sections on previous

exactly what the programme is looking for, but

qualifications, prizes, research projects, special

these were the main things which seemed to be

interests, extracurricular activities, positions of

asked about in my interview.

rums research

WHAT IS THE APPLICATION PROCESS LIKE?

responsibility, and your practical experiences of medicine. There is also a 1-page personal

WHAT IS IT LIKE BEING AN MBPHD STUDENT?

statement to detail your reasons for applying

So far I have thoroughly enjoyed being a part

to the programme and for you to outline any

of the MBPhD programme. In particular, it

potential areas of research interest. People often

has been great to be able to pursue research to

have misconceptions about the latter, thinking

a higher level and with a greater level of inde-

that you need to have a specific project in mind.

pendence and autonomy than was afforded at

This is certainly not the case, and this section

iBSc. Equally, it’s also been really refreshing to

of the application is just for you to express an

learn clinical medicine without the constant-

interest in a particular area. For instance, I just

ly looming threat of exams. This has meant it

stated how I was interested in exploring the use

has been possible to learn topics properly and

of tissue-engineered and regenerative medicine

to a deeper level, rather than the usual mantra

strategies to repair the damaged central nervous

of cramming information during rotations in

system.

preparation for what is likely to come up in the

After submitting the application, shortlisted

end of year OSCEs and SBAs. Moreover, all the

candidates are then required to attend an inter-

people involved in the programme are nothing

view around mid-March and hear back whether

short of fantastic, and I feel incredibly well-sup-

they have been successful or not very shortly

ported, both in terms of my research and in

after. Generally speaking, you can either apply

maintaining my clinical knowledge. Further-

to the programme in your iBSc year or 4th year.

more, due to a long-standing arrangement with

The only exception to this is for projects hosted

the annual UCL Clinical Prize Lecture, last year

at The Francis Crick Institute, where, because

we were all fortunate enough to go for coffee

of an additional internal interview, you must

with the pioneer of somatic nuclear transfer

be accepted onto the programme during your

(cloning) and Nobel Prize winner, Prof Sir John

iBSc year.

Gurdon. This was an amazing experience, and not one I ever could have anticipated a year ago!

IS IT ONLY PEOPLE WHO ARE TOP OF THEIR YEAR WHO GET A PLACE?

Overall, the programme offers a fantastic and

Students often have the misconception that

unique prospect for anyone hoping to pursue a

they need to have scored top in their year to

clinical academic tract, and given the excellent

apply to the programme. It’s probably fair to

support and opportunities available through-

say that most applicants will have competitive

out, I would strongly encourage anyone inter-

academic results, however, these do not equate

ested to apply.

TESTAMENT // DR JOEL WINSTON

to an immediate place on the programme, nor

For young trainees interested in academic careers, it’s hard to know when is the right time to break from the clinical treadmill and take the plunge into a research degree. My experience of taking that plunge early and completing my MBPhD at UCL was a highly positive one, and one which continues to contribute to my academic progress. My PhD research was entirely pre-clinical and concerned the functional neuroanatomy that underlies human face perception. For me, doing an MBPhD meant the freedom to conduct research at a career stage when my ideas were still fresh, and allowed a depth of training in research methodology that is perhaps harder to attain later on. Additionally, it meant that I went back to full-time clinical training more mature, better equipped to evaluate evidence, and with a proven academic record (early publications, talks and other evidence of impact) that has helped me at every single subsequent career point.

For sure, there are downsides - it’s always going to be harder work to do a PhD than not to do one! The juxtaposition of finishing one’s PhD as the world expert on an (admittedly small) area and returning to being another one of 400 anonymous medical students is quite tough. Completing the clinical aspect of the course without any substantive scientific productivity is also a challenge, as can be re-entering into a different peer-group.

15 years after starting on the MB PhD programme, I am now pursuing post-doctoral research funded by the Wellcome Trust MBPhD Postdoctoral Research Fellowship. This has allowed me to build on the technical foundations laid during my PhD research as well as learn new research techniques, and tackle questions of much greater clinical relevance. I am also reaching the end of my clinical training in neurophysiology. Admittedly, there are other paths that would have got me where I am today, but I think that pursuing the UCL MBPhD programme was definitely the right one for me.

Useful additional information: www.ucl.ac.uk/mbphd

17

vol.

I,

no.

III


THE

OPIOIDS

H Y POT H E S I S

IN

I N S E N S I T I V I T Y T O PA I N . When mice are genetically

‘ M U LT I P L E OF

A LC O H O L I C

HIT’ NON-

A

NOVEL

TRIALS

IN

NOVEL

T R E AT M E N T O F D I F F U S E

UCL researchers found

SYSTEMIC SCLEROSIS.

I M P R O V I N G A U TO M AT E D

ACUTE KIDNEY INJURY (AKI)

that clerking improved in

Patients with established

Non-alcoholic fatty liver

almost every section, after

diffuse systemic sclerosis

To improve on the current

a loss of function in

disease

a series of interventions

were given an intervention

system used by UCL

their

SCN9A

gene,

the accumulation of fat

that

of hyperimmune caprine

hospitals to monitoring

the

subsequent

loss

in the liver of patients

clerking pro forma, a

serum

to

AKI alerts, a study on

sodium

who do not consume

guide to clerking written

determine

safety

and

patients’ outcomes found

excess alcohol, of which

by final year medical

tolerability.

This

the

understanding

students, and new lectures

was shown to be not

bicarbonate

correlated

to pain. This loss leads

its

development

with

mortality

to an upregulation of

progression

an

described by a ‘two-hit’

a

specific

channel congenital

results

in

insensitivity

endogenous

opioid

LIVER DISEASE. (NAFLD)

has

is

of and been

included

an

a

new

integrated

(AIMSPRO)

agent

ALERTS.

that

levels

of

only clinically safe, but

with

also

potential

and a greater chance of

introduced.

improvements in patients’

being admitted to the

mean Modified Rodnan

ICU. AKI alerts can detect

Skin

these

hypothesis.

Researchers

significantly to the pain

from UCL, however, have

SPECIALITY

insensitivity.

created a new model to

C O N S I S T E N C Y.

CHOICE

describe the pathogenesis

Students

of NAFLD: the ‘multiple-

penultimate

hit’ hypothesis. This new

medical

model may potentially

asked

+

showed

Score,

examination

in

their

clinical

levels

of

serum

technique,

bicarbonate and add them

suggesting clinical benefits.

to the patient’s clinical

of

report automatically. This

were

suggests these alerts can

specialty

be used to predict which

be used to help elucidate

they were interested in

patients are at higher risk,

the

mechanisms

as a career, and then

and ensure these patients

NAFLD,

followed up two years

receive

in

turn

later with a questionnaire

sooner.

inform new therapeutic

to see which specialty they

interventions

as

actual chose. It was found

targeted pharmacological

that only 65% of specialty

treatments.

choices were consistent,

which

in will

such

school which

with

post-graduation

experiences

significantly

influencing

people’s

decisions.

18

year

a

higher

venous

focus on clerking were

system, that contributes

involved

review

TO

modified and there is

of

rums

W AY

IMPROVE CLERKING.

F AT T Y

UCL RESEARCH DEPARTMENT OF INTERNAL MEDICINE

UCL RESEARCH DEPARTMENT OF INFLAMATION

UCL ACADEMIC CENTRE FOR MEDICAL EDUCATION

UCL WOLFSON INSTITUTE FOR BIOMEDICAL RESEARCH

UCL RESEARCH DEPARTMENT OF LIVER + DIGESTIVE HEALTH

rums research

ROLE OF ENDOGENOUS

interventions


UCL RESEARCH DEPARTMENT OF RESPIRATORY MEDICINE

UCL RESEARCH DEPARTMENT OF NEPHROLOGY

UCL RESEARCH DEPARTMENT OF METABOLISM + EXPERIMENTAL THERAPEUTICS P O T E N T I A L

P R O T E C T I O N

CHANGES

PREVENTION

A

THE

F E TA L

OF GROWTH

R E S T R I C T I O N THROUGH

GENE

G

A

I

N

S

T

IN INCIDENCE,

P R O G R E S S I V E

PREVALENCE,

KIDNEY DISEASE.

M O RTA L I TY

By reducing metabolism of

AND OF

B RO N C H I E CTA S I S.

asymmetric

Bronchiectasis is a chronic

Researchers at UCL have

dimethylarginin

respiratory condition that

been experimenting with

(ADMA), an inhibitor of

results in persistent airway

using gene therapy to treat

nitric oxide synthesis, a

infections.

fetal growth restriction,

study has shown that this

to 2013, a cohort study

failure of the fetus to reach

decreased

renal-specific

of the UK population

its full growth potential.

ADMA metabolism has

revealed that for each year

In a guinea pig animal

led to protection against

during this period, the

model, researchers have

progressive

incidence and prevalence

shown that by using gene

function decline.

T H E R A P Y.

therapy

to

target

the

kidney

From

2004

of

bronchiectasis

the

population

in grew.

maternal uterine artery,

Bronchiectasis

it increases the weight of

associated

is

the guinea pig at birth.

mortality,

This suggests that this

these

therapy may play a role

an important place in

in preventing human fetal

providing patients with

growth restriction.

the appropriate clinical

with

also higher

and

increases

so have

care.

RESEARCH ROUND-UP WORDS BY ENG O-CHAROENRAT ILLUSTRATIONS BY KATE ALICE MACKENZIE

19

vol.

I,

no.

III


alumnus interview

Hugh Montgomer y WHAT WAS YOUR EXPERIENCE OF UNIVERSITY LIKE?

What I remember of Medical School is of great parties, lots of sport, Christmas shows and all sorts of other things…I probably had to work quite hard, but you don’t remember that! Imagine being lectured by people

like Eric Neil who discovered the carotid sinus; 78 of us, always hungover!

Hugh Montgomer y

I was in the rugby social team, ‘the dead ants’ (when it was almost clear we were going to concede, everyone would throw themselves on their backs, wave their arms and legs and then let them score!) and I was an MD - we

had our own theatre back in the day, the Edward Lewis theatre. It had a professional stage and sound system. At the time, the head of EMI, the

big record label, had been shot in the face nearby in Hampstead, and our Dean dug the bullet out. The head of EMI was pretty grateful and offered

to do something for the hospital, and being a great Dean, he said, ‘Why

don’t you give a load of money to the medical students?’ He didn’t, but he gave us the best EMI sound recorder for two weeks every year, so we’d have

Professor Hugh Montgomery, current director of the UCL Institute of Human Health & Performance, is both a

the guy who was recording the albums for the Rolling Stones doing the sounds for the MDs’ Christmas concert. I’ve still got my review from the Evening Standard – ‘the best entertainment in the West End!’

delight and a challenge to interview.

YOU ARE THE WORLD RECORD HOLDER FOR UNDERWATER PIANO PLAY-

To cover all of his accomplishments in

ING. TELL US THE STORY BEHIND HOW AND WHY YOU DID IT.

a single interview - let alone condense them into the mere 2 pages of A4 our printing budget allows - would be quite an achievement. From discovering the gene for fitness, to delivering the Royal Institute Christmas lectures, he appears to have done it all - spent time on Everest, written a series of children’s books, co-founded the UK Climate and Health Council, run ultra-marathons.… the list goes on. However, many of you will be familiar with Hugh from the inspiring, perception changing lectures he delivers on climate change, something he has taken a lead stance on in terms of its global health implications. Here, we delve into Hugh’s time at Middlesex Hospital Medical School, his most quirky achievements, thoughts on current affairs, how we can change the world and, finally, touch on some of his sports related research to tie in with this issues sports and exercise medicine theme - all in 2 pages!

I think I’d drunk too much beer when I agreed to do it for RAG week! [I was under for] 110 hours. It was in the John Astor House Nurses’ home swimming pool, on Foley Street – it’s probably not there anymore. It was an electric piano. I think the record before that was pretty short because pianos packed up, so as it turns out it wasn’t too difficult! We raised 17 and a half grand for the first portable ultrasound machine in Britain, which was about the size of a small car. Chris Tarrant used to present the Capital Radio Breakfast show, which was a big thing in London when I was a student. He decided we had to surface on the breakfast show, so we added an extra 10 hours to our 100 hour goal to surface live on radio! HOW DID YOU EAT, DRINK, SLEEP, ETC.?

[I slept] a bit, but I was largely awake. You are allowed five minutes an hour outside for a Guinness book of records endurance attempt, and you can stack them up so that you can have half an hour every 5-6 hours. HOW MUCH “OTHER STUFF” DID YOU CONTINUE DOING AS A JUNIOR DOCTOR? ARE CONDITIONS STILL THE SAME?

Not much. There wasn’t much time for doing other things. I swapped some sports like diving for things I could do quickly like skydiving, but I did go back to writing. I used to write with a guy called Rich - now head of discovery for Respiratory Medicine at Glaxo [GSK]. We wrote a bit for telly when we finished – I got my telly-writing career largely through that. We ended up writing a show some years later, where I met my wife, oddly enough – she was an MD too. I think junior doctors have a much worse time now. It sounds odd, given that we were working 160-hour weeks, but we had a much better life! Everyone was nice to us – if you got to casualty, you’d say, ‘I’m really sorry I kept you waiting,’ and patients would say, ‘Don’t worry, Doc, I know you’re busy,’ whereas now you get, ‘I know my ----ing rights!’. IS THE HEALTH SERVICE VIABLE IN THE LONG TERM?

In it’s current form? No, not at all. WHAT NEEDS TO CHANGE?

It’s prevention. We’ve got my generation getting old: loads of us with comorbidities, all living longer. Our care pathways are complex; we, the public expect more and more, and the number of you paying taxes is less and less. That’s a completely unsustainable system and we have three models: one, there’ll be efficiency savings – well, we’ve trimmed the fat to the bone

rums

review

20


On a bigger political scale, it’s about voting. It shouldn’t be that old people

keep spending money,’ that’s not going to work either. The third is you pri-

determine the policies of this country, but at the moment that’s what it

vatise it in one of two ways: either going public, which no one will do be-

is, when it should be dictated by you. Students understand things like

cause that’s toxic, or you do it through the back door – I think that’s what’s

social media, which got Obama elected. You can do extraordinary things

happening now. But there is an alternative – a lot of what we treat now

with social media - if you want to make it the way such that young people

is entirely preventable by public health policy. The health service is about

influence elections, you can.

alumnus interview

“When you get older, you realise that if you really wanted to change the world and you had a skillset to do anything you chose to do, you wouldn't do medicine. You would do politics or economics, because the drivers of ill health remain as they always have; poverty, inequity, conflict… as well as the environment.”

y

now. The second is a sort of, ‘oh no, the election will vote us out, we’ll just

treating diseases, and most of what matters in health isn’t in health at all, it’s in transport policy, it’s in alcohol and cigarettes, taxation, employment

YOU DISCOVERED THAT THE ALLELE FOR THE ACE GENE AFFECTS

and social equality. These are the things that determine when you get sick.

PHYSICAL FITNESS, THE FIRST DISCOVERY OF A FITNESS-RELATED GENE. WHAT DEVELOPMENTS HAVE YOU SINCE MADE IN THIS RESEARCH?

YOU STRONGLY SUPPORT PREVENTATIVE MEDICINE. HOW DID YOU COME TO CHOOSE ITU THAT IS SO FAR AT THE OTHER END OF THAT SPECTRUM?

It has got very interesting; it seems to have taken us into looking at the regulation of mitochondria. We realised that [the ACE gene] was linked to the regulation of oxygen consumption and then we started getting data

I like complexity and I like biology, so my skill set is better suited to in-

that suggested it was regulating efficiency of the use of oxygen. I remember

quisitive stuff. I would much rather deal with something here and now,

suddenly having the epiphany, realising that we were focusing on oxygen

where I have to make quick decisions. When I was at medical school,

delivery and that actually there were two other elements to it. You could

psychology and sociology made me think: “this is woolly nonsense, give

either, if you were short of oxygen, deliver more, or you could use less

me the big red thing that makes your hair fall out, that’s proper medicine!”

by switching things off or use less by improving their efficiency. Biology

But when you get older, you realise that if you really wanted to change the

is generally fairly straightforward - if you think of a really obvious way

world and you had a skill set, you wouldn’t do medicine. You would do

round, usually that’s the way it has evolved. So we held a meeting called

politics or economics because the drivers of ill health remain as they always

‘give and take’. We just got all the ‘big cheeses’ together up in Windsor,

have; poverty, inequity, conflict… as well as the environment.

at Christopher Wren’s old house, and it was the first time, I think, it had been put together: ‘is it possible that oxygen use is not just about delivery

WHAT FIRST INTERESTED YOU IN THE EFFECTS OF CLIMATE CHANGE

but about consumption, switching off and efficiency?’ That then led onto

ON HEALTH AND WHAT MADE YOU SEE THAT THIS IS SOMETHING THAT

Everest-related work and we were right, that is how you adapt hypoxically.

NEEDS INVESTIGATING?

It was accidental. I was doing molecular research in the 90s and I would

In terms of genetics of exercise, there’s a bunch of genes - though not

be looking up a paper [in Nature] and right next to it there would be

that many - we [UCL Institute for Human Health and Performance] have

something about a new fossil hominid, or a black hole or something that

published a couple, but is it good enough to select your athletes with yet?

made you think ‘ah, that looks a bit interesting’, you know what it’s like

No, it’s still better to watch kids playing on a football pitch than to try and

when you’re looking through a magazine. The general media line at the

select them genetically.

time was “there’s no such thing” or “maybe it’s getting colder” and yet the science appearing, to my eye, looked pretty convincing the other way. I’ve never quite got around to making those big decisions about God etc., but climate change is one of those big decisions that you ought to make at some point in your life. So I spent a few years trying to learn about it, to form my own opinion really and soon realised that it was that bad. The

MUCH OF YOUR RESEARCH INVOLVES DOING SOME REALLY FUN THINGS, LIKE CLIMBING EVEREST, MANY OF WHICH ARE SIMILAR TO YOUR INTERESTS OUTSIDE MEDICINE. WERE YOU ATTRACTED TO THESE AREAS OF RESEARCH BY THESE OPPORTUNITIES OR WAS IT A COINCIDENCE?

advantage that you have as medical students is that you are so broadly ed-

Neither. If you do enough things, you can make connections that people

ucated. If you’ve done enough physics and chemistry, you can understand

who don’t do all those things can’t make. I had a minor interest in hypoxia

the implications of what is happening to our atmosphere and weather sys-

but we were doing the ACE work in performance. I went off to climb a

tems, you understand how people live and what the drivers of health are.

big hill in the Himalayas and it was quite high- above 5000 metres. One

It was peculiar that no one had done that before!

night, I got woken up at silly o’clock in the morning by this Australian nurse saying, “are you the doctor?” So I said that I happened to be one and

AS MEDICAL STUDENTS, WHAT CAN WE DO TO COMBAT CLIMATE CHANGE

she asked if I could come quickly because her friend was dying. She [her

AND OTHER BIGGER ISSUES?

friend] was indeed really trying very hard to die so I got her down the hill

A lot, is the answer. The first thing is, just remember that you are amongst

very quickly... The climb up to that height had taken me 7 hours the day

the most loved and trusted community sectors in the world, for lots of rea-

before and there was a storm coming in so I thought “either I stay here

sons. Not just because you’re going to be doctors, but also because you’re

and I get stuck, or I go up but if I get caught in the storm I’m completely

young. People love young people! You’ve got a voice, a traction in a way

on my own without a tent, this could go horribly wrong.” As I was going

that many people are denied.

up I could see it [the storm] was coming in quite quickly but I got back up in a little under 40 minutes on a route that had taken me over 6 hours

There’s the political and professional, which relates to what you are doing

the day before. Admittedly a bit of adrenaline helps but it was then that

as students and that’s talking to people, saying “we don’t want it to be this

I thought, “hang on, this can not have been done by adaptation through

way, we want it to be a different way” and proposing solutions - “we’d like

increased delivery, which is what I had been told at medical school, it’s

to see UCL drop its carbon emissions by 20%. We will bully you”, because

just not possible, it cannot be that way. Something has changed about the

a big part of the role of students is to demonstrate and demand. Everyone

way I’m using oxygen because I’m not breathing any harder (I might have

I know in senior management at UCL is a really delightful, open-minded

been but it’s a marginal increment) and I can’t have an increased red cell

individual and they are on your side in a very big way, even if they can’t be

mass within 12 hours!” That made me realise it’s about use, not delivery.

quite as demonstrative.

Of course it’s a combination of the two, a happy circumstance that you end up finding these things.

21

vol.

I,

no.

III


article by enny s. paixão

the

spread

for

the

to

americas

olympic

games

and in

the

implications

brazil

Amidst eager anticipation of the 2016 Olympic Games, the Zika virus outbreak has taken the world by surprise. Questions surrounding the virus’s transmission and its contributions to birth defects are abound, while researchers are fervently working to find a vaccine. Here PhD candidate Enny S. Paixão, from London School of Hygiene and Tropical Medicine, outlines what is currently known about the virus and its transmission, and describes the measures taken to keep further spread to a minimum leading up to the Olympics.

rums

review

Zika is a mosquito-borne disease, not ob-

agents and are very difficult to control, so

served outside Africa and Asia regions until

vector-borne diseases that once were restrict-

an outbreak was reported in Micronesia in

ed to some areas are now apparent in several

2007. In the last three years, this disease has

previously unaffected regions. Zika is one

emerged in French Polynesia, Cook Islands,

such disease. The first evidence of humans

and more than 20 American countries - fuel-

infected with Zika is from 1952 and since

ling concern as its link to severe birth defects

then this disease circulated almost silently

and neurological syndromes becomes more

until 2007, when there was a large outbreak

probable.

in Yap, Micronesia.

The emergence or re-emergence of some in-

Outbreaks of Zika have a high rate of trans-

fectious diseases has been changing the epi-

mission, estimated at 73%, and a high rate

demiological pattern in many countries – es-

of asymptomatic disease, with just one in five

pecially the emergence of diseases caused by

infected patients developing clinical symp-

virus transmitted by mosquitoes of the genus

toms. When symptoms occur, they generally

Aedes (Stegomyia). These vectors have great

are characterised by acute fever, rash, arthral-

ability to transmit a number of infectious

gia, conjunctivitis and oedema. According to

22

illustration by kate alice mackenzie

articles

ZIKA


to ensure that the athletes are receiving med-

pitalisations and deaths are rare. Before the

ical advice along with information on mos-

outbreak in French Polynesia and Brazil the

quito bite prevention strategies.

articles

information from previous outbreaks, hos-

symptoms of this disease were described as mild and limited to the individual. However

However, Brazil’s decision to go forward with

more recently Zika has aroused the fears of

the Games is not unanimously accepted.

the society and public health authorities be-

Arthur Caplan from New York University

cause it is suspected of causing microcephaly

insists that it would be reasonable to post-

in several infants born to women who were

pone the games for at least 6 months, or even

infected during pregnancy. Guillain-Barré

cancel them entirely. Caplan and Igel argue

syndrome has been linked to Zika outbreaks

that young women cannot travel to Brazil

as well. However, more studies are required

safely and that men who are sexually active

to prove a causal relationship between Zika

could transmit the disease to a partner. They

and microcephaly and Guillain-Barré syn-

insist that it would be irresponsible to host as

drome, as well as the spectrum of outcomes

important an event as the Olympic Games

that could be associated with this disease.

during a public health emergency of international concern. The US Centers for Disease

The Zika virus (ZIKV) was detected in Bra-

Control and Prevention advised pregnant

zil for the first time in early 2015 and later

women to avoid travelling to countries af-

in the same year epidemiological evidence

fected by Zika.

suggested that ZIKV infection of pregnant women in Brazil might be associated with the

There is no information about the extent to

increasing numbers of microcephaly. Despite

which an international event like the Olym-

the connection between ZIKV and congen-

pics could contribute to the spread of Zika.

ital defects, according to the World Health

Travellers could be infected during the event

Organization (WHO), athletes and sports

and introduce the virus in their home coun-

fans should not fear travelling to Olympic

tries, and imported cases might result in lo-

Games in Rio de Janeiro this August. A study

cal transmission and spread the virus in areas

that analysed the risk of dengue during the

that have the appropriate mosquito vectors

2014 FIFA World Cup in Brazil showed that

already.

football fans were unlikely to get dengue dur-

1

To increase the evidence of infection and

2

To develop a serological test – the test avail-

potential outcome

ing the competition period, because dengue

The current situation with regard to Zika

is a seasonal disease and during the dry sea-

is challenging, and according to Margaret

son its incidence decreases and the density of

Chan, the head of the WHO, ‘things may

cases becomes residual even in North-East-

get worse before they get better’. There is no

ern Brazil, the epicentre of the outbreak. The

vaccine, no treatment, and no commercial-

study found that in Rio de Janeiro, located in

ly available serological test. The only way to

south-eastern Brazil, risk of dengue infection

prevent Zika is to avoid mosquito bites and

is close to zero. As Zika is transmitted by the

even this does not remove the challenge of

same mosquito as dengue, a low risk of tour-

vector control. The Brazilian Minister of

ists and athletes contracting Zika infection

Health warned that the country is badly

can be assumed as well. According to some

losing the battle against the mosquito. To re-

public health experts the fact that the games

duce the risk of spreading Zika, attendees of

are held in a single city during a cold and dry

the Olympics Games should take additional

month means that the risk of Zika will be

care and try to minimise their exposure to

reduced to an acceptable level.

mosquito bites.

involved in the infection, but current events

To assure the safety of travellers, Brazilian

There are more questions than answers about

cine.

authorities have announced plans to prevent

Zika, but scientists from different areas

the spread of Zika during the games, and the

are working to fill these gaps. Barreto et al

British Olympic Association will be moni-

(2016) suggested six central components to

toring the situation over the coming months

achieve success in battling Zika:

able now is the detection of viral RNA, which is present during viraemia

3

To control infestation by Aedes mosquitos

4

To define protocols for treatment

5

To develop a vaccine – because Zika is an emerging disease there is a lack of information about the immunological mechanisms have expedited the development of a vac-

6

To reprogramme the health-care system

For a full list of references, please visit: www.rumsreview.co.uk Despite the connection between ZIKV and congenital defects, according to the World Health Organization (WHO), athletes and sports fans should not fear travelling to Olympic Games in Rio de Janeiro this August. The New England Journal of Medicine has recently published a paper which confirms that the relationship between pregnant women contracting the Zika virus and babies born with microcephaly and brain abnormalities is causal: Rasmussen S, Jamieson D, Honein M, Petersen L. Zika Virus and Birth Defects — Reviewing the Evidence for Causality. New England Journal of Medicine. 2016;

23

vol.

I,

no.

III


articles

WITH AN INTERVIEW

DR.

DAN BROMAN the field of sports and exercise medicine

(sem)

is the latest medical specialty to be recognised by the royal college of physicians. it is a highly dynamic

specialty

athletes,

but

that

rather

doesn’t has

a

treat

elite

preventative

just

focus

with an aim to improve the general health of the public. doctor daniel broman speaks to rums review about this evolving specialty.

who need to increase their level of exercise, and elderly women who have had fragility fractures and need help to reduce their risk of falls. We try to target mostly those who are sedentary and get them to incorporate a little bit of exercise into their everyday life: the Department of Health Hi Daniel! Thanks for talking to us!

recommends moderate exercise five times per week for thirty minutes.

Please introduce yourself. No problem. I’m a Sports and Exercise

Where did you study?

Medicine registrar in London, currently

I did five years at Birmingham Medical School and did my elective in

working out of the Whittington Hospital.

Sports Medicine in Sydney. I also worked in a Sports Medicine clinic.

I also work for the Football Association

Before my elective I wasn’t too sure about what specialty I wanted to

(FA) for the England Under 18 football

choose. I had considered Accident and Emergency which is a great

team as a team doctor, and for Reading

specialty but I also really enjoyed my elective. I did my Foundation

FC as a Doctor alongside Bhavesh Kumar,

Training in Mersey Deanery at Leighton Hospital. Then, I decided to do

who also works at UCLH. Bhavesh is my

Core Medical Training, which I did in London. After my core training

consultant supervisor for the work that

I did a full-time master’s at UCL Institute of Sport Exercise and Health

I do at Reading because anything that

(ISEH) in Sports Medicine, Exercise and Health.

is done outside of the NHS training programme has to be supervised by a

Brilliant. How was taking a year out to do a master’s degree after

consultant, just like in an NHS hospital. I

having worked as a doctor for two years?

also sit on the Royal Society of Medicine

It was great. At first it was a bit strange to go back into education but

Sports and Exercise Council and I am

a lot of my colleagues were in similar stages in their career as they had

the co-chair on the Junior Doctors

just completed either foundation training, core training or were GPs.

Committee for the European College of

The professors at UCL were brilliant. I would definitely recommend this

Sports and Exercise Physicians.

course to anyone thinking of doing SEM. I did have some time to keep up with my clinical practice and support myself by doing some locum

Wow, so you’re very busy then.

work. I also had time to do some work for the FA with the under 18s,

Yes, it’s good to be involved in those kind

where we played Holland, Poland and Russia away games.

of things. I have a passion for football medicine.

Why are you so passionate about Sports and Exercise Medicine? Exercise is extremely important to prevent illness and injury. An example

How would you define Sports and

of this was demonstrated in a paper that I read recently, which suggested

Exercise Medicine?

that regular moderate physical activity can reduce blood pressure by

It is a small specialty which can cater

12/5 which is a bit better than most single therapy antihypertensive

for anyone and everyone. We assist

treatments.

elite

rums

review

athletes

who

are

undergoing

rehabilitation, as well as patients in their

Do you play sport yourself?

fifties with hypertension and diabetes

Yes, I play football and tennis, and enjoy swimming and going running.

24


articles

2 words by fabianne viner, mbbs year

Could you describe a typical week in the life of Dr

What is the most difficult aspect of your job?

Broman?

My work in elite sport is probably the most difficult, be-

I am on an orthopaedics rotation at the Whittington Hospital at the moment, but within this I have lots of flexibil-

cause you are working under time pressures where the ath-

ity to meet my learning needs. On a Monday morning I

letes are rushing to get back to physical activity. You get

do a musculoskeletal ultrasound clinic with a radiologist.

pressure from the players themselves who want to return

On a Monday afternoon I do a foot and ankle clinic with

back to sport and from the coaches who want their players

an orthopaedic surgeon. On Tuesdays I work at a fracture

to be available. Sports people are high achievers and see

clinic followed by a knee clinic. OnWednesdays I do a

the injury as a massive block. There are lots of non-clinical

cardiology clinic, where I treat a lot of arrhythmias and

skills that come into this – for example communication

see patients with chronic cardiac problems and explain the

skills, being honest and dealing with people.

“ REGULAR MODERATE PHYSICAL ACTIVITY CAN REDUCE BLOOD PRESSURE BY 12/5 WHICH IS A BIT BETTER THAN MOST SINGLE THERAPY ANTIHYPERTENSIVE TREATMENTS. ”

benefits of physical activity to them. Then, on Wednesday afternoons, we have our specialist registrar teaching. On

Could you give an example of a hot topic in sports and

Thursday I do a rheumatology clinic and in the evenings

exercise medicine?

I practice at the Isokinetic clinic which is a private sports

Currently, concussion is a hot topic in SEM. There was a

medicine clinic on Harley Street, where I do some phys-

lot of talk about it during the Rugby World Cup. In foot-

iological testing. This includes maximum threshold tests

ball you must remove the player from the field of play if

and isokinetic tests. Friday mornings are spent at Reading

they have a concussion. The risks of concussion are high –

FC, where my role is a lot more focused around General

it’s a brain injury and it’s something that is not visible un-

Practice.

like a broken leg. It can be subtle but the risks are danger-

“ I ALSO LIKE THAT YOU ARE USUALLY WORKING WITH

PATIENTS WHO WANT TO RECOVER QUICKLY. RUNNING ON A

PITCH IN FRONT OF 40,000 PEOPLE IS UNUSUAL – WE ARE CERTAINLY NOT TRAINED TO DEAL WITH THIS IN MEDICAL SCHOOL.”

ous. There’s been some reported evidence in the NFL that Would you agree that Sports and Exercise Medicine is a

repeated head injuries could increase your risk of chronic

very varied specialty?

traumatic encephalopathy, which is a degenerative neuro-

Absolutely. For example, the female athlete triad is a health

logical disorder, so concussion must be treated properly.

concern for active women who are driven to excel in sports

You must give the athlete time off work to recover.

such as athletics and gymnastics. It involves three distinct and interrelated conditions: disordered eating, irregular

What’s the single best thing that we can do for our

or absent menstrual periods and end stage osteoporosis

heath?

which leads to low bone mass and risk of fractures. We

There’s a great video on YouTube by Dr Mike Evans which

work alongside rheumatologists to improve bone health.

talks about the importance of physical activity. It’s called

However, you are a specialist in treating musculoskeletal

23.5 hours and describes how we should only be sedentary

injuries and using exercise to treat them. The cardiologists

for 23.5 hours a day as there is great evidence that physical

take the lead on the cardio problems but we still carry out

activity helps in physical, mental and sexual health.

“ YOU GET PRESSURE FROM THE PLAYERS THEMSELVES WHO

WANT TO RETURN BACK TO SPORT AND FROM THE COACHES WHO WANT THEIR PLAYERS TO BE AVAILABLE. ”

cardiac screenings. What advice would you give to medical students interWhat is the best thing about working in Sports and Ex-

ested in SEM?

ercise Medicine?

Get involved. Think about doing your elective in SEM.

I like that it’s a small but important specialty. I am grateful

When you’re a junior doctor you could volunteer at the

that I am able to work for the FA and travel and see things

London Marathon. Email people that are involved in

that the average doctor would not. For example, I recently

SEM, put yourself out there. Go to the meetings arranged

went with the England under-17 team to the World Cup

by the London Sport and Exercise Medicine society. At-

in Chile and we visited local schools in the area. I also like

tend conferences. Join the British Society of Sport & Exer-

that you are usually working with patients who want to

cise Medicine. My advice to any medical student would be

recover quickly. Running on a pitch in front of 40,000

to enjoy medical school and to remember that there is no

people is unusual – we are certainly not trained to deal

such thing as a silly question.

with this in Medical School.

25

vol.

I,

no.

III


article by dr patrice baptiste

articles

DR. PA

-

life after

TRICE

BAPT ISTE medical school

After 6 or more years of long, hard study, our finalists have taken their exams, passed, and been judged fit for practise. Whilst an exhilarating and exciting time, for some, it can be daunting. Dr. Patrice Baptiste, UCL 2013 graduate, tells us about her time after medical school and what they should expect.

During the year 2013 I graduated from UCL, and it was one of the best days of my life. I always wanted to be a doctor and I worked so hard, day in and day out, to ensure it happened. After numerous exams and assessments I could finally say I was Dr. Baptiste; no more “Hi my name is Patrice, I’m a medical student”.

shouldering

responsibility

I was placed at Whipps Cross Hospital for my first year and I couldn’t wait to start; I was typically eager and enthusiastic. Coupled with this was the apprehension and fear of being ‘let loose’ on patients and responsible for their care. It was not until I started working as a doctor that I realised how much responsibility the role carried. I still remember my first week working in the Coronary Care Unit (CCU) - patients, nurses and other staff would ask me questions and it would take me a while to realise they were asking me. Oh, so now I’m the doctor? I’m meant to make decisions? It takes a while to get used to and as the FY1 you are the most junior person on your team and more often taking orders than giving them out! But unlike a student the patients on your ward are your responsibility, if they need investigations you have to request them, ensure they are carried out and check the results ensuring you feed back to your team and ask for help when necessary. If your patient develops a new symptom - for example chest pain, it is your responsibility to ask them more, examine them, request an ECG, a troponin level etc. It can be very scary but no matter how busy or short-staffed the hospital was, I have always been able to find someone senior to help. Whether that was my SHO, registrar, a registrar from a different team, or even the consultant, help has been there when I most needed it. So don’t worry!

rums

review

26


journey

&

articles

my

development

I think it is fair to say that as a junior you often have moments where you feel like you have absolutely no idea what is going on - lost in a heap of investigations and multi disciplinary team meetings, running to cardiac arrests, unsure what you will encounter, or worse - that you will be the first one there not knowing what to do! You may think, when will I actually feel like I know something? After almost three years I still have moments where I am unsure. It is important to remember that there is much to learn and as long as you stick to your basics, you truly will be fine. I look back at all those ward rounds I attended as a student, not being able to keep up with the various patients on the ward, lost in all the medical jargon. Then, I look back at my first day on CCU - surrounded by all the cardiac monitors beeping and the numerous jobs piling up on the ward round. I look at today, when I can confidently manage a ward, knowing what to do and how to construct a clear plan in most situations, and in the times that I don’t, knowing where and how to get help. There are so many useful resources and people to help you on your journey and it is crucial that you use them. Not sure which antibiotics to use - what about the guidelines on the intranet, what about the pharmacist or the microbiologist? I have learnt so much but I have also forgotten many of the things I used to know as a medical student. It can also be frustrating because somewhere like UCL is so academic and the wards are so clinical. I can run a ward but there are loads of things that would pop up on a ward round or in teaching and I would just think “I actually used to know that!” You spend hours revising and a few months after finals you’ve forgotten all the causes of hypokalaemia!

the

future

I spent my second year working in Southend and, whilst everyone was busy submitting applications, I decided to take a year out. There were many reasons for this: I felt that I needed a break; I had left school only to enter medical school and then started working unsociable hours which did take a toll. I also felt that I never really had enough time to fully pursue my interests outside of medicine like writing, playing the piano and long-distance running. I also was very unsure about what specialty I wanted to commit to and with the junior doctors’ contract dispute I was even more unsure about what the future had to offer. I am glad that I have taken a year out and know many other doctors who I have met along the way who are taking a year or even two out of training. Taking a break is a good thing; it allows you time to think about your next step and future choices. It also allows you to enjoy life and explore so many opportunities. I enjoy writing various articles and I have written for the BMA, BMJ, MPS, Support for Doctors Network, Medic Footprints and The Canary websites among others. I am also looking forward to a taster week at the BMJ in June. In addition, I publish content on my blog and I am working on publishing a collection of poems this year. I dedicate a proportion of my time to helping students understand more about medicine and applying to medical school and at present I am working on delivering courses for such students (if you want to know more and are interested in helping then please email me - see below). I still remain connected to UCL by being a part of the Black and Minority Ethnic (BME) alumni committee here. After my year out I plan to re-commence medical training in August via the GP programme.

do

what

is

right

for

you

There are a lot of changes going on in the NHS, and medicine is a very demanding but also a very rewarding profession. Some of you will start work and won’t enjoy it - perhaps you were ‘pushed’ into medicine or perhaps you always wanted to be a doctor but the politics, the system or other factors like moving frequently to different hospitals means you do not think it is right for you. Rather than the end of the road, this could just mean that a change of direction is in order. Some of you will love it, you’ll love the adrenaline rush, you’ll love helping people and putting a smile on their face and you will go on to be amazing doctors. I want to end by saying that our profession of choice can ultimately consume us, if we let it. As medics we are highly skilled individuals and we must not let the voices of others, or medicine itself, institutionalise or define us. We are more than just doctors and we have so much to offer whatever we choose to do with our lives!

For Patrice’s tutoring website, please visit www.dreamsmarttutors.com If you would like to get in touch with Patrice you can email her at drpatriceb@gmail.com or to read more, please visit www.infinitypages.wordpress. com for Patrice’s blog.

27

vol.

I,

no.

III


articles

dr. farah jawad Dr Farrah Jawad is a registrar in Sport and Exercise Medicine. She currently works at the Institute of Sport, Exercise and Health in London and co-ordinates the British Journal of Sports Medicine Trainee Perspective blog. Here, she outlines the considerable benefits of exercise, and why both doctors and medical schools should be talking about it more.

PRESCRIBING

PREVENTION

It has been said that exercise, if it were a pill, would be prescribed for almost

as hypertension or diabetes. Doctors, whilst knowing wide range of benefits

everyone and would be one of the most cost effective interventions available.

of exercise, perhaps do not always realise the opportunities they have in

Low cardiorespiratory fitness has been shown to be a more important risk

clinic to propagate the physical activity message and offer advice on physical

factor for all-cause mortality than hypertension, high cholesterol and smok-

activity and being less sedentary. The focus tends to be that of a disease

ing. One systematic review and meta-analysis has shown that self-reported

service rather than a health service, and perhaps that is a reason why exercise

physical activity reduced all-cause mortality by 29%. To put this into per-

prescription does not feature in many medical school curricula.

spective, the commonly prescribed ACE-inhibitor reduces all-cause mortality by 10%. Low fitness has been shown to kill more people than smoking,

Part of the problem with designing such curricula is that they are packed to

diabetes and obesity combined. Individuals exercising just 15 minutes a day

the rafters because there is so much to cover; there is always a feeling that

live approximately 3 years longer than inactive individuals.

one topic has to come out in order to fit another topic in. Perhaps the way to solve this is for lecturers to incorporate physical activity in each of their

rums

Prolonged sitting time is strongly associated with obesity, metabolic syn-

lectures on various diseases; the effects of physical activity are far-reaching.

drome and type 2 diabeties, as well as cardiovascular disease and cancer.

Physical activity is beneficial in a number of diseases and normal physiolog-

It is also associated with total mortality independent of daily moderate to

ical states, including: fibromyalgia and chronic pain syndromes, osteoarthri-

vigorous intense physical activity. What this means is that it is better to be

tis, pregnancy, obesity, mild to moderate depression, diabetes mellitus types

frequently active throughout the day rather than to exercise once a day for

I and II, cardiovascular disease and chronic obstructive pulmonary disease.

an hour and spent 16-hour days sitting. This message is important to get

Being more physically active does not mean being sporty, and does not re-

across to patients as it has significant health implications.

quire special equipment or expensive gym memberships. People can make

Most people presenting to their GP have a non-communicable disease, such

even the smallest changes to their lifestyle – taking the stairs instead of the

review

28


articles

words by dr. farah jawad

photo by jessica nash

lift, getting off the bus a stop earlier and walking, for

of exercise as they have different positive effects, for

example – which can help to contribute to an overall

example, aerobic exercise for cardiovascular fitness

increased level of physical activity.

and muscular strength for mobility and falls preven-

The UK Physical Activity Guidelines advice for adults

tion. When tailoring advice regarding a specific pro-

(19-65) states:

gramme of exercise for a patient, you can discuss the

“THE FOCUS TENDS TO BE THAT OF A

DISEASE SERVICE RATHER THAN A HEALTH

SERVICE, AND PERHAPS THAT IS A REASON WHY EXERCISE PRESCRIPTION DOES NOT FEATURE IN MANY MEDICAL SCHOOL CURRICULA.”

FITT principles:

• Aim to be active daily. Activity should add up to over 150 minutes per week by participating,

Frequency - How many times a week to do

in at least 30 minutes of moderate intensity

the activity

physical activity on 5 or more days a week, or

Intensity – How hard to exert oneself during

in multiple bouts of 10 minutes or more.

the activity

• Comparable benefits can be achieved through

Type – The type of activity agreed with the

vigorous activity of 75 minutes a week or in

patient

a combination of moderate and Wvigorous

Time - How long the patient might partici-

activity.

pate in the activity in minutes

• Adults should also undertake physical activity to improve muscle strength on at least two

The FITT principles can help a clinician make sure

days a week.

all the bases are covered when discussing exercise pre-

• All adults should minimise extended sedentary (sitting) periods.

scription. One example of how the FITT principles can be applied is if a patient, when prompted about any particular activity they might like to do more of,

The guidance for children aged 5 to 18 is that they

mentions walking, the clinician may then suggest that

should participate in a minimum of 60 minutes a

the patient walks at a moderate intensity, so they feel

day and up to several hours every day of moderate

slightly sweaty and short of breath, for 30 minutes a

to vigorous intensity physical activity. Three days a

day, five times a week as a goal. But that they might

week should include vigorous intensity activities that

start with a lower intensity, time and frequency ini-

strengthen muscle and bone. This age group should

tially so that they can build up their fitness in time.

also minimise the amount of time spent being sedentary (sitting) for extended periods. For under 5s

In summary, exercise can be a cheap and effective way

capable of walking, they should spend a minimum

of reducing morbidity and mortality, and we need to

of 180 minutes a day playing and being active, and

address potential barriers to exercise and the reduc-

those that cannot should be encouraged to play in

tion of sedentary behaviour. Even a short discussion

safe environments and minimise time spent sitting or

with patients on the benefits of exercise is a start.

restrained.

Active children grow up to be active adults and so

One way you can bring exercise into the consultation

intervening at a young age is important. The Active

is by asking “The Exercise Vital Sign”: “On average

Movement project aims to do this by integrating low

how many days/ week do you engage in moderate or

level activity into the normal day of schoolchildren.

FOR LINKS TO THE BRITISH JOURNAL OF SPORTS MEDICINE TRAINEE PERSPECTIVE BLOG, INSTITUTE OF SPORT, EXERCISE AND HEALTH’S 5 OR 10K RACE IN

REGENT’S PARK, MORE USEFUL LINKS AND REFERENCES, PLEASE VISIT: WWW.RUMSREVIEW.CO.UK

greater physical activity (like a brisk walk)?”, then, “On those days, how many minutes do you engage in

As clinicians, it is good to lead by example. On Sun-

activity at this level?”

day 26th June 2016, why not walk, jog or run the

This helps to start the discussion about physical ac-

Institute of Sport, Exercise and Health’s 5 or 10K race

tivity and being less sedentary with patients. It is

in Regent’s Park? Perhaps I will see you there!

important to extol the virtues of the different types For a full list of references, please visit www.rumsreview.co.uk

29

vol.

I,

no.

III


D E M Y S T I F Y I N G

M E D I C A L review

best

answers

( sbas )

cording to their global rating.

Our SBA papers pass marks are set using the modified Angoff Method. In the Angoff meth-

The pass mark is where the best fit line inter-

od, a panel of faculty members who are famil-

sects the halfway point between borderline

iar with the curriculum and the standard of

pass (3) and borderline fail (2). The OSCE

the student in that year reviews each question.

pass mark is the average of each stations score.

Each panellist then estimates the percentage

clinicians throwing their reckonings into the mix too.

year, the rumour mill manages to generate the same misconceptions, often cemented by some

summative assessments. Setting of the pass mark is probably the most frequent of these. Every

Perhaps one of the most common misconceptions I end up having correct are those relating to

summative our are

- how

S C H O O L

pass

marks

set ?

articles rums

single

of ‘just passing’ students that would answer

It is possible to pass the OSCE overall while

the question correctly. Each panellist does this

failing some stations provided you have

independently. There is then moderation on

enough marks. There is no threshold for the

questions that have a range of over 40% be-

number of stations failed, leading to a fail

tween predictions. Once the probability is set

overall.

for each question, the pass mark is calculated by averaging these scores.

what happens to poorly performing or osces ? Dr Alison Sturrock, academic lead for assbas

Thus there is a pre-test set standard. Contrary

sessment for UCL Medical School explains

to rumours, this means that there is no quota

what happens to poorly performing SBAs and

for passing or a set percentage of students des-

OSCEs.

tined to fail. ‘After each assessment the performance of objective exams

structured

clinical

( osces )

each SBA and OSCE station is reviewed. The question and answer for each poorly perform-

The borderline-regression method is used to set

ing SBA is checked to make sure the answer is

the pass mark for the OSCEs. To understand

correct. If there appears to be a question that

this, we first need to know how the OSCE is

is performing poorly we consider whether we

marked. The OSCE mark sheet consists of two

should remove this item from the assessment.

components, individual criteria (‘objectives’)

We remove the questions from that paper if

for the examiner to assess you against, and a

they are ambiguous, misleading or do not have

box for a ‘global’ rating.

a single correct answer. The remainder of poorly performing questions are removed from the

For each criterion, the examiner can indicate

bank so they are not available for future as-

to what degree you’ve satisfied it – on a scale

sessments.

of ‘pass’, ‘borderline’ or ‘fail’ for years 1-5 and ‘clear pass’, ‘pass’, ‘borderline’, ‘fail’ and ‘clear

We also review the statistics, as well as the

fail’ for final year. These determine your mark

candidate and examiner feedback from each

for that station. In years 1-5 and in the final

OSCE station. If there appears to be a station

year short station OSCE, a 5 minute station

in which there has been significant differences

has a total of 20 marks and a 10 minute sta-

between how the station has been run between

tion has 40 marks. In the final year long sta-

sites/days, then we discuss whether or not this

tion OSCE, 10 minute stations have a total

station should be withdrawn from the assess-

of 15 marks and the 30 minute history station

ment at the exam board. As we have enough

has 45 marks.

stations in the OSCE to ensure that the withdrawal of a station does not reduce the relia-

You may notice on the sample mark schemes

bility of the assessment, we believe it is fairer

provided online that there are fewer than 20

to students to withdraw a station if students

‘objectives’. This means that different objec-

have been assessed differently between differ-

tives have different weightings, for example

ent sites/circuits.’

you might get 3 marks for using appropriate you ?

communication skills throughout the station

what

and 4 marks for completing an appropriate

There are no quotas for the number of stu-

examination.

dents who pass/fail.

does

this

mean

for

- An entire cohort is able to pass. The examiner is also asked to rate you on a

- Standard setting methods used for the

global judgement. This is the overall impres-

SBA paper and OSCE station allow tricky

sion of your performance on the station and

questions to be included without unfairly

asks whether your overall performance was a

disadvantaging students.

‘clear pass’, ‘borderline pass’, ‘borderline fail’ or clear fail.’ There are no marks attached to this judgement. Instead it is used to plot a regression analysis. (see fig 1). Here, candidates’ mark for the station is plotted in groups ac-

30


ravi mistry

(y5) // rums

1

1

1

2

1 2 5 5 4 2 5 1 2 2 4

vice-president for education y4-6

articles

“contrary to rumours, this means that there is no quota for passing or a set percentage of students destined to fail.�

1

4 7 5 3 2 9 12 8 10 13 14 11 5 12 8 13 8 6


SPORTS + SOCIETIES ROUND-UP

mer carried through into their fantastic

tions. It was the first time this event

performance of Bedpans and Broom-

was run so hopefully it can become a

sticks (sports clubs really need to work

staple of the RUMS calendar.

on their heckling for next year though). March was on us in a flash. Sporting

ANDY WEBB MBBS YEAR 5 RUMS SPORTS & SOCIETIES VP

Photos: Leo Garbutt

We moved into December and the end

seasons came to a close, Sports Ball

of term rush began. First up we raised

preparations were well underway and

over £100 with our Red Sportsnight in

the MDs got us off to a winning start

support of HIVE. Then came the infa-

with their continued domination of

mous Naked Sportsnight: everyone got

the UH Comedy Revue!

naked, lots of people forgot to cover

The Rugby UH final, hockey and net-

themselves up, we deleted a lot of pho-

ball varsity, and the first ever women’s

tos, and playing cards and calendars

UH football final were next on the

will be out in the not so distant future.

schedule. Unfortunately results didn’t

The second years were victorious over

go our way, but they were great events

the Freshers in Bill Smith’s, with strong

and the RUMS support turned out

spectator turnout and port sales had

in force – a credit to all the teams in-

their annual spike in the Bloomsbury

volved.

area.

RUMS then celebrated with the new

The Boat Club got things moving

generation of doctors at Finalists’

again after Christmas with the very

Sports Night! It was a fitting end to the

first RUMS Pub Quiz. Apart from the

year of sport’s nights and an emotional

3-strong Exec team getting robbed, the

one with it potentially being Stu’s fare-

night was a great success. January also

well in charge of the security team who

saw the union threaten to withdraw

look after us so well.

Since RUMS ran Richmond in Sep-

travel reclaim for all sport within zones

tember, the schedule has been jam-

1-6. After a couple of strongly worded

The last week of term arrived. Lumsden

packed with activities and sporting

emails and some meetings with the rest

raised a shedload of money, the Fresh-

events. In late September we welcomed

of the UCLU Sports Panel, everything

ers won John’s cup to deny the second

our latest intake of Freshers. The Wel-

was cleared up and is set to continue

years quadruple winner status and

come Fair was packed out as usual and

for next year.

Sports Ball was the biggest it has ever

although the medical school did their

rums

review

been with 470 guests! It was a superb

best to scare Freshers away from extra-

February was host to LGBT Pride in

night and it reinforced how amazing

curricular activities, our sports clubs

Sport Week and RUMS Dine With

RUMS is and how proud I am to have

and societies worked hard to steadily

Me. All RUMS Sport Presidents signed

been a part of running it this year.

increase Fresher numbers throughout

the pledge and attended the ‘Tackling

the year.

LGBT-Phobia in Sport’ panel. RUMS

Thank you to all the Presidents and the

Rainbow Sportsnight also raised £120

rest of the Exec team for all the help

Trials and fixtures got underway and

for Stonewall. Next up was RUMS

this year. Congratulations and good

UH Sports Night was as big and cha-

Dine with me. Over 200 members of

luck to James Shuttleworth who is tak-

otic as always. Then the MDs’ success

RUMS Sport descended on Brick Lane

ing over as RUMS VP Sports & Socie-

from the Edinburgh Fringe in the sum-

and ULU to develop inter-club rela-

ties next year!

32


long you have been at ucl?

I’m in charge of security for the following UCLU Bars: the Huntley and Mully’s, where I work closely with all UCLU and RUMS clubs and societies to ensure that customers follow the venue’s rules and regulations. This means that they experience a safe, relaxing and enjoyable atmosphere, resulting in a close bond, friendship and mutual respect between myself and RUMS. I try and help out RUMS as much as I can to show my gratitude for their respect towards myself and my security team. I have been at UCL for nearly 8 years, I spent 4 years over at the UCLU Bar Phineas and I’m coming up to my fourth unforgettable year at the Huntley and Mully’s.

OF TIME IN MULLY’S, WILL KNOW STU ARRAND. HIS REPUTATION FOR RUNNING A SMOOTH SPORT’S NIGHT IS WELL NOTED AMONGST THE RUMS COMMUNITY, AND EVEN STRETCHES AS FAR AS CLUB DE FROMAGE (AS VERIFIED AT END OF SEASON DINNER). MANY OF YOU WILL ALSO KNOW THAT HE IS SADLY PLANNING TO LEAVE US LATER THIS YEAR. ON BEHALF OF RUMS AND THE RUMS REVIEW TEAM, WE WOULD LIKE TO THANK YOU FOR MANY ENJOYABLE EVENINGS - YOU WILL BE SORELY MISSED! HERE’S WHAT HAPPENED WHEN WE CAUGHT UP WITH HIM.

does

the

rums

community

sport’s night?

There are so many to choose from, but if I have to pick one, it would have to be this year’s finalist’s Sports Night; the atmosphere was unforgettable. We had all the final year medical students downstairs to raise a glass and congratulate them on finishing their exams and to give them a goodbye gift. As I called up the teams one by one, everyone in the room sang songs affiliated with their sports team and cheered them on. Also, with everyone’s emotions running high, you all made sure it was a sports night that they would never forget.

differ

so, what makes the rums community different?

is there any advice you would give to the rums students?

There are plenty of things that I can say for this. Part of university life is to find your own footing - everyone is different and will handle things in different ways. The only thing I can say is to make sure that you give whatever situation you are faced with everything you have and never feel afraid to ask for help from others. You are all surrounded by people that care for you and will be more than happy to help you out. Finally, please don’t let the fact that I might not be around UCL anymore deter those of you that usually come to me for advice or just to rant to get things off of your chest, you can always use Facebook or emails to contact me.

what’s next for you?

I have a few open doors for me when I finish my course, which involve me working in either marketing or graphic design. There might also be a position I am considering on applying for, without going into too much detail, which would see me still being around UCL.

33

+

what has been your most memorable

from other ucl communities, and if

The RUMS community stands out more to me than other UCLU communities because it seems to have more of a family connection between students, from the way you all look out for each other, especially after a sports night, to the way you allocate medical parents to the freshers. Every game, event, and show RUMS students hold, you can guarantee a massive turn out. But more importantly, you extend this family feeling and support towards non-medical students like myself and other students, for example, RUMS badminton and tennis who have non-medical student members.

sports

you are involved with rums, and how

SPORTS NIGHT, OR SPEND A SIZEABLE AMOUNT

societies

stu

please may you briefly explain how

farewell

MANY OF THOSE WHO MAKE THE WEEKLY TREK TO

are

there

any

rums

students

you

will miss in particular, and why?

I am going to miss all of you like mad - each and every RUMS student has left their own personal mark in my life that I will never forget. Both current and past RUMS students have a special place in my life and heart.

can we expect to see you at any sport’s nights next year?

I will still be around for the first few sport’s nights of the next academic year and, after that, no matter the outcome, I will still be based in London. This means that I will be able to pop in every now and then on a Wednesday to see all of your lovely faces and to make sure that you are behaving yourselves. Also, I promise that I am going to make sure I keep an eye out for RUMS events, shows and games so I can come along and show my support and catch up with everyone.

vol.

I,

no.

III


societies

and see you soon; we’ll always

isoc

sports

+

the

highlight

year in three words

time for everyone though!

save a seat for you in Mully’s.

of the year

Winning the UH Revue for a

biggest

achievement

this

Enjoyable, inspiring and like

record third time in a row by

notable

a family

a unanimous judges vote.

sults:

Getting a spot in London

An amazing Christmas show

Varsity Series for the first

with our biggest attendance

time! So great to see the 1sts

highlight

lowlight

of the year

of the year

end

of

year

re-

year

The night of the Charity

Not going to Centre Parcs on

to date, another fantastic per-

playing and have lots of sup-

Week Dinner, where we man-

Weekend Away for once.

formance at the Inspire Med-

port too.

aged to auction off a cake for

icine Conference, performing

£20,000 to a collective of

with the Cheese Graters at

message to graduates 2016

students. It wasn’t the sum

their joint comedy show in

GOOD LUCK! RUMS Net-

for which the cake sold for

February, winning the UH

ball wishes you all the best.

that made it special, rather it

revue for a record third year

You will all be sorely missed;

was the highlight of the year

in a row.

please come back and visit us

as it showed unity amongst

and stay in touch!

students in working towards

most improved member

a positive goal.

Charlie Hall. He started off

notable end of season re-

a little shy and rough around

sults

the edges but after six years

53 netball girls attending

year

with us he’s finally found his

Sports Ball this year! An im-

Attaining record membership

voice. He even gets a few lines

pressive turn out!

levels and increasing engage-

now and again when he’s real-

ment with the RUMS Islamic

ly on form, even a laugh once.

biggest

achievement

this

society cohort to the extent

most improved player

A difficult one with so many

where our members consider

most

memorable performance

teams and great players. A

us more as a family than anything else. message

to

graduates

2016 The final years have contrib-

and

uted so much to this society,

FOR A FULL LIST OF AGM RESULTS, PLEASE VISIT

www.rumsreview.co.uk

helping to get us to the level we are and giving us their precious time and advice to build

biggest

us from strength to strength.

year

We would like to thank them

Performing for the first time

for all their efforts, smiles

at the Edinburgh Fringe Fes-

and presence, and wish them

tival last August for 8 nights

the very best in the new chap-

to a sell out crowd every sin-

ter of their lives as doctors.

gle show.

achievement

this

sports

They are always welcome at RUMS Islamic Society and

most

we hope to see them again!

Jonathan Au, for being a

valued member

&

why

technical wizard with all things lighting and sound

Greg Dewar: “I’m sorry I’ve

few players that stand out are

sults:

related. Who needs a smoke

forgotten my lines everyone,

Sophie Parrock, Emma Beck,

We managed to hold a pleth-

machine when you’ve got Jau.

I’m really hungover.” 5 stars.

Alice Meredith and Beckie

ora of events such as a work-

message to graduates

shop on laparoscopic surgery,

The society has transformed

a conference on mental health

in the six years you’ve been

this year, and of course the

here and that change began

£20,000 cake! We also had

with your year. As a collec-

our annual AspireMed con-

tive, you ushered in a new era

highlight of the season

dlesex 1s to win by 2 goals. A

ference as well as many out-

of sketches that transformed

TOUR! Such a fun weekend

great show of determination

reach basic life support cours-

us into the most successful

of RUMS Netball doing what

and teamwork!

es and academic tutorials.

RUMS society competing

they do best!

notable

end

of

year

re-

mds the

year in three words

Just three words?

rums

review

2016

netball the season in three words

most memorable performance

Fun, feisty and friendships!

The 2nds pulling it back in the last quarter against Mid-

in UH competitions and inspired writers to produce

lowlight of the season

work we never could have

One week only 7 people were

imagined possible. Good luck

at training… it was a busy

34

Fisher.


been a blast!

ing pulled out of BUCS at AGM

the year in three words

message to graduates 2016

notable

Inspiring, fun and exciting.

Keep up the amazing fundraising

We end the year with two groups of

have gone unbeaten and done the

and hard work you've done to help

committed, lovely people making

double over UCL! What more could

highlight of the year

those who need it most around the

up RUMS Music. Choir is com-

you ask for!

Jailbreak of course, with new and

world!

posed mainly of freshers who I hope

societies

hours for Jailbreak)!

rag

last year and making their maiden

interesting adventures every year;

will continue to sing with us until

message to graduates 2016

their final year.

Thanks so much for all the hard

but also launching new trips to run

notable end of year results

the Athens Marathon and climb the

Raising £15000 for our 3 supported

Atlas Mountain range!

charities Teenage Cancer Trust, The

most

Cure Parkinson's Trust and Pump

Jordy – choir’s piano accompanist;

lowlight of the year

Aid; as well as over £60000 for our

thanks for sticking around and

Not being able to organise a cycling

trip abroad for Hope For Children!

keeping us in tune!

most developed member

most

Our lovely freshers who joined

(good

committee meetings in Term 2 after

All of the choir did really well car-

reclaiming the position as UCL 1st

being so enthusiastically involved in

olling at the Whittington at Christ-

XV from the UCL side.

our events.

mas and also at the Medic to Medic

+

voyage into the LUSL leagues, they

sports

end of year results:

graft you’ve put in over the last 6 years, best of luck and see you all for

improved member

another shot at UH next year! notable end of season results

trip abroad with our charity in time for Term 2; but we will definitely work on it for next year! biggest achievement this year

Recruiting the biggest team we've ever had for our trip to climb Mt. Kilimanjaro for the charity Hope For Children! most valued member

All the members of the RAG Commemorable

performance

or bad) and why?

societies

charity event.

mittee who have organised and

double over UCL. The 1st XV also

most improved player

John Partridge. Got himself fit and

most memorable contribution

Arthi; for getting us Chicken

Both the 1XV and 3XV doing the

is now a real force at prop in the

Cheques from Nando's as prizes for

rugby

our Jailbreak teams!

the season in three words

captaincy for next year, which he

Up and down

will do a wonderful job of.

highlight of the season

most memorable performance

Our plate victory at the Oktoberfest

Nick Cox gave the most memorable

7s competition in Munich with a

performance of the year, completely

RUMS vs RUMS final - nice to get a

missing the game in Paris because

bit of silverware! This only narrowly

he’d had a couple of strong French

beats (and although bittersweet) get-

lagers the night before. Him and

lowlight

ting to the UH final again and play-

Jack Webb were quite the double act

Being rudely kicked out of a rehears-

ing in front of a great RUMS crowd.

on tour as well…

music

the

year in three words

Fun, musical, laughter! highlight

of the year

Our Spring Concert

Boars. Earned himself the Piggies

al room by Pole Fitness!

hosted all the fundraising activities;

lowlight of the season

including tracking teams for 48

biggest

hours (12 hours for LOST and 36

Recruiting lots of new members

down to Chichester. 1x Refresher

(maybe it was the free pizza!)

Munich for Dennis the Menace

achievement this year

Leaving the 1XV kit on the train

Effiom. most

valued member

&

why

Lloyd Warren – our secretary, head

biggest achievement this year

of strings group and president next

Renewing our link with PSL and

year! Worked so hard for each group

travelling to Paris to play them once

of RUMS Music and recruited lots

again. We’re looking forward to wel-

of new members.

coming them back to London again next year!

message

to graduates

2016

Thanks for recruiting us older years

most valued team

to join originally; good luck, it’s

It has to be the Piggies. After be-

35

vol.

I,

no.

III


societies

bank captain by explaining

as you’ll undoubtedly be get-

year

the laws of cricket, or Cap-

ting call ups again when we

Everyone’s phenomenal indi-

the season in three words

tain Greenwood’s first over in

are short of players.

vidual improvement.

Preseason, Exceptional and

indoor cricket, recording 3+,

Exciting

3+, 3NB, 4+, 4, W… truly

most improved player

most valued team

dreadful.

Rover had a fantastic season.

Women’s – for excellent re-

Ever present and destroyed all

sults in their BUCS league

opposition he faced.

and for progressing the fur-

sports

+

cricket

highlight of the season

considered UCL’s 1st team

men’s football

indoor. We are especially

the season in three words

message to graduates 2016

proud of this considering our

Having a party.

Thank you so much for all

Having come above UCL 1s and 2s indoor, we are now

thest in the BUCS Cup.

team is made up of predominantly freshers. lowlight of the season

your contributions. We will highlight of the season

welcome you back as Alumni

Winning NAMS for the

with open arms!

351st time in Liverpool

Kit orders. Still not here.

notable end of season results biggest

achievement

Isaac

this

Aristidou

winning

year

RUMS Squash Individuals

year

To be able to bring home

Shield.

Managing to find two new

the coveted NAMS trophy

sponsors and we received a

for the 5683th time, simply

very impressive fresher intake

because it means so much to

this year.

all our fans to do well on a

biggest

achievement

this

national level – and with the message to graduates 2016

European

Thank you so much for all

coming up this summer it

Championships

the service you have given to

puts us in a good place.

put the club into the position it is in today. Also, please buy

message to graduates 2016

membership next year, we

Thank you – you will be sore-

squash

need the money…

ly missed and make sure you

the season in three words

still have your Saturdays free

Tight, deep and hard.

notable end of season re-

most improved player

Split between Samir Ab-

sults

highlight of the season

Beating UCL 1s by 29 runs

RUMS

to

dulkarim, Rebecca Heath,

and UCL 2s by 37 runs.

Brugge and playing against

Tom James, Louis Saada, and

semi-professionals.

Kieran Francis. Impossible to

Squash

tour

decide.

most improved player

Fresher Eggplant.

lowlight of the season

most memorable performance

Losing to Cardiff in the

most memorable performance

NAMS final 3-2.

Tom Western – beating the

Snail for being condescend-

RUMS Squash nemesis from

ing to the London South-

rums

review

biggest

36

achievement

this

Sheffield at NAMS 3-2.


on court. Sadly she only has 1 year

her hands (she’s a defender) and

Fun. Flirty. Fierce.

at UCL, so we have to say goodbye -

got red carded, I think a first in the

you will be sorely missed Anya.

club’s history. She did however earn herself the role as back-up keeper

highlight of the season

The final match of the season, end-

and actually surprised us all with her

and women’s teams! Emotions were

women’s football

running high as the finalists played

the season in three words

their last ever match for RUMS

Together anything’s possible.

tennis

ing in home wins for both the men’s

societies

Rowe saved the ball on the line with

the season in three words

+

about 15 minutes in when Charlotte

match she was annihilating everyone

sports

great natural ability, and by the final

badminton

Badminton. It was made better by

skills in goal.

the season in three words

the fact that the men’s team had

highlight of the season

won all of their league matches this

The first team beating Leyton Ori-

season!

ent against all odds!

biggest achievement this year

lowlight of the season

After the women’s victory last year at

Lack of commitment across the club

BUCS, there was a lot of pressure at

meaning many games got cancelled.

Middle middle middle!

the beginning of the season for the guys to match up to the girls’ suc-

biggest achievement this year

cess. However, thanks to a talented

The seconds team winning more

intake of freshers and the leadership

than half of their games to finish in

of men’s captain Tom Ngan, the

their highest league position for as

men’s have come away with great

long as we can remember!

success this season and will be promoted next season. Their killer per-

most valued team

formance has opened up talks to po-

My committee as they have been my

tentially set up another men’s team.

rock and their help has been incred-

highlight of the season

ible this year.

Lifting the United Hospitals League Cup at Wimbledon!

message to graduates 2016

It’s always sad to say goodbye to

message to graduates 2016

finalists, but this year will be par-

I literally cannot imagine the club

lowlight of the season

ticularly difficult. We are saying

without them. They are such a huge,

The Men’s 1sts being dumped out of

goodbye to perhaps one of the most

influential year and we would not be

their cup competition semi-final in

dedicated and talented intakes that

where we are today without them.

some dubious circumstances.

we have had as a club, as highlighted

They will be missed a ridiculous

by our four honorary-life members.

amount and I hope they come back

biggest achievement this year

It’s the end of an era and we’d just

to visit.

The Women’s team have really ex-

like to thank you all for your com-

celled this year, coming within a

mitment to the club and we wish

notable end of season results

whisker of promotion, and the

you the best of luck with your fu-

Actually winning multiple games on

Men’s 1sts almost went the dis-

ture careers!

NAMS (practically unheard of!) and

tance in their cup competition af-

our 2s finishing 4th out of 9 in their

ter a successful summer! As a club

most improved player

league, with some really impressive

for the first time we have secured

Aswin Suri - he has attended all so-

results throughout the season.

sponsorship, and grown in size to 90

cial and team practices this year and

members.

is a well-known figure in the club.

most improved player

The commitment to badminton has

I think I would have to say Lisanne

message to graduates 2016

shown in his continued improve-

Schoutens. She is a transfer who

Thank you for everything you have

ment this year.

joined us last year in the seconds

given the club over the time you

team but has improved so much in

have spent with us! Good luck in

most memorable performance

her time with us that she has be-

the future, please come and share a

We would like to give a special men-

come a very strong and valued first

pint with us again soon!

tion to Anya Chen, a non-medic

team player this year, with an in-

student who joined the club but

credible attitude and huge amount

most memorable performance

has become as much a part of the

of dedication to the club.

A notable mention to Richard Be-

team as any. It was obvious from the

koe, who thrashed his opponent so

start she was an outstanding player,

most memorable performance

hard that he went and complained

always dedicated to training and

It was the match where we played

to the union (he was eligible by the

matches. She started off very wary

against the top of the league team in

way, sorry Roehampton).

at singles but soon realised she had

horrifically windy conditions. It was

37

vol.

I,

no.

III


societies

+ sports

men’s hockey

message to graduates 2016

The 1s beating UCL and rele-

lowlight of the season

message to graduates 2016

We are saying goodbye to 6

gating them out of the league.

The captains having to read

Thank you for your years of

the riot out over support at

service to the club, you won’t

Novice Sprints…

be forgotten soon and see you

the season in three words

finalists this year who have

What a year!

all given a lot to the club over

biggest

their years of service. We will

year

highlight of the season

miss them all, both on and

Being able to maintain 3

biggest

Our Varsity match with

off the pitch. I wish them all

teams playing every Wednes-

year

notable end of season re-

GKT, like previous years,

good luck in their futures as

day and Sunday - excellent

BUCS Head! A lot of logisti-

sults:

didn’t disappoint. Addition-

doctors and hope they will

commitment from the whole

cal planning and working out

M1: 21/48 in BUCS, UH

ally, our club-wide tour is al-

stay in contact with us for a

club.

how on earth UCLU actual-

Head winners; W1: 19/33

ways well anticipated by club

long time to come!

ly works culminating in all

in BUCS; M4+: UH Head

message to graduates 2016

6 crews racing at BUCS in

winners; Women’s 4+: Allom

members and this year’s one

achievement

this

all at VPs! achievement

this

to Leeds was a particularly

notable end of season re-

We’ll miss you! have a fabu-

Newcastle for the first time

Cup & UH Head winners;

enjoyable one. A tough act to

sults

lous time on elective and have

ever - and nobody came last!

M2: Novice Regatta, Winter

follow for next season.

The 2nd XI had a very im-

fun starting your new jobs.

pressive result against UCL

Please come back and visit!

Sprints and UH Head winmost valued team

ners; W2: Novice Regatta

The Men’s Second VIII.

& UH Head winners; MN

lowlight of the season

3s earlier in the season win-

The loss at Varsity was disap-

ning 9-0 against the team

notable end of season re-

Close competitors for the

and WN: not coming last at

pointing after we performed

that finished above them in

sults

overall RUMS Team of the

BUCS

so well on the night, but the

the league last year. They have

Canterbury 1s v RUMS 1s =

Year (Congratulations ten-

support from everyone who

narrowly missed out on pro-

1-1 allowing the 1s to main-

made it to the Olympic pitch

motion this year and will be

tain their position in the

and the night out afterwards

pushing hard for it next year!

league and relegating UCL 1s

made the loss that much more bearable.

out of it! most improved player

Luke Hailston was our most

most improved player

improved player this year. It

Speaking on behalf of all the

year

was difficult to pick out an

captains I think every player

Reaching out to alumni

individual player for this ac-

has shown a great improve-

and hosting our first alumni

colade as many players have

ment this term, without

drinks at the beginning of

upped their game this year.

which our club wouldn’t have

this term - welcoming back

Luke, however, has improved

been so successful!

some faces from RUMS

greatly on the pitch and de-

most improved member

Men’s Hockey’s past. This is

serves the praise he has been

Gracie Sutton - coming into

set to continue later this year

getting for it.

this year as a novice cox, she

biggest

achievement

this

with our Old Boy’s match

now has a race win to her

against the alumni at South-

most memorable performance

name and an established

gate.

I feel Hamish Miller has had

crew in the women’s seconds

a storming season this year

and has come on leaps and

most valued team

and a highlight of this would

bounds this year.

Our 3rd team is a vital part of

be his performance in our

the club. With many people

Varsity match. This was a

most memorable performance

joining the hockey club who

high stakes match and with-

Greg Gibson - for being the

have never picked up a stick

out him running the game

cox of the novice women and

before, a welcoming 3rd XI is

at times in the middle of the

very important for allowing

field it would have been a

rumsbc

these players to develop on

very different score line.

the season in three words

the pitch and keep them in-

being bigger than all of them, just to increase the challenge.

Medal Medal Medal! highlight of the season

3rd team which shows just

women’s hockey

Winning 5 of the 8 categories

nis...) these guys have won

how important it is. A special

the season in three words

at UH Head and the whole

everything in UH this year.

mention should go out to our

Exciting, challenging, suc-

club losing it when the men’s

They

3rd team captain Ollie Toth-

cessful.

first VIII won their first event

‘A’ game on race day and

for four years!

Wednesday evenings!

terested in the sport. Many of our 1st XI started out in the

am who has been excellent this year. rums

review

highlight of the season

38

always

bring

their


societies sports

+

TY VA R S I T Y darshni pandya

//

After weeks of blood, sweat and tears (believe what you want), Varsity day was

netball mbbs tear

3 //rums

finally upon us! Bright-eyed and bushy-tailed, we began our trek to East London

netball fixtures secretary

at 8am, decked head to toe in RUMS stash there was no mistaking who we were representing. With our new fave anthem (Work by Rihanna, big tune) blasting in the background, we had an early morning bonding session (involving many a braid) and began warming up.

Jennifer Westwood, Ria Mehta, Hannah James, Darshni Pandya, Robyn Brown, Corrina Horran, Emily Irwin, Sahana Gnanasampanthan, Elen Roblin, Roohi Bhatti

- women ’ s

As we approached 10:30am, the stands began to fill with our sign-bearing fans, and we readied ourselves to be called on to court by our president, Anna. The cheers were deafening, the banners were waving, our hearts were pounding, and as Roohi stepped into the circle, the battle began. The first quarter was fast and both teams showed skilled play. The first centre alone was intercepted multiple times by both teams, but it was ultimately RUMS who sank the first shot. As the quarter progressed, GKT settled into their rhythm more quickly and their shooting accuracy allowed them to start pulling away. After leading the first half of the first quarter, we finished on the back foot at 2-12. After a couple of substitutions, we were eager to close down the gap during the next quarter. We started out strong and immediately turned over a GKT centre, putting us in the driving seat for this quarter. Although we still had issues getting the ball up to our shooters and faced a lot of congestion in the centre third, the defensive team of Issy, Maddy and Ria was solid and we managed to hold the majority of possession. We made life very difficult for GKT and this was our best quarter – both teams scored 3 goals each. The third quarter saw the introduction of a new shooting combination by GKT. We maintained position for the first few minutes but soon enough, there were more long balls being passed straight into the circle. This was difficult to defend and GKT started to increase their lead again. Our own opportunities at goal also increased as we created more space and had greater movement around the circle. We went into the final quarter with a score of 8-32. With our final cry of ‘RUMS!’ we stepped onto court for the last time. GKT took the first centre and we immediately responded with a number of interceptions up to goal. We kept up the pressure and earned the majority of possession. With some excellent support play in midcourt, we brought the ball up well and created lots of chances at goal. We kept pushing until the final whistle, where the score was called at 11-39 to GKT. We might have lost this round, but we had an amazing time and played very well as a team. We’re so proud of each and every player for giving it their all and we’ll see what happens next year!

39

vol.

I,

no.

III


ITY

VA R S I SITY

The time of year was upon us once again, where RUMS would don their stash and go head to head against GKT in the annual varsity series. With the exciting addition of Medic’s Netball to the series this year, RUMS Review caught up on all the action…

- men ’ s harry bamber

As part of the London Varity Series, the first team once again had their match

hockey //

mbbs year

4 //

against GKT at Lee Valley. We knew it was going to be a tough game, and I feel we gave a very good account of ourselves out on the pitch.

first team captain

RUMS went 1-0 down after an early penalty corner conversion, but created several chances and were unlucky at the break. Forward Tom Chambers had a good Henry Sergeant, Henry Hill, Ben Miles, Josh Gardener, Hamish Miller, Harry bamber, Tom Chambers, James Shuttleworth, Sam Price, Ryan Nolan, Alex Maidwell-Smith, Will Southall, Harry Goss, Adam Muse, Adam Blackstock, Christopher Bu

opportunity to level the scores after a Hamish Miller flick could only be parried,

rums

review

but he was unlucky not to strike the resulting shot cleanly. Buoyed by an inspirational team talk, RUMS started the second half the stronger of the two teams. GKT went 2-0 up against the run of play with another well taken penalty corner but RUMS were able to mount a swift response via Hamish Miller’s goal from an acute angle. It was then that the talking point of the game occurred. The ball struck a GKT foot in the circle and was subsequently missed by the umpire leaving for an easy finish at the near post. RUMS were able to peg one back a minute later through a well struck Sam Price shot, leaving GKT to run down the clock in the final few minutes to hold onto the lead and take the win. Thank you to the members of other RUMS sports teams for supporting us - the support we received was fantastic. See you all again next year! Man of the Match : Sam Price Dick of the Day : Alex Maidwell-Smith

40


societies sports

+

TY VA R chloe hall

//

With RUMS and GKT Women each holding 1 victory from the London Varsity

hockey

mbbs year

3 //

Series, 2016 came around with everything to play for. A BUCS reshuffle awarded both teams with a promotion into South-Eastern 1A, so the rivalries had been

first team captain

building throughout the season; both home and away matches cumulating in tense 0-0 draws. The 5th March dawned breezy and cold, and after a team carb-load we embarked Frankie Bügg, Issy Norris, Iram Hassan, Cara Rocks, Elin Hughes, Josh (coach), Brogan Rudge, Phoebe Verbeeten, Annie Mosley, Alice Dewsnip, Amy Foulkes. Sitting down L-R: Rachael Sprio, Aisha Damerell, Chloe Hall, Charlotte Griffiths, Maddy Bangham

- women ’ s

on our journey to the Olympic Pitches. We were informed just prior to pushback that all seating had sold-out, and the atmosphere heightened as captain Chloe Hall’s team warmed-up and prepared to begin. RUMS took a while to settle into our rhythm, before the transfers between seasoned centre-back Lotty Griffiths and fresher Amy Foulkes began to flow. After 20 minutes of battling in midfield and some great attacking from inner Iram Hasan, GKT won a short corner where a flairy deflection managed to sneak the ball over the line. Not to be disheartened, RUMS retaliated with some great running and leads from forwards Annie Mosley, Izzy Norris and Alice Dewsnip, and some fantastic shots and nail-biting near misses in the GKT circle. Unfortunately, before the first half drew to a close, GKT managed another 2 goals from opportunistic breaks at RUMS short corners. However, after a rejuvenating team-talk and wine gums, inner Aisha Damarell ran the ball from the halfway line into the GKT circle, and a quick one-two allowed her to put the ball in the net. Tensions built in the second half with RUMS beginning to claw back, and some fantastic runs from right midfield Brogan Rudge up the line began to anger GKT as Brog continued to draw fouls against them. More chances arose with some sneaky balls up the line to speedy Maddy Bangham, but RUMS were unable to convert. A brief interlude as a GKT player took a hit to the head gave some time to re-group, but RUMS were shaken by this and let in a goal shortly after play resumed. A knee injury to defender Elin Hughes saw more GKT insults brought upon keeper Frankie Bugg, which she countered with some fierce saves to prevent further assaults on our score line. Some confusion in the RUMS circle saw a penalty flick awarded to GKT, which they slickly put between the posts, bringing the score to 5-1. As the full-time whistle blew, RUMS were awarded a short corner – a final chance at redemption. A fast-paced ball from fresher Cara Rocks was saved by the GKT keeper, but the rebound was caught by Rachel Spiro who put the ball back into the goalmouth for Phoebe Verbeeten to convert, drawing the match to an exciting close and a final score of 5-2. Player of the match was awarded to Brogan Rudge for some amazing runs up the line, and DOD went to coach Josh for the slowest boat race anyone has ever witnessed. We were immensely thankful to everyone who came to watch and joined us in Walkabout afterwards – despite our loss it was an amazing night and the RUMS support was much appreciated!

41

vol.

I,

no.

III


AND THERE IS, IN MY EXPERIENCE, A STRONG PRESSURE NOT TO STRAY FROM THE GIVEN PATH.

I wasn’t lying. I was in awe of the healthcare professionals I shadowed, and I did want to follow in their footsteps. I did want to understand human perception and identity. However, I hadn’t fully considered the emotional impact of medicine because my decision was already made. I had done the right subjects, I had the right grades and medicine was the only way I could have a positive impact in the world. When I shadowed my mother’s neurologist, I was devastated by a sixteen-year-old’s Multiple Sclerosis diagnosis. I brushed this off, MS was always going to be a soft spot, especially in girls my age. I was drained every day I came back from working at the nursing home and ignored it because I felt this was simply a consequence of my inexperience. When I came to medical school, I couldn’t seem to learn how to develop the necessary professional distance. I shadowed a cardiothoracic surgeon, and his patient nearly died on the table in front of my eyes, which left me confused for many days. I could only cope with the dissection through extreme abstraction. Each experience added to my doubts. I dreaded leaving medical school to be the UCL doctor.

rums

review

42

Last summer, I weighed all my options and decided to apply for law, which would be a good foundation for a career in policy, whilst continuing my medical degree. After consulting several law firms and the UCL careers service, I entered second year and rounded off my application. When I received my offers, I decided I would defer them to finish my BSc in History and Philosophy of Science and Medicine. So far, the reaction from the medical school and my colleagues has been very positive. I am very happy with my decision, and astounded by the support and the opportunities I have been given. Of course, I will only know how this all turns out in a few years, but I feel like I am finally following my own vocation. I encourage everyone who feels a similar selfimposed pressure to release themselves of it, to own their own power, and to consider what future they truly dream of. After all, as I have seen during my time at medical school, a doctor is in the unique and privileged position to have an amazing positive impact during people’s darkest hour, but only when they are fully passionate and well suited to medicine. Should they not feel like they belong and still soldier on, they may end up depriving society of their true gift.

photographs by elliot nash

words by corlijn reijgwart, mbbs year

2

LOWEST DROP-OUT RATES,

f i n d y o u r v o c at i o n

THE COURSES WITH THE

:

MEDICINE IS ONE OF

Before I was entirely clear on the purpose and practice of tying shoe-laces, I had decided I wanted to be a doctor. I can’t even remember where this dream came from. In hindsight, I think the fact that I was a sickly child, and that I was around doctors often had something to do with it. I couldn’t admit to this on my personal statement, because it was, and still is, such an unconvincing cliché. It doesn’t show any reasoned decision making, or even any particular aptitude for medicine. In my actual personal statement, I described the study of medicine as an opportunity to better understand the basis of human perception and identity. I wanted to look into the link between matter and mind. I was impressed by the nurses at a home, who coped by cherishing the moments where they relieved some of their residents’ suffering. Then, I concluded my passion for medicine was rooted in my academic interest in the sciences, my will to challenge myself intellectually and most importantly in my wish to positively impact the lives of others.

At medical school I was gripped by medical law. The Clinical and Professional Practice course and the SSCs gave me some reprieve from the science in the horizontal modules. They gave me the opportunity to examine the mind from a philosophical perspective, and to learn more about medical policy. Soon, leaving became more of a positive choice to follow my passion and less of a flight from the challenges of science and medicine. I now feel like I no longer have to continue with a course, and later a profession, which will drain me emotionally and won’t allow me to tap into my true passion. The current situation with Jeremy Hunt has highlighted the fact that policy makers can have a massive impact on public health. Sadly, as in this case, sometimes a negative one.

comment

At school, my heart went out to the humanities. I loved to read and I excelled in essay subjects such as English, History and philosophy. My favourite extracurriculars involved debating and policy. However, I brushed my interest in these subjects and my slight distaste for the sciences aside. I felt that everybody knew the sciences were more difficult than the humanities. My logic was that things that are more valuable, tend to be more difficult. Giving up would be a sign of weakness.


words by katie hodgkinson

READ, LEARN,

RELAX. do no harm: stories of life, death and brain surgery Henry Marsh ‘First, do no harm.’ We’ve all heard it, all adopted it as a life motto, but none have truly considered it to the extent that neurosurgeon Henry Marsh has. Considering both the risks and benefits of treatment is something we will all have to do as clinicians, but we’ll never truly appreciate it the way he does. He is painfully honest about how medical intervention can cause more harm than good, how hospital bureaucracy has no place in modern medicine, and just how transient the bond between doctor and patient really is. This book is both elegant and brutal, describing every patient’s story - and his own career - in a truly reflective way, seen properly for the first time outside of the dreaded portfolio. His writing reassures you that no matter how much horror you see in your career, you will never lose that sense of humanity and feel for injustice which are so present in medical students today. His details around life and death decisions will make you think and certainly send you into clinical practice with a fresh sense of empathy. It’s all too easy to see neurosurgeons as the best of the best, but his sense of humility is evident and his care for his patients even more so. He is truly honest about what a career in the NHS and looking after people entails; it’s something so beautifully recorded that it’s a must-read.

i think you’ll find it’s a bit more complicated than that Ben Goldacre I’ve covered Ben Goldacre’s books before, but for a good reason. His writing style is beautiful - relaxed and digestible, yet it instils you with informed anger at just how science is portrayed in the media. This book is a collection of his writings on science and the lack of it, whether that’s pseudo-science, poor reporting, bad clinical trials or misinformation of the public. A perfect read for those wanting to understand just how the media represents both the medical and scientific communities, this will entertain you and cause outrage in equal measure. This book contains less of a linear narrative than Bad Pharma and Bad Science, but instead groups his writings by topic to make things clearer, and it also makes it much easier to read in small chunks. It’s a brilliant introduction to science writing and makes more sense if you read it before going on to read his other books, covering a massive range of topics and viewpoints easily. If you want to be informed on just about everything you’ve ever considered in terms of scientific writing, consider this book. It’s easy to read, well organised, funny and you can tell it’s written by a UCL medic, because it links beautifully with everything we’ve ever been taught in CPP.

43

trust me, i’m a junior doctor Max Pemberton One of three books written by Dr Pemberton on the subject of being a junior doctor, Trust Me is the first and details the very start of his medical career post-university. Max started writing weekly columns about being a junior doctor for The Telegraph and this book is a collation of those, presented in an easy-to-read diary format. Whilst the book was published in 2008 and Max now writes for the Daily Mail, the stories remain as pertinent and witty as ever. From run-ins with consultants, to making friends with the nurses - it’s all still relevant, still brilliant and definitely a more relaxed way to learn about post-medical school life than being on the ward all day. Dr Pemberton’s writing starts off as a very optimistic junior doctor ready to do the best by his patients, and ends ruminating on just how medicine changes you. An eye-opener to the reality that foundation years could be less about patients and more about paperwork and politics, this is a must-read for anyone looking for a more chilled way to learn just what the NHS is like for newcomers. It’ll make you laugh, it’ll make you cry, and it’ll make you angry at just how the NHS works- but most of all, it’ll make you excited to get out there and start making a difference, one patient at a time. vol.

I,

no.

III


Yul Kahn Pascual

ending

? Professor Martin Elliott 16th March 2016 Museum of London

As the lecture theatre began to fill up, a very relevant quote was projected onto the first slide: ‘Hearts will never be practical until they can be made unbreakable’. Many will recognise this quote from a film featuring a Wizard and a character called Dorothy, but will never have thought about it’s underlying relevance.

the Pooh) and a well known ventriloquist, Paul Winchell, was in fact the first man to patent an artificial heart in 1956. After watching a surgeon lose a patient on the table, he was adamant that the patient could have survived had there been an artificial heart. His design patent very much resembles parts from some of the more recent successful ones.

The talk began by levelling the audience, with a detailed overview of the heart and the mechanics of the heart, highlighting what often goes wrong. In 2013, in the US, 5.8 million people were being treated for heart failure and each year over 650,000 new cases are being diagnosed. One in five of us will develop heart failure in the course of our lives with less than 10% of those diagnosed surviving the 10-year point. These figures are staggering and beg for a solution to what is an evident worldwide problem and a major factor in the plateau of lifespan.

In 1969 the Liotta heart, a double ventricle air-driven pump, was inserted in a patient for 64 hours, before a heart donor came forward and the artificial one was replaced by a much more reliable real heart. This was the beginning of artificial heart development. Soon many different companies released prototypes and while they were successful in their own way, no significant findings were made - the patients eventually died and their quality of life was often not great. In 2016, the artificial heart does have a place but in a ‘bridge to transplantation’ role. The Berlin Heart is one of the continuous flow pumps being used at Great Ormond Street, keeping the patient alive but restricting mobility as the child must move around with the machine. The success rates are staggeringly close to transplantation however, at 70% alive after 2 years compared with 80% in transplants.

Prof Elliott ran through the current management of heart failure, and went on to mention some early failed surgical attempts, such as Kantrowicz’s idea of using muscle from the latissimus dorsi to wrap around the heart in order to try and share the contraction load. Stem cells for muscular wall regeneration has been looked into by several groups but no effective solutions have come of it yet, since it is a relatively new emerging field.

Technologically may be progressing, but like most new treatments in modern medicine, they need to be evaluated for cost/benefit. The cost of each assistance device currently is around 1/4 of a million pounds per patient, and although this comes down to the manufacturer, high demand means it doesn’t look likely that companies will throw away this profitable opportunity. 100 were given out last year per 60 million people in the UK, so how do we decide who deserves it and who doesn’t? Do we give it to the sickest, or less poorly with a higher chance of accepting it? Do we give it to those contributing to society or have a lottery for it? Do we invest in cancer treatment and research, or artificial heart devices? An interesting question brought up by someone was that surely if the device didn’t work on someone it could be reused on another patient, but Prof Elliott ensured us

What naturally followed was the topic of transplantation - the next best solution for someone in last stages of heart failure. Since the turn of the 21st century, the number of heart transplants being performed worldwide has stayed around 3,750 whilst the number of people around the world suffering from heart failure is about 25 million. This means that we are able to attempt to help much less than 1% of people, 0.015% to be precise. Of these people only 16% are alive 30 years post op, bringing the figure even lower. Then came the greatly anticipated topic of artificial support. Now for another television reference, the man behind the voice of the Tigger(Winnie

rums

review

44

illustration by elva choi

words by yul kahn pascual

reviews

+ comment

the artificial heart: a new


LISTEN,

Yul Kahn Pascual

world suffering from heart failure is about 25 million.”

has stayed around 3,750 whilst the number of people around the

DO.

“the number of heart transplants being performed worldwide

WATCH, lets talk about aids Ms Lorna Benton 7th March 2016 LT2 Despite the small turnout, Ms Benton led a great discussion, covering her experiences in the HIV/AIDS field abroad and in the UK whilst encouraging us to add our thoughts. She stressed her fascination with HIV/ AIDS, saying this was down to its dependence on behavioural perspective and research. Thinking of different ways to approach the social campaigns in different countries is part of the thrill of working in this field. The most interesting part I found was how the virus developed in South Africa. The epidemic began to emerge during the time where president Mbeki turned his back on both the Western AR therapies that hit the market and the prominent scientific research at the time, and took the advice of AIDS denialists who said that AIDS was just a weak immune system and not a virus. He rejected offers of free drugs and grants, and was an obstacle to the treatment of many South African citizens at the time. It has been calculated that this misinformed decision led to the death of 300,000 people. Uganda, on the other hand, took all the advice and treatment on board and saw their AIDS rates decline substantially during the same period.

that the companies had made these devices for one-time use, £250,000 a go. The next topic was that if you put someone on a machine that could technically keep them going indefinitely until they become demented, how do you decide when to turn it off? It is part of their patient autonomy to decide and as a doctor you have a duty of care to the patient. Peter Laussen came up with the potential idea of these machines becoming a bridge to decision - so until family members or the patient come to terms with their family members’ death. How do you measure the futility of the machine, the doctors medical point of view may differ from that of that patient and would judges and courts need to get involved?

She addressed the lack of a HIV vaccine by stating that its absence isn’t actually much of a pressing issue. With the right prevention basket and constant engagement of behavioural interventions, we can slowly but surely reduce the figures of HIV sufferers in generations to come. She posed a question to the floor: who do we turn to when we have a problem? All of us answered peers or family. The conclusion she helped us visualise was that peer education is one of the key target areas of HIV prevention in generations to come. A new approach being tried is using behavioural approach models that are working out in Bangladesh, for Bangladeshi communities in London, to see if there is a cultural way of approaching targeted prevention.

He is a strong believer that the technology will keep evolving and that these ethical questions and dilemmas must be faced before an advanced version of the artificial heart becomes only available to certain members of the population and causes an uproar in the public health system. We must engage in a debate like in the 1984 debate about human fertilisation and embryology, before anarchy ensues and demand exceeds supply. He finished off by saying that 1% of the population holds 50% of the world’s wealth and if things continue in the direction they are going, what will we ever do with an everlasting Trump, Putin or Al Assad? This was a fascinating talk which was excellently delivered. I would very much advise going along to one of the upcoming Gresham talks at the Museum of London, especially Prof. Elliot’s next talk on the 25th of May!

medsoc and hive ucl:

It was a greatly informative talk covering both the past and current approaches to HIV. I would like to thank UCLU Medsoc and HIVE UCL for organising this talk and would encourage more of you to attend HIVE talks in the future!

45

vol.

I,

no.

III


RUMS

Alumni Association

C O N G R AT U L AT I O N S to all of the new RUMS doctors! The RUMS Alumni Association are pleased to share in your celebrations by being proud sponsors of the

RUMS Finalists Ball 2016 We are also organising a Summer Event to allow the Class of 2016 to connect with other RUMS alumni! To receive the details of this, and for more information about the RUMS Alumni Association, please join the ‘RUMS Alumni’ Facebook group. Wishing you all a safe, enjoyable and rewarding elective, and we hope to see you soon!

-

The RUMS Alumni Committee

follow us on twitter @RUMSalumni


We’ve got the books to get you through medical school!

Visit http://bit.ly/CRC-20 to automatically receive 20% DISCOUNT on all revision guides WWW.CRCTEXTBOOKS.COM


! KEYWORKER

LIVING

!FOR LESS! PARK HOUSE 0203 202 0360 EARLS COURT SW5 (ZONE 1&2) Single room £178.41 p/w! 2 mins from Earls Court Underground

ZONE 1+2

(DIstrict & Piccadilly Lines)

Female only

AFFORDABLE SELF-CATERED ACCOMMODATION FOR STUDENTS AND KEYWORKERS

HELEN GRAHAM HOUSE 0203 202 0342 HOLBORN WC1 (ZONE 1) Twin room £117.91 p/w and single room £180.88 p/w! 5 mins walk from Holborn tube (Central & Piccadilly Lines) or Tottenham Court

ZONE 1

Mixed

Road tube (Central & Northern Line)

GOLDSMITHS HOUSE 0203 202 0381 CAMDEN NW1 (ZONE 2) Single room from £138.48 p/w! 7 mins walk from Mornington Crescent

ZONE 2

Tube (Northern line)

Female only

STAFF ONSITE

ALL BILLS

24/7 INCLUDED

WWW.KEYWORKERACCOMMODATION.ORG.UK

Rums Review Issue 3  

Summer 2016 edition of RUMS Review, the magazine for UCL medical students.