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Your Essential Reading List for UCL Medical School Exclusive 20% discount on all these books! Atlas of Human Anatomy 7th Edition

Frank H. Netter

ISBN 9780323393225 PUB DATE March 2018 PRICE £61.99

NEW N EDITIO

The only anatomy atlas illustrated by physicians, Atlas of Human Anatomy, 7th edition, brings you world-renowned, exquisitely clear views of the human body with a clinical perspective. In addition to the famous work of Dr. Frank Netter, you'll also find nearly 100 paintings by Dr. Carlos A. G. Machado, one of today's foremost medical illustrators. Together, these two uniquely talented physicianartists highlight the most clinically relevant views of the human body.

Visit the website, select your books and use the discount code RUMS20 to get an exclusive 20% off for all readers of RUMS Review. Expires 1st May 2018 Kumar and Clark’s Clinical Medicine

Guyton and Hall’s Textbook of Medical Physiology

Netter’s Anatomy Flash Cards

9th Edition Parveen Kumar & Michael Clark

13th Edition John Hall

5th Edition John T. Hansen

The ninth edition of this best-selling textbook of clinical medicine builds even further on its formidable, prizewinning formula of excellence, c omprehensiveness and accessibility. 'This book is stunning in its breadth and ease-of-use. It still remains the "gold standard", thorough guide to clinical medicine its forefathers were.'

The 13th edition of Guyton and Hall Textbook of Medical Physiology continues this bestselling title's long tradition as the world's foremost medical physiology textbook. Unlike other textbooks on this topic, this clear and comprehensive guide has a consistent, single-author voice and focuses on the content most relevant to clinical and pre-clinical students.

Learn the essential anatomy you need to know - quickly and easily! Each flash card in this full-color deck features high-quality Netter art (and several new paintings by Dr. Carlos Machado), numbered labels (with hidden answers), and concise comments and clinical notes for the most commonly tested anatomy terms and concepts. Focusing on clinically relevant anatomy, this easy-to-use, portable study tool helps you learn anatomical structures with confidence.

ISBN 9780702066016 PUB DATE July 2016 PRICE £56.99

ISBN 9781455770052 PUB DATE June 2015 PRICE £79.99

ISBN 9780323530507 PUB DATE March 2018 PRICE £29.99

BMA Medical Book Awards judges.

www.uk.elsevierhealth.com

NEW N D E ITIO


Editor-in-Chief: Beth Gillies Deputy Editor-in-Chief: Melika Moghim Director of Medical Journalism: Izabella Smolicz Treasurers: Carol Chan Augustina Jeyanathan Sub Editors: Rachel Parker Sophie Douglas Davies Sabrina Matica Hickey

UCL Medical School Student Magazine Vol. III No. II

Obstetric and Gynaecology Issue

News: Emma Lewin Anamika Kunnumpurath Summer Chan Out of Hours: Beth Gillies Research: Eng O-Charoenrat Andrien Rajakumar Features: Ian Tan

Email: rums-review@ucl.ac.uk Website: www.rumsreview.co.uk Facebook: https://www.facebook.com/rumsreview Twitter: @UCLRUMSReview

Alumnus Interview: Naomi Joshua

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.

Sports and Societies: Asha Dave Perspectives: Cheh Juan Tai Demystifying Medical School Tanya Drobnis Book Reviews: Katie Hodgkinson Eleonora Vulpe Careers: Izabella Smolicz Online team: Jonny Knight Ian Tan Liam Taylor Design Editors: Rebecca Mackenzie Rosie Clarke Artwork: Karim Chraihi Grace Navin


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Skull / Editorials Editor’s Welcome RUMS President Foreword The Director’s Update

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Clavicle / News The latest from in and around UCLMS

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Sternum / Out of Hours Dr Julie Andrews

Scapula / Alumnus Interview Dr Henrietta Hughes

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Radius / Research Dr Helen O’Neill

spine / Careers Obstetrics and Gynaecology

Research Round-up: Women’s Health

Dr Melissa Whitten

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Pelvis / Perspectives Cases for the Courtroom: Obstetrics Negligence Claims

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metacarpal / demystifying medical school Halfway Planner

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Femur / Book reviews The Hospital by the River: A Story of Hope Dare to Dream: My struggle to become a mum Cut How to Grow a Baby

Contents Fig. 1 Plan of RUMS Review Vol.III Issue II

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Tibia / Sports and Societies VP Reports Round-up RUMSBC Cycle London to Paris


Editorials

Editor’s Welcome Beth Gillies RUMS President Ozzy Eboreime Director’s Update Professor Deborah Gill 5 Vol.III No.II


Editorials

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the field of obstetrics.

Happy New Year to you all from the RUMS Review team! We hope you are all well-rested from your Christmas break and ready to delve into the Spring term with enthusiasm (or, at least, able to drag yourselves through the not-so-dry-January). No matter how dreary the time of year, we always aim to deliver your much-needed RUMS booster, and this term is no different. In this issue, we focus on all things Obs and Gynae. So much more than the stereotypical “babies and vaginas”, O&G is a fascinatingly broad specialty incorporating medicine, surgery, ethics and more. A particularly interesting and rapidly developing area of this specialty is that of research, and UCLMS is privileged to be associated with the incredible epicentre that is the Elizabeth Garrett Anderson Institute for Women’s Health. A vast range of different projects and focuses run within this centre, highlights of which can be found in our Research Roundup. Alongside this, we chat to Dr Helen O’Neill, who is Programme Director for UCL’s Reproductive Health and Women’s Health MSc and a prominent figure in the world of genome editing and preimplantation genetic diagnosis. She talks to us about her current work and the ethical dilemmas that challenge the field. Our exploration of ethics continues as we unpick some prominent obstetric negligence cases in Perspectives, and our Book Reviews recommend some thought-provoking reads that confront the sensitive and often under-discussed topics of infertility and female genital mutilation. Meanwhile, our Careers section once again gives you all the guidance you may need to pursue this stimulating specialty, along with a captivating dissection of ‘The UCL Doctor’ definition aided by advice from UCLH’s very own Dr Melissa Whitten. Our Alumnus Interview gets to know the newly appointed NHS National Guardian, Dr Henrietta Hughes, who chats to us about the reasons behind the creation of her role and the importance of creating an environment in which healthcare professionals feel comfortable and enabled to raise concerns and improve practice; something which is of particular importance in

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Our line-up of successful, inspirational women (which was not intentional, but is rather fitting in light of the approaching International Women’s Day!) is concluded as we get to know Dr Julie Andrews Out of Hours. A well-known face to clinical students and to anyone who has stepped foot in the Whittington, this is a must-read (even if we do say so ourselves). As always, we also have our directorial update from Professor Gill and presidential update from Ozzy Eboreime. The support that RUMS Review receives from both Prof Gill and Ozzy, and the bodies they represent, is overwhelming and we continue to be so grateful for this. We also introduce you all to your new RUMS VP for Finance and Operations, Ankit Bhatt, who – despite being a little late to the game – is incredibly keen to represent your views and wishes as a student body. Our News section grows larger with each passing issue and it is humbling to see all of the incredible things that our colleagues and friends achieve both within and outside of the medical degree. If all this just isn’t enough to drag you out of your post-winter slumber, our Demystifying guru provides us all with a handy halfway guide as to where each respective year group should be at with their studies by this point in the academic year. Finally, we give you the ultimate RUMS fix as we catch up on the feats and frivolities of our Sports & Societies, featuring an update from both our current and previous Sports & Societies VPs (Shuttles, just move on already). On a personal note, as I write my final editorial as Editor-in-Chief (sob), I’d like to thank all of the wonderfully creative people on the RUMS Review team, who work so hard to pull each issue together. I’d also like to thank each and every one of you who read and respond so positively to our publication – we are incredibly honoured to represent you as RUMS students and hope you continue to enjoy and engage with us. Beth out (mic drop)

Beth Gillies

Melika Moghim


Editorials

As we move into this new term, I look forward to the continued work of both of our academic VPs. I would particularly like to mention the work of Aayushi and her academic reps for their contributions to the Quality Assurance Unit's Review of the Whittington. I look forward to the report being processed and the changes that will follow. Not to be outdone, Anush and his

determination. I would personally like to thank the RUMS Review Committee for never ceasing to be a stellar example of just what our students can accomplish when they put their minds to it. I look forward to future successes awaiting us all in this new year; in particular, the successes Ankit will achieve on behalf of RUMS in his new role as Finance and Operations VP. First and foremost, however, I would like to celebrate some of the achievements of our RUMS Executive team over these last few months.

Ozzy Eboreime

D

ear all,

I hope the holidays have provided much needed respite and the opportunity to recharge ahead of what promises to be a very enjoyable – but also a potentially taxing – term. We are all aware of how challenging it can be to adjust to new settings and environments each academic year. However, reading reports of some of the achievements of our student body last term, I am happy to conclude that we faced those challenges with courage and

We at RUMS have had a successful term. We began the year as always with our welcome programmes, first for the incoming transfers into the clinical years and later for the freshers. Thanks to Dan and his events subcommittee, the Fresher's Fortnight welcomed the first years into RUMS in style. From the boat party to the survivor's ball and everything in-between, the first years were able to make fond memories that I am sure will stay with them for life. I can’t wait to see the events lined up for this term, which promise to be just as entertaining. In particular, the inaugural RUMS Take Me Out; I hope to be writing in the next RUMS Review about many people who have found love because of this event. I was proud to see that not only did the first years throw themselves into the welcome programme of activities, they also decided to get involved with our RUMS Sports and Societies. It was encouraging to see our sports teams reporting record numbers of new members this year. Special congratulations are in order for Charlie, who has been working tirelessly to champion our sports and societies. It seems they are going from strength to strength as they continue to maintain their winning streaks, especially against their SUUCL counterparts. Yes, SUUCL. What better way to celebrate than through various tours around the country? These tours are, of course, primarily to showcase our sporting and performing talents, not just weekends of frivolity traipsing around other cities – despite what others may think. With another entertaining MDs Christmas show and Bill Smith's cup, we welcomed the winter break with open arms.

team have continued to work on helping manage the AV difficulties in LT1, as well as suggesting further changes to course content to aid learning. I am sure no one will complain about transferring some of the pharmacology teaching from second year into first year to help lessen the burden. Please all join me in thanking them for helping to shape to our course to better suit our needs. Similarly, I am aware that improving access to and provision of support services is high on the list of priorities for many of our students. I am, therefore, very grateful for all the hard work of Iram and her welfare subcommittee in trying to accomplish this. Through collaborating with the new manager of the MBBS Student Support and groups such as Medics4Medics, the RUMS Welfare team have been working tirelessly to raise awareness of the various issues surrounding student support. Whether it is during Mums and Dads via pizza-induced bonding or through lecture shout outs, they are working to fight the taboo around welfare and wellbeing, to the benefit of all. Thank you. Looking to the near future in our course and careers, I believe it is easy to be disheartened. The news is filled with stories of how stretched the health service is in the face of growing demands. Almost all forecasts are bleak. However, at times like these, I believe a change of focus is in order. What fills me with hope is focusing on the one thing which is constant through all these reports: the countless examples of the resolve of various health professionals to provide the best care they can for their patients. They truly are an inspiration to us all. This term will be equal parts enjoyable and daunting; when things get tough in the coming months, please look after yourself and look to these inspirational stories of service to help inspire you, as I know I will. As always, I welcome any of your thoughts and opinions. With RUMS love, Ozzy Eboreime RUMS President, 2017-18

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s ever, I am delighted to be providing an update about life in the UCL Medical School for RUMS Review. Last term was busy as always for staff and students alike. Starting as a brand-new student, beginning a new year of study is an exciting but somewhat unsettling experience. The New Year and the second term always brings about a more focused and settled period of learning for students in all years of the MBBS. The next few weeks are a particularly important period for our sixth year students: they are now just a few weeks away from finals. Some may feel relatively calm (recognising that this is a pass/fail test and there are no dreaded deciles); others are probably terrified. However, the medical school team know that everything they have achieved so far is leading to this point, that they are well prepared and are all capable of doing very well in this final hurdle. We are all rooting for them!

The national picture There have been a number of developments over the last few months at a national level that will affect our students and our school. The national plans to increase student numbers will see twelve extra students joining UCLMS each year. We thought very hard about how many extra students we could accommodate: balancing the huge demand to study at UCLMS with the capacity of the staff and buildings to deliver an excellent course. We have also bid for some additional students in the next wave of expansion to study at UCLMS through an innovative pathway. More about this in the next edition if we are successful… The GMC have reached the very final stages of consultation of the new ‘Outcomes for Graduates’ document. Once released in the next few months, it will stimulate a review and refresh of our curriculum and assessments to ensure UCLMS graduates all meet the new

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outcomes. It is reassuring to note that UCLMS is ‘ahead of the curve’ on a number of the new areas to be addressed. The new curriculum guidance coincides with more detail about the national Medical Licensing Exam (MLA) to be introduced in 2022 – so taken by our current first year students. The exam will be a knowledge test only, in the single best answer (SBA) format that is very familiar to UCLMS students. It will be targeted at ensuring minimum competence and will primarily focus on safety. The existing medical school finals exams will not be changing significantly other than some increasing commonality between schools in their approach to OSCEs. We have a number of UCLMS staff members already involved in the work of the Medical Schools Council Assessment Alliance, which develops shared resources and best practice in knowledge tests across all medical schools. It is likely these same assessment experts will be called upon to develop the MLA. I am sure UCLMS students will be very well prepared for the MLA.

The MBBS at UCLMS At a local level, we have introduced some new SSCs and iBScs, are looking at the shape of Year five to ensure there is good quality exposure to primary care throughout the programme, and are working hard on making student support services more accessible and reactive. A special thank you to students who are helping to shape these developments. The buildings have been our weak spot in recent years. We are delighted to see the plans for the refurbishment of the Rockefeller Building coming on apace. Work is likely to start next summer with the Bloomsbury Clinical Skills Centre being targeted first to get a long overdue face lift. It is great to see the new mini medical student hub on the ground floor next to Sam’s office being well used too. The student spaces at the Whittington are now looking much more student-friendly and Royal Free social and learning spaces are being reviewed to ensure they keep up with the increase in student numbers on the site. It is slow work but we are determined to make the spaces the best they can be for our students.


Editorials

MEDICAL SCHOOL NEWS Our alumni Now we have started the work of our alumni relations team in earnest, it has also been a busy time for some of our alumni. Our alumni are an important part of our school. We are determined that our current students feel part of, and benefit from, the huge community of UCL doctors out there and that those who have graduated still feel that they ‘belong’ to UCLMS and RUMS. The RUMS brand is a great way of bringing together all of our alumni, whether they attended UCLMS or one of the three schools that merged to create this fantastic and dynamic school. There have been a number of alumni events, formal and informal, over the last few months but four really stick out for me and showcase the incredible diversity of talent of our UCL Doctors. The MDs’ exhibition in the Cruciform library showcases the long history of comedy and performance in our school. I attended the MDs’ Christmas show and was delighted to meet the entire cast of the 1975 MDs’ show in the audience. I look forward to seeing them, and many other MD alumni again when we have a celebration of the MDs in the spring. The Women in Medicine exhibition at the Royal College of Physicians (RCP) is a fantastic showcase

of some of the incredible women leading medicine today. UCLMS was very well represented with the current and recent presidents of the RCP, the Royal College of Obstetricians and Gynaecologists and the Royal Collage of Surgeons, the Principal of St George’s University of London, the lead for Health Education England and the editor of the BMJ all being UCL graduates. The RCP president, Professor Jane Dacre, who is a professor at UCLMS and my predecessor as Director, kindly hosted an event for current UCLMS students that included ‘micro-mentoring sessions’ with some of these incredible women and other more junior but equally inspiring women who have graduated from UCLMS and are forging brilliant careers. Jane also captained the UCL alumni team in the Christmas University Challenge. Whilst just losing to Reading in the semi-finals, Jane was a great advert for the medical school, and she got the questions about medicine correct (phew!). Wishing all our students and staff a successful 2018,

Deborah Gill, Director, UCLMS Follow us on twitter @doctordeborah @UCL_MBBS

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News

NEWS pg. 11 Viva la Vulva: Tackling the Stigma Surrounding Women’s Health pg. 12 Library announcements pg. 13 This UCL Girl Can! pg. 13 RUMS Halfway Ball pg. 13 Huntington Disease News pg. 13 RSM Reforming Anatomy Conference pg. 13 MDs Exhibition pg. 14 200 Years of Parkinson’s Disease: Where are we now? A reflection pg. 14 AcaMedics Symposium pg. 14 RUMS Finance and Operations VP pg. 15 UCLMS Graduates Launch Adaptive Learning Tool for Students pg. 15 Whittington Health Won CKHS 2017 Top Hospitals Award pg. 15 The Royal Free Association pg. 15 The Hernia Games pg. 15 RUMS Acapella Groups Perform for Charity

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News

News

of Viva la Vulva and lead for Medical Ethics and Law, is one of the creators of this documentary and the documentary’s screening for International Women’s Day will be followed by a Q&A with the women who appear in the film. All this makes it a particularly notable event in the medical school calendar!

Tackling the Stigma Surrounding Women’s Health Words by Emma Lewin

Beyond workshops and events, Viva la Vulva is also set to take the Bloomsbury Theatre by storm. Taking advantage of its members’ creative talents, a new play is in the works to be performed in December 2018. Written by Polly Cohen, a final year medical student, the play will be based on the real stories of students’ experiences of sexual misconduct at university. Alongside these events are a number of more academic projects, including interviewing pharmacists about emergency contraception and interviewing medical students from Queens University Belfast and UCL about their contraception and abortion education.

Demonstrating a passion for the promotion of women’s health rights, Viva la Vulva has gone above and beyond this year. With so many different events being organised, they are bound to reach a wide audience with their cause. If you would like to get involved contact Jayne Kavanagh j.kavanagh@ucl. ac.uk.

With no less than eight projects taking place, 2018 is set to be a pivotal year for Viva la Vulva, a UCL Medical Student society which campaigns to raise awareness of issues surrounding women’s health. Set up in September 2014, it has a particular focus on sexual and reproductive health rights and gender-based violence. In 2015, following the success of its student-led school teaching programmes and various other engaging events, the society was awarded the title of UCL Best Newcomer at the UCLU Volunteering Awards. In the years since, the society has continued to promote awareness for a number of pressing issues, including sexual violence, abortion rights, and female genital mutilation. Now the project is looking to expand further. One new and exciting pilot this year is the Education for Choice abortion education scheme. Last term, 19 medical students were trained to deliver evidence-based workshops on contraception, pregnancy decision-making and abortion to students in Key Stage four and five. This scheme provides young people with information that places emphasis on bodily autonomy and the right to make decisions about their own lives – a perspective that they may not otherwise be presented with in mainstream education. In a single one-hour session, the students are given a strong foundation of core knowledge and are directed to reliable sources of information and confidential services. Not only do these sessions explore the options available in the event of an unintended pregnancy, they also discuss factors which may impact a person’s decision to continue with or end a pregnancy, and also recognise the impact and involvement of groups whom may not always be included in conversations on abortion, such as young men and LGBT+ people. The scheme hopes to empower young people by providing reliable and unbiased information on pregnancy prevention and available services in a non-judgemental environment, as well as to reduce stigma by encouraging an open discussion on this topic. International Women’s Day on 8th March 2018 provides the perfect platform to discuss issues surrounding women’s health. The society has organised a number of events in celebration, of particular note is the “My Body My Life” exhibition which will take place at UCL on 5th-9th March. A travelling multimedia exhibition, it will showcase women’s abortion stories and even allow visitors to contribute their own stories, start conversations about real abortion experiences and enable us all to speak, listen, and understand without judgement. Another highlight is the first public screening of the documentary “Being Kind to Women: How the 1967 Abortion Act Changed Our Lives” on 6th March (7 pm Cruciform LT1). Jayne Kavanagh, founder

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Library Announcements

1.

Space Availability

New technology is being introduced across the UCL campus to help us make better use of our space. Small devices are being placed under desks throughout UCL’s 4,000 study spaces. The devices use infra-red technology to detect if a desk is available. The data from these will be used to show students where there are available study spaces through a live, web-based dashboard, thus making it easier for students to find available space. The project is currently being piloted and should be launched in the new term.

2.

ShareTheSpace

In response to student feedback, the #ShareTheSpace scheme has started again in several libraries, including the Cruciform Hub. The pilot runs during term-time and is hopefully helping make it fairer for students who are waiting for a study space. Anyone taking a break from studying for more than 30 minutes will be asked to remove their belongings to make the study space available for another student

3.

Laptop Loan Service Improvements Students can now borrow self-service laptops at any time when the libraries are open, including overnight and weekends, extending access to this popular service.

4.

Cruciform Hub Entry System The Cruciform Hub entry system has been upgraded such that all UCL members can only gain access by touching their UCL card. External members need to obtain a new library smart card.

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5.

Green Awards

Library Services participates in the UCL Green Impact initiative and ten sites were recognised in 2017, including the Cruciform Hub and the Royal Free Library, which received platinum and silver awards respectively.

6.

E-resource News

UCL now has online access to 34 Elsevier core medical textbooks. These include Gray's Anatomy for Students, Kumar and Clark's Clinical Medicine, and some Crash Course titles. The ebooks can be accessed via the UCL library catalogue or from the Elsevier eLibrary: https:// elsevierelibrary.co.uk/bookshelf. The full text can be annotated and downloaded for seven days at a time. Instructions on how to use the Elsevier eLibrary can be found at www.ucl.ac.uk/library/ electronic-resources/e_book_guides. Library Services has also recently purchased three packages of Lippincott Williams and Wilkins (LWW) medical e-books: LWW Doody’s Essentials 2017 LWW Doody’s Core Obstetrics and Gynaecology 2016 LWW Doody’s Core Paediatrics 2016 We also now have a subscription to Emcare (on the Ovid platform), a new database covering nursing and allied health specialties alongside CINAHL.

Got a story for us? Have you or anyone you know done something amazing recently? Have you recently organised a successful event? Do you have an announcement that you would like to publicise? Do you want to be featured in the RUMS Review? If you answered yes to any of these, the RUMS Review News Section wants to hear from you! We write articles of all lengths so no story is too big or too small. Get in touch at rums-review@ucl. ac.uk or fill out our form here: bit.ly/2kPYSjY


News

Huntington’s Disease News AK

This UCL Girl Can! SC Emma Kerr, a third-year medical student studying the Paediatrics iBSc, and an avid runner, is this year’s This UCL Girl Can officer. The highlight of the Autumn Term was the This UCL Girl Can Neon Rave Run on the 21st November 2017. It brought together women across different London universities to run five kilometres through central London, complete with 1500 glow sticks! What Emma loves about This Girl Can is that it empowers anyone of any skill level to get involved with sport, and step outside their comfort zone. Not only does Emma organise major events, she also leads a free fitness session every Saturday, meeting at UCL Main Quad at 10:30 am.

RUMS Halfway Ball EL As is RUMS tradition, on the 27th October 2017 the fourth year medical students gathered at Sway Bar to celebrate making it to clinical years, and halfway to becoming a doctor. Formal wear, a two-course meal and free drinks could only mean one thing: a night to remember. Special thanks go to Ozzy Eboreime, RUMS President, for organising this much-needed celebration which gave the fourth years a rare opportunity to all be together in the same room at the same time.

It has been over ten years in the making, however in December 2017 it was announced that the first drug to target Huntington’s disease, IONIS-HTTRx, was successful in its first human trial. Professor Sarah Tabrizi (UCL Institute of Neurology and UCLH consultant neurologist) and her team conducted the trial over nine centres across the UK, Canada and Germany, collating a total of 46 participants, all of whom were in the early stages of Huntington’s disease progression. UCLH’s Leonard Wolfson Experimental Neurology Centre in the National Hospital for Neurology and Neurosurgery was the UK centre for the trial. Patients received either placebo or IONIS-HTTRx injections delivered into the spinal fluid. The trial was successful in establishing the drug’s safety in humans, and it was shown to reduce the level of mutant huntingtin, the key protein implicated in neurodegeneration, in the nervous system of patients. A comprehensive account of the ground-breaking trial’s findings will be presented in a peer-reviewed journal, as well as at future meetings and will be the subject of ongoing research.

MDs Exhibition George W X Barker

RSM Reforming Anatomy Conference AK

On 24th September 2017, the Royal Society of Medicine hosted the unique Reforming Anatomy Conference. The focus of this conference was to explore the human body from an alternative perspective, using artistic tools to engage with the complexity of anatomy. Delegates were treated to an array of workshops on embroidery, suturing and life drawing. Exploring parallels between art and anatomy, the conference inspired attendees to rediscover the human form in a manner that was a far cry from that of the wet lab!

Photos courtesy of Royal Society of Medicine

On New Year’s Day of 1898, an intrepid group of medical students and doctors ventured onto the wards of the Middlesex Hospital to bring some festive cheer to those spending Christmas in hospital. In the decades that followed, these concerts became an annual tradition, featuring sketches, songs and stand-up. The group became known as the Manic Depressives (MDs), and continued to perform their annual Revue throughout both world wars, and later went on to perform in the Edward Lewis Theatre of the Middlesex Medical School. Much of this history had been preserved and stored, unbeknownst to the modern-day incarnation of the society! After perusing Windeyer, History of a Building, a booklet littered with many references to the Revue, the MDs were inspired to uncover the history of the group. The UCLH archives hold volumes of the Middlesex Journal, which feature articles about the MDs and reviews of their shows. The archives are home to a number of vinyl records, scripts, programmes and posters from past MDs productions, as well as relics that have been handed down between generations (including trophies, scarves and a rather conspicuous proctoscope). With the support of UCL Medical School, the way was paved for a showcase about the society’s history. Thanks to expert help from UCL Special Collections in conserving old posters, specialist input from UCL Museums, and superb recommendations from UCL Libraries, the exhibition finally made its debut in October 2017, chronicling over 100 years of medical-based comedy under the watchful eye of denizens of the Cruciform Hub. The MDs will next be performing at the Surgical Society Conference, inspireMEdicine Conference, Leicester Square Theatre and the annual UH Revue competition! All are cordially invited to join us for sketches, songs and shindigs. Don't forget to like us on Facebook, follow us on Instagram and subscribe on YouTube! 13 Vol.III No.II


News

200 Years of Parkinson’s Disease: Where are we now? A Reflection Theresita Joseph and Carlos Siganporia (Society Chairs and Event Organisers)

In a joint effort between UCL Medical Society’s Research and Academic Medicine subsection and their Neurology division, a Parkinson’s Disease (PD) Symposium was held on the 4th December 2017. The event involved a wide selection of talks from esteemed members of UCL’s Parkinson’s Disease Consortium, which were complemented by insightful talks from those affected by the condition. Organised to commemorate the 200year anniversary of British practitioner James Parkinson’s Essay on the Shaking Palsy, it was an evening of discussion regarding both current research in PD and the experience of living with the disease. The event aimed to describe how far medicine has developed in the 200 years since Parkinson became the first to publish an accurate description of the physical manifestations of the disease, and what the future may hold with regards to treatments for those affected. The second key purpose of the event was to raise money for Parkinson’s UK, a charity founded in 1969 that has since gone on to extend its reach nationwide. It core aims are to support patients and their families in dealing with a diagnosis of PD, to collect and distribute information on the disease and to fund research. Great thanks are extended to the charity for providing information leaflets to the attendees, as well as helping to decorate the lecture theatre for the occasion. Whilst the event was free, several donations to Parkinson’s UK were made throughout the night, including through the purchase of RUMS Christmas cards, designed by medical student Azmain Chowdhury on behalf of the UCL Medical Society’s Anatomy subsection. Over £100 was raised on the night itself, however this figure continued to rise following the Symposium due to the sale of the Christmas cards. Overall the event was a great success, and it was wonderful to see such a range of attendees from medical students and researchers, to members of the public wanting to learn more about where we currently stand in our understanding of PD. We are very grateful to all of the speakers, and to the several members of the UCL Medical Society who helped organise and make the event a success.

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From left to right, Dr Alastair Noyce (guest speaker), Professor Tom Warner (guest speaker), Carlos Siganporia (lead conference organiser), Theresita Joseph (lead conference organiser), Simona Southgate (Parkinson’s UK regional coordinator)

Better Late than Never A Message from our New Finance & Operations VP Hi all, arriving slightly late to the party but happy to be here, I am Ankit and I am your VP for Finance and Operations. Last year, this side of RUMS was managed with great success; my aim is to carry that forward and use it as a launchpad to develop our capacity to serve all medical students at UCL. My role is two-fold, as the name suggests. I will be in charge of the overall budget, helping to oversee the budget and expenditures for each and every RUMS event. Part of this involves liaising with the medical school, the student union and, of course, filling out a lot of forms. The second part is assisting in the Operations of RUMS in general. This involves a variety of jobs, but in essence it is about helping to support the President and all sections of the RUMS committee in achieving their goals and targets in their respective areas.

Lead conference organisers Theresita and Carlos with other members of the Research and Academic subcomittee of MedSoc who helped organise the conference: (left to right)Theresita Joseph, Juhi S Rastogi, Carlos Siganporia, Blanca Sanz-Magallon, Jaya Upadhya

AcaMedics Symposium AK

Back in October, AcaMedics held their annual Symposium in the cloisters of UCL. The Symposium celebrates the culmination of a year devoted to projects undertaken by keen students who produced an academic poster to showcase their work. Students gave visual as well as poster presentations to fellow students and esteemed judges. An impressive 17 projects made their entry into the exhibit, a record high for the society. The winner of the best oral presentation went to Linda Lei for her project presentation on ‘Ultrasound joint abnormalities in patients with arthritis associated with Sjogren’s syndrome and lupus’. The best poster presentation prize was awarded to Zoe Bothamley for her project ‘Understanding patient expectations of anaesthesia for orthopaedic surgery’. If you see yourself presenting your own project at a future Symposium, visit the AcaMedics website and get involved!

During this year, I want to create a more open relationship between RUMS and the student body. All of you, as UCL medical students, should feel that the RUMS committee is there to represent you and your views as part of their electoral mandate. Each and every member of the committee has a strong desire to work hard to improve medical school life for all of us. I want to make it easier for you to speak to us about what you think should be done, and for us to inform you about what we are currently doing to improve things. In this vein, I also want to increase transparency on what RUMS spends on you financially, and how we try to make sure the money we are allocated gets used most effectively for you. As part of this, we will be advertising two new sub-committee roles: Sponsorship Co-ordinator and Communications Officer. Keep an eye out on the RUMS Facebook page and the RUMS bulletin for more news! As ever, if you have any thoughts, ideas or suggestions, please don't hesitate to get in touch with me at ankit.bhatt.13@ucl.ac.uk.


News

UCLMS Graduates Launch Adaptive Learning Tool for Students AK Dr Yezen Sammaraiee (Foundation Doctor at the Royal Free Hospital) and Dr Stefan Mitrasinovic (Academic Foundation Doctor at Southampton General Hospital) have launched an advanced learning system devised for students in all years of medical school. With the help of junior doctors and medical students, the duo founded ‘Ques’, a one-stop-shop website for students to practice exam-style questions as part of an algorithm-derived personalised learning programme. Speaking to RUMS Review, Yezen discussed the importance of this approach to revision: “The idea centres around our learning needs as doctors – as useful as memorising is for being a doctor, we also need to develop our clinical reasoning skills and understand how we use that information effectively to make decisions.” After coming across the evidence base supporting spaced repetition as an effective learning strategy, Yezen was inspired to incorporate a consistent questioning style into Ques. Meanwhile, Stefan has a background in coding and web design and was integral to the development of the user platform of Ques. Their pre-clinical platform has enjoyed tremendous success, with 300 people signing up to the website in its first year. However, this success does not come as a surprise. Stefan taught himself to code at an early age and produced very successful gaming platforms in secondary school. He also enjoyed the role of Medsoc Webmaster during his time at UCL. Furthermore, Yezen is well acquainted with the field of medical education, having developed the Years One and Two Education Society and the PACS scheme whilst at medical school. Due to his experience delivering high quality tutorials to medical students, Yezen became invested in exploring “how you can scale medical educational initiatives to provide a large amount of resources that are interactive and personalised to medical students.” Ques now boasts over 2500 pre-clinical and clinical questions and are looking for students to get involved with the platform to fine-tune their algorithms. For more information, visit quesmed.com and like their Facebook page.

Whittington Health Won CKHS 2017 Top Hospitals Award AK

Whittington Health NHS Trust has been named as the winner of the Caspe Healthcare Knowledge Systems (CHKS) Top Hospitals programme national award 2017. As well as recognising acute sector groups for the quality of the services they provide,the CHKS Top Hospitals awards also look at improvements in healthcare. The quality of care award is the result of months spent analysing public data on criteria such as length of patient stay and whether care pathways were followed as expected, and spans across every NHS acute trust in the UK. The Whittington Health NHS Trust’s win is a national recognition of the unrelenting passion and commitment of the staff. We would like to congratulate them on their win.

The Royal Free Association (incorporating the Royal Free Old Students' Association and Members of the School) www.royalfree.nhs.uk/rfa

President Dr James Dooley Tel: 07967 013810 e-mail: j.dooley@ucl.ac.uk 3rd January 2018.

Treasurer/Secretary Dr Peter Howden Tel: 01205 260601 e-mail: peter.howden1@gmail.com

The origins of our association date back to 1929. It was then called “The Royal Free Hospital School of Medicine Old Students Association.” After a short lapse it reformed after the second world war and today has 4000 members. Following the merger of The Royal Free with University College in 1999 the name was changed to The Royal Free Association. As well as alumni of the RFHSM all hospital consultants are now members as well as some non medical staff connected with the Hampstead site. We have an annual clinical meeting and AGM held in The William Wells Atrium which this year is being held on Thursday 15th November. All UCL medical students are welcome to attend the afternoon presentations which commence at 2pm. Ten clinical students attended last year to listen to Professor Lesley Regan, president of the RCOG’S. Presentations were also made by an elective bursary recipient and the RUMS student president. We support students in several ways. Each year we offer bursaries for electives in the final year of study and have funds available for students who find themselves in acute financial distress. In addition this year we are offering four Royal Free Association Awards exclusively for 4th year mature students. If you wish to apply for any of these please contact either Holly Riches (h.riches@ucl.ac.uk) or Deanne Attreed (d.attreed@ucl.ac.uk) Dr Peter Howden. Honorary Secretary and Treasurer The Royal Free Association.

The Hernia Games EL The last weekend before the Christmas holidays is always an exciting time in the RUMS calendar. Not least of all because of the annual trip to the Royal Free Hospital’s Peter Samuel Hall for the MDs Christmas Show. This year the show did not disappoint. Directed by Nabil Jetha and Aisling O’Sullivan, the first half was comprised of sketches which showcased the MDs’ admirable ability to find humour in all aspects of the medical school. One particular highlight was “Keeping up with the Kardiologists”, a hilarious Kardashian spoof which can now be found on the MDs’ YouTube channel. Rounding off the sketches was the emotional final years’ song, which celebrated the commitment and dedication of those who were performing in their last show. After the interval came ‘‘The Hernia Games: Clerking Fire’’, a loose adaptation of The Hunger Games that focused on the challenges of adapting to life in clinical medicine. With a talking Moodle, a cameo from the notorious Royal Free lifts and some familiar faces from the UCLMS Faculty, the show was not something to be missed. The vibrant atmosphere in the theatre both during and after the show was proof of the success of this year’s production.

RUMS Acapella Groups Perform for Charity SC On 3rd December 2017, RUMS Chordiac Arrest and RUMS Accarhythmia performed at the UCH Cancer Fund Christmas concert. This was held at the beautiful and historic St Giles in the Fields church near Tottenham Court Road. Both acapella groups, with all-male and all-female members respectively, were formed in 2016. They have since become two of the largest groups in RUMS Music, incorporating singing with volunteering services, fundraising for the Macmillan Centre, and towards the end the Spring term they can be heard performing in the reception lobby.  

15 Vol.III No.II


Out of Hours

Dr Julie Andrews Dr Julie Andrews is a Consultant in Medical Microbiology and Associate Medical Director at the Whittington Hospital. She is well known and loved by many a fourth year, and has been described as “a cross between the Hippocratic Oath and supercalifragilisticexpialidocious” on iwantgreatcare.org. In this issue’s Out of Hours, we get to know more about Dr Andrew’s fascinating journey and career highlights, as well as her Netflix recommendations – enjoy! Vol.III No.II 16


Out of Hours

What first sparked your interest in science and medicine?

properly, another group about a patient with intra-abdominal sepsis, and then someone else about quality improvement methodology. I love the challenging questions, so please keep them coming!

I am told I was naturally curious as a child and definitely recall science being amongst my favourite subjects at school (although I originally wanted to do Geography and History A Levels!). I had a chemistry teacher called Mrs Wrigley whose daughters were at medical school and she encouraged me to consider medicine myself. Once I looked into it and completed a range of work experience, I was obsessed. I have never regretted my decision.

The worst part is over-juggling: trying to combine service and teaching commitments whilst your phone is ringing and you’re already late for your next appointment. Good planning can usually avoid this kind of scenario but it does happen occasionally and it is not enjoyable for me or my students. There is nothing else I can think of that I don’t enjoy about teaching medical students – it is a privilege.

What did you study and how did you become associated with UCL? I studied medicine at St George’s Medical School (one year above a certain Dr Faye Gishen) and qualified in 1996. I have always been interested in Infection as it allows you to treat patients of all ages, requires strong diagnostic skills and is a rapidly changing specialty: one minute swine flu and the next, Zika! I did my postgraduate medical training in Southampton and they had a highly visible and inspiring Infection team. Soon after passing my Membership of the Royal College of Physicians, I moved to London to train on the highly sought after UCLH/GOSH/Whittington rotation. I have taught UCL medical students since 2004, so I am now seeing ex-students as consultant colleagues!

What's the best thing about working as part of UCL and in London? Although I really enjoyed studying at a standalone medical school, I now benefit from working within a university which allows me to meet a variety of staff from a broad spectrum of academic disciplines. We all have so much to learn from one another and the forums and networks at UCL are well developed. My husband Peter (UCLMS graduate 1993) and I decided to move out of London ten years ago, but we both enjoy working in London too much! Like many people, I enjoy the true multicultural vibe of London that you see both professionally and socially.

What are the best and worst things about teaching medical students? The best thing is how quick medical students are to pick up new skills and knowledge when taught well. I love seeing how fast students (who listen) can absorb information and then apply it. I also enjoy the range of subjects that I teach; just today I have taught a student how to percuss the chest

What have been the highlights of your career? I have had many career highlights but one of my proudest moments was being nominated for the British Medical Journal Clinical Leadership award. I enjoy combining leadership, quality improvement, patient safety and medical education with my busy clinical career, and I am lucky that my job allows me to wear many different hats!

talking. I also like to swim or do Pilates.

What are your guilty pleasures? Netflix in bed - recommendations for viewing usually from my fourth year medical students. I have binged on Suits, The Good Wife, Game of Thrones and Breaking Bad. I also enjoy a glass of red wine with my friends and gorgeous husband. I favour quality of alcohol over quantity these days…

What one piece of advice would you give to your students? Look after yourselves in terms of sleep, food, guilty pleasures and joy. Your wellbeing and resilience are the most relevant factors to longer term survival in medicine. Seek joy in medicine – your patients and colleagues will often be a source of joy. When things get tough, talk to peers, family, friends and your team about how you feel.

Describe yourself in five words Robust, loyal, compassionate, interested, scatty….

Which one person has most changed the way you think about medicine and science? Professor Mike Stock, my beloved physiology Professor at St George’s and my BSc supervisor in 1993. He sadly died in 2001, but his way of thinking critically and his incredible mentorship skills still resonate with me now.

What are your greatest ambitions for the future?

Dr Julie Andrews receiving her flu jab!

I have many career goals but they are team or organizational ambitions rather than personal. On a personal front, I like mountain walking and “go high” at least once a year with a group of girlfriends, and Everest base camp is on the cards…

What is your favourite way to relax after a long day at work? Sitting down with a cup of tea and my kids: Katy, Isabel, Emma and Robert. I like to hear about their days and they often ask me to tell them a story of mine. My older two are experts at head massage so I try and get one of those as they are

17 Vol.III No.II


Alumnus Interview

Dr Henrietta Hughes After graduating medical school and initially pursuing a career in Obstetrics and Gynaecology, Henrietta Hughes chose to transition into General Practice and has since adopted numerous leadership roles within the NHS. In 2016, she was appointed as the first National Guardian for the NHS, a new position created after the Francis Inquiry into the events at the Mid Staffordshire NHS Foundation Trust. Here, Dr Hughes talks to us about balancing her clinical and managerial roles, and the importance of healthcare professionals and students alike feeling able to raise concerns about patient safety and medical practice.

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Alumnus Interview

RR: What did you do after graduating medical school, and what led you down those paths? HH: When I graduated I had already decided that I was going to do Obstetrics and Gynaecology, because I took a year out in the middle of medical school to work in IVF and had undertaken two electives in the USA. Following house jobs I applied for a two-year rotation, spending one year in a district general hospital doing Obs and Gynae as a senior house officer, and then a research year at Hammersmith Hospital working in IVF. Following this, I spent another year at Hammersmith as a research fellow, but when I met my husband, he was in the army, and we thought that if I was pursuing a career that involved multiple rotations, we would never get to see each other. So, I changed to General Practice, and I have to say that was my best decision because it is a really fascinating career.

feel useful. What I would say is that it is really important to plan a career to fit around your life, and make sure that it is possible to have a personal and family life.

RR: What have been the highlights? HH: So many highlights! I know this is really corny, but the highlights are the patients. The people you work with are great, but with patients you feel like you can actually make a tangible difference, and that might be at a really difficult time in somebody’s life or it might be at a really great time in their life. As a GP, you get to build a relationship with an individual over a period of time in the context of their family and you can have really good conversations.

the frontline. I am lucky because I get to go on the frontline every week, seeing patients as a GP and, because my remit as National Guardian is for trusts, I spend more time in hospitals than I do in General Practice! I don’t like to be too far from the action, which is quite hard if you are doing a job based in an office like this – you start to think, ‘Should I be doing something clinical?’ However, you realise you can actually influence and impact more people by being one step removed.

RR: What drew you to a management role? HH: There is a difference between seniority and leadership. People can be in senior positions but may not have leadership skills, and there are other people who have leadership skills but are not in

After working as a GP for five years, I became the lead appraiser for that area. Very quickly, as the various iterations of the Health and Social Care Act happened, I became the Deputy Medical Director for five Primary Care Trusts (PCTs), and the Acting Medical Director for five PCTs. Subsequently, I became the Medical Director for 12 Clinical Commissioning Groups (CCGs) at NHS England – all in the space of two years. So, it was quite a big change from doing predominantly clinical work to predominantly managerial work, but I still have that balance spending one day a week seeing patients and I am still doing appraisals. I worked at NHS England for three years, as Responsible Officer for 3,000 GPs and working with hospitals with complex issues in challenged health economies. In my role I often heard from staff who had concerns about patient safety or other issues which prevented them from delivering high quality care to patients. Historically, the NHS – along with many other sectors of the economy – does not have a great track record of enabling their staff to speak up about issues. You may be aware that there have been some very high-profile cases where people have raised concerns and been victimised as a result. When I heard about my current role, as the National Guardian for the NHS, I saw this as a great opportunity to support staff across England to speak up. I started in post in October 2016.

RR: Why were you initially interested in pursuing Obstetrics and Gynaecology? HH: I liked that it was a combination of medicine and surgery, and I was particularly interested in reproductive endocrinology. Also, as a medical student, I think it was the most hands-on you were allowed to be. In my day, you had to deliver 15 babies in order to get qualified, which has definitely changed now, but back then it made you

RR: How have you found the transition from clinical work into a more managerial role? HH: When I started working in an office, it was just like the show The Office. It was just so different from the clinical environment and that took some getting used to. I immediately started working with managers and, whilst we each had our own skillset, we also had a common objective – when you get that relationship right it is absolutely magic. Everyone comes with their own knowledge and subject matter expertise, and you can achieve things you couldn’t do on your own by working together. In my team now, I am the only clinician – I don’t have any nurses, or doctors, or physiotherapists working in my team – which is amazing because I expect my team to go into hospitals and talk to staff, talk to patients and just get on with it! I think in some organisations there is a real dissociation between the leadership and what is happening on

senior positions. Leadership is finding things that are getting in the way of what you want to do, and then doing something about it. Sometimes you can be more impactful in a management role than in a clinical role.

RR: Why was your role as National Guardian for the NHS created? HH: After what happened at Mid Staffordshire NHS Foundation Trust, Sir Robert Francis chaired a public inquiry in which he identified barriers for staff who were trying to raise concerns. Staff at Mid Staffs tried to raise concerns, and were not only ignored by the management, but actually bullied and victimised. He was commissioned to write a report –‘Freedom to Speak Up’ – which included 20 recommendations for creating a culture of raising concerns, visible leadership and valuing staff. There’s a link to the report on the homepage of our webpages: www.cqc.org.

19 Vol.III No.II


Alumnus Interview

uk/national-guardians-office/content/nationalguardians-office. One of the recommendations was that all trusts and foundation trusts should have a Freedom to Speak Up Guardian to whom workers are able to raise concerns anonymously, confidentially or openly, and that there should be a National Guardian to lead this network and also to provide national leadership to the system.

RR: What do you find exciting about your role? HH: This role is very creative, as new systems need to be set up from scratch. In my previous role as Medical Director I worked under two sets of regulations, but now I don’t have powers so we can only achieve change through consent and transparency. That is what is so exciting about a leadership role. It is about saying, “What needs to be done right now? Who can help us to achieve it? How can we get buy-in across the system? How can we get more for less? And how can we make people’s lives better without it costing anything?” It is really exciting!

Vol.III No.II 20

RR: Is there something throughout your entire career that you would pin as your greatest achievement? HH: That is a really difficult question, and again this probably sounds incredibly corny, but you really cannot do things yourself, you can only do things through other people. Creating an environment for others to do their best in is what gives me my biggest sense of satisfaction. If what I am doing allows the Freedom to Speak Up Guardians to do their jobs well, supporting NHS staff to deliver better care to patients, then that is what is important to me. There is a thing called the ‘Iceberg Illusion of Success’, where the successes that you see are all above the water like the tip of the iceberg, which is I suppose equivalent to my annual report. What it doesn’t show is all the really tricky stuff that happens: people working long hours, Guardians having difficult conversations, and the challenges that the staff they support have faced. That doesn’t go into the report, but all those successes are there, below the water. I suppose my greatest achievement is how big my area is under the water; it is not the nice stuff on the top, it is how you deal with the difficult things, learn from them, and use them to help you improve without

seeing those things as a threat. That, to me, is resilience and growth and I hope I am helping to spread that mindset. I would really like medical students to know that I am helping to smooth the path of their career – not to make it easy, but to smooth it, so that you are supported when you are dealing with difficult things. If you are facing a challenge, but have people supporting you, then it all becomes easier. If you are trying to do things where you are feeling isolated and alone, then it is impossible. I think that is why there are a lot of issues with morale at the moment, because people don’t feel supported.

RR: You are not a UCLMS graduate yourself, but could you tell us more about your family connections to the medical school? HH: Two of my grandfathers and my grandmother were all UCL graduates. My grandmother was actually a Royal Free graduate, and did a lot for women in medicine. She campaigned for women to have tax paid separately from their husbands, as well as creating the retainer scheme – which is where you can work part-time if you have


Alumnus Interview

dependents, whilst still maintaining your clinical practice. I benefitted from that myself! She was the president of the Women’s Medical Federation, and she was also the female representative on every BMA committee. My grandfather studied at The Middlesex, and as a house officer in Oxford he treated one of the first patients with penicillin. At one point, he had the world’s entire supply of penicillin on a piece of litmus paper – it was powder back then – and he was very nervous as he was walking across the ward that he would sneeze! My other grandfather was a consultant at UCLH and has two eponymous syndromes named after him. He was also one of the first to name testosterone. They all did very interesting, ground-breaking, and varied things! My reflection is that we all build on the great work that has been done by those who have come before us, and this is why we need to pay it forward to the next generation

RR: Do you have any advice for current medical students? HH: I would say spend as much time as you can with your patients, because they will tell you everything. That is the best way to learn. They will tell you things they have never told anybody else so you are in a very privileged position. I didn’t

always follow that advice myself but when I look back it is definitely the patients that I met as a medical student that I will remember for the rest of my life. The other thing is to build excellent relationships with your nursing and other colleagues. That is really important because they will help you and get you out of every scrape. Everything you do should be enjoyable, apart from the revision! It is such a cliché, but the whole career is such a privilege. I’m not saying it is easy, because it’s not. I hope I have given you the understanding that everything comes with hard work, but it should all be enjoyable.

with them. Ask them to come and talk to all of the medical students, because they will have a lot of insight into what is happening, the ongoing conversation and the backstory. The other thing I want to say is that I am always really happy if anyone would like to shadow me for half a day. What I do is so different and unique, that if you would like to have an insight into this exciting world, then please get in touch with me at enquiries@nationalguardianoffice.org.uk. Previous spread: Dr Henrietta Hughes, the first National Guardian for the NHS, chats to staff This page: Dr Hughes balances her managerial role with clinical work

So that’s my advice: enjoy your patients, enjoy your colleagues and enjoy your work!

RR: How can we learn more about Freedom to Speak Up Guardians? HH: Get your QR code reader, download the annual report, and have a read, you can also find more information on our website via the link above and follow us on Twitter @ NatGuardianFTSU. If this is something that you find really exciting, then go find your local Freedom to Speak Up Guardian and have a chat

21 Vol.III No.II


Features

Vol.III No.I 43


Featuring Dr Helen O’Neill Research Round-up Women’s Health


Research

What made you choose to focus on molecular genetics? I am an identical twin, so from a very young age I was aware of what genetics meant. I guess it partly stemmed from wondering why it was that my twin and I had identical DNA and yet I felt we were so different as individuals. I come from a medical family, but I was fascinated by genetics. There are so many medical textbooks that describe genetic and congenital syndromes, purely based on symptoms and appearances, but they don’t explain why these genetic syndromes occur. Modern medicine did not answer any of the questions I had about this, so I chose to pursue a career in which I could discover the answers for myself.   

Why have you chosen this specific area of interest (Women’s Health)?

Dr Helen Dr Helen O’Neill studied Molecular Genetics for her undergraduate degree at University College Cork in Ireland. This was followed by an MSc in Prenatal Genetics and Fetal Medicine and a PhD at UCL. Dr O’Neill’s PhD was based at the National Institute for Medical Research (now the Francis Crick Institute) in the Department of Stem Cell Biology and Developmental Genetics, in the laboratory of Professor Robin Lovell-Badge. There, she researched the genes involved in sex determination, including genes crucial for the formation of ovaries. Dr O’Neill currently works in the Embryology, IVF and Reproductive Genetics Group at the EGA Institute in UCL, where her research focuses on genome editing and embryonic development. She is Programme Director for the MSc in Reproductive Science and Women’s Health and lectures both masters and medical students. Interview by Eng O-Charoenrat, Research Editor

Vol.III No.II 24

Developmental biology fascinates me: how every gene, protein and pathway work together in a time-dependent and coordinated way, like an orchestra. Females are incredible specimens. The events occurring in-utero during gestation which lead to a baby being born are some of the least understood events in biology, despite being the most important. I wanted to work in an area that allowed me to explore areas of science that are relevant on a personal level to everyone. We were all embryos once!  

What are your top current research focuses?  My research is focused on  morphokinetics  of preimplantation embryos and using  genome editing (using CRISPR*-Cas9 and base editing) to assess the treatment and understanding of sex chromosome disorders and neuromuscular disorders. Genome editing is the precise ability to alter or correct a mutation in a genetic sequence. This technology has taken the research world by storm, allowing genes and diseases to be studied and understood in a way which was not possible before.


Research

“Developmental biology fascinates me: how every gene, protein and pathway work together in a time-dependent and coordinated way, like an orchestra. Females are incredible specimens.” What is the most controversial topic in your field? By far the most controversial topic in the field is germline  genome editing. The advances in genome editing coupled with assisted reproductive technologies lend themselves to the correction of disease in embryos. People feel, however, that to alter genes in an embryo, even if it is to cure life-threatening diseases, is one step too far.

What do you think will be the next big breakthrough in the field? Genome editing; it has already taken over as the most powerful biomedical breakthrough in the last decade.  It is transforming our ability to understand and treat diseases by taking medicine to a molecular level. Our genetic code is a complex language and we have relied on deciphering its meaning through mistakes; when a mutation occurs, this allows us to mine the molecules to find a cause. Now, however, we can use this information to correct that mistake. Adopted from the clever immune systems of bacteria, CRISPR not only acts to target specific areas of a genome when directed but can also function as a “find and replace” mechanism; it is the newest spell check of our genetic language. Every day new research is published highlighting the broad range of applications of this technology. We are entering an era of personalised medicine. Very soon, every child that is born will have its genome sequenced and personalised precision medicine will be the norm.   

Assisted reproduction and in vitro  fertilization (IVF)  were previously considered  controversial and  unethical; many believed that to intervene and assist with conception in the lab was “playing God”.  Today, one in seven babies are the product of IVF: they are the product of human intervention and not intimate interaction. When a family has a known genetic mutation, cells from an embryo can be removed for preimplantation genetic diagnosis, to ensure the embryo is free from that mutation; if it does carry the mutation, the embryo is discarded. With advances in genomic testing we can now tell more and more about the genetic state of this future child and, whilst many diseases are not fully understood, single gene disorders are among those that could be corrected in these embryos. While we still have much to learn about the safety of this technology, there are many other treatments which we take as  the  gold standard that are very flawed. Sometimes risks need to be taken.  

Do you have any advice for medical students interested in research? Be truly fascinated by what you are researching. If you are not driven by discovery, you will get lost.  We thank Dr Helen O’Neill for her time and for contributing to this issue of RUMS Review. *Clustered Regularly Interspaced Short Palindromic Repeats


Research

Round-up:

The UCL Elizabeth Garrett Anderson Institute for Women’s Health (EGA IfWH) was founded in 2004 and has four main academic research departments: Reproductive Health, Maternal and Fetal Medicine, Neonatology, and Women’s Cancer. The EGA IfWH covers a wide variety of research topics, ranging from areas such as molecular investigation of oocytes and embryos to public health initiatives aimed at reducing sexually transmitted infections. Recent highlights from each of the departments are detailed below, with more research updates available at www. ucl.ac.uk/womens-health/research. Words by Eng O-Charoenrat, Research Editor

Maternal and Fetal Medicine Hospital admission for hyperemesis gravidarum in women at increased risk of spontaneous preterm birth Changes in progesterone concentration are seen in the development of two conditions in pregnancy: spontaneous preterm birth (sPTB) and hyperemesis gravidarum (HG). HG includes symptoms such as prolonged and severe nausea and vomiting, electrolyte imbalance and ketosis. Prior research suggests that low concentrations of progesterone in women lead to an increased risk of sPTB, whereas higher concentrations of progesterone appear to correlate with HG. In this study, UCL researchers sought to clarify the link between sPTB and HG. The hypothesis was that women at increased risk of sPTB would be less likely to have a diagnosis of HG during their pregnancy. Women from two groups were analysed: those at increased risk of sPTB (n= 394) and those with no identifiable risk factors (n= 4762). In the highrisk group, six patients were admitted with HG compared to 159 patients admitted from the norisk group (p-value < 0.049). This data supports the idea that women at increased risk of sPTB are less likely to suffer from HG. Researchers hypothesise that HG and sPTB are clinical descriptions of opposite ends of the biochemical spectrum, thus providing evidence that HG and sPTB are linked. Future research into the pathogenesis of HG could help further the understanding of sPTB.


Research

Reproductive Health

Women’s Cancer

The MOMI Project: Global Reproductive Health

Developing a Stepped Approach to Improving Sexual Function After Treatment For Gynaecological Cancer (SAFFRON)

The Missed Opportunities in Maternal and Infant Health (MOMI) Project is an international project aimed at improving maternal and neonatal outcomes in four African countries: Burkina Faso, Kenya, Malawi and Mozambique. Taking place over five years and working in collaboration with eight international academic institutes, the MOMI project looks at introducing different strategies in the postpartum period to reduce morbidity and mortality of both the mother and newborn. Initial research identified a lack of standardised provision of postpartum care, as well as a lack of awareness of the importance of postpartum care amongst healthcare professionals and in the community. Thus, two of the main focuses of the project were on implementing facility-based care through child health clinics and communitybased care through Community Health Workers. The Community Health Workers were chosen by each community to build trust with women in the postpartum period and to serve as a bridge between the community and healthcare professionals.

One key area of research in Women’s Cancer is focused on the psychological response of cancer diagnosis and treatment. For instance, gynaecological cancer and its treatment can have a negative impact on a woman’s sexuality. SAFFRON is a pilot study that aims to provide affected women with advice on how to recover their sexual function and satisfaction. Using a stepped care approach, UCL researchers have devised a 3-step model that includes a clinical assessment of the patient as well as different treatment algorithms depending on their needs. All patients begin by being given literature on psychosexual difficulties after cancer to read through, while those with more serious requirements are offered weekly sessions of psychotherapy.

Neonatology NEMO: Treatment of NEonatal seizures with Medication Off-patent NEMO is the largest multicentre European study of neonatal seizures and their treatment. Research suggests that giving bumetanide (a diuretic) at the same time as phenobarbitone (a barbiturate) may allow for a greater therapeutic effect. One of the primary objectives of the NEMO study is to determine the optimal dose of bumetanide when given in addition to standard therapy (phenobarbitone). Perinatal asphyxia occurs in approximately 20 in 1,000 live births, complications of which include hypoxic ischaemic encephalopathy (HIE). HIE is responsible for a significant amount of mortality and long-term neuro-disability. Seizures following HIE are common and despite phenobarbitone remaining the therapy of choice, evidence suggests it is only effective in 30-50% of cases. The results of the NEMO study will hopefully help assess the efficacy and safety of bumetanide in the treatment of neonatal seizures and potentially offer an additional therapeutic option.

The conclusions of this study will assess the feasibility of this stepped therapy approach as well as its benefits to patients and their partners.

The conclusions of the project show the benefits of increased service delivery and community engagement with postpartum care, but more work needs to be done in areas that have difficulty implementing these strategies.

27 Vol.III No.II


Spring 2018


Obs & Gynae Issue

Vol. III Issue II

RUMS Review


Careers

Obstetrics and Gynaecology

Vol.III No.II 30


Careers

How do I become an obstetrician and gynaecologist? As with many specialties, the Royal College of Obstetricians and Gynaecologists (RCOG) provide much useful information on this specialty, with case studies of current trainees, information on the full career path and even information on all the different modules in the curriculum. In general, it takes seven years of specialty training following Foundation Years to complete training. There are three MRCOG exams and the training is mainly competency based. There is the opportunity to subspecialise in four areas: Gynaecological Oncology, Maternal-Fetal Medicine, Reproductive Medicine and Urogynaecology. Like during clinical years at UCL Medical School and Foundation Years, an ePortfolio is used to log training, from reflective practice to recording clinical experiences. There is also a separate academic curriculum with the RCOG, supporting trainees who wish to be involved in academic medicine in some way, for example research. To show an interest in O&G, the RCOG has awards and prizes that can be applied for by medical students, from essays to presentations. In addition, you may choose to carry out an audit during medical school or do an elective in O&G. If you have an interest in O&G or any specialty, do not be afraid to ask specialty trainees why they chose the specialty and ask their advice on how to show further interests.

In this issue, our focus is on obstetrics and gynaecology, aka “obs & gynae” or “O&G”. For some medical students, One Born Every Minute may be their only exposure to O&G before medical school and until year five!! O&G is a specialty involving both medicine and surgery, caring for potentially half of the population at some point during their lives. In particular, it requires collaboration with many other specialties, from neonatology to anaesthesia, and allows clinicians to be involved in exceptionally significant and memorable moments of people’s lives. We hope you enjoy reading this issue’s Careers, providing information on the training required to become an obstetrician and gynaecologist along with an interview with Dr Melissa Whitten, Consultant in Fetal Medicine and Obstetrics at UCLH.

How can I find out more about obstetrics and gynaecology? In addition to speaking with clinicians who have chosen O&G, the RCOG website is a brilliant way to find out more information and is very comprehensive. www.rcog.org.uk/en/careers-training/ The RCOG also publish an O&G undergraduate curriculum which may be useful in UCL Year 5: www.rcog.org.uk/globalassets/documents/careers-and-training/undergraduate-curriculum/undergraduatecurriculum_og.pdf Further information regarding RCOG can be found at: www.facebook.com/RCObsGyn www.twitter.com/rcobsgyn In addition, MedSoc has a section dedicated to O&G so make sure you look out for events during the academic year! www.medicalsociety.org.uk/sections/obstetrics-gynaecology/ Email: og@medicalsociety.org.uk

Words by Izabella Smolicz, Director of Medical Journalism 31 Vol.III No.II


Careers

‘A

highly competent and scientifically literate clinician who is equipped to practice patient-centered medicine in a constantly changing modern world and has a foundation in the basic medical and social sciences’. If you’ve read the UCL prospectus or spent enough time at UCL Medical School, you’ve likely heard this description of the ‘UCL doctor’. Certainly, the above statement makes a good effort to succinctly describe what makes a capable doctor, incorporating some of the ‘buzzwords’ which no doubt filled our personal statements when we applied. Yet, are those really the only qualities we need? My early years of medical school involved countless hours of sitting through lectures (and buffering Lecturecast) and looking rather out of place on Gower Street in a flock of white lab coats heading to the Rockefeller. I came to rely on what I would term ‘colour osmosis’: the act of defacing my notes and copy of D&P with an impressive range of highlighters, hoping that some knowledge would diffuse into my head. My newfound competency in colouring aside, I have learnt a lot and have had the privilege of belonging to an incredible cohort of medical students over the past three years. However, looking forward is a daunting prospect – to think, within the next couple of years I need to be well on my way to becoming a good doctor.

Dr Melissa Interview by Andrien Rajakumar, Research Editor

Dr Melissa Whitten studied at King’s College London School of Medicine and Dentistry, graduating in 1993. Dr Whitten then underwent postgraduate training in Obstetrics and Gynaecology and is now a Consultant in Fetal Medicine and Obstetrics at UCLH, having undergone subspecialty training. Dr Whitten is actively involved in medical education, being Undergraduate Lead for Women’s Health at UCL and Medical Education Lead at the UCL EGA Institute for Women’s Health. In addition, Dr Whitten won the Living the Values UCLH Celebrating Excellence Awards in August 2017.

Vol.III No.II 32

I recently sat with Dr Melissa Whitten, Consultant in Fetal Medicine and Obstetrics at UCLH and the Undergraduate Lead for Women’s Health at UCL; she kindly offered her time to discuss the impact we can have on a clinical culture and recent advancements in her field. One of the features of a great doctor, is the ability to understand that you will learn something new every day on the job. Learning by clinical incidence was one of the aspects stressed by Dr Whitten as an area all specialities can improve upon; ‘in the past, there was somewhat of a blame culture and if lessons were to be learnt from events, they were disseminated to the wider workforce. However, over time we are moving to a learning culture in which staff involved in incidents are debriefed and provided with support’. This statement is important because a good doctor will not only be a recipient of support, but should also facilitate a learning culture such that the healthcare professionals around them can be elevated also. Although this seems rather obvious, it is the simple qualities: kindness, communication and organisation which enable such a culture to thrive. One’s passion in a subject does not necessarily predict their aptitude in a said field, but I would think most of us would agree that we would do better in areas of study that we are interested in. Thus, choosing the right clinical specialty is an important decision which can influence the impact we can make as a good doctor. Gaining experience and taking the time to nurture a particular interest is what I believe allows most to achieve this. Dr Whitten stated ‘I didn’t really know exactly which specialty I would go into, I had four or five areas in mind but I only really knew what I wanted to do after my SHO job in Obs and Gynae in Brighton. I really enjoyed my time there and it truly was a lovely unit with so many doctors who inspired me’. Despite the assumed pressures to specialise early or to know


Careers

“Choosing a specialty is just the start; I think that exploring your niche, whether that be through teaching, research, altering health policies or medical technology will also dictate how each of us can impact our clinical environment. ” what you want to do in medical school or the early stages of foundation training, there is more time than one would expect before making a decision. Choosing a specialty is just the start; I think that exploring your niche, whether that be through teaching, research, altering health policies or medical technology will also dictate how each of us can impact our clinical environment. One of the major problems that is faced in O&G in the UK is perinatal mortality, where factors such as the care of the woman in labour, assessment of the fetus in labour, identifying the at-risk baby and clinical training could be further optimised. Dr Whitten describes how ‘in comparison to other Scandinavian countries, the UK is not as good as we would want to be’. Since being appointed as a consultant, Dr Whitten was part of the team which pushed for simulation training for postgraduates, the midwives and the doctors working at UCLH in 2008. She described the amazing difference it has made in managing postpartum haemorrhages at UCLH, a serious concern at the time, allowing the ‘identification of problems in our process that existed within the unit and leading to a change in the whole guideline for obstetric haemorrhage’. Lessons that were learnt from these exercises also changed strategies for communication with the blood transfusion department – not only in obstetrics, but a change in approach trust-wide at UCLH. In many ways, this is unsurprising since simulation training is firmly grounded on the principles of encouraging communication and openness between staff and reducing the inbred hierarchy seen between healthcare professionals. The work by Dr Whitten and her team is also one of many examples, which shows the influence doctors can have on bettering hospital management and treatment guidelines.

One of the aspects we all value, especially if we go to visit our doctor, is how they approach our concerns and empathise with us, this being a fundamental part of patient-centered care. This is of the great importance in sensitive healthcare settings. One of the clinics Dr Whitten runs, a perinatal clinic, places her in difficult scenarios where she is consulting a woman who has lost a child, often very recently. I wanted to know what her thought process was when trying to care for patients in such circumstances. Her advice was that ‘the most important thing is thinking about what kind of support you can give a woman, whether that’s practical or emotional – trying to convey that you really do empathise even though that might not even be quite the right word. You should keep in mind that whatever words you say or actions you take might not change the current situation, but you can make a difference in how that traumatic event is remembered by that family’. Medicine is unique in that as a doctor, you are given a real insight into a person’s life and you develop a relationship with the people you provide

care for. Tied in with this is an inevitable degree of attachment, which in unfortunate circumstances, can emotionally impact healthcare professionals. A quality which I am sure most of us will agree is crucial is the ability to cope with such scenarios and moving on to the next patient, not allowing the previous experience to negatively impact the care that you provide later on. In our conversation, Dr Whitten spoke about how coping with these situations comes both with experience and the ability to talk with colleagues who are part of a team offering care to a particular patient. To conclude, what I feel the description of the UCL doctor could further address is the positive impact a good doctor can have on the clinical culture and healthcare professionals around them. Although the life of a medical student focuses around keeping on top of lectures and exams, we must not forget that medical school offers far more than the mark sheet we get at the end of each year. Rather, these six years are really the start of us figuring out, each in our own way, how to become a good doctor. I would like to thank Dr Melissa Whitten for taking the time to speak with me on behalf of RUMS Review; her insight proved invaluable in writing this article.


Demystifying Medical School

Demystifying M Half-Way Planner

I have yet to meet a single person who bears anything resembling even a lukewarm fondness towards the first few weeks of the New Year. It is constantly dark, even though the days are allegedly getting lighter, and a yearâ&#x20AC;&#x2122;s worth of rain decides to get it all over within this time. Whilst, RUMS Review may not be able to fix the weather, we can provide you with a handy half-way planner which will break down exactly where you really need to be at this gloomy stage in the year. So, read on, and you may realise that things arenâ&#x20AC;&#x2122;t as bad as they seem. Words by Tanya Drobnis , Demystifying Medical School Editor

Image by Grace Navin


Demystifying Medical School

Medical School 2.

Year.1 1.

Solidify your learning style. By this point in the year, you will have had the opportunity to try out a variety of note-taking techniques. Are you a slide-annotater, an old-fashioned hand-writer or a cheekily-use-someoneelse’s-ready-made-notes-andannotate-those-instead aficionado? Whichever tactic suits you best, commit to it and you will find yourself steadily building up a bank of revision material without even having to think about it.

3.

Collate material. Gradually starting to organise yourself means that when it comes to summative time, you’ll be a step ahead of the game. Make folders (these can be digital or physical depending on which century you fancy yourself in) and use these to organise your notes from each topic. Dedicate a separate folder to CPP and the Data Interpretation paper – write out a list of all the stats equations and slot it in. Doing this now will hugely decrease your stress levels over Easter. Get ready for anatomy. It’s finally here – and it’s going to hit you hard. Make sure you start labs armed with your lab coat, anatomy locker, and copy of D&P. Sharing a locker with a friend seems like a

great idea to get more bang for your buck until you fall out/ realise that you leave the lab at different times/start wearing bulky fur coats. Try and keep on top of things as much as you can; the sooner you do the D&P reading associated with a lab session the more likely you are to gradually build up a picture. Having uttered such stern words, however, it’s important to emphasise that everyone feels as though they are always behind and struggling – there’s a good reason the pass mark is 50%! 4.

Face your fears. Everyone has their ‘terror topics’ – the ones that get buried somewhere in the graveyard of panic. Dig them out now, while you’re still refreshed from your break and filled with hope for the new year, and try to really get to grips with them so they don’t grow into bigger problems later on.

35 Vol.III No.II


Demystifying Medical School

Year.2 1.

Perfect limb anatomy. Compared to head and neck, limb anatomy is a walk in the park so it’s worth putting some time in now to really get it sorted. You’ll be able to pick up easy marks in the spotter, and feeling like you’ve gotten to grips with a topic will give you a much-needed midwinter morale boost. Since so much of MMB is based around the anatomy of the limbs, nailing it will also mean that you’ve pretty much revised an entire module already!

2.

Don’t let N+B get you down. Everyone struggles with the sheer volume and complexity of this module. N+B has rightly been described as a

Year.3 “confusing, abstract and desolate place”. Keep at it: slow and steady wins the race to passing second year. Try and retain two or three key points from each lecture and keep making good notes as you go along. If, after all that, you’re still staggering blindly through a hopeless world of cranial nerves and mysterious tracts, don’t panic. Providing you keep chipping away, this module should all fall into place around summative time. 3.

Organise your pharmacology. Pharm can be a rote-learner’s dream, if approached correctly. Everything you need to know can be summarised in several large tables and memorised. It’s not imperative to start revising pharmacology at this point in the year, but it’s helpful to have an approach in mind for when you do tackle it. Knowing that this particular beast can be tamed is a welcome relief for anyone (and that means everyone) who is dreading the sheer volume of revision which will hit in Easter.

Year.4 1.

Vol.III No.II 36

1.

Be confident. The settling-in period is over and you’re better than you realise. Make more of an effort to clerk by yourself, and then try to find a drifting doctor to present to. Make sure you can perform a good, full medical exam in all the core specialties with-

Get your project (‘dissertation’, if we must) ball rolling. Your project is a big deal so it’s worth putting some time and thought into it. The earlier you start sorting things out, the more likely you are to finish the year in style, stress-free and with a marvellous project to boot. There will be some who are aiming to finish the year with a publication to their name (even if that name is • in the middle of a 57-long list): again, now is the time to start pinning this down. Scrutinise your project carefully – it has been designed by a fallible human and may be flawed. You are aiming to do good science, not necessarily to get aesthetically pleasing results.

out guidance. It’s only your first year in clinics and you’re a horrible mix of confused, tired, and worried. But you’re also strong enough to stand on your own two feet. 2.

Focus on core communication skills. The real emphasis at this point in the year should be perfecting your patient interactions. You’ve already got a good scientific grounding from your pre-clinical years, but this is the first time you’ve been let loose on real wards with real patients who have real diseases. Talking to them is going to be a strange, new

2.

Gradually start revising. The message here is to take it slow, but get it started. The format of exams may be different to the SBAs you have come to know and love, and it will therefore take some time to adjust to a new way of answering questions. With a project thrown into the mix, it can be easy to abandon modular content until the last minute, but it’s far better to creep up on revision gradually than to let it creep up on you suddenly.

experience. Practice history taking as much as possible, and make sure you get comfortable talking about uncomfortable topics. 3.

Befriend your firm. Think of your firm as a ready-made study group. Get into the habit of doing gentle OSCE practice with each other – every time you finish a module, practice any questions which might arise from it, and then write out a mark scheme. This works especially well for exams, like the speech and language exam in neuro. Your firm is also the place to ask questions without feeling like an idiot, to moan, suffer, and get support.


Demystifying Medical School

All years

“Remember – it’s always salvageable”

Year.5 1.

Get a handle on your elective. It may seem early, but now is the time. Elective applications and the paperwork around them can take months to process, and you don’t want to find yourself miss-

ing out on the destination of your dreams just because you didn’t get organised. Research the language requirements, vaccinations, insurance and cost associated with each potential option. Some electives will also allow you to finish with an extra practical qualification. January is a good time to start the hunt, initially on the MDU electives website.

Some applications will even have opened by now, so get cracking. 2.

Start small. There are some modules which are comparatively small and easy to get to grips with. Really nailing urology and ophthalmology will give you a sense of achievement completely disproportional to the amount of time required to actually do it, and will ensure that they don’t get put off until the end when you are guaranteed to feel panic worthy of the arrival of the apocalypse.

Year.6 1.

Leave the regrets of the SJT behind. No matter how well or how badly you feel this went, it’s now firmly in the past, where it should be left – forever.

2.

Revise for finals. This may seem so obvious that it’s hardly worth mentioning, but from now until the dreaded day is past, you should expect to become a hermit-like creature, emerging from the

library only to stock up on brain food and spare HB pencils. 3.

Make any last-minute elective preparations. Make sure you’ve thought of everything. Do you have the necessary insurance? Have you had all the correct vaccines? Have you booked your plane tickets?

4.

Get ready - you’ll be a ‘real’ doctor soon. Although the only thing really on your mind is finals, it’s worth giving a thought to the future before it hits you like a ton of cannulating equipment. Whilst you are still a sixth year student, you have all the jobs of an FY1 with none of the actual responsibilities. So, make sure you can do everything to a reasonable degree. Now is the time to make sure you are truly confident prescribing, giving a differential diagnosis and management plan, and presenting. You’ll need all these skills soon enough – and as an FY1, it will be your head on the block if you don’t know what you’re doing.

37 Vol.III No.II


Perspectives

Cases for the Courtroom:

Obstetrics Negligence Claims Obstetrics is a unique specialty in the sense that it can often result in either extreme elation or great despair, depending on the outcome. Notorious for its seemingly close relationship with the legal world, it is no wonder lawyers have even started advertising their litigation services in some NHS waiting rooms. By the year 2020, it is estimated that the NHS will be forking out ÂŁ3.2bn per year in claims. In this issue, we look at three notable obstetric negligence cases and try to unravel the complexities that were addressed in the original court case. Words by

Cheh Juan Tai, Perspectives Editor


Perspectives

The Last of the Bolam Test? Case: Montgomery v Lanarkshire Health Board Country: Scotland, UK Judgement given on: March 2015

D

iabetic women tend to have larger babies, and a known health risk for around ten percent of these babies is that they could suffer shoulder dystocia if delivered vaginally. Whilst 10% is a significant figure, most shoulder dystocia incidents are well managed and the actual probability of a grave outcome is very small (less than 0.1% for cerebral palsy). Nadine Montgomery, a young expectant mother with Type One diabetes, had expressed concern in consultations during the course of her pregnancy about the size of her unborn child, Sam, and the possibility that she would be unable to have a vaginal birth. Despite the clear concerns that Montgomery had about the procedure, her doctor, Dr McLellan, did not mention the increased risk of shoulder dystocia for larger babies, nor did she suggest the alternative possibility of having a caesarean section.

likely she would have been able to comprehend and assess these risks with discretion, had she been informed of them in the first place. Whilst the judge ruled that Montgomery’s expression of concern was not a sufficient justification for Dr McLellan to inform her of the risk of shoulder dystocia, it was decided that Dr McLellan should have considered Montgomery’s likely reaction if she was informed of the risk, which in this case, was to opt for a caesarean section. Montgomery was awarded £5.25 million in damages. This case led to the re-examination of the Bolam test, which was consequently deemed unsuitable for cases regarding the discussion of risks with patients as such discussions are unrelated to medical learning or experience.

Although this may appear to constitute medical malpractice, the Bolam test shows us that this was standard practice among obstetricians during that time. The reasoning behind this was that if all diabetic mothers were informed of the risk of shoulder dystocia, they would all almost invariably choose to have a caesarean section instead. Whilst it seems reasonable to encourage mothers to opt for this ‘safer’ alternative, it is important to note that caesarean sections are not free of risks either. Furthermore, because shoulder dystocia is usually well managed, it may be seen as unnecessary to spark paranoia in a mother who already has other worries concerning the arrival of a new child. In this case, Dr McLellan believed that it was not in Montgomery’s best interests to have a caesarean section over what seemed to be a very small risk of injury due to shoulder dystocia. With that said, Sam did have shoulder dystocia during his birth. The medical personnel were able to free him, though not before he suffered oxygen starvation and cerebral palsy as a result. Despite the risk of encountering serious complications due to shoulder dystocia being relatively low, one of the key issues which complicates this particular situation is the fact that Montgomery had expressed concerns about the vaginal birth early on. Having a BSc in molecular biology and two immediate family members being GPs, it is

39 Vol.III No.II


Perspectives

Dennis Quaid and 10,000 units of Heparin

A

merican actor Dennis Quaid’s newborn twins developed a staphylococcal infection a few days after their birth. The twins were treated with intravenous antibiotics at the hospital, during which time Quaid and his wife went home to get some rest. Quaid called the hospital to check on the twins that night, and a nurse reassured him that they were absolutely fine. He later found out that this was far from the truth. The twins, who were supposed to receive ten units/ml of heparin to keep their intravenous lines clear, had received 10,000 units/ml instead – twice. A pharmacy technician had accidentally put the vials of different dosage together in the same bin. Whilst this alone was not enough to cause the mistake, the nurse caring for the twins had taken the vials out of the bin without checking the dosage. These two negligent errors left the twins fighting for their lives over the next few days. They eventually recovered, but the

Vol.III No.II 40

Case: Quaid v Baxter Healthcare Corporation Country: United States of America Judgment given on: June 2009

incident highlighted very similar cases that had cost the lives of other babies in the United States – cases that were almost too similar for this to be simply coincidence. Interestingly, many of these cases involved the same drug, and the same dose mix-up. Quaid believes that this is because the labelling of the heparin vials was almost identical, making it easy to mistake one dose for the other. Baxter Healthcare Corporation, the supplier, had actually altered the background colour, font size and added a “red alert” label just a month before this incident, making it apparent that it was already aware of the issue. However, many hospitals were still using the old vials when this error occurred, including the hospital treating Quaid’s newborn twins. Quaid sued the Baxter Healthcare Corporation, not only for selling different dosages of heparin with the same blue background, but also for failing to recall or repackage the 10,000 units/ml vials that were

already distributed and failing to issue an urgent warning to healthcare providers who were using the old vials. Quaid lost this case. Why did he not sue the hospital too? Many sources suggest that he was more concerned about the hospital preventing recurrences than receiving compensation. The hospital quickly removed all heparin used for IV flushes from the paediatric unit, and started using a saline solution instead. They also enforced additional checks before highrisk medications are stocked in patient care units. More than $100m was invested by the hospital on new technology, including a computer barcode system for medications, to ensure that the mistake is never repeated. A settlement was reached between Quaid and the hospital, and Quaid has publicly expressed his approval for the measures that the hospital has since taken to avoid making such errors in the future.


Features

The Wrongful Birth Case: Meadows v Khan Country: England, UK Judgment given on: October 2017

W

hat would you do if you found out that your parents received compensation just because you were born? For six-year-old Adejuwon from Oxford, this is a harsh reality. His mother, Omodele Meadows, received nine million pounds in compensation because of the claim that she would have aborted Adejuwon had she known that he would be born with haemophilia. When Meadows’ nephew was diagnosed with the condition in 2006, she went to her GP to find out if there was a chance that she could pass on the disease to any future children. She was given the green light to conceive after several blood tests confirmed that she did not have haemophilia. However, what she did not know was that blood tests do not confirm whether a patient is a carrier of haemophilia or not – such information is usually provided from a haematologist after genetic testing. Furthermore, the GP who had arranged the blood tests for Meadows was not the same GP who presented her with the test results in the second consultation. A lawsuit was brought against the second GP, Dr Hafshah Khan. The basis of Meadows’ claim was that if she had been identified as a haemophilia carrier in 2006, she would have undergone checks of her fetus when she later fell pregnant, and would have subsequently aborted her haemophiliac child. Adejuwon’s condition is severe, and his more recent diagnosis of autism makes this situation even more

complex as he will undoubtedly find difficultly in independently managing his own treatment plan and finding paid employment in the future. This complicated case demands solutions to questions that are almost impossible to answer. Which doctor’s fault was it? There are countless possibilities when trying to discern the intention of the doctor in the initial consultation. Perhaps his plan was to first test if Meadows was a haemophiliac before he sent her off for genetic testing. What about the second GP? It definitely takes a lot of courage to admit liability for test results of a test you yourself did not order. Yet, why hadn’t he noticed that a blood test was not going to provide the information Meadows needed? Regarding Adejuwon’s diagnosis of autism, haemophilia brings no additional risk to a fetus be-

ing born with autism. All parties agreed that the autism was the result of what could only be described as very bad luck. However, had Meadows aborted Adejuwon, the probability of her having an autistic child in her next pregnancy was extremely unlikely. Between 2003 and 2014 alone, the NHS paid out more than £95m on 164 successful claims for damages from parents seeking compensation for the birth of a child. Raising a disabled child comes at a huge cost, not just financially but also mentally, physically and emotionally – for both the child and the parents. In this case, it is clear that Meadows’ endeavour was to avoid bringing a child with haemophilia into the world, knowing the suffering that the condition brings. The judge therefore ruled that Meadows would also receive compensation for the autism.

Images by Grace Navin

41 Vol.III No.II


RUMS Review/Vol. III Issue II Book Mark

Book Reviews

The Hospital by the River: A Story of Hope Dr. Catherine Hamlin “The Hospital by the River” tells the story of two gynaecologists, Drs Catherine and Reginald Hamlin, and their lifelong dedication to the women of Ethiopia suffering from obstetric fistulae, a condition rarely encountered in the Western World. Leaving their home in Australia for a short post in Ethiopia establishing a midwifery school, the Hamlins were so struck by the outcast and neglected women that they remained there, setting up the first and only hospital dedicated to women with obstetric fistulae. In this autobiography, Dr Catherine Hamlin writes of their successes and difficulties in setting up the hospital, of finding cures and treatments for the women and most significantly, of the suffering of these women. A common story arises – girls married as young teenagers and, without a fully developed frame for childbirth or access to midwives and hospitals, labouring for days to give birth to a stillborn child, leaving them incontinent and consequently abandoned. What is particularly striking about the Hamlins’ story is their unwavering devotion to the cause, despite multiple adverse conditions - lack of hospital space, inadequate working materials, and importantly, political unrest and rebellions in Ethiopia. Bringing to the forefront a condition which had previously been relatively unreported and untreated, this book is not only eye-opening but also serves as a reminder of the fundamental values of medicine. While the somewhat convoluted flow of the narrative can be, at times, confusing, and the religious overtones can sometimes feel a little insistent, there is no doubt that the story itself is as humbling as it is inspiring.

EV

Vol.III No.II 42


Book Reviews

How to Grow a Baby Clemmie Hooper

Dare to Dream: My Struggle to Become a Mum Izzy Judd

Clemmie Hooper is a midwife and mother of four, famous for her instagram and blog where she discusses all sorts of issues to do with pregnancy, birth and motherhood. Written in the perfect mix between medical speak and layman’s terms, How to Grow a Baby is both informative and hilarious. It has anecdotes from lots of different women about all sorts of pregnancy related issueswhether it’s the ethics of antenatal screening or what exactly can be done for women whose babies are in the breech position. This book is the perfect bridge between reading the dense Oxford Handbook of Clinical Specialities and some of the more popular guides to pregnancy and birth. An easy read, this delivers all the basic information you need for an obstetrics placement without being something that would send you to sleep.

There are lots of dry clinical textbooks out there about infertility, miscarriage and IVF, but this one is written in an empathetic, informative style with absolutely heartbreaking detail. Not really emphasised in the medical school curriculum, infertility will affect thousands of families every year and yet it is barely spoken about. This book really gives you more of a chance to see into the minds of the families struggling to conceive, to the extent that you just wouldn’t see in a clinical setting. You get the chance to follow Izzy through her journey with miscarriage and IVF in a completely open and honest way that we don’t really get to see in mainstream media at the moment. Dare to Dream really starts the conversation about infertility and what we can do as doctors and healthcare professionals to be more understanding and helpful to these women and their partners. It was really interesting to read about how infertility can affect anyone at all- rich or poor, famous or not (Izzy’s husband is Harry Judd of McFly fame) and that it all comes down to the services in your area and the professionals you see. This book really gives you food for thought as to how we can be better doctors for the women we see throughout fertility struggles and beyond.

KH

Cut Hibo Wardere “Cut” by Hibo Wardere, longlisted for the Orwell Prize 2017, is not an easy read, but ultimately a very important one. It tells the story of Hibo, a Somalian woman who undergoes FGM as a 6 year old, and the effects that this has throughout her life as she emigrates to England. Her fierce rejection of this cultural practice has consequences on her family, friendships and work life, but despite pressures from her community she remains a prevalent UK campaigner against FGM.

Recommended by midwives, How to Grow a Baby contains all the clinical knowledge you need and the accompanying statistics without being dry and instead being concise, light-hearted and fun to read. It works as a great book whether you’re a medical student on placement or an expectant mothers- and some of the recipes recommended for hyperemesis gravidarum look pretty fabulous even for non-pregnant people! With sections by different health professionals, mums who have had entirely different experiences and Hooper herself, this book really gives you a holistic and clinically perfect view of the antenatal period.

KH

The first section of the book focuses on Hibo’s own experiences, but as the story continues she intertwines stories from other women she encounters. This includes girls taken out of school to have the procedure done against their will but also friends who (despite having suffered through FGM themselves) insist on carrying on the practice on cultural grounds. Throughout, Hibo emphasises the need for education on FGM, not only for FGM-practising communities, but for all members of the British public since it is, as she puts it, “a very British problem” happening in this country as well. Nonetheless, this book is not only a memoir as it brings up cultural, religious and anthropological points as well. There is a meticulous coverage of the many reasons why FGM is still being practised, and its physical and psychological consequences. Most importantly, it provides a deeply personal account of a harmful custom that is often reduced to statistics. “Cut” is hugely haunting read, raising awareness for a cause that is all too often shrouded in secrecy.

EV

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Sports and Societies

p.46 Reports p.47 Round-up p.54 RUMSBC Cycle London to Paris 45 Vol.III No.II


James

Charles

Sports and Societies

T

he first term of the 2017/18 season has brought some big changes in RUMS, including a new look for Netball and Hockey under TeamUCL, and a few fresh Union ideas about how to mix things up at sports night, allowing our clubs to get… ahem, creative in meeting new regulations. Nonetheless, normality remains upheld through some stalwart RUMS events; BUCS Winsday chants regularly sweep through the Huntley, rumour mills continue to spin about what happened on tour, the second years comfortably won Bill Smith’s, and the MDs put on a cracking show at the end of the year, providing some much-needed end-of-year entertainment. Some of our RUMS Sports teams have been busy volunteering for charities this term too. A squad of our finest Boat Club members cycled from London to Paris in under 24 hours, earning thousands of pounds for charity Anthony Nolan, and Rugby are still raising a lot of money for the UCH Cancer Fund up at Saracens Rugby Club. I am looking forward to next term, Sports Ball preparations are coming along nicely and we are working to open applications up for the RUMS Sports & Arts Scholarship in January. To echo James’ sentiments, Sports & Societies VP has been great so far, and it is imperative that we continue to demonstrate the importance of RUMS Sports to the Union and the medical school, and I shall also be looking out for an heir next term too. Message me if you think you may be interested!

Vol.III No.II 46

L

ast year was a huge success for RUMS Sport; record uptake across all clubs, Varsity victories, BUCS Winsday and capping it off, Sports Ball. However, it is of course all history and RUMS Sport has moved on, even if I haven’t. New presidents, new committees, new freshers and new invisible buckets at sports night. Many things don’t change though – second year syndrome, £2 pints and troughy Thursdays. Since the fateful night of March, many moons ago, where freshers (of the year) Spoor and Cocks danced the night away, Dr Andy Webb was crowned the people’s King of RUMS, and everyone forgot about team of the year (TOTY) Cricket (who subsequently lost the RUMS T20 day again to RUMS Hockey). Most notably, Charlie Travers has taken the wheel and is continuing to fight all for RUMS rights. Half of his tenancy has passed, and I’m sure he has many things up his sleeves for the coming months. The need for this role in maintaining RUMS Sport in the eyes of the Union is paramount. The whole RUMS committee have put in a huge shift this term making it as successful as it has been, and they all deserve our thanks. I look forward to not being responsible for Sports Ball!


Sports and Societies

ROUND-UP

WOMEN’S FOOTBALL The first half of the year has been a success! Though it may not be reflected in the match results, our teams have had a great start to the season with everyone in the club getting involved and, most importantly, having fun! Our firsts have made it to the quarter-finals of the LUSL cup, while our seconds are in the final 16 – two great achievements! After a much-needed rest, we hope for an even better performance in the second half of the season. Our social calendar was busy last term, with highlights including our Fresher Tour to Norwich for some interclub bonding with the boys, as well as our traditional Christmas meal at Pizza Express. There is a lot to look forward to this term, particularly with UH, Varsity, NAMS, volunteering and some football zorbing coming up. Congratulations to everyone so far and we’re looking forward to the coming year! Judith Rossey, President

RUMSBC at Cambridge Winter Head

RUMSBC

RAISE AND GIVE (RAG) It has been an exciting and successful Autumn term for the RAG Society. We kicked off the year with our famous hitchhiking event ‘LOST’ which, amazingly, sold out! The event saw 21 teams of students abandoned on a remote stretch of English coastline and challenged to race their way back to London, raising money for the charity VITAL along the way. Congratulations to the winning team ‘Purple Raise’ who made it back to campus in under four hours! The event impressively raised over £3,500. 2018 will see our first ever RAG Week, during which we will be collaborating with many other societies to host a variety of exhilarating and fun events on campus, all in the name of charity! If hitchhiking appeals to you but you missed out on ‘LOST’, get involved with ‘Jailbreak’ this February! Teams have 36 hours to get as far away from UCL as possible without spending any money. Can you beat last year’s winners who reached Istanbul? Our commitment to charity will also see several teams of UCL students climb Mt Kilimanjaro and trek Machu Picchu. Good luck to the students involved in these upcoming expeditions! Finally, watch out for the return of our famous Tuesday socials at The Roxy!

This first term has been a busy one for the Boat Club. The whole club descended on the River Cam in November for our first race against student crews from Cambridge and the United Hospitals. It was an incredible day, with over 70 competitors and port-guzzling spectators on the riverbank, many of whom were chanting ‘MIDDLE, MIDDLE, MIDDLE!’ as each RUMSBC crew flew past. After a great performance on the water, the Club bonded with games on the Common before clambering onto the magical coach to Bloomsbury, ready to own the karaoke stage in Mully’s. With the UH Novice Regatta two weekends away, we had a rapid turnaround period after Cambridge to prepare for sprint races. Our men and women’s novice eights absolutely smashed it on the day, with both crews making the final. The boys narrowly lost out to Barts, but the women defeated their opponents in the last 100 metres, earning a stunning victory and bringing home the first medals of the season. On the ergos, the senior mens crew have been hard at work entering relay competitions; they came first at BUCS Indoor in Surrey and then fifth at the British Rowing Indoor Competition, narrowly missing out on a second set of medals, but executing an impressive feat nonetheless. We have so much more to look forward to this term, with competitions ramping up to the BUCS Head and UH Head races. After a well-deserved Christmas break, we are back and raring to go. RUMSBC President, Tintin Larsson.

Emma Hodge, President 47 Vol.III No.II


Sports and Societies

HIVE HIV Education UCL is a student-run volunteering project that runs talks throughout the year, raises money for HIV charities and teaches in local sixth forms. Our aim is to raise awareness of HIV and reduce stigma. HIVE has had several notable events in term one.

MEN’S FOOTBALL With first term having come to an end and second term well on its way, now is a good time to look back on the start our five teams made to the 17/18 season. The first team have had a tough start to the year and are still waiting on their first win in their BUCS league. However, performances are on the up and things are looking a little brighter in LUSL, where they currently sit in mid table. Hopefully their form continues to improve in time for another Varsity win in March! The second team also had a tough start but finished 2017 with a run of three wins – the last of which finished 12-0 to RUMSFC. In the Wednesday league, they currently hover precariously over the relegation zone, but are second in the Saturday league and looking to push for promotion. The third team have performed well so far, currently placing third in their Wednesday league and midtable in the same Saturday league as the seconds. Our fourth team’s start has had some ups and downs, with some good wins and a draw against the thirds, to some big losses earlier on in the season. They currently remain well placed in both leagues and one place behind the third team in the Wednesday league. The fifth team have had a slow start to the year and are still waiting for their first win. Off the pitch, the club has enjoyed some wonderful first term socials, which we rounded off with our annual Christmas dinner. Ben Barker, President

Vol.III No.II 48

We had a bake sale on World AIDS Day during which we managed to raise an impressive £70 for National AIDS Trust, a charity actively fighting for the health and equality of people living with HIV whilst also campaigning for a change in attitudes towards HIV. This term we will run more bake sales – you do not want to miss out on our delicious homemade cookies and brownies while contributing to a great cause! For the first time, our fabulous team ran for Positive East in the World AIDS Day Red Run. The Red Run is a 10km run in Victoria Park hosted by Positive East, a HIV charity aiming at improving the quality of life of people with HIV. Last year, there were over 1000 participants raising over £100,000 for 28 charities! It was a huge success and we are very grateful to Positive East for their help and their inspiring work. Finally, in collaboration with UCL-TB, we co-hosted a talk on HIV and Tuberculosis by Dr Gerald Friedland, Professor Emeritus at Yale University. Professor Friedland has been working with HIV patients in the US since 1981 and, more recently, has pioneered research in integrating HIV and TB care and treatment in co-infected patients in South Africa. It was an honour to host such an amazing speaker! Overall, a very exciting and rewarding first term! To get involved this term please visit our Facebook page: @HIVE UCL or contact us via email: hive.ucl@gmail.com. Estefani Conde, President

MEDICS4 MEDICS We are Medics4Medics, a group of medical students who want to open up the discussion surrounding wellbeing and mental health within RUMS. We want to tackle the taboo and stigma around mental health and support RUMS students to develop and maintain good personal wellbeing. Through the work of our peer navigators, we aim to help medical students feel less isolated, whilst also providing a safe and non-judgmental space for support and conversation. Equally, we them ining At Medics4Medics, we host fortnightly talks, often followed by informal discussions, that are open to all. Visiting speakers cover a variety of important topics surrounding mental health. This term, some of the topics of discussion include self-care, coping with failure, evolutionary psychology and the professional benefits of talking about mental health. These sessions are held every other Thursday, from 18:00 to 20:00, in the Cruciform building. Check out our website for more information: uclm4m.co.uk and email us at UCLmedicsgroup@rethink.org. Please don't hesitate to get in touch! This term’s scheduled events are below. 08/02/18: Coping with Being in a Competitive Environment 22/02/18: Burnout 08/03/18: How to Support Friends Going Through Difficult Times 22/03/18: Perfectionism Medics4Medics President, Kerry Wales


Sports and Societies

RUMS MEN’S HOCKEY

RUMS WOMEN’S HOCKEY

RUMS Men's Hockey Club has never been so vast in both numbers and stature. It really has been an action-packed term. A brace of new freshers helped Henry Hill’s first team to a most wonderful victory over UCL – a great boost as we build up towards the UH cup and Varsity. Watch out for tickets to Varsity, which will be held on 12th March and will be great fun for all of the RUMS family. As I predicted in the last edition, Tom Chambers is storming away in the golden stick competition and was awarded the first team ‘Man of the Half Season’ award. Will James Shuttleworth’s hip be restored in time for a late charge? Will Rhys’ Christmas fitness regime bring him back to form? Or will fresher Moulder grow into a striking powerhouse? We can only hope... Ollie Sluijters’ second team have gained a solitary fresher with an inspiring Scottish accent, and a handful of impressive promoted second years who are regularly dropping ‘the old guard' to the bench (it hurts). I am sure Ollie's intensive training schedule and mysterious superstitions will get us playing like his Dutch homeland's national side in no time. Let's hope this happens in time for the big Reading away day. Karan Dahele’s growing confidence and astonishing pace won him the ‘Man of the Half Season’ award for the seconds. A gloriously large cohort of freshers joined us in the Autumn, giving thirds’ team captain, Matt Solomans, a substantial headache for selection every week. Many have gone from never holding sticks to pushing for promotion, which is very promising for next term and beyond. Adam Everett takes ‘Man of the Half Season’ for the thirds. Wintour came as we travelled to Liverpool (or was it Norwich?) for our ‘Game of Thrones’-themed main tour. The consensus is that it may even have topped the “unsinkable” Leeds 2014 tour. Thank you Rhys and Becca! Elsewhere, as well as a tour in Southampton, we have had what has felt like a never-ending stream of socials from Jos, including an emoji pub crawl and a seven-house Christmas dinner crawl. This term, the throng of hockey goodness does not look like slowing. What a time to be alive. Fred Vivian, President

TENNIS We have come to the end of a stellar term for RUMS Tennis. It started with a large fresher intake, a number of whom have made first and second team and are performing brilliantly! Our Men’s firsts have made the quarter-finals of the BUCS Cup and have beaten teams from much higher leagues in the process. They’re hoping to better their run to the semi-finals two years ago, which saw them awarded RUMS Team of the Year (hope you’re reading this, Dr. Dilworth!). Our women’s firsts are still in with a chance of a league title and subsequent promotion in what will be a close fight next term. Our socials have proved as popular as ever, the highlight being our first tour of the year. 54 of our strongest members descended on Leeds, and only about half of them have fully recovered. It was an incredible weekend arranged by social secs Calum Jack and Ola Oyawoye – more of the same is expected on our second tour in a few months! Tour aside, our sports nights, meals and other events have been popular throughout and we have a lot of surprises already planned for next term.

Our first term has been incredibly hectic and fun-filled! We started well with the biggest intake of freshers we have ever had, and kicked off the social calendar with a curry and the annual pub crawl in October. The following month featured the first of our tours, with a return to T.I.T.S in Southampton, and just when we feared the fun was drying up, we were off on our annual university tour with the men’s Hockey Club, which was held in Liverpool this year. We ended the half-season with Christmas dinner at the wonderful Guanabana, where we celebrated a fantastic term with some special awards. Shout out to Annie Mosley who won ‘Dick of Half-Season’ after falling into a canal (with her bike) on the way to training. We also played some hockey along the way, with the firsts finishing 2017 at the top of their league, and the seconds in second place, battling closely for the top position. The thirds continue to grow with their largest squad yet, and even managed to feature on a BT Sport commentated match at the Olympic pitches! We have also done some great charity work this year, including a NHS blood drive which saw over 20 members of the club donating blood, and a charity carol singing event at Ealing Common tube station which raised £147 for Medic to Medic. Post-Christmas, we look forward to more hockey including some beginner mixed matches and our Varsity match against GKT. Plus many more socials, of course! Chloe Hall, Women’s Hockey President

Overall, it has once again been a brilliantly entertaining and successful term for RUMS Tennis. The club keeps going from strength to strength and it looks for all the world that this will continue for the rest of the year! RUMS Tennis President, Rishi Gupta

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Sports and Societies

Freshers in Barcelona

RUMS CRICKET CLUB

SPECTRUM This term, Spectrum has recruited many new volunteers to be paired up with several of the children that we work with. Volunteers have started visiting their child on a fortnightly basis, either playing with them at home or taking them on outings. Unfortunately, our Christmas trip was disrupted due to heavy snow but a few of our volunteers and children thoroughly enjoyed a day out at the Natural History Museum. We also recently had a successful bake sale, raising over £140!

How does one go about topping an international tour to Barbados in the Summer? Well, I’ll tell you how…Term one rolled around and the RUMSCC fresher fortnight was jam-packed with events, from presidential dinners to cocktail nights to ping pong tournaments and everything in between! A special mention to the social secretaries for making our RUMSCC social calendar as chock-a-block as ever – the perfect antidote to getting back into life as a medical student. RUMSCC take pride in welcoming cricketers of all abilities, from freshers who have never held a cricket bat to players who have represented their respective counties. With RUMSCC enjoying lucrative success in the indoor arena, the future is looking bright indeed! As our last international tour was such a roaring triumph, the club decided that it was high time for another one! After the destination was revealed at Gatwick airport, the RUMSCC men jetted off to Barcelona to soak up the November rays, and to enrich the Spanish with the good ol’ game of leather and willow. Let’s see what next term has in store for RUMSCC! Dhiraj Patel, President

SEXPRESSION Here at Sexpression UCL, we have had an exciting start to the academic year. We focus on teaching comprehensive and inclusive Relationships and Sex Education (RSE) to secondary school students across North London. This term, we welcomed a large intake of first year medical students to our double-block SSC. We have already covered topics such as contraception, STIs and consent, which will be applied to teaching sessions in schools next term. Additionally, we have recruited a fantastic cohort of UCL student volunteers who will also be accompanying us to teach in schools! Excitingly, we held our annual Sexpression UK National Conference in October, which was hosted by the University of Edinburgh’s Sexpression branch. The busy weekend included multiple workshops, an invigorating talk by a stripper and a traditional Scottish ceilidh dance. One of the highlights was a workshop about ‘Planet Porn’. Increasing numbers of young adults are watching porn, and we were so inspired by this workshop regarding the issues that can arise this that we are considering incorporating this into our future lessons! Next term, our passionate SSC students and UCL volunteers will start going into schools to deliver lessons that represent the core values of Sexpression. Jaya Ponnampalam, President

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This year, we have our annual residential trip in February during which all of our volunteers and children will spend a weekend away at an activity centre. Whilst there, we will partake in a variety of activities including archery, swimming and rock climbing – all very exciting experiences for the children of Spectrum. This incredible opportunity is possible due to the generous National Lottery Awards For All grant we were lucky enough to receive. We also hope to plan some other volunteering, socials and tutorial sessions in 2018. We rely purely on donations and grants to keep our amazing work going. Therefore, if you are interested in making a donation of any amount, please visit the following link: https://mydonate. bt.com/charities/spectrum. Thank you! Khushboo Khatri, Spectrum Vice-Chairperson


Sports and Societies

WILDERNESS MEDICINE SOCIETY

RUMS SQUASH The first term of this academic year saw heaps of RUMS Squash activity. After a successful Fresher’s Fair and well-attended taster event, we sat with a cosy number of members, including our golden oldies from final year and a fresh intake of first and second years. Squash-wise, we had a good start to the season with promising efforts from all the men’s teams and an amazing result from the ladies’ first team who, in their first match, took down UCL Women’s second team for (probably?) the first time ever. We also had a great social scene, with several dinners at the infamous Dar’s Tandoori (pictured), a karaoke night (which our social secretary, Karan Kapur, decided to name after himself) and several nights out, which were also pretty good (from what we remember of them). Next term sees us face the second half of the season, which is the most exciting part of our year. We will be defending our title at the NAMS Squash Competition in Birmingham, trying for a new title at a national competition in Sheffield and working to defend our title as winners of the University Hospitals Cup.

UCL Wilderness Medicine Society has had an active time since the last issue of RUMS Review. We began our year with an old favourite; the Walking Wounded Hike on Hampstead Heath. Everyone enjoyed the usual balance of fun, first aid and impalings… Our lecture series began by welcoming back Dr Clare Warrell, an ex-UCLWMS president, for an inspirational talk on her experiences in Wilderness Medicine. The term finished with a fascinating talk from Dr Oli Firth on diving physiology and medicine. This included subjects as diverse as the perils of being a goat in Haldane’s diving research and the medical management of air emboli. So, what is coming up this term? Keep your eyes peeled for workshops, your evenings free for some exciting talks and your calendars ready for our winter trip. Tom Durham, President

MDS Kicking off the year with the Fresher’s show in Mully’s, the MDs were on fine form, even if we do say so ourselves. After auditioning scores of keen freshers, we welcomed several new faces into the society to take starring roles in the Christmas show as cast, techies and impossibly aesthetic band members. ‘The Hernia Games: Clerking Fire’ premiered to a sell out audience, even attracting medical school celebrity Deborah Gill who, rather sportingly, endured a cross dressing parody of herself. The show was a complete success in raising money for the Royal Free Charity and raising questions about the show’s plot and the sanity of its writers. Stellar reviews included “good” and “it was better than sitting at home alone eating Sainsbury’s basics mince pies”. Keep up to date with the exciting events lined up for this term via our Facebook page.

Daniyal Jafree, President

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RUMS BADMINTON RUMS Badminton has had a great year so far! Thanks to all of you who turned up to trials – our teams are much stronger and are sitting comfortably in each of their respective divisions. In November, we participated in the annual NAMS tournament, this year held in Birmingham. Although we did not get our hands on the trophy, we put in a strong showing and everyone had a great time! Elsewhere, our social base is thriving with a consistently great turnout to our practice sessions on Wednesdays and Saturdays. We have had a lot of fun running events this past term, with some of the highlights including our Fresher’s Meal, President’s Welcome and Christmas Party. Thanks to everyone who attended our tutorials and volunteering sessions, especially those who lent their beautiful voices for Christmas caroling in support of North London Cares! We have a lot more in store for this term, including our biggest event of the year: Tour! Feel free to pop in and say hi at social practice and sports night (see our Facebook page for details), and we can not wait to share with you what we have in store! Patrick Man, RUMS Badminton President

RUMS NETBALL MED TECH The newly founded UCL MedTech Society aims to demonstrate the changing landscape and impact of technology on healthcare. The society is truly multidisciplinary as it is comprised of students from many different backgrounds including medicine, computer science and neuroscience. We recognise that future leaders in healthcare will not only need to embrace technological changes, but also be at the forefront, adapting to and developing new approaches. UCL MedTech is one of the only societies that focuses solely on technology in healthcare. We welcome speakers who are leaders in the field and drivers of the technology revolution, in addition to hosting interactive coding events and demonstrations of augmented reality applied to medicine. In term two, the society will be partnering with NHS Digital to host a Health Data Science course that will involve coding workshops focusing on the application of data-driven science to healthcare. There will be talks, panel discussions and debates from important figures in medical technology, companies and researchers. UCL MedTech is also partnering with other London MedTech societies to host a full-day MedTech conference. The society takes advantage of the strengths that UCL possesses in research and technology in order to encourage students to join in learning about this evolving field whilst providing opportunities to develop the skills required to become a leader in healthcare. Stay up-to-date with UCL MedTech via our Facebook and Instagram pages, and watch out for the exciting new blog coming soon! If you have any questions, please feel free to contact me at nastazja.laskowski.14@alumni.ucl.ac.uk Nastazja Laskowski, MedTech Marketing officer

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What a term the ladies of RUMS Netball have had! With seven teams now competing at a variety of levels, we have celebrated victory after victory in both BUCS and LUSL, with many teams lined up for promotion next season in either one or both of their leagues. The girls have enjoyed heaps of socials, from a ‘School of Rock’ themed pub crawl with the Rugby Club, to our huge space-themed social tour to Cardiff – where we found a new club mascot in the form of Julian! We ended the term on a real high with a legendary Christmas dinner, during which we scoffed lots of food and dished out some classic netball banter. This was followed by a huge turnout to our Christmas training on the final Tuesday of term, where we played a festive ‘round robin’ versatility tournament, with prizes for the winners and the best dressed (shout-out to Meg for those fantastic socks!) Thanks to the whole committee for all of their hard work in making last term so much fun, and we look forward to seeing what you have in store for us in the New Year! Frankie Cackett, President


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4901: 05/17


Sports and Societies

London to Paris

RR: Why did RUMS Boat Club choose the London-Paris cycle route?

On 20th October 2017, 12 ambitious members of RUMS Boat Club left their natural habitat of the River Thames, swapping their boats for bikes, in order to cycle from London to Paris in aid of the charity Anthony Nolan. Whilst funding research is a priority for the organisation, it is through their Anthony Nolan register that the charity principally supports people with various forms of blood cancer; spearheading campaigns and furthering public education to increase the stem cell donor pool enhances the matching process required for bone marrow transplants, and works to save lives. Completing the whopping 287 kilometre journey from Trafalgar Square to the Arc de Triomphe in 24 hours is no small feat, especially considering the overnight ferry, subsequent sleep deprivation and unsurprisingly awful weather! After raising close to £4000 in donations, I spoke to Mattie and Beth, two of the foolhardy cyclists who took part, to see why they would dream of undertaking such a task and how the team fared overall. Interview by Asha Dave, Sports & Societies Editor

Vol.III No.II 54

A: The idea for the route initially developed because one of our members, Jack, had previously cycled to Paris for Macmillan Cancer Support, but had done so over a three day period. It is also a world-renowned cycling route, and we knew it would be achievable in 24 hours (especially because it is relatively flat!).

RR: Why is Anthony Nolan the sole charity you chose to cycle for?

ishing line – the Google Maps route said it would take 22 minutes to reach the Arc de Triomphe, but we had 18 minutes left on the clock! We all dug deep and sprinted between traffic lights, weaving through Parisian traffic and throwing caution to the wind. Despite running on exhaustion, we all pulled together and united as a peloton. When we reached the famous Arc de Triomphe roundabout, we cycled straight though all five lanes of traffic and reached the island in 23 hours and 59 minutes. The euphoria was unforgettable, we were all so glad that we had made it - it would have been so heartbreaking to miss out on the 24 hour window! The entire sequence of events was surreal, and it felt as if we were living out the final scene of a film!

A: Over the past few years, members of the Boat Club have become increasingly involved with UCL Marrow, the student branch of Anthony Nolan, and helping the charity’s cause. Blood cancer has also affected the Club, therefore it seemed fitting to do the cycle for a charity that we have become emotionally invested in. Logistically, there was already established communication between the Boat Club and Anthony Nolan, and having this contact meant it was really easy to liaise with them – they were incredibly supportive and provided us with cycling jerseys, which was a bonus!

Mattie: I would agree with Beth, that was a real highlight of the cycle. However, I think my favorite bit was being waved off by everyone in Trafalgar Square at the beginning of the 24 hours. As the sun was setting, there was this golden glow to everything and the excitement was palpable; everyone was so buzzed and nervous! Our first departure as a peloton was such an amazing feeling; we were so giddy and, after months of planning, I could not quite believe that we were finally doing it! I was also really touched that so many people came to see us off because I was not expecting anyone to come. The support we have had from RUMS throughout the process was incredible and we were are grateful!

RR: Can you describe your training schedule in preparation for the cycle?

RR: What was the biggest hurdle you had to overcome?

A: In order to allow people to decide whether they wanted to sit on a bike saddle for over 200km, we organised an initial group cycle to Brighton in June 2017. However, it was not until six weeks prior to the big day that we began weekly training rides, which started at 50km long, building up to a duration of 100km. Shout-out to Strava for their list of London’s top rides; the routes took us to Ashford, the Chilterns, Windsor, Essex, Hertford and many other places. We also used cycling as our principle method of transportation around London, and did laps around Regent’s Park and Richmond Park alongside our usual rowing training. Some of these rides took nine hours to complete and were incredibly challenging. During the cycle to Ashford, we battled the elements, cycling through sheet rain and wind and experiencing several off-road encounters thanks to a questionable route. The low point was probably a 200m climb along a muddy woodland path, which took more energy than the rest of the entire cycle. Ashford was definitely more of a training exercise in mental endurance than anything else, and even at low points during the actual ride to Paris, we could always say that it was not as bad as Ashford!

A: Rallying the troops and coordinating everyone for the training cycles was tricky because everyone was just incredibly busy. We really needed to ensure that everyone had put in enough training, and making sure we all clocked in the miles was paramount. However, the biggest obstacle had to have been the ferry company who single handedly drove Beth insane – Jessica from DFDS is definitely now on Beth’s kill list.

RR: What was the most rewarding part of your trip? Beth: For me, the most rewarding part was the final sprint through Paris as we were racing against the clock in order to get to the Arc De Triomphe in less than 24 hours. By that point, we had lost three hours due to Storm Brian delaying the overnight ferry, but we were definitely close to the fin-

RR: Considering the length of the journey, and 17 hours of exercise, how did you keep up morale and remain in good spirits? A: The good old British sense of humour and lots of Battle Oats bars. Some points were extremely challenging, namely Mattie coming off her bike multiple times, the hailstorm as we entered the Parisian suburbs, and the many technical issues we experienced with the bikes. Despite all of the hurdles, no one threw a tantrum at any point and we simply kept each other going. Neel really deserves a mention here for discovering his secret talent as a vlogger and keeping us entertained with his documentation of the trip! We also had a morale boost on the first leg thanks to Mattie’s free Apple Music streaming, and we could not have kept up the spirits without the beloved Men with Ven providing us with constant support and comic relief.


Sports and Societies

RR: What was the worst part of your journey? A: One particular road in France was a real test of character – Ali literally lost his mind! Even as we continued to pedal, the end got no closer and we were being battered by the crosswind whilst trying not to be blown into traffic. Despite this, it still wasn’t as bad as Ashford.

RR: What kept you motivated throughout the long training cycles and the main cycle itself? A: Firstly, Beth’s passive aggressive Facebook/ WhatsApp essays that no one read but appreciated nonetheless. Secondly, the amount of money that people donated to our cause! It was incredibly important that we do Anthony Nolan justice, and we just want to say a massive thank you to everyone that donated to the cause because we raised an insane amount of money, for which the charity was very grateful .

RR: Would you do it again? A: Absolutely. UCL Boat Club are planning to do the route in summer – it is a great route for your first long cycle as it’s fairly flat and the scenery is incredible: we would definitely recommend it!

RR: Is there anything you would do differently? A: Ideally, we would avoid Storm Brian. Cycling the route during the Summer, or at least a month with more daylight, would have also been better. We would also leave Will McCaughran behind.

RR: In addition to the London to Paris route, RUMS Boat Club have also done the London to Brighton cycle, do you have any other big adventures in mind for RUMSBC Cycling Club? A: Yes, we have set up RUMS Velo Club, which is a forum for all the cycling enthusiasts in RUMS to post about when they are planning cycles and to enable us to plan big things in the future. We are keen to do another long-distance cycle, perhaps London to Brussels or Amsterdam. We are still awaiting contact from Ollie Totham who has ‘big ideas’, so watch this space...

RR: How can our readers get involved with Anthony Nolan’s amazing work? A: Signing up to the stem cell register is one of the biggest and most important ways anyone can get involved with the charity. It is incredibly easy: on the Anthony Nolan website there is a registration process, after which a swab kit is sent to your house. It is also possible to get involved via one of the many recruitment events that UCL Marrow run throughout the year. You can also get involved by volunteering with UCL Marrow at their events, or you can support Anthony Nolan by participating in sponsored events, such as the marathon or the Prudential RideLondon-Surrey 100. However, the best way to support the charity is definitely by signing up to the register because you can potentially save a life.

RR: How did you manage to get such good sponsors and raise such a magnificent amount of nearly £4000? A: Over 100 emails were sent and we were really lucky to get support from such great companies. Battle Oats deserve a special mention as they single handedly fuelled us throughout the entire ride, and we would not have made it without them. The RUMS Boat Club’s Instagram account also helped promote the cycle and we received a lot of support from the other RUMS clubs, raising over £150 from one sports night collection alone. We also bumped into some cyclists on the way to Newhaven, one of whom had a broken chain, so we stopped to help them and gave them a lift to the ferry. Though we bid them farewell at the French border, after returning to England we were delighted to see a donation of £50 from the guy with the broken chain!

55 Vol.III No.II


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Rums Review Vol.III No.II The Obstetrics and Gynaecology Issue  

Vol.III No.II of the UCL Medical School student magazine.

Rums Review Vol.III No.II The Obstetrics and Gynaecology Issue  

Vol.III No.II of the UCL Medical School student magazine.

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