Page 1


Get the most out of your time in medical school

ElsEviEr is a Global information analytics company spEcialisinG in sciEncE and hEalth We are here to provide you with invaluable information at medical school that will help you not only pass, but excel. Trust us - we’ve been doing this for over 100 years! The Elsevier Survival Guide has everything you need to deal with the highs and lows of medical school. You’ll find accumulated wisdom from fellow med students, and you’ll also have access to unique, rich content that makes us the global leader in medical and scientific information.

®

Download your frEE Elsevier Survival Guide medicalstudent.elsevier.com Like our page ElsevierMedStudents


Editor-in-Chief: Beth Gillies Deputy Editor-in-Chief: Mel Moghim Director of Medical Journalism: Izabella Smolicz Treasurers: Carol Chan Augustina Jeyanathan

UCL Medical School Student Magazine Vol. III No. I

Health and Wellbeing Issue

Sub Editors: Rachel Parker Sophie Douglas Davies Sabrina Matica Hickey News: Anamika Kunnumpurath Emma Lewin 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 Aishah Ahmed

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 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


5

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

16

Sternum / Out of Hours Dr Joanna Porter

34

Thoracic spine / features The Food Medic

12 20

Clavicle / News The latest from in and around UCLMS Scapula / Alumnus Interview Prof Michael Farthing

28

Pelvis / Perspectives Medical School: Tried and Tested

The Curious History of the Cruciform An Opiate of the Masses for the 21st Century? A Career in Psychiatry

22

Radius / Research Cognitive Behavioural

18

Therapy and Mental Disorders Research Round-Up: UCL Division of Psychiatry

Femur / Book reviews Eureka Gastrointestinal Medicine This is Going to Hurt Pocket Tutor ECG Interpretation

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

47

Tibia / Sports and Societies Welcome Society Reports Fresher Of The Year: where are they now?


Editorials

Editor’s Welcome Beth Gillies RUMS president Ozzy Eboreime Director’s Update Prof Deborah Gill RUMS Reports 4

Vol.III No.I


Editorials

Editor A new academic year brings excitement in many different forms: new freshers, new friends, new experiences and, most importantly…a brand new RUMS Review with a whole new look! We are constantly evolving and updating to suit you, our readers. Whether you are students, staff or alumni, our aim is to satisfy your every RUMS need. However, to do that, we need to hear from you! Please get in touch with your feedback (positive and negative!) to help us create your UCLMS magazine.

online exclusive Feature considers internet addiction as we ask: An Opiate for the Masses of the 21st Century? Head to our website to read this fascinating piece! Elsewhere, our Research team will guide you through the ins and outs of cognitive behavioural therapy, whilst our Roundup uncovers the work going on behind the laboratory doors of UCL and its associated research centres. Discover more about the fascinating specialty of psychiatry in Careers, and find something for everyone as our one-off Tried and Tested section allows you to receive letters of advice from your future medical student selves.

In all this development, there are some things we couldn’t bear to part with so, in traditional style, Professor Gill kicks us off with her medical school update. Professor Gill’s wish to maintain communication with students and increase transparency between us and the medical school is abundant and we are, as always, so grateful for her contribution. A warm welcome goes to our new RUMS President, Ozzy Eboreime, along with his elected committee for 2017/18, as we get to know them in RUMS Reports, and – of course – we give you all the med school goss in our News section.

An enduring focus for RUMS Review is our desire to strengthen ties with a cohort we are all aiming to join: the RUMS alumni. This issue, we make that desire more tangible as we discover The Curious History of the Cruciform, which not only reveals some of our more famous past students, but also unearths some notable births and deaths occurring back in the functioning hospital days of this most intriguingly-shaped building. Our alumni links are further fortified in our Alumnus Interview with Professor Michael Farthing who, from his UCLMS graduation in 1972, has come full circle to rejoin us as an Honorary Professor. Also in this issue, Out of Hours gets to know Dr. Joanna Porter who, despite not being a UCLMS alumni, joined UCL for her PhD studies over 20 years ago and has never looked back since!

This issue, we delve into a topic which has, arguably, become one of the most prominent for medical students and professionals alike: mental health and wellbeing. Notorious for self-neglect, doctors and medical students have some of the worst statistics when it comes to their own mental wellbeing, particularly concerning the discussion of such a topic. We hope that, by exploring aspects of this area, we can encourage and promote good self-care to a cohort for whom it is most crucial in allowing them to subsequently care for others. As part of this issue’s exploration, RUMS Review chats to Instagram sensation Dr. Hazel Wallace, a.k.a. ‘The Food Medic’, who promotes nutrition and healthy living as a first line treatment and prevention for disease. Alongside this, our first

Vol.III No.I 5

To round us off, our Book Reviews outline the must-have reads for fourth year students and, very appropriately, we bring it back to you, the RUMS students, as we discover the weird and wonderful achievements of our beautifully diverse Sports & Societies (did someone say Fresher of the Year? I wonder where they are now…). Finally, we would like to wish this year’s freshers the best of luck for their first year as part of the RUMS family – you really are going to love it.


Editorials

President D ear all,

I hope you are well and that your holidays, however long or short, were both enjoyable and relaxing. More importantly, I hope that they allowed you time to recuperate ahead of the approaching academic year. I am aware that the RUMS Executive and Review teams have been working hard to ensure that in this upcoming year we build upon the achievements we made last year. I am sure you have all been doing the same. It is important to look back nostalgically at the past, as well as to look forward optimistically to the future.

As we are all aware, the current geopolitical climate both nationally and internationally is one of uncertainty and apprehension. Much of what the next few months and years hold is unknown, which, unsurprisingly, causes some uneasiness. What we do know is that the medical field, which is always quite politicised, very well may face changes which will influence medical education and medical schools in turn, including ours. As always, the RUMS Executive and I will strive to ensure that your views are heard and respected as we try to navigate these uncertain waters. Whilst trying very hard to pretend that September was not approaching, the new RUMS

Executive were hard at work making plans for the next academic year. I can barely contain my excitement, but must do so for the purposes of this foreword. I am sure you can join me in anticipation of some of our well-loved events coming up in the calendar, such as the Sports Ball. I am sure you have all figured out that this is just an elaborate experiment to see how many medical students we can fit into a hotel function hall and what fun ensues when we do. However, I also very much look forward to the plans for new events or new takes on old classics that will grace our social calendars this year. I remain ever the optimist. I believe change is something not to be feared but something to be faced, head on, with tenacity. This is easier said than done, granted, but it does not make it untrue. I look forward with hope and excitement for what this year will hold and I am ever grateful for the opportunity to face it with you, as your President. I look forward to working with and for you in the coming year, whatever it may hold. I hope you will join me as we work to make these new beginnings into cherished memories. With RUMS love, Ozzy Eboreime RUMS President, 2017-18

6

Vol.III No.I


Editorials

Directo

r

I

s

am delighted, once again, to be providing an update about UCL Medical School for RUMS Review. As we start a new academic year and welcome 320 new future UCL Doctors to the UCL Medical School (UCLMS) family, this is a time when we look forwards: to the exciting times ahead for our brand new students, to the opportunities, challenges and achievements that lie ahead for our current students as they progress through the remainder of the programme, and to the brilliant careers awaiting the graduating class of 2017. This year, however, we also look backwards too: as we roll out our ambitious alumni relations activities, reaching out to reconnect all of those former Royal Free, Middlesex, UCLH and UCLMS students with the medical school and its current students and staff. This issue of RUMS Review will be going out to a much larger alumni audience than usual, and I am sure they will agree that we have a school and a student body of which we should be very proud. UCLMS celebrates the past but has its ambition firmly directed towards the future. Vol.III No.I 7

d a p te U Making UCLMS behave and feel like a family, and creating a life-long sense of belonging has been one of my major goals in the two years since I took over as director. As a large school spread out over a metropolitan campus, using an everincreasing range of clinical placements, it is easy to lose that sense of belonging. Some students go through the programme feeling disconnected and un-cared for, and some graduate without a real connection to the school and their fellow students. For me, this is a failure on our part and a terrible waste of what should be one of the best experiences of a young person’s life. I am very fortunate to work with a fantastic bunch of staff, with an active group of alumni and a really dedicated RUMS team who share my ambition of improving this sense of belonging and the student and alumni experience. This is not a quick fix: so many different experiences impact on one’s sense of belonging (don’t get me started – this was the focus of my PhD thesis!) and there is much work to do. The following bits of news I think all point towards progress but, of course, ‘the proof of the pudding is in the eating’: tell me what we are getting right, tell me if you feel UCLMS for life and tell me what we can do to make it better.e and tell me w hat we can do to make it better.

UCLMS does Open Day

Open Day is the first impression many students have of UCL. In the past, it has been a somewhat lacklustre affair. However, over the past two years, our admissions tutor Sarah Bennett and her team have turned this into a fun and informative event. Speaking to current and past students is the best way to get a feel for the school and its values, and taking part in clinical skills sessions, taster lectures and talking to staff is a good way to test out whether the UCLMS experience is for you. Special thanks to all the students, faculty and administrative staff who turned out en-masse on a sunny September Saturday to make the UCLMS Open Day a memorable experience for visitors. The t-shirts were great, by the way! Next year, we aim to start up ‘post-offer’ visits and activities and so the volunteer team needs to get even bigger. If you are a student, staff member or alumnus who wants to get involved, please contact Dr Bennett directly sarah.bennett@ucl.ac.uk

New Year ONE Welcome Event Once the hurdle of the UCLMS offer and getting the right grades are over, the next big challenge is starting university as part of a huge cohort. I give the opening lecture to this terrified but excited group every year and I always feel terrified and excited on their behalf. Following on from the success of last year’s Faculty Lunches for first years, the year one team have introduced a Welcome Event on the second day of term for all new students. An opportunity to talk to teachers, support staff, older students, alumni and their fellow first years in a more informal setting should help to build those important initial relationships. Free food, drink and entertainment should be a good draw for staff and students alike.


Editorials You will find me in my RUMS sweatshirt next to the tower of 300 Krispy Kreme doughnuts during the event….

The new medical school building The initial work begins on the Rockefeller Building this winter to revamp this space into the home of the Medical and Dental School (yes, we have one, albeit a postgraduate school!). This will, we hope, transform the student spaces: particularly the rather decrepit but much loved clinical skills centre, the quiet study space and the reception areas. This should make the interactions between students and the administrative and student support teams more conducive to a sense that ‘we are all in this together’. As a stop-gap, we have done some work on the medical student hub on the ground floor of the Rockefeller building (thank you SLMS ISD for a fantastic job), and I am sure you will agree that this is now a much more useable space. Please tell us how we should decorate the space: it is one of the very few truly medical student spaces so we can celebrate all sorts of UCLMS and RUMS achievements and activities.

UCLMS for Life

o ol N h c S ew l a

s

If our current students are the beating heart of UCLMS, our past students are… some other vital organ in this analogy – kidneys? Liver? Blood?... Nothing seems to work very well here. We have been rather neglectful of these fantastic individuals in the past (yes, you get even more fantastic when you leave) but no more. Led by some truly dedicated individuals including Deanne Attreed, who looks after partnerships and alumni for the medical school, Katie Singer in the UCL Development Office, the RUMS Alumni Association, and a host of others, we are looking at the range of ways alumni can stay in touch with each other, give something back to current students and stay connected to the life of the school. We have launched the new alumni page on the website and hope this will be a good place for past students, new and old, to find out about alumni events and opportunities. From reunion dinners, giving careers advice and opportunities to taking part in admissions, teaching and assessments and raising money for the new student support fund, there is something for everyone. We are always delighted to hear from alumni and hope we will see much more of them around the place in coming years.

resources are currently being revamped and this will include a better online booking process. You will see the support team more often at events (they were out in force at the recent year four welcome event and at open day) and they will continue to run targeted events such as Mental Health Awareness Week. The vast majority of students who use the service say the team are brilliant but many students do not access support even when they would really benefit from doing so. Our next job is to reach out to those members of our family that need a little bit of extra support to really thrive.

Implementing Improving Clinical Placements As Chair of London Medicine, I have been working with colleagues and student representatives from across London for the past year to identify ways of maximising the London students’ experience of clinical placements. Not surprisingly, the main messages coming through from students were not about the teaching but about the sense of belonging and feeling valued: students wanted someone to know they were coming, to give them information about the placement in advance, to welcome and orientate them on arrival and to be available when they needed support to make the most out of the placement learning opportunities. We have shared the findings with our placement providers and Health Education England and will be working on making sure UCLMS placements pay attention to these small details that make such a difference. Let us know through the student evaluation questionnaires how we are getting on with this. Wishing all our students and staff a successful year and looking forward to meeting more members of the extended UCLMS family.

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

Revamp of student support The student support team are forging ahead with improvements to the ways in which the school offers support to students who encounter academic or wellbeing issues during their time with us. We have increased the number of support tutors, improved the feel of the support office, and worked on making booking appointments more straightforward. The support service web

8

Vol.III No.I

Med i c


My role is, essentially, to act as an interface between you guys and the medical school faculty. To facilitate this, Student Representatives in Y4-6 have been assigned to each module across the various sites. They are useful contacts to approach with any concerns you may have and I would encourage you to do so! This information will be relayed on to the faculty at meetings throughout the year. The main focus for me this year is to continue the excellent work of my predecessors: punctual distribution of timetables, reducing inter-site variation and ensuring a supported transition into each year - all factors that heavily influence our day-to-day lives. All of this is dependent on getting plenty of feedback from students; only with feedback can we make informed and convincing arguments for change. It is a privilege to be given such responsibility. I am really looking forward to it and hope to achieve long-standing changes within our medical school that we can be proud of.

Vol.III No.I 9

H

i, I’m Dan and I am your RUMS Vice President for Events. RUMS events  have been some of the most memorable parts of my time at UCL so far and I’m excited to  put on some fantastic events for you this year, whilst  continuing to make them as affordable as possible! I am committed to maintaining and  building on the high standard of the existing RUMS events and working with the rest of the committee to improve RUMS as a whole. Although the planning and execution of the RUMS Freshers’ Fortnight is without doubt the busiest and most time-consuming part of my role, it is also the most enjoyable. At the start of this term, I am looking forward to showing the freshers what RUMS is all about and see what they will bring to the RUMS family. My role gives me the exciting privilege of getting to know people from all stages of medical training. I can’t wait to meet, talk to and (most importantly) share the dance-floor with you all!

RUMS

H

ello! My name is Aayushi and I’m currently in my fifth year at UCL. Over the next year, I’m going to be your RUMS Vice President for Academic Representation Years 4-6.

RUMS Vice president for Events Dan Ntuiabane

RUMS vice president for academic representation years 4-6 Aayushi GuptA

Editorials


H

RUMS vice president for academic representation (years 1-3) Anush Shashidhara

RUMS vice president for Welfare Iram Hasan

Reports.

Editorials

H

ey, my name is Anush and I’m taking over as RUMS Vice President for Academic Representation (Years 1-3) this year.

Medicine at UCL has traditionally been one of the highest scoring courses when it comes to engagement with academic representation, and I hope to continue the trend this year! I have a few key target areas on which I’d like to focus.

ello, I’m Iram and I’m your RUMS Vice President for Welfare this year! Through this role, I really hope to continue increasing students’ awareness and access to the variety of student support services available within RUMS.

Firstly, last year’s second years faced the first ever summative OCAPE (Objective Practical and Clinical Examination), an exam that was met with severe backlash – I hope to ensure the faculty makes sufficient changes to warrant a better experience for this year’s cohort.

My role will include collating information and contact details about these services, and distributing them across the year groups through posters, leaflets, talks and via Moodle. I aim to have more Welfare events in second and third term so that students feel supported throughout the year. I also hope to continue collaborations with Medics4Medics, and would also like to work with the medical school in continuing to improve the personal tutor system and explore new ways that our own mental health and well-being can be incorporated into the curriculum.

Secondly, the student representatives within the medical school have always done a great job, but the rest of the cohort often don’t get to hear about what was discussed until a good while after meetings have taken place. To increase transparency, I’m launching an online roadmap of everything Year 1-3 representatives are currently working on, so that students are aware that their concerns are being addressed on a regular basis.

With the help of my fabulous sub-committee, I hope to make some long lasting and meaningful changes. Welfare is such an important and integral part of our time at medical school, so I would also love to hear from you about how we can make welfare great again!

I look forward to working with many of you over the course of the upcoming year so that we can ensure that students’ requirements are met and the quality of teaching continues to improve.

10

Vol.III No.I


News

Written by Anamika Kunnumpurath and Emma Lewin

Mental Health Awareness Week

The week beginning the 8th May was the official Mental Health Awareness Week and UCL Medical School was particularly involved by hosting its own events. The theme this year was “surviving or thriving”. On the Wednesday, the afternoon began with a Fayre in the cloisters, which had contributions and demonstrations from therapy pets, Headucate UCL, Sexpression and student support, as well as smoothie-making with Planet Organic, and many more activities. In the evening, Dr Sarah-Jane Smith, a ST6 registrar in respiratory medicine, gave a talk on her personal experiences with mental health issues and practices she uses to survive and thrive. Both these events were open to all students and staff. They were a great method of raising awareness and helping the student population, if not only to relieve stress during the exam period.

Vol.III No.I 11

Harriet Hall, the winner of the UK Balint Society Essay, with the two leaders of her Balint group: Dr Oliver Samuel (left) and Dr Peter Shoenberg (right)

News UCL Final Year Wins Gold Medal

The prestigious University of London Gold Medal for 2017 has been awarded to Melanie Jensen. The UoL Gold Medal Viva competition is held annually and sees the top final year students at London medical schools have their medical knowledge tested by a panel of examiners. Melanie was nominated by the UCL medical school to enter the competition due to her exceptional academic performance. The Viva involves being interviewed on six key areas- pathology, medicine, surgery, clinical pharmacology and therapeutics, paediatrics and obstetrics and gynaecology- and is very difficult to prepare for. It is an immense achievement to come out on top, and we would like to congratulate Melanie for her triumph as London’s “best medical student”. We hope that UCL can build on this success next year!

Clinical Skills Team win Excellence Award

UCL Medical School’s very own Clinical Skills Team were the proud recipients of the Excellence in Medical Education Award (EMEA) at this year’s UCLMS MBBS degree ceremony. The EMEA was set up by the Medical School as a platform for the recognition of outstanding contributions to undergraduate medical education. The annual award is open to academic, clinical and administrative staff who are involved in the education of students at any stage of their degree. The application process is rigorous and final decisions of the judges were announced in May. Other team winners were the Clinical Pharmacology Registrars and Fellows and Leadership of Person-Centred Education Initiatives. Individual winners were Professor Anisur Rahman (Professor of Rheumatology, UCL and Consultant Rheumatologist, UCLH) and Dr Christopher Turner (Consultant Neurologist, National Hospital for Neurology and Neurosurgery).

UK Balint Society Essay Prize Winner

Fifth year medical student Harriet Hall won this year’s UK Balint Society Essay prize for her essay based on her personal experience interacting with a patient. Harriet took part in the UCL Student Balint Scheme run by Camden and Islington NHS Foundation Trust’s Psychodynamic Psychotherapy Service, which provides students with a platform to speak about their emotional reactions to the challenging environment of clinical medicine. The Balint group gave Harriet an opportunity to engage in weekly discussions with her peers about clinical encounters with patients and explore the student-patient relationship. Harriet will be awarded her prize at the International Balint Federation Congress in Oxford this year and her prize-winning essay will be published in the Journal of the Balint Society. Jonathan Illiff, also a fifth year medical student at UCL, was a runner up for the essay prize.


News

Medical Student Publishes Article On Approaching Supervisors

Year 5 Medical Student Awarded £10,000 for research project

UCLMS student Dina Radenkovic was awarded the Josephine Lansdell grant, the BMA Foundation for Medical Research Award of £10, 000. This grant will go towards the funding of a research project in Cardiology. In her project, Dina will examine dark blood late gadolinium enhancement as a novel cardiac imaging biomarker for early identification and risk stratification of patients with lamin dilated cardiomyopathy. Under the supervision of Professor James C Moon (Professor of Cardiology at UCL and Head of Cardiovascular Imaging at Barts) and Dr Gabriella Captur (Senior Lecturer in Cardiology), Dina hopes to use her research to aid the development of timely defibrillator placement. Speaking to RUMS Review, Dina offered words of advice to students seeking research grants: “I would like to encourage other medical students who need funding to get involved and apply – we are allowed to be on the grant if we have a senior supervisor i.e. the grant holder”. Dina will be attending the prize giving ceremony in December later this year.

Dina Radenkovic reviews T1 mapping -- a technique in cardiac magnetic resonance -- which can detect both intracellular and diffuse myocardial change: these images show abnormal myocardium tissue in acute myocarditis. Her project will test a new way to darken blood (which appears bright on imaging and can obscure fibrosis) to enable detection of early changes and guide potential intervention.

MBPhD student Daniyal Jafree has published a peer-reviewed article titled “How to approach supervisors for research opportunities” in the Annals of Medicine and Surgery. Co-authored with Katharine Whitehurst and Shivanchan Rajmohan, the article guides the reader through how to formulate the pivotal first email to supervisors, provides advice on subsequent meetings and discusses the all-important question of how to choose your supervisor. Daniyal wrote this article based on his own experience as a medical student looking to get involved in research and the difficulties he faced during the process. He told RUMS Review, “I had a crack emailing and contacting supervisors and failed several times, learning through the process. I noticed when I came out of it all that no one around me felt comfortable with contacting people out of the blue. So I wrote this article to help them. It has been way more successful than I had hoped – it’s been downloaded over 9,900 times on ScienceDirect. I am hoping it is getting the right message across!!”. To download the article, visit www.annalsjournal. com/article/S2049-0801(16)00025-X/abstract. If you would like to get in touch with Daniyal with any questions you can email him at daniyal. jafree.13@ucl.ac.uk.

Women’s Health iBSc 2017

iBSc Students Graduate

At the end of their last long summer, a new cohort of Integrated BSc (iBSc) students graduated on 31st August 2017. After a day of lectures in the Cruciform, the current year 4 students made their way to Senate House to collect their robes and have pictures taken before the ceremony. At this year’s graduation, the students were joined by the first cohort of graduating Applied Medical Sciences students, as well as two new iBSc groups from the Cardiovascular Sciences and Women’s Health courses. From Senate House, the students made their way to Russell Square Gardens. Fortunately, the weather was on their side, which made for a perfect photo opportunity amongst the greenery. The Ceremony lasted approximately an hour, including a musical performance from Majestic Brass and an inspiring opening address from the Vice-Provost for Health, Professor David Lomas. The room was buzzing and filled with pride as each student walked the red carpet to cheers from their year group. The Faculty Medal went to Martin Tan, who obtained his iBSc in medical physics. Not only did Martin outperform his iBSc counterparts in his final exams, but he also performed better than students on the 3 year medical physics BSc course. He received huge applause when his achievements were announced, with everyone in attendance immensely impressed. A thoroughly well-deserved prize! After the ceremony, a reception was held with drinks and canapes, where friends were introduced to parents and parents got to know each other. Comments heard frequently among students included sentiments expressing that they “enjoyed the ceremony much more than expected”, and that it was “nice to have the whole year group back together after spending the last year in smaller course groups”. The students ended the night with feelings of excitement for the years to come, whether continuing at the medical school or elsewhere. Overall, it was a delightful celebration of those who had made it through the first three years of medical school to obtain their iBSc, in addition to the growth and accomplishments achieved during the iBSc year. We wish all graduating students a hearty congratulations, and the best of luck for the future! 12

Vol.III No.I


News

StreetDoctors:

How UCL Students are Helping to Tackle Youth Violence Since we do not often encounter it as students, we are perhaps less aware of the prominence and severity of youth violence than we were as teens. But it still exists. In fact, every year the incidence of youth violence is rising, particularly that involving knife crime. In Europe, street violence is the third leading cause of death in young people and costs the NHS an estimated £2.9bn each year. StreetDoctors, a UK charity which teaches life-saving first aid skills to young people at a high risk of witnessing street violence, aims to change young people’s attitudes towards violence as well as giving them the skills to save lives. The North London Team at UCL is one of 18 from around the UK. With 25 current active volunteers in the team, and hopes to double this number for the 2017/18 session, they use first aid to empower and educate young people. Aiming to fulfil two main goals: save the lives of victims of street violence and discourage young people from becoming the perpetrators. Throughout the year they have taught high risk groups, including Youth Offending Teams, prisons and schools, with sessions addressing issues such as what to do when someone is bleeding or unconscious. With around two sessions taking place every week in the North London Branch, and volunteers free to sign up to as many as they wish, StreetDoctors has achieved a huge amount this year! In fact, 95% of young people agreed that the sessions had helped them

to understand the consequences of violence. Two fourth year medics, Ally Mansfield and Liam Collins-Jones, have been particularly involved through their respective roles as Head of Recruitment and Fundraising, and Team Leader. Having volunteered with StreetDoctors for at least two years each, we asked them what makes StreetDoctors so special to have kept them committed for so long, despite a challenging degree course. “There are very few ways you can feel that you’ve changed the lives of young people in less than an hour; the sessions are so interactive that you really can see the impact you’re making. One of the key skills of a Doctor is being able to communicate with people from a wide range of backgrounds, and StreetDoctors is the perfect opportunity to learn and practice that skill. It is also so flexible that you can fit volunteering entirely around your schedule rather than having a weekly commitment. It’s such an amazing cause - street violence is such a huge problem and needs to be tackled!”Ally Mansfield “It’s apparent that many people we teach don’t realise the dangers associated with knife crime. By the end [of the session] we’re getting asked all sorts of interesting questions: about science,

about how to adapt what they’ve learnt to different medical emergencies. These young people may have never had the chance before to ask such in-depth questions! After the session, perhaps the people we teach will think twice about carrying a knife. We give young people a chance that has eluded them and that they thoroughly deserve – and that’s why I’m immensely proud to volunteer with StreetDoctors.” - Liam Collins-Jones, in his StreetDoctors blog post Certainly a rewarding and worthwhile volunteering opportunity, we would like to congratulate StreetDoctors on all the work they have done this year and wish them the very best for the year ahead. For more information you can visit their website (streetdoctors.org) or watch the new promo video featuring the UCL team (youtube.com/ watch?v=ryj_UOCT9h0). Keep your eyes peeled for news of auditions in our announcements section!


News

Announcements The RFA Annual Clinical Meeting and AGM

The Royal Free Association’s annual clinical meeting and AGM are being held in the William Wells Atrium at the Royal Free Hospital on Thursday 16th November 2017. All students are very welcome to attend the three afternoon presentations commencing at 14:15, which are as follows: 1. Improving Women’s Health by Professor Lesley Regan, President of the RCOG. 2. Hypnosis in Medical Practice by Dr Sarah Booth, Clinical Director for Palliative Care, Addenbrooke’s Hospital Cambridge. 3. Do we need autopsies? by Professor Guy Rutty, Chief Forensic Pathologist, East Midlands Forensic Pathology Unit. All speakers are Royal Free Graduates.

PsychIARTY conference

Following a very successful inaugural conference, psychART- the psychiatric recruitment conference which celebrates creativity, the Arts and Psychiatry- will be back on the 3rd November 2017. Supported by the Royal College of Psychiatrists, the conference provides an opportunity for attendees to learn first hand about, and take part in, the exciting links at work between the worlds of Mental Health and the Arts. It will be held at the Ortus Learning & Events Centre, on the historical  Maudsley Hospital site in London. The conference is open to everyone, particularly if you are considering Psychiatry as a career, you enjoy the Arts or you are interested in how health services can work with charities,

artists and specialist health professionals to promote recovery.

If you are interested, please purchase tickets via our website at: www.psychart.co.uk There are bursaries available for a limited number of students, please apply soon before the deadline on 1st October! There is also a competition where you can submit your work to be presented at the conference- again deadlines are looming so get your submissions in. If you have any questions, queries, comments at this time please email us at info@psychart.co.uk

Library opening hours Following a successful bid to further extend library services, from the 2017-2018 academic year, the Cruciform Hub will be open 24/7 without any breaks for two weekends in July. This is in addition to the 10 weeks when the Hub is already open with no breaks in the run up to the June exams. The two additional weekends will be 14-15/07/2018 and 21-22/07/2018. This is in support of the revision needs of MBBS Year 4 and 5 students – you said, we did! From 2018 onwards, the Cruciform Hub will also be open for reference only 11.00-21.00 on the August Bank Holiday.

Cruciform Hub Café Exciting news for Cruciform Hub users: a new café is due to open in the Cruciform Hub! The café will sell cold food and drinks, including fair-trade and healthy options, and will be staffed Monday to Friday during daytime hours. We hope that the café will help to make the Hub an even more lively social space at the heart of the Medical School. We are currently choosing the café name, so please email any suggestions to crucilibservices@ucl.ac.uk - a jury made of Cruciform Hub staff members and contractors will choose the winner!

StreetDoctors are Recruiting!

StreetDoctors is a UK charity which teaches life-saving first aid skills to young people at a high risk of witnessing street violence, giving them the skills and confidence to save lives. We are on the hunt for a new batch of first aid teaching volunteers to join our North London team! On Monday 9th October we will be holding an information evening where you can find out more about becoming a StreetDoctors volunteer.

ELIGIBILITY/ AUDITIONS To apply, you must be a medical student and be available to attend our training conference on 28th-29th October 2017. We ask that you attend an informal audition where you speak for any topic of your choice for 2 minutes. Audition slots will be held on the afternoon of Wednesday 11th October and the evening of Friday 13th October. To sign up, fill out this short form: bit.ly/2xUyxFd CONTACT: To keep up to date with timings and locations, follow our Facebook page @StreetDoctorsNorthLondon. If you have any questions, you can message our Facebook page or email us at northlondon@streetdoctors.org

Winner Room

The Winner Room in the Cruciform Hub has been completely revamped. It now features 39 additional pop-up computers, A/V equipment and desks suitable for group study. The room may be booked for student group work for up to two hours per day – please see www.ucl.ac.uk/library/ sites/cruciform for more details.

14

Vol.III No.I


Out of Hours

Out of Hours

Dr Joanna Porter is a Consultant in Respiratory and General Medicine at UCLH and a HEFCE Senior Lecturer in the Department of Medicine at UCL. Cambridge, Oxford, St. George’s, St. Thomas’ and a refugee camp in Rwanda have all featured in Dr Porter’s extensive career – yet an interest in respiratory has always been at the core of her work. In 1995, this led Dr Porter to UCL for her PhD in T-cell immunology, and she’s remained part of UCL ever since to become a well-recognised and well-loved face for UCLMS clinical students! Find out more about Dr Porter’s medical journey as we get to know her Out of Hours.

Written by Beth Gillies

Vol.III No.I 15


Out of Hours

Dr Joanna Porter What has been the highlight of your career?

What first sparked your interest in science and medicine? I grew up in a family of scientists and artists. My father was a nuclear physicist and both my older brothers did science subjects. Our house was full of books on science and electronics and I read voraciously. Aged 5, I announced that I wanted to be a doctor. My parents latched on to this and really encouraged me; having ignored the ballet dancer, artist, martyr and train driver I had previously voiced a desire to become.

What did you study and where? I studied Medicine at Cambridge, with my clinical years at Oxford, before moving to London for what were then SHO and registrar rotations. My PhD with Nancy Hogg and Peter Beverley on T-cell immunology brought me to UCL in 1995, and I never left.

What’s the best thing about working as part of UCL and in London? UCL is a top academic university with a fabulous history and perfect location. If you need an expert in any field, you will find one at UCL. I love the mix of science and arts students, and the eclectic range of subjects. What a delight to stumble across inspiring works by Slade alumnae in the most prosaic of university buildings!

What are the best and worst things about teaching medical students?

As the doctor in charge of a camp of 100,000 refugees in Cyanika, Rwanda, in 1994, I desperately needed a hospital and latrines. I went to talk to the head of the 23 Parachute Field Ambulance who controlled the area. He ordered his men to build me whatever I needed. They started immediately and were finished in 24 hours. No bureaucracy, no business case: just a vision that became a reality. The thank you letter I sent to Field Marshall Sir Peter Inge was published in The Soldier!

Which one person has most changed the way you think about medicine and science? As a student, I was heavily influenced by Sir William Osler and would recommend you all to read Aequinimitas. More recently Jonathan Friedland, now my husband, whose incredible energy, enthusiasm and ability to get to the bottom of a challenging case so inspired me as a junior doctor. He taught me not to confuse the life of the ant hill with the world at large.e.

What are your greatest ambitions for the future? To discover something truly unexpected which then seems self-evident.

Describe yourself in five words Committed, confident, optimistic, honest and, easy-going.

What is your favourite way to relax after a long day at work? Theatre, homework or reading -– usually with a glass of wine!

What are your guilty pleasures? House of Cards, murder mysteries, day dreaming…and wine!

What one piece of advice would you give to your students? Aim for a career in which you cultivate dignity, authority, compassion and integrity – your choice of specialty is not nearly as important as it might appear.

The best: their youthful enthusiasm and potential that challenges you to keep one step ahead. The worst: when you don’t keep one step ahead and find yourself saying something that makes a whole group double up uncontrollably with laughter, but have no idea what they found so funny! 16

Vol.III No.I


Whether you’ve forgotten your anatomy and physiology from first year or you want to be well prepared for clinics, this book has you covered from start to finish.

Vol.III No.I 17

ra Vulpe

Another seminal Eureka title, this book is vital for fourth year UCL medics studying Module B. Guiding you through the gastrointestinal system, it provides the perfect amount of both medical and surgical detail. There are enough diagrams, tables and pictures to make this textbook suitable for those easily bored by large tomes, as well as plenty of detail to satisfy even the keenest of students. The information is clear and concise without being brief, and covers the entire range of conditions and procedures required by the UCL exam board. The only drawback is that it’s slightly larger and less portable than the handbook series.

Written by Katie Hodgkinson and Eleono

Eureka Gastrointestinal Medicine by Jeff Turner, John Green and Rachel Shakespeare

Book Reviews

Book Reviews


Book Reviews

This is Going to Hurt by Adam Kay Adam Kay is a junior doctor’s memoir, chronicling Kay’s times on the wards, from house officer to senior registrar. Written in the form of short diary entries, the book has received excellent reviews from famous names such as Stephen Fry as well as members of the medical community including Professor Clare Gerada (previous chair of Royal College of GPs). This book is presented with high expectations which do not disappoint.

Pocket Tutor ECG Interpretation by Simon James and Katharine Nelson

By the time you do cardiology in Module A of fourth year, you’ll be sick to death of hearing about ECGs and wondering what on earth all the squiggly lines mean. This book is the lifesaver you need: it is pocket sized for easy reference on the wards, organised from easy to difficult, and explains each change and pathology as it goes along. The book itself appears too small and innocuous to be of any use, but the insides are packed with information to give you enough understanding to rival your registrar (or not).

Among a swathe of similar memoirs, this one is significant in that Kay deviates from the pre-set path for a junior doctor, leaving the system to become a TV presenter and writer. This results in a retrospective cynicism that is both refreshing and, ultimately, heart-breaking. Kay writes without frills – he is unapologetic in his ridiculous patient anecdotes which, working as an obstetrician and gynaecologist, there are plenty of. Equally, there are frank accounts of his personal life. He writes of the tolls that a medical career has on his relationships, friendships and personal hygiene – but also on how much simple acts of kindness (gratitude from a patient; a Diet Coke from a colleague) left him feeling cheerful even after hectic twelve-hour shifts. Nonetheless, the title serves as a good warning for the fact that this book is as harrowing as it is hilarious, putting the abstract idea of hospital horrors into a realistic perspective. When you’re passionate about becoming a doctor, it can sometimes be easy to brush off warnings about the emotional effects of the job as something to deal with in the future, but this memoir brings them to the forefront. An excellently balanced mix of the highs and lows of medicine – this is going to hurt, but it’s worth it.

The writing style can be quite dense, with the explanations almost a little too thorough to be of any use if you haven’t already studied the book over time, but the diagrams and quick reference points are enough to make this a great reference tool. In fact, the diagrams are so clear and well labelled, they almost make the text redundant. In a small and handy format, this is better than any of the larger textbooks – you can even carry it with you to check during the inevitable waiting around on the wards! 18

Vol.III No.I


Alumnus Interview

“I think one of my failings in life is that I rarely ever say no” RR: You have had an incredibly varied career. What did you do after medical school and what have been the highlights?

Alumnus Interview Prof Michael Farthing After graduating from UCL Medical School in 1972, Michael Farthing has gone on to have a diverse and widespread career. Choosing gastroenterology as his passion, he proceeded to hold leadership positions at several medical schools including St Bart’s and the London, Glasgow, Hull and York, and Brighton and Sussex. He has also pursued an influential academic career spanning numerous countries, from India to Costa Rica, with a particular focus on tackling health problems in developing countries. Dr. Farthing’s dedication to his specialty has led him to win many notable awards over a 40-year career. Now he returns to UCL as an Honorary Professor, with the aim of strengthening alumni relations and helping to establish the Student Support Fund, which aims to provide financial support for medical students throughout their university career.

Vol.III No.I 19

MF: I have to admit: there was no plan. I have always been someone who has seen opportunities and tried to grasp them. When I was at medical school doing my final examinations, I had a bit of a wobble and wondered whether I wanted to practice clinical medicine, then went off to try to get a job as a science researcher on one of the TV programs. I was very interested in the performing arts and I did drama at medical school. Eventually, I got myself together and did my training jobs – but absolutely no plan. I think the inspirational points all revolved around people. Particular individuals and clinical consultants who inspired and encouraged me to move towards the discipline I ended up in: medicine and then gastroenterology. I was inspired by some researchers I came across and I think this moved me towards a research career. Following this, I became very interested in developing world medicine. As a student I went to India in the middle of the course (after I had just finished my intercalated degree) for four months, and that really changed my view of the world .

RR: What interested and motivated you to shape medical education? MF: Somebody offered me an opportunity! I rarely say no. If somebody asks me to do something, my default position is to say yes. By and large it has been a good approach to life. At the time, Barts & the London Hospital Medical Schools were merging with Queen Mary’s, and the principal of Queen Mary’s asked me to take on the role of Dean of the Faculty of Clinical Medicine. I never considered taking on a job of that size but I said yes – and I really enjoyed it! It was the first time I realised how exciting it was to work on a bigger scale. To take that on, on an institutional scale, was a wonderful opportunity.

RR: Gastroenterology has been your specialty and passion – why were you drawn to it? MF: Again, it comes back to people. I was a student on the gastroenterology firm here in the Cruciform with an absolutely inspirational leader – a very effective researcher and also a wonderful physician. I was particularly interested that there was quite a young group of patients with inflammatory bowel disease; it wasn’t just people of my age or older. We also had quite a


Alumnus Interview

RR: Would you say that academia has been a particular highlight for you? MF: It has been fantastic for me. It has allowed me to balance my very serious interest in clinical medicine against the creative rewards of research and new knowledge. I think the academic life gave me huge international experience; I worked in South India, Zambia, South Africa and Central America. It gave me the opportunity to work with colleagues from very different environments and to work on problems that you don’t find here.

RR: You are involved with the Student Support Fund here at UCL Medical School. Why do you think it is important? MF: I was a first generation scholar, being the first person in my family to undertake a formal university course. Both of my parents were bright and able people but didn’t have those opportunities. I believe very strongly that there is a huge proportion of people out there who do not have all of the benefits and don’t always go to the greatest schools. When I was at Brighton and Sussex, over 40% of our undergraduate intake were first generation scholars. What struck me was that the new fee

system was not what was putting them off. They were concerned about just surviving those dayto-day living expenses at university. My feeling is that it is very important to do whatever we can to make life easier for those who are struggling financially, particularly for students who do not have parental support. I think the reason some students think seriously about whether they can get through to the end of the course is not that they are worrying about fees, but worrying about how to survive. For me that would be an absolute tragedy – to get most of the way through the course and be so anxious about survival that you cannot continue. The last thing I would want to see is students who have worked extraordinarily hard to get into medical school, have performed well, but then have major disincentives to complete the course because their own personal position is too perilous.

RR: You have been involved in shaping the curricula of many medical schools. What do you think is the future for medical education? MF: I’ve seen some of the most academically distinguished medical schools, who have stuck to the conventional curriculum with pre-clinical teaching early on followed by a more clinical approach later. I have seen other medical schools who have turned to 100% problem based learning (PBL). I’ve also seen some hybrids where PBL has become part of, but not the whole, of the learning technique.

Interview and text by Naomi Joshua

lot of young women, mainly with anorexia, who presented with the clinical picture of undernutrition. I enjoyed working with those patients.

Learning to think of the patient as the centre and their problems as the core of your work is a very good thing to do. However, I think PBL is best done when you already know something, otherwise I think you can get quite disheartened. Ultimately, as a clinician, you have to be able to sit with a patient and unpick their problems and put together a plan for them. My personal view is that I am not really an extremist on anything – I tend to like the blended approach.

20

Vol.III No.I


Research

Cognitive Behavioural Therapy and Mental Disorders Vol.III No.I

21


Research

A look into the past, present and future of cognitive therapy, and our current understanding into it’s mechanisms.

A

t some point in your life, you’ve probably been told that the world doesn’t revolve around you. A sentiment aimed to detract from an egotistic nature, yet to some extent quite untrue. Our experience of the world around us is very much our own: only we can see through our own two eyes, only we can perceive our own sense of touch and only we can feel what we feel. The mind is frustratingly exquisite in this regard; its exclusivity defines our very existence, yet it is the reason why mental health disorders are so challenging to diagnose and treat. It makes us wonder: how does one treat an ailment of the mind? A difficult question no doubt, but perhaps it should not be considered as difficult as one would imagine. When defining disability, we refer to a disadvantage or inability of an individual which prevents them from fulfilling a role. People who may have similar impairments do not necessarily experience the same disability. For example, if two people suffered from hearing loss but one was given hearing aids and a hearing loop, the impact of their impairment would be less in comparison with the other individual. Accordingly, one should approach disorders of the mind in a similar fashion to the body, targeting real world problems individuals may have and focusing on personal coping strategies to tackle them.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a blanket term describing all cognitive-based psychotherapies. Although they slightly differ in their methods and foci, they all aim to develop coping mechanisms and challenge one’s way of thinking through communication, either with a therapist, a group of people, or through electronic means. CBT was founded upon the idea that cognitive distortions and inappropriate behaviour both develop and maintain psychological disorders and

Words by Andrien Rajakumar, Research Editor

symptoms. CBT techniques therefore explore and change cognitive errors such as overgeneralising, focusing on negative emotions and diminishing positive thoughts which cause continual emotional distress and self-defeating behaviour. To a lesser degree, we all do this; we may turn to friends and family, reflecting on or seeking consult on certain situations, our emotions and how we respond to said scenarios. The roots of modern CBT can be dated from the early 20th century, with the creation of behaviour therapy, the subsequent development of cognitive therapy in the 1960s and their later integration. Behavioural therapy was greatly influenced by classic and operant conditioning paradigms developed from the work of Pavlov and Skinner respectively. These principles define learning as the process of recognising the relationship between a conditional and unconditional stimulus, which is subject to reinforcement and punishment. It was thought that adverse reactions as a result of

22

Vol.III No.I


Research

“much of what shapes your personality are the experiences which you encounter in life”

psychological problems develop much like other forms of learning. To a certain extent, such a statement does ring true; much of what shapes your personality are the experiences which you encounter in life. Yet, one may consider the behavioural account to be somewhat ‘passive’ in its approach to mental health disorders. Surely, it could also be considered that the inverse is true: our mind-set influences the experiences we face and how we respond to them. Cognitive therapy is based on such an idea, where one’s emotions, cognition and behaviour are interlinked elements which can actively be changed to affect outcomes. Despite behavioural therapy’s early success with the treatment of several neurotic disorders, its lack of effect in the treatment of depression paved the way for the creation of CBT. Currently, CBT is recommended by NICE in the United Kingdom and is utilised to treat several psychiatric disorders: major depressive disorder, eating disorders, anxiety disorders, bipolar disorder, schizophrenia and post-traumatic stress disorder to name a few.1 In several of these disorders, it has demonstrated to be just as effective as psychotropic medications in numerous studies.2 For example, a 2004 review conducted by Institut national de la santé et de la recherche médicale (INSERM- the French National Institute of Health and Medical Research) summarised CBT to be a proven means which relieved the symptoms of post-traumatic stress disorder (PTSD) even more effectively than drug treatment. Similarly, comparisons drawn in this review between meta-analyses studying CBT’s effect in obsessive compulsive disorder (OCD) conveyed similar, if not better efficacy, compared to antidepressants.3 However, it should be noted that the efficacy of CBT can be greatly limited depending on the training given to practitioners and patient dropout rates.4 Nevertheless, there is ample evidence in the literature to suggest that CBT does work. The question we should be asking next is: how?

striatum amygdala thalamus hippocampus prefrontal cortex orbitofrontal cortex sensory-motor cortex anterior cingulate cortex A diagram summarising the neural correlates of anxiety and related disorders including post-traumatic stress disorder (PTSD); panic disorder; generalised anxiety disorder; social anxiety disorder; obsessive-compulsive disorder (OCD)

Vol.III No.I

23


Research

Neural Correlates of CBT In the 17th century, a French philosopher, René Descartes, derived the concept of dualism: an idea which suggested that the mind and body were separate entities. He suggested that the mind was the seat of consciousness acting as our sense of being and was non-material. Contrastingly, he argued that the body was tangible and made a clear distinction between the brain and the mind, positing the idea of the brain as an area of intelligence, rather than one’s sense of self. Nevertheless, he suggested that there was constant interplay between both entities which could affect their activities. Such an example would be the findings of the World Health Organisation, who observed that the main presenting problems given by sufferers of the depression in the developing world were actually physical symptoms such as: temporary blindness, fatigue and digestive problems.5 The opposite also remains true; damage of limbic brain areas involved in emotive processing also affect the mind. A rather famous example of this was Phineas Gage, a man who suffered a lesion to his ventromedial prefrontal cortex, after which he started to display peculiar social behaviour and judgement. Similarly, others who suffered analogous lesions were known to suffer from ‘acquired sociopathy’, conveying their personality changes and decision-making abilities.

important to understand that in many cases, the presentation of symptoms is not necessarily homogenous. At the time, the meta-analysis could not detect significant activity change in limbic areas like the amygdala, an area normally hyper-activated in depression and anxiety. These findings could be explained perhaps with regards to how emotional stimuli were presented as distractors in a cognitive task rather than passive exposure, which could be less effective in inducing amygdala activation.8,9 However, with this field ever growing, several recent studies looking at major depressive disorder, PTSD and generalised social anxiety disorder have demonstrated CBT to increase amygdala connectivity and thus likely contribute to improvements in their emotional processing.10,11 In truth, the field of neuroimaging in psychotherapy remains a young one, but it does yield some promise in answering how transforming our mind can affect our brain. Albert Einstein once suggested that ‘We cannot solve our problems with the same thinking we used when we created them’. Never more does this ring true than in the purpose of CBT, a form of therapy which immerses itself within the world revolving around a single individual. If you are in need of any kind of support, including challenges to your mental wellbeing, please make sure to visit the UCL support and Wellbeing webpage. You’ll be directed to numerous services both within and external to UCL which can help you with any difficulties or issues you may face during your time at UCL.

PTSD An axial brain activation map demonstrating regional activation most altered by CBT in both obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

References 1.

2.

With that in mind (pun somewhat intended), we should look to see whether CBT actually affects brain areas involved in emotive processing. A systematic review conducted to evaluate the effects of CBT on anxiety and related disorders found that the neural outcomes for different disorders presented both ‘broad similarities’ but also ‘discrete differences’.6 They found that in studies of PTSD participants, CBT was associated with greater left dorsal striatal and frontal network activation during inhibitory control. These findings likely indicate that improvements to these inhibitory networks contribute to better treatment response. Interestingly, improvements in cognitive appraisal and emotional intelligence seen in OCD patients corresponded with prefrontal and occipito-temporal activation and alterations in limbic brain circuits. Another meta-analysis in 2013 looking into CBT in patients suffering from anxiety or depression, however, suggested that the findings for CBT’s effect on brain circuitry is slightly more complicated.7 They could not demonstrate involvement of the dorsolateral prefrontal cortex in neuroimaging studies after CBT. This is particularly strange given its specific association with executive attention, working memory and with emotion regulation. This could be because of an insufficient number of studies, or perhaps even a lack of consistency in methods or of findings of prefrontal cortex involvement. It is

OCD

3. 4.

5. 6. 7. 8.

9.

10.

11.

“Cognitive behavioural therapy for the management of common mental health problems” (PDF). National Institute for Health and Clinical Excellence. April 2008. Retrieved 2013-11-04. Hollon SD, Beck AT (2013). “Chapter 11 Cognitive and Cognitive-Behavioral Therapies”. In MJ Lambert. Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change  (6th ed.). Hoboken, NJ: John Wiley & Sons. pp. 393–394 INSERM Collective Expertise Centre (2000). “Psychotherapy: Three approaches evaluated”. Johnsen, TJ; Friborg, O (July 2015). “The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis.”. Psychological Bulletin. 141 (4): 747–68. Patel V, Abas M, Broadhead J (2001). “Depression in developing countries: Lessons from Zimbabwe”. BMJ. 322 (7284): 482–84. doi:10.1136/bmj.322.7284.482. A systematic review of the neural bases of psychotherapy for anxiety and related disorders- Samantha J.Brooks, Dan J.Stein (Sept 2015) Irene Messina, Marco Sambin, Arianna Palmieri, Roberto Viviani ‘Neural Correlatesof Psychotherapy in Anxiety and Depression: A Meta Analysis’ (2013) 8(9): e74657 Costafreda SG, Brammer MJ, David AS, Fu CH (2008) Predictors of amygdala activation during the processing of emotional stimuli: A meta-analysis of 385 PET and fMRI studies. Brain Res Rev 58: 57–70 [PubMed] Groenewold NA, Opmeer EM, de Jonge P, Aleman A, Costafreda SG (2013) Emotional valence modulates brain functional abnormalities in depression: Evidence from a meta-analysis of fMRI studies. Neurosci Biobehav Rev 37: 152–163 Haochang Shou,a Zhen Yang,b Theodore D. Satterthwaite,b Philip A Cook,c Steven E. Bruce,d Russell T. Shinohara,a Benjamin Rosenberg,b and Yvette I. Shelineb,c,⁎ Cognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD Neuroimage Clin. 2017; 14: 464–470 Yuan M1, Zhu H1,2, Qiu C1, Meng Y1,2, Zhang Y1, Shang J1, Nie X1, Ren Z1, Gong Q3, Zhang W4,5, Lui S6,7. Group cognitive behavioral therapy modulates the resting-state functional connectivity of amygdala-related network in patients with generalized social anxiety disorder. BMC Psychiatry. 2016 Jun 13;16:198. doi: 10.1186/s12888-0160904-8.

OCD PTSD A coronal brain activation map demonstrating regional activation most altered by CBT in both obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

24

Vol.III No.I


Research

Research Round-Up:

UCL Division of Psychiatry Words by Eng O-Charoenrat, Research Editor

Vol.III No.I

25

UCL is one of the leading institutions in the United Kingdom for research into mental health, with four main research departments: Mental Health of Older People, Mental Health Neuroscience, the Marie Curie Palliative Care Department, and the Epidemiology and Applied Clinical Research Department. UCL also hosts many events and speakers prominent in the field of mental health research, details of which can be found at www.ucl.ac.uk/psychiatry/ layout-components/lower-columns/psychiatry-events-viewer. The projects run by UCL range from biomarker and gene analysis of common mental illnesses to developing effective care assessment tools, a few of which are described below.

Epidemiology and Applied Clinical Research Department

PsyLife: Socioeconomic Environments and Risks in Later Life Using many different epidemiological study designs, PsyLife looks at the social and economic determinants of health and their role in increasing the risk of psychiatric disorders. Specific risk factors that are currently under investigation include the role of social isolation, ethnicity, or discrimination in developing mental illnesses later in life. Current research has looked at the impact of refugee migration on the development of schizophrenia and other non-affective psychoses. In a population cohort of 1,347,790 people living in Sweden, 24,123 refugees and 132,663 non-refugee migrants were identified and compared to their Swedish-born counterparts. It was found that refugees had a significantly higher risk of developing psychosis compared to both non-refugee migrants as well as Swedish-born cases. As the global refugee crisis continues, health care planners should be aware of the increased care and attention these at-risk groups require.


Research

Marie Curie Palliative Care Department

Mental Health Neuroscience Department

Mental Health of Older People Department

Improving Palliative Care: The Compassion Programme Manual

Biomarkers for Psychosis and their Genetic Importance

The Impact of Dementia on Women

Established in 1999, the Marie Curie Palliative Care Research Department is aimed at assessing the current state of palliative care and end-of-life care planning, as well as assessing psychological needs and issues of sexuality and spirituality. One of the more recent programmes developed by the department is the Compassion Intervention Programme. A manual for this programme has been released and details how to support an integrated and holistic approach to end-of-life care and planning for patients, including those with dementia. It describes the need for an interdisciplinary care leader to act as a liaison between health and social care professionals and the family and carers, as well as recommendations for training and risk management for staff. The programme has already been tested in two nursing homes so far, with preliminary results suggesting positive results towards improving end-of-life care.

The focus of this research group is on identifying the genetic risk factors or potential biomarkers that lead to the development of various psychotic disorders, such as schizophrenia and the various bipolar disorders. This is achieved through analysing the data of patients and their families, and studying cognitive changes as well as functional and structural brain alterations. Recently, a paper published by UCL provides additional evidence for the role of copy number variants in establishing schizophrenia. In a large, genome-wide study of 21,094 patients with schizophrenia and 20,227 controls, increased copy number variants were found in a number of genes associated with synaptic function and possible neurobehavioral phenotypes. The results of this study will be used in future whole-genome sequencing studies to identify new loci and associated genetic markers.

In a study comparing 68,000 patients with dementia and 259,000 people without dementia, it was found that patients with dementia received less medical care and attention despite their increased susceptibility to physical and mental illness. In addition, new research from UCL shows that women with dementia are particularly affected by these inequalities in care when compared to their male counterparts. Women were found to have fewer visits to their GPs, which translated into less health monitoring. As a result of this, more women were found to be at a higher risk of staying on potentially dangerous psychotropic drugs for unnecessarily long periods of time. The conclusions of the study suggest that the accessibility of required services continues to be a barrier for patients with dementia, especially women. The study also calls for a greater emphasis on annual reviews.

26

Vol.III No.I


Perspectives

zon and borrowed other books you needed from the library. Don’t be fooled – the D&P books look deceivingly thin, but you will live off these before your anatomy spotter. If you find a particular liking for some extra textbooks, then by all means buy them – but don’t buy any books before you know for sure that you are going to use them simply because some of these books cost more than the NHS funding.

Words by Tanya Drobnis, Demystifying Medical School Editor & Justina Tai Cheh Juan, Perspectices Editor

Medical School:

Tried and

Tested

New year, new rules. For this issue, we’ve thrown ego aside and decided to work together. The result is a grand collaboration between the Demystifying Medical School and Perspectives sections. You see before you now six letters, one specific to each year of medical school, which have been written specifically for you by your future selves (with some help from various members of the student and staff body). So if you’re thinking “I wonder what useful bits of information I’ll later wish I had known at the start of this year”, all you have to do is read on…

Vol.III No.I

27

1

Dear Year 1 self,

I’m so happy for you – you’re finally going to be a doctor! Things may seem overwhelming at first, but let me assure you that I survived first year (barely), so I know you will too. Although you are going to be absolutely fine, I’m itching to impart some invaluable advice so that your journey from here may be as smooth as possible. All right, let’s cut to the chase. I can’t believe you bought those expensive textbooks already! You could have gotten second hand Dean & Pegington anatomy books from Ama-

LAPT is a UCL question bank website some students swear by. I think you’ll like it; questions are organised topically, and answers even come with explanations! This will be especially helpful with anatomy because the questions are based on D&P. Atlases and Acland’s videos are also great for learning anatomy. Please do the SPLs and turn up to the CALs. I can’t emphasise enough how important these are. You will probably convince yourself that you can catch up on all of them closer to the exam, but there will simply be too many. You may or may not detest embryology with a passion when you first encounter it. However, keep in mind that embryology will be a recurring topic in all modules. It’s probably best to learn at least some embryology so that you won’t have to start from scratch every time Professor Dale pops up on stage in LT1. Try not to compare yourself with your friends and don’t be too hard on yourself for getting your first 50%. Do you know what they call the student who graduates with the lowest score in the class? Doctor. Oh, and one last thing. Search for “Haemolytic Memes for Anaemic Teens” on Facebook. You’re welcome.


Perspectives

though they do require a reasonable amount of patience. It’s crucial that you get a supportive supervisor. Take notes when you’re discussing your project with them as their comments will be invaluable when writing your dissertation.

Dear Year 2 self, I know we haven’t had any formal introductions yet, but there is something I really need to get off my chest. Remember the anatomy lecture you skipped last week? And the week before? Now that you want to be a surgeon who in particular requires a good anatomy foundation, you will really wish you had done that less often. Having to get up for three anatomy lab sessions a week is going to be overwhelming at first, but hang in there – it gets better. In second year, consistency is crucial. While missing a few days of lectures in first year meant that you probably had some extra work cut out for you, a few missed lectures in limb anatomy or neuroanatomy in

2

second year will set you back faster than you can ask “What is the central dogma of molecular biology?”. If you do happen to fall behind though, know that there is quite a lot of self-study time (or catch-up time, depending how you look at it) in the well-organised Endocrine Systems and Regulation (ESR) module. You’ve had some pharmacology teaching last year; but first year pharm compared to second year is like a drop of saliva to projectile vomit. Pharm is a big thing in second year, and it’s heavy on memorisation (although try to understand the content!). Flashcards and constant quizzing is how some people remember all the drugs. In my humble opinion, this is the best method because you learn the material early on and then can revise from your flashcards before the exam. Here’s another tip: the number of lectures you get on a topic is not necessarily proportionate to its importance; so having fewer lectures on lower limbs doesn’t mean you’ll be tested any less on this than head and neck. With that said, the sheer volume of work will probably be your main issue in second year. I wish I could tell you that there’s a secret potion to help you, but I can’t – and that’s not just because it’s out of stock, but because there’s a safer, cheaper option that works just as well: discipline.

3

Dear Year 3 self,

Congratulations on surviving second year! The fact that you’re still alive and standing is enough for me to commend you for your valiant efforts. Enjoy your time in your iBSc year, but if you think it’s going to be easy, you’re sadly mistaken. Unlike the first two years, it involves a lot more independent work. Although everyone says that it’s a chill year (and it really is, compared to second year), it doesn’t mean that it won’t be stressful or won’t take up a lot of your time! If you do a lab project, I hope I inspire you with my next few words: the probability of getting a negative result is greater than a positive result. Lab projects can be fun al-

You may be glad (or devastated – who am I to assume?) to know that the SBA system is relatively similar to what you are used to. However, the essay-based examinations require you to read papers beyond the scope of your lectures and quote them in order to get a good grade. I’d recommend refreshing your memory on the basics of good scientific writing, especially on how to structure your arguments effectively. FREE COFFEE. Now that I have your attention, let me go on to my point about dissertations. Please don’t leave writing to the last minute. This may be tempting, especially if you have trouble getting experiment results up to a few weeks before your deadline. If you find yourself in this position, try to write what you can while waiting. If thinking about all the research you’re going to do this year gives you a thrill, then congratulations! You could be one of the few people who choose to spend an extra three years in medical school getting a PhD! Jokes aside, the MBPhD programme is perfect for you if you want to become a future clinician-scientist and you can apply either this year or next year. Remember to take it easy (if possible!) and genuinely think about what you want out of this year. This is the best chance you have to develop other interests before you hit clinicals. I hope you take full advantage of it!

Keep your chin up, it’s not all gloomy! Being in second year means you now know your way around, and you’re no longer the new kid. Join new clubs and start thinking about what you want to do in your iBSc year. Medical school is all about working hard and playing hard. All the best!

28

Vol.III No.I


Perspectives

“You’ll never be able to learn everything, but simply by being aware you will gradually come to recognise what is important”

4

Dear Year 4 Self,

So – you’re finally going to be let loose in a hospital! This year will be extremely different to anything medical school has thrown at you before, so it’s just as well to be prepared. I’d like to give you some helpful advice so let’s dive straight in: pay attention, and maybe even make some notes on the go (incidentally something you’ll be doing an awful lot of this year). A large proportion of the initial hurdle you have to overcome this year is just getting to grips with terminology which will be flying all around

Vol.III No.I 29

with an FY1 and check in with them so they know what you’re hoping to achieve that day.

you. Every time you read or hear something you don’t understand, ask what it means or write it down so you can look it up. Launch into your textbooks early. There are two advantages to knowing about the specialty you’re in beforehand – much like with any good skincare product you’ll both look good (in front of the doctors) and feel good. Try to at least skim read relevant chapters before you get into the hospital. Kumar and Clark is a great starting place, but once you’ve started getting to grips with some of the terminology and pathology go straight for the Oxford Handbook! Get your SLEs and procedures done as soon as you can but at least wait until you get signed off on the procedures first! The nurses know what procedures need doing, so get friendly with them and they’ll be able to help you out. Also, buddy up

You’ll never be able to learn everything, but simply by being aware you will gradually come to recognise what is important. There’s a process involved in learning each condition, so go through these for each disease. If you feel that there are things you have not been taught, have the confidence to borrow other people’s notes or ask someone. Using resources like Quizlet or Anki will help you with any topics that must be rote learnt and as soon as you can, start heading for the question banks (e.g. Passmed or Pastest). Dire warnings aside, I know you’re enjoying the clinics, but let me just remind you of your secret research-loving side. You miss the peace of the lab, don’t you? You’re just dying to analyse some data, so why not apply for the MBPhD programme. There’s still time… Just before I sign off, let me impart a final slice of wisdom. This is the first year where you’ll have the chance to really soak up not just theoretical knowledge, but the atmosphere of working in a hospital on a regular basis. Make the most of it!


Perspectives

Dear Year 5 Self, You’re probably feeling pretty good about yourself right now – you’re no longer a clinical newbie, you’ve spent some time in the hospital environment already, and you think you know what’s what. However, hopefully you’re still sensible enough to recognise that some advice wouldn’t go amiss. So read on, and prepare to be greatly assisted. As usual, it’s important to be organised. The best place to arrange sign-offs is without a doubt Gynae and Urology surgery. Try and arrive early to gain consent from patients before their surgery begins, so you have permission to examine them whilst they are under general anaes-

5

thetic. This might mean an 8am start but can be an appropriate time to complete gynae exams and catheters. It’s also vital to persevere with things this year, even when time drags on and you find yourself getting tired. This will mostly happen during deliveries – it can take hours for women to progress in labour. Prepare yourself for some late nights, because the payoff will be huge! It’s completely understandable that you’ll get sleepy, so nobody will mind if you scoot off to grab some tea and toast (yum!). Try and be independent when you’re in GP: launch yourself into that deep end and see as many patients on your own as you can. The best place to get maximum exposure in Paediatrics is A&E. You’ll have to learn developmental milestones this year, and a good way to do this is by playing “guess the age” with every child you see. I know you regularly think about this with adults anyway, but this way the satisfaction rate is much higher because you’ll actually be able to find out how close you are. Hours of fun – guaranteed!

6

Dear Year 6 Self,

You’re probably terrified right now. It’s all been leading up to this, and the pressure is immense. You’re working yourself up to what you presume will be the hardest year yet, but don’t worry – I’m actually here with some good news… You’re in a fantastic and absolutely unique position! You have a vast amount of knowledge, but not much responsibility, so treasure it. Being in final year is your passport into almost any department in the hospital, so take time to do the things that interest you. UCL have spent all this time on you already, so they’re really not out to fail you at this stage. Having said that, there’s still a lot to be done. A good approach to have during final year is to get a patient list at the ward round at the start of the day. As the ward round progresses, write up a list of jobs for each patient and compare this to the list the FY1 has made.

Another helpful thing to do is to skim through drug charts to see the corrections the pharmacist has made, and to learn common drug doses. If you do this, and go through the emergency section of the handbook, you’ll start to gain a real feel for some of the doses used in emergency scenarios. This will help in OSCEs and when you’re on call being bleeped. So, bleeps – don’t be scared! Answering bleeps and phoning colleagues at every corner of the hospital will become a big part of your job as a doctor. Ensure you practise placing calls to microbiology and asking for their guidance, or calling other medical teams to review your patient. Learning to present patients concisely over the phone will help you in lots of ways, including for OSCEs. By the end of the year, you’ll be expected to have a good working knowledge of common diseases such as asthma and COPD, and how to diagnose and manage these. If you can get your head around these, you’ll look good, and you’ll be well prepared for finals. Before you get to finals though, make sure you’re properly rested and have a real break or even a holiday before Christmas! Also, get organised and plan your elective before the finals madness hits as you’ll be grateful that you took the time to sort it out properly. I’m going to wrap up now, because I’m sure that you don’t have a lot of time (not that I do either). Make this year about discovering your passions, and preparing yourself to finally becoming a “real” doctor, not about being able to prove your knowledge on paper.

Speaking of fun, don’t forget to have some time outside of the hospital too. Yes, you’ll be busy and tired, but that doesn’t mean you should abandon all attempts at frivolity. Keep up with your societies, keep up with your friends, and keep going out (in moderation and NOT right before you’re due a late shift). You’ll thank me later!

30

Vol.III No.I


Free MDU membership for medical students MDU members get:

     Â

Notes - the MDU’s student digital journal access to sponsorship for student events assistance with medical school fitness to practise procedures online access to case studies, videos and podcasts medico-legal advice and guidance an electives guide, indemnity* for electives and exclusive access to The Electives Network website

 situational judgement test support for final year students. The MDU is a mutual, not-for-profit organisation that provides access to indemnity and medico-legal advice for members.

Visit themdu.com Join the MDU Call membership 0800 716 376

@the_mdu

MDU student

MDU video

*call the MDU membership team to arrange your indemnity before you go. Some countries are excluded. © 2016 STU210-f-1607 - Student advert

Special offer for UCL students Join the Royal Society of Medicine and receive a FREE NUS EXTRA – worth £12 www.rsm.ac.uk/join quoting “RUMS18” Benefits of RSM Student Membership • A world class medical library open 24/7 with free printing and photocopying • Discounted rates at all 400+ RSM meetings • Student specific prizes and awards • Access 13,500 ejournals and ebooks • Members’ only club facilities

“The RSM provides excellent opportunities and support for medical students. I have attended meetings, won a poster prize and regularly use the RSM library. I encourage you to join the RSM.” Carol Chan, Fourth Year UCL Medical Student


Features

Vol.III No.I 33


Features

Interview by Sophie Bracke & Carol Chan

od M e Fo

Th e

di

c

Junior doctor at UCLH, qualified personal trainer, best-selling author, and Instagram sensation with nearly 200,000 followers. Dr. Hazel Wallace is taking the world by storm and leading a generation of doctors that realise the true power of simple healthy meals and efficient exercise in overcoming some of the world’s most pressing health problems. She’s perhaps better known as The Food Medic, an online platform that she created whilst at medical school in an effort to prove that healthy living can be fun, easy and delicious. After following her online presence and success over the past few years, RUMS Review sat down with Dr. Wallace and discussed her role in inspiring and providing resources for medical students to learn about nutrition and how to live healthy lifestyles.

34

Vol.III No.I


Features

RR: Hi Hazel, thank you for taking the time to speak with us today! For readers that are unfamiliar with you, could you please introduce yourself and summarise your approach to nutrition and exercise? HW: Hello! I am a junior doctor; I graduated from Cardiff University in 2016, and I completed an undergraduate degree in medical sciences prior to that. I’m also a qualified personal trainer. These qualifications allow me to explore health and fitness on both professional and personal levels. I first started blogging four years ago, under the persona of ‘the female fitspo’. When I decided to become more serious about it, I changed the name to ‘The Food Medic’ and developed a logo. It just went from there - from a very small scale blog for myself, to a website, and now to a whole team of people helping me with my book and social media platforms. I didn’t expect it to grow to this size, but with the widespread positive feed-

RR: What do you think is the most important change people can implement in order for them to maintain good health and fitness? HW: I think my biggest recommendation is to cook from scratch. Although food is so readily available these days with many healthy highstreet options, you can end up having a lot of unnecessary calories with a bad distribution of macronutrients. But, if you are cooking from scratch, you’re in complete control of what you take in; you can make it as nutritious as possible, and it doesn’t have to be difficult! I always try to give this advice to other junior doctors, especially those who complain about not having enough time. I tell them “I have two fulltime jobs and I’m still doing it”. It can be done and doesn’t need to be complicated! You can batch cook your meals to save time, and most meats, vegetables and grains are so inexpensive that you end up saving a lot of money too! Vol.III No.I 35

back that I’ve been receiving, I definitely plan to keep going! I feel like I am in a new generation of doctors who are realising how nutrition and fitness are under-utilised in medicine. I believe that these topics are of rising importance, especially because most of the diseases that we manage in the UK are conditions such as high blood pressure, obesity, and type II diabetes. The first line management for such health issues is usually lifestyle management, but in the 10 minutes that doctors have with patients, it’s often difficult for them to provide comprehensive, uncomplicated advice and set realistic plans to make such lifestyle changes. This leaves most of the public confused and can cause greater deterioration of their chronic conditions. Hence, what we need is better health education for the public and that is where my passion lies. I want to make health more accessible, ensuring that everyone has the resources they need and to see that being fit and healthy can be convenient and completely feasible!

RR: In your book, you talked about how medical schools focus heavily on physiology but not enough on practical nutritional information in their curricula. Could you explain this further and share what changes you think are necessary? HW: Many general practitioners (GPs) have spoken to me and said “We don’t know enough. We don’t know how to apply the knowledge that we learned at medical school to patients”. They may know how carbohydrates are absorbed, but struggle with communicating this to patients in terms of how to reduce carbohydrate consumption and how to differentiate the good and the bad. Similarly, I find many junior doctors coming to me for nutritional advice for themselves, because they lack the understanding of how to improve their eating habits. Hence, I definitely think practical nutrition should be incorporated into the curriculum, whether at medical school level or GP level. And it doesn’t need to be extremely robust - it’s just basic nutritional knowledge, such as what amount of protein to eat, that we can then use to advise patients who are hoping to improve their health. I really do believe that both patients and doctors would love better access to such information!

“I find many junior doctors coming to me for nutritional advice for themselves”


Features

RR: In light of the current lack of practical nutrition information on the medical school curricula, where can medical students go to educate themselves on this topic? HW: My website has a section on the basics of nutrition, and both the NHS and British Dietetic Association have a lot of good information. The website Precision Nutrition also provides many educational, comprehensible infographics. In addition to those, I would recommend the website The Rooted Project, created by two dieticians, which again offers lots of nutritional facts as well as regular talks and events that you can attend.

RR: Who should medical students look towards as important influencers in this field, besides yourself? HW: Firstly, I would recommend researching Dr. Rangan Chatterjee. You may know him from the show Doctor in the House, and he has also been a GP for 11 years. He is currently delving into functional medicine and looking at how small changes in food, sleep, relaxation and movement can help maintain good health, all of which deserves more attention. He says that our current medical training may not fully equip us to deal with the epidemic of chronic lifestyle-related conditions, There is Dr. Rupy Aujla, known as The Doctor’s Kitchen. He is also passionate about making healthy eating and lifestyle medicine a part of his work as a GP. He looks more into natural approaches to healthcare – such as food and movement – as medicine. He is currently very busy writing his first book about this!

I also know Dr. Zoe Williams. She is an iTV This Morning Doctor and an ex-Gladiator. She’s a keen sportswoman and empowers patients to improve their health through lifestyle changes. She believes that the positive consequences of being active are still not fully understood by people. Currently, there are not many of us doctors who share similar approaches and put emphasis on nutrition, fitness and exercise. However, I have noticed many medical students are becoming interested in these fields, so there will hopefully be more of us in the future!

 

“I definitely think practical nutrition should be incorporated into the curriculum”

RR: Do you think people in the medical profession still hold misconceptions about nutrition, and if so, what is one common misconception?

RR: And to finish - could you describe yourself in five words? HW: motivated, determined, happy, energetic, adventurous!

HW: Yes, I feel some doctors do still hold misconceptions about nutrition. And it’s not just older doctors, but also younger doctors. They are very interested in reading up on the current research in their area of speciality, but when it comes to nutrition, they are not so up to date about it. One big misconception that I continue to see is that doctors tell patients to cut down on fats in order to keep cholesterol levels low, while in reality low-fat diets can actually make risk factors worse. Specifically, it can cause patients to avoid foods like meats and eggs, while eating more processed foods that are high in sugar and refined carbohydrates.

36

Vol.III No.I


Features

The Curious History of the cruciform Words by Jonathan Knight

32 37 Vol.III Vol.III No.INo.I


Features

An exploration into the renowned history, architecture and people of UCL’s beloved Cruciform building.

T

he Cruciform building was built in 1906, in response to the overcrowding of the previous University College Hospital (UCH). It was designed by renowned Victorian architect Alfred Waterhouse, who also designed the Natural History Museum in South Kensington. This distinctive building stands on Gower Street, bordered by the modern UCH building, University College London’s main quad, the Rockefeller building and a construction site for UCLH’s new centre for proton beam therapy. The building has a characteristic red-brick Victorian construction, with an unusual diagonal design, which, according to Waterhouse, was based on “the most modern principles” intended to help with problems of ventilation, drainage and lighting. The cross design also allowed wards to be suitably isolated from each other. The building possesses several interesting quirks. For example, a

tunnel was constructed connecting the hospital to the Nurses’ Home and the Medical school, both also designed by Waterhouse, for the transport of patients between the two sites. Today, these two buildings collectively form the Rockefeller building, and the tunnel still exists to this date. The Cruciform seems to have its own internal architectural logic, with terracotta tiling, spires and flamboyant lettering above each entrance. The year that construction started is indicated above the Gower Street entrance in large roman numerals (MDCCCCV). At the time, each ward had 28 beds and these were arranged symmetrically in each arm of the cross. What is now the Cruciform hub library housed various hospital departments including radiotherapy and pharmacy, as well as being a place for the storage for sterile fluids. Two years after the hospital closed in 1993, UCL bought the facility and over time converted it into the Cruciform hub we know today. Being an important hospital in North London, many famous people have been born and have died in the Cruciform building. In addition, many famous physicians were trained there.

33 Vol.III No.I


Features

George Orwell 25 June 1903 – 21 January 1950 English journalist and novelist. Famous for his novels 1984 and Animal Farm, as well as his non-fiction writing.

Dick Emery 19 February 1915 – 2 January 1983 British comedian notable for radio and TV shows in the 1950s, 60s and 70s.

George Padmore 28 June 1903 – 23 September 1959 Trinidad-born Pan-Africanist and Black rights activist. Campaigned for the creation of a united Africa.

Agatha Christie 15 September 1890 – 12 January 1976

Ben Elton Born 3 May 1959 British comedian and writer. Wrote scripts for The Young Ones, Blackadder, Mr. Bean, and the West End productions of We Will Rock You and The Phantom of the Opera.

Ed Miliband

Richard Harris 1 October 1930 – 25 October 2002 Irish Actor most famous for his roles as Emperor Marcus Aurelius in Gladiator and as Albus Dumbledore in the first two Harry Potter films. Died in UCH from Hodgkin’s Lymphoma.

Janet Chance

Born 24 December 1969

10 February 1886 – 18 December 1953

British politician, leader of the Labour party and Her Majesty’s Opposition from 2010 to 2015. Resigned leadership after Labour’s defeat in the 2015 general election.

British feminist writer and advocate for the legalisation of abortion. Committed suicide by throwing herself out of a window in UCH after the death of her husband.

Births

Deaths

Bestselling British novelist. Worked in the pharmacy at the cruciform during the Second World War and acquired a good working knowledge of poisons which she later used in her crime novels.

John Bowlby 26 February 1907 – 2 September 1990 British Psychiatrist, notable for developing Attachment Theory (a theory which seeks to explain early psychological and social development in infants and children) and working to reform Victorian-era restrictions on visiting times for children in hospitals.

Alumni and Former Staff

People Associated with the Cruciform Vol.III No.I 39

Children’s Tiles


Features

Top

Doctor in the House

Bottom 39 Steps

Film Appearances In the Wet Teaching Laboratory on the first floor, there is a set of large tiled tableaux on the walls. They depict scenes from fairy tales such as Jack & Jill and Little Red Riding Hood, using Art Deco motifs and glazed, vivid colours. These are the work of British artist Margaret E. Thomson, and were installed when the room was a children’s ward in the early 20th century. During the First World War, when the room was used for wounded troops, these tableaux were covered up as they were deemed unsuitable for the military. They were later rediscovered when UCL took ownership of the building. Today, thick Perspex has been mounted over them, not for preservation purposes, but to protect people from the radioactive paint pigments used in the 1900s.

Above

Image of the tiles

Bottom 39 Steps

There are two fictional hospitals portrayed by the old UCH in film: St. Swithin’s Hospital in the 1954 hit Doctor in the House, and St. John’s Wood Hospital in the 1959 film adaptation of 39 Steps. However, both of these films used the UCL main quad as the stand-in for the entrance of their hospitals rather than the Cruciform building itself, probably because at the time it was still actively being used as a hospital.


Features

An Opiate of the Masses for the 21st Century?

Can we become addicted to the internet? This question has garnered much controversy for decades- not long after the dawn of the internet itself, in fact. Mental health experts disagree strongly; some have set up internet rehabilitation centres and clinics, while others dismiss it as the ramblings of fear-mongering luddites. With all the noise surrounding this issue, it is important to rely on evidence-based approaches rather than anecdotal reports. This article outlines a brief history of the emerging phenomenon of internet addiction. Also highlighted are a few interesting studies that may provide us with valuable insight. Words by Ian Tan

W

hen was the last time you spent a whole week unplugged from the internet? No social media; no email; no video games; no online videos. Most of us will agree that we spend a huge chunk of our day connected to the internet, but few are willing to label it an outright addiction. Whilst it might seem ludicrous to draw parallels between smoking, alcoholism and internet use, the idea that internet addiction should be viewed as an actual psychiatric disorder dates back to 1996, when American psychologist Kimberly Young suggested that it should be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM).1 The inclusion of gambling disorder in the DSM-IV had already established behavioural addiction - as opposed to substance addiction - as a clinical problem. In 2008, an edi-

Vol.III No.I 41

“Most of us will agree that we spend a huge chunk of our day connected to the internet, but few are willing to label it an outright addiction”

torial published in the American Journal of Psychiatry called for internet addiction to be included in the next iteration of the DSM.2 Although that did not happen, the DSM-V did recommend ‘internet gaming disorder’ for further study. Experts disagree on whether internet addiction is a real problem that needs to be viewed in the same way as gambling addiction. Most arguments against labelling internet addiction as a true problem insist that the addiction is not to the internet itself, but to the activities it facilitates, such as gambling, gaming, pornography, etc. The DSM-V does not formally recognise internet addiction disorder, but numerous rehabilitation centres have nonetheless sprouted up in the US, ranging from simple counselling centres to ten-week-long intensive boot camps. Countries such as Australia, China, India, Italy, Japan, Korea and Taiwan already recognise internet addiction as an official disorder.3


Features

42

Vol.III No.I


Pathological Users

4.4%

Features

A recent study conducted by researchers from Swansea and Milan on 144 students showed a withdrawal-like effect of problematic internet use (PIU),4 supporting the existence of internet addiction. The participants first completed a range of psychometric tests to gauge their mood, anxiety level, clinical symptoms of depression, as well as the degree to which their internet use disturbed daily life. The researchers also monitored their heart rate and blood pressure throughout the study. The participants were then instructed to browse any site they wanted during a 15-minute period. Immediately after that, the researchers found that those who identified themselves as having PIU displayed an increased heart rate, systolic blood pressure and anxiety state, along with a reduced mood. These changes, seen after halting internet usage, mimic those seen after cessation of sedative or opiate drugs. On the other hand, those without self-reported PIU showed no such differences except for reduced anxiety. The researchers believe their findings necessitate further investigation of PIU to determine whether it should be labelled a disorder. How is internet addiction disorder different from normal use, given that most of us rely on it every day at work or in school? How much is too much? The difference may not lie in the absolute number of hours one spends online, but in how it affects daily life. The aforementioned AJP editorial2 proposed three subtypes of internet addiction: gaming, sexual and email or text messaging. Common to all subtypes are excessive use, withdrawal, tolerance, and continued use despite negative consequences. We can easily spot the similarities with drug misuse and other established forms of addiction. Assessment tools such as Young’s Internet Addiction Test5 have been developed to help identify individuals who struggle with problematic internet use. Modelled on DSM-IV criteria for pathological gambling and alcoholism, this test attempts to measure the magnitude of effect of internet use on the subject’s daily routine, sleeping habits, productivity, social life and emotional state. Other similar tests include the Problematic Internet Use Questionnaire and the Compulsive Internet Use Scale. The fact that excessive internet use is fairly common is hardly surprising. A large cross-sectional study attempted to estimate the prevalence of internet addiction among 11,956 adolescents recruited from 11 European countries.6 The authors classified the participants into three categories based on their score on Young’s Internet Addiction Test: adaptive users, maladaptive users, and pathological users (in order of increasing severity). 13.5% of all participants were found to be maladaptive users, while 4.4% were pathological users. The authors discovered that the higher their score on Young’s test, the more hours they spent online; the maladaptive and pathologiVol.III No.I 43

Maladaptive Users

13.5%

82.1%

Adaptive Users

The prevalence of internet addiction A large cross-sectional study estimating the prevalence of internet addiction among 11,956 adolescents recruited from 11 European countries. The authors classified the participants into three categories based on their score on Young’s Internet Addiction Test: adaptive users, maladaptive users, and pathological users.

cal groups reported spending an average of 1.98 hours and 3.75 hours a day online respectively, representing an almost two-fold increase in hours online. More importantly, this finding suggests a dose-response relationship between time spent online and level of addiction. Interestingly, their findings also support previous studies claiming that some online activities are more addictive than others. Most male participants played online games, with a two-fold increase from adaptive use to pathological use. Female participants, on the other hand, predominantly engaged in social networking and e-mail. According to the authors, the interactive nature of these activities predisposes users to remaining online for longer than intended, by way of psychological stimulation. Granted, this cross-sectional study – one that also relied on self-report – cannot prove any of the proposed causes of internet addiction, but its large study sample does add weight to the findings of other studies. There is little doubt that excessive use of the internet is harmful and needs to be addressed. Howev-

“The internet is ra reshaping the way harbour any hope an era built on the imperative that w understand how i better or for wors


Young’s Internet Addiction Test

Features

A test to identify individuals who struggle with problematic internet use. What effect does the internet have on a user’s daily activities:

Sleep

Productivity

Internet use has been on the rise since global adoption began in the 1980s and will only continue to increase. Here in the UK, 99% of adults aged 16-34 years have used the internet recently this year.7 The steady embrace of the internet is not just seen in younger age groups; internet users aged 75 years and above increased from 52% in 2011 to 78% this year. Internet-based technologies used to be mere alternatives to conventional services. Today they are ubiquitous, having replaced most traditional technologies in wildly varying sectors, from banking to shopping to education. The internet is radically reshaping the way we live; if we harbour any hopes of coping with an era built on the internet, it is imperative that we truly understand how it affects us, for better or for worse. References: 1.

2.

3. Social Life

adically y we live; if we es of coping with e internet, it is we truly it affects us, for se.”

Emotional State

er, we need to determine whether it is addictive in the same way that gambling can be, and if so, its diagnostic criteria and mechanism. The nicotine dependence hypothesis and assessment instruments that measure the degree of dependence helped us refine smoking cessation treatments; similarly, understanding these aspects of excessive internet use would allow us to develop effective treatments. For the very first time, the US National Institutes of Health are funding a randomised controlled study on internet gaming disorder, which will take place over two years at the University of Connecticut School of Medicine.3 This study aims to examine the effects of cognitive behavioural therapy on 13 to 18-year-olds with a gaming problem. Dr Nancy Petry, the lead researcher, believes the controversy surrounding whether internet addiction is a real disorder is due to its recent emergence as a phenomenon, as well as the variation in its diagnostic criteria. She hopes that the findings will help move internet gaming disorder from the DSM appendix to recognition as an official disorder. In any case, the results of this prospective study should prove both interesting and very useful.

4.

5.

6.

7.

Cash, H., Rae, CD., Steel, AH., Winkler, A. Internet Addiction: A Brief Summary of Research and Practice. Current Psychiatry Reviews [online]. 2012;8(4):292-298. Available from: https://dx.doi.org/10.2174 %2F157340012803520513 Block, J. Issues for DSM-V: Internet Addiction. Am J Psychiatry [online]. 2008;165:3. Available from: http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi. ajp.2007.07101556 Booth, B. Modern Medicine: Internet addiction is sweeping America, affecting millions. [online]. CNBC; 2017. Available from: https://www.cnbc.com/2017/08/29/us-addresses-internet-addiction-with-funded-research.html Reed, P., Romano, M., Re, F., Roaro, A., Osborne, LA., Viganò, C., et al. Differential physiological changes following internet exposure in higher and lower problematic internet users. PLoS One [online]. 2017;12(5):1–11. Available from: https:// doi.org/10.1371/journal.pone.0178480 Young, K. Internet Addiction: The Emergence of a New Clinical Disorder. CyberPsychology & Behavior [online]. January 2009, 1(3): 237-244. Available from: https://doi. org/10.1089/cpb.1998.1.237 Durkee, T., Kaess, M., Carli, V., Parzer, P., Wasserman, C., Floderus, B., et al. Prevalence of pathological internet use among adolescents in Europe: demographic and social factors. Addiction [online]. 2012;107(12):2210–22. Available from: http://dx.doi.org/10.1111/j.13600443.2012.03946.x Office for National Statistics. Internet users in the UK: 2017. [online]. ONS; 2017. Available from: https://www.ons.gov.uk/ businessindustryandtrade/itandinternetindustry/bulletins/internetusers/2017

44

Vol.III No.I


Features

A Career in Psychiatry Words by Izabella Smolicz, Director of Medical Journalism

Welcome to the new UCL MBBS students! Here is a little introduction to Careers. We established this section in RUMS Review last year and have tried to make it as informative and interesting as possible, from articles on different specialties to interviews with clinicians. We hope it will continue to allow

Vol.III No.I 45

you to become more informed about the various specialties: from how you explore different options as a medical student, to what is required to progress through the specialties as a doctor. There is something for all MBBS students and, as always, we hope you enjoy reading the section!


Features

W

ith the focus of this issue being on health and wellbeing, Careers is concentrating on psychiatry. Many preconceptions may come to people’s minds when they think of this specialty:

“It’s the same as neurology!” “There are no good treatments in psychiatry compared with other specialties, for example, adrenaline for anaphylaxis.” “When will research catch up with the level of advancement in other specialties?” Well, it is not true that psychiatry equals neurology, although it overlaps with various specialties. In addition, many developments have been made, from new therapies such as cognitive behavioural therapy (CBT) to new generation antipsychotics. In addition, psychiatric illness is not just anxiety and depression. There are a range of conditions and subdivisions, as outlined in the International Statistical Classification of Diseases and Related Health Problems (ICD). This manual includes a classification of mental health conditions and is used in the UK, in contrast to the Diagnostic and Statistic Manual of Mental Disorders (DSM-5) in the US. You will become familiar with these in clinical years!

How do I become a psychiatrist? Some people know on the first day of medical school what they would like to specialise in – and this includes psychiatry, not just becoming the best surgeon in the UK! It is fair to say that not everyone feels they are suited to this specialty but you may be surprised during liaison psychiatry week in year four or the main psychiatry placement in year five – so keep an open mind!

with research or teaching.

The Broad Based Training Programme used to allow doctors who had completed the Foundation Programme to work for six months in psychiatry, paediatrics, general practice and core medical training. Although this programme is not currently recruiting, if it does so in future, this may be the perfect way to experience working in psychiatry if you are not sure whether it is for you.

In general, psychiatry takes six years of specialty training in total: three years of core training and three of higher training. This may take longer if, for example, trainees decide to complete a PhD or subspecialise in more than one area. As with other specialties, you can train as a general psychiatrist or eventually subspecialise in psychiatry, from perinatal to geriatric psychiatry. There are also psychiatrists who combine their clinical roles

Second Year Foundation Doctor (FY2)

On a separate note, you may have seen in our previous GP Issue that one of the compulsory exams to become a qualified GP is £1663. The good news is that all psychiatry exams are less expensive, with the most expensive being £918 for Pre-Membership Psychiatric Trainees (PMPT) and Affiliates. Always a bonus!

6 years

Consultant Psychiatrist

3 years Core Training

3 years Higher Training

PhD

Sub-Specialise

Research

Teaching

Psychiatry

Sub-specialise

How can I find out more about psychiatry? As with most specialties, the Royal College is a great place to start. Medical students and foundation doctors can become student associates at the Royal College of Psychiatrists, giving them free access to journals, free or discounted access to psychiatry-related events, as well as other advantages. There are also prizes and bursaries available, including for electives. One award that is particularly interesting is the Pathfinder Fellowship for MBBS year five students seriously considering a career in psychiatry.

In addition, UCL MedSoc has a psychiatry section, so it is worth following their Twitter and Facebook pages. These pages include information about events during the academic year and recent mental health issues referred to in the news. Click here for the link to the webpage. Twitter: https://twitter.com/ucl_psychsoc Facebook: UCL MedSoc Psychiatry Contact email: psych@medicalsociety.org.uk

46

Vol.III No.I


S p o an Socie Vol.III No.I 47


r t s nd eties 48

Vol.III No.I


i there! My name is Charles Travers, I am a fourth-year medical student and this year’s Sports and Societies VP. It almost goes without saying that a successful year will involve building on the good work of my predecessor James Shuttleworth. James has left big shoes to fill and I will be looking to echo his successes, namely ensuring Sports Ball is as grand as it was last year (but with more free wine!). I will continue to voice our opinions to the union as every Sports & Societies VP has done before me. I am lucky to be part of a conscientious committee that cares about the large student body we represent. Every RUMS student should know that they can contact us and can trust us to communicate effectively with the union.   RUMS has given all of us a truly unique and enjoyable university experience, with our sports and societies at the core of that. It is vital that we maintain our identity and ensure that the incoming freshers see how great it is to engage with our sports and societies. Historically, we have had a great level of engagement and I would like to make sure we as students continue making full use of the great opportunities that RUMS has to offer!    The time and effort that our students commit to our societies should be better acknowledged. Therefore, Ozzy and I are planning to introduce commitment recognition awards, akin to the sports’ colours scheme. I would also like to extend the sports and arts scholarship awards to be more inclusive to our freshers.    A good understanding between us and our beloved bars, The Huntley and Mully’s, is especially significant this year. I will continue to uphold and improve our relationship to allow for the smooth operation of our social calendar and much-loved sports nights.    It is no secret that Medicine is a demanding degree, and balancing everything university has to offer can be daunting. On a personal note, fully engaging with RUMS has massively helped me to find the correct ratio of work and play. I encourage everyone to commit to at least one sport and one society: the benefits are vast and the memories are priceless.   I am very excited about representing our RUMS family in the year to come. Vol.III No.I 49

Joining RUMS Women’s Football is perhaps not the most obvious of choices, as often it involves taking on a completely new sport, but I can assure you, it is the best choice you can make. We are a club with a wide range of experience and welcome all abilities. While we do enjoy football, RUMS WFC is most importantly a family and provides you with a solid group of friends and support system at medical school. The majority of our members have never touched a ball before university, while a select few have been at it for years. We have three teams which cater to all levels: the firsts (newly promoted, play competitive matches), the seconds (welcome everyone with open arms, giving anyone a chance to play) and a mixed ability (BUCS) team. No matter the team, we are notorious for being the happiest on the pitch! Off the pitch, we have an exciting social scene, including weekly sports nights at Mully’s, club meals, volunteering opportunities and two mixed tours with the boys. With our teams looking to expand further and our social calendar packed, this year is sure to be a great one! Check us out on Facebook, Twitter and Instagram at @RUMSWFC for more information and our upcoming events! For any questions feel free to email me at judith.rossey.14@ucl.ac.uk. Judith Rossey, President

Surgical Society

H

RUMS Women’s Football

Sports and Societies

Welcome all to the new year! Surgical society is back again with a variety of interesting talks, workshops and sessions to inspire you about surgery, whether or not it is a career you have already considered. Following another successful year, we plan to match and if possible exceed the opportunities we can offer to students at UCL to get involved in this fascinating field. We have a large number of events that will be taking place this year, one of which are extra tutorials aimed at first year and second year students. If you would like to brush up on your knowledge or learn something new, keep an ear out for when these start in the next couple weeks. We will continue to run multiple sessions across various specialties from ENT to Paediatric surgery, and a number of practical workshops, such as ‘Airway Management, are in the pipeline. Our shadowing scheme will be launching soon, which will give you all the opportunity to shadow surgeons in clinics and learn about the inner workings of a surgical theatre, within which there may be the possibility to assist in operations. Be on the lookout for posts and listen for shout-outs for this in lectures! Lastly, our annual conference has gone international! The International Undergraduate Surgical and Foundation Conference (iNUGSC) will be held in January 2018, with international speakers, opportunities for prizes and a wide range of workshops on everything from ‘Women in Surgery’ to suturing. This is all just a snapshot of what is to come this year, so we hope you will take advantage of all of these opportunities. Check out the Facebook page, website and twitter for further information. Tobi Rotimi, UCL Surgical Society President


MDs

RUMS Music Society is a fun and inclusive space to nurture and showcase the musical talent within RUMS. We currently run four very different groups and take a relaxed approach to all kinds of music, welcoming absolutely all abilities! RUMS Choir is our un-auditioned, fun, friendly and relaxed mixed choir. They cover a wide range of music genres and welcome singers of absolutely any ability who would like to sing in a group. Our RUMS String Ensemble is also un-auditioned, and provides a space for those violinists, violists and cellists who want to continue playing while at university. We also have Chordiac Arrest, our auditioned male barbershop quartet, which is a fantastic opportunity for any male voices interested in barbershop style music. Finally, Accarhythmia is our auditioned ladies’ close four-part harmony group, singing a-cappella style to create a wonderful sound.

HIVE

RUMS Music

Sports and Societies

We aim to build on the success of last year, which included our groups performing at the RUMS Alumni Dinner and UCL Winter Arts Festival, as well as for charity at local hospitals and churches such as the Whittington and UCH Macmillan Cancer Centre. We have a number of exciting events lined up this term! We will be hosting a Fresher’s Showcase in October where you can catch a glimpse of our groups performing and meet with current members over free pizza. Towards the end of term, we will also have a Winter Concert which will be an excellent opportunity to showcase the talent of RUMS. We will of course have regular socials, including trips to Ronnie Scott’s, as well as our society’s first tour later on in the year. So, whatever you play or however well you sing, come and have a go! RUMS Music Society is committed to allowing as many musicians within the RUMS community as possible to develop their talents and ideas, and will try our best to facilitate your music! If you have any queries or suggestions, please contact me on RUMSMusic@live. ucl.ac.uk, check out our Facebook page or tweet us @RUMS_Music. Joseph Cheung, President of RUMS Music

From a fourth UH victory in a row, to unifying the performing arts in UCL, the MDs have had another good, dramatic and eventful year. As we enter into our 125th (ish) year of being a society that celebrates the funnier side of medicine, we are showcasing our long, lasting history through an exhibition in the Cruciform Hub of hospital comedy throughout the ages. Our exhibition case will include posters, pictures, programmes, LPs and MDs memorabilia. There may even be a sneaky picture of a young Deborah Gill! We are excited to welcome a new bunch of freshers to the exciting, friendly world of MDs and hope that everyone will come to see the Christmas show on the 7th-9th of December. Robert John Shaw, MDs president

HIV Education UCL is a student-led volunteering project that aims to promote awareness and knowledge of HIV through education. We will be teaching in secondary schools and sixth form colleges, as well as fundraising throughout the year and organizing a conference. We also hope to invite people with AIDS to speak about what is like to live with HIV/AIDS. We are passionate about sharing our understanding of the issues relating to HIV and AIDS in order to enrich the student body; providing students with the knowledge, experiences and opportunities that will foster HIV prevention and stigma reduction. HIVE is back and stronger than ever! With a brand-new committee that brings together students from 3 different continents, across medicine, biology, neuroscience and biomedical sciences, we want to bring change to the project and fight HIV stigma with a revolutionary perspective. We want explore art and music as a medium for expressing the feelings of those living with HIV. We will host art exhibitions, organize creative writing workshops and compose songs to help promote mental health awareness and wellbeing. By bringing together the power of science with art and music, we aim to end stigma and actively promote mental health. We welcome all UCL students to come meet us in the VSU Fair to get to know more about our project and learn how you can help with our mission of raising HIV awareness. If you have new ideas or are interested in volunteering with us, don’t hesitate to get in touch through email (hive.ucl@gmail.com ) or Facebook (@HIVE UCL). Do not miss the opportunity to make a difference in society while also enhancing your CV! Stay tuned. Estefani Conde, President

50

Vol.III No.I


RUMS Tennis

RUMS Cricket Club

Sexpression

Sports and Societies

The UCL branch of Sexpression is getting ready for another year of teaching Relationships and Sex Education (RSE) to secondary school students. Last year we taught over 1000 students with a team of passionate RSE-advocates, spreading the word to help the adults of tomorrow make safe informed choices. Recent developments in government include mandatory education from 2019, the announcement of a large trial on pre-exposure prophalaxis for HIV, and funding released to allow women from Northern Ireland to access abortions in England, Scotland or Wales – all of which will be incorporated into our upcoming sessions, delivered across North London to over 1500 students. Students in first year can apply to take Sexpression as a double block SSC, and all students are able to volunteer via the Student Union Volunteering Services Unit. I’d like to take this opportunity to thank the outgoing co-ordinators Nicole Sarens and Jennifer Dhingra for their hard work and dedication over the past few years, and for Jenny’s contributions to Sexpression as Externals Director for the charity. We look forward to meeting new faces over the next academic year, and don’t hesitate to get in contact should you ever want more information or have any questions.

Fresh off the plane and dusting off the sand between our toes from our latest international tour to Barbados, RUMS CC is ready for yet another ground-breaking season. Having won the acclaimed “RUMS Sports Team of the Year” title for reaching spectacular heights in the national university leagues, we are ready to break even more records. As a club, we take pride in playing the game and embracing its social aspects, and new members of all abilities are encouraged to join, whether a seasoned cricketer or a genuine beginner. We meet every week for a training session at the home of cricket, Lords Cricket Ground, followed by the ever-entertaining Sports Night. Along with a fiercely contested inter-club indoor cricket league, you will always find something to enjoy, so make the right choice and be part of the best sports team in RUMS.

Following our incredible French Open trip in May, RUMS Tennis ended a successful season in June with a breath-taking win in the UH Cup! Our rivals were dismantled by the formidable doubles pairings of Benjamin Low and Alex Orbaum, Lawrence Best and Dom Fritche, and Jonny Pass and Luke Smith. We secured the cup for the third year in succession, meaning we are getting used to the idea of never giving the trophy back. Special mention to Lawrence Best, who, as well as being part of that cup-winning team, was the inaugural winner of the Lawrence Best Award (it would have been a farce if he hadn’t won). This was presented at our end of season dinner for allround contribution to the club over a number of years. Congratulations to Lawrence, it was thoroughly deserved! The picture is from the aforementioned dinner. To be completely honest, I wanted to include a picture of the UH Cup winning team instead. However, the team decided to take absolutely no nice pictures on the day. It’s a shame, because I’m pretty sure that a bit of publicity would have catapulted them into Kardashian-esque fame and fortune, alas it was not meant to be. What they lack in photography they make up for in tennis, at least! With lots already planned for the year ahead, I’m excited and honoured to be the president of RUMS Tennis this year. Things are only going to get bigger and better for this outstanding club!

George W X Barker, Co-ordinator

Dhiraj Patel, RUMSCC President

Rishi Gupta, RUMS Tennis President

Vol.III No.I 51


Renowned ladies of RUMS Netball, here is a tribute to last season for all to enjoy… Under the influence (of much fun!) many memories have been made and forgotten in the midst of our socials: from UH Sports Night to our beloved Club De Fromage outings… Achievements have soared as we saw many of our teams gain promotions at the end of last season! Well done to the third team for winning both of their leagues - long may it continue! A mention to the nativity fun we enjoyed during our festive tour this year; with costumes ranging from angels to pigs in blankets, Christmas truly did come early. Our enthusiasm in RUMS Netball is boundless; we bring passion and determination (and jelly sweets) to every single match we play…MIDDLE MIDDLE MIDDLEEE!... Teams were made this year as our club continues to grow. We saw the competitive debut of our sixth team, bringing us up to a grand total of seven teams. More members were welcomed in September as we saw a humongous contingent of Freshers join the club, and indeed fit seamlessly into our RUMS Netball family as if they had always been there! Sports Night, as ever, is on EVERY WEEK- how can hump day not be our favourite day, with our circle fun every Wednesday evening celebrating our wins of the week. Bristol was taken by storm on our annual tourwhere will we head this year? Come join us to find out! Lifelong friendships link all RUMS Netball girls together, past and present. We LOVE each and every one of you! Here’s to next season, ballers! Davina Nylander (Club Development Officer) and Frankie Cackett (President)

RUMS Rugby

RUMS Netball

RUMS Squash

Sports and Societies

RUMS Rugby head into the 2017/18 season full of excitement. On the pitch the first team have two sevens titles to defend, as well as an international one to reclaim. As well as this, our successful second fifteen will be hoping to retain their UH title for the third year in a row! However, we won’t be satisfied with matching last years’ achievements; the club is always looking to do better. Next year the seconds will be chasing promotion, and the ones are desperate to repeat the 2014 UH cup win. Our new pre-clins team offers younger members of the club the chance to take on some responsibility, as well as allowing more casual players to enjoy game time and to play with young RUMS sportsmen from other clubs. Whatever happens on the pitch, it is sure to be a fantastic year socially; a busy touring schedule will see us go overseas twice, to Munich and Paris, as well as to a mystery UK destination. Throughout the year we will hold events coupled up with, to name a few: RUMS Netball, George’s Women’s Hockey, UCL Women’s Rugby and King’s Lacrosse. Add into this the other socials which run through the year and the fact that Nick Cox is already being touted as the best circle chairman in living memory, RUMS rugby is more than holding up to its reputation as the best social club in UH. Also follow us on twitter and Instagram...please.

RUMS Squash eagerly awaits another year of rip-roaring, racket-breaking action. We are both very proud to see off our cohort of finalists, who are now wading into the vast ocean of the NHS, and sad to see them leave RUMS Squash. The Royal Free courts are far too quiet without Tom Western wailing like an infant after losing matches. However, a new year brings with it a new squad of finely tuned athletes, returning from a summer of hardcore training (haha just kidding). We also have a new committee, featuring the social sovereign Karan Kapur, who will be bringing you a ton of squash and non-squash related social events to look forward to. We also have the title of “National Association of Medical Schools Championships” to defend, and a fantastic medical educational programme for preclinical and clinical students alike.  So whether you’re a newbie to squash, a squash veteran, or you’d prefer to sit in the Chester’s Chicken Shop every day with Sri Srivarajan, we look forward to welcoming you. Look out ladies and gents, RUMS Squash is back in business.

Nick Cox, Men’s 1st XV Captain

Daniyal Jafree, RUMS Squash President

52

Vol.III No.I


Our 2017 Jailbreak teams getting ready to set off on their 36h hitchhike – one team got as far as Istanbul, while another ended up getting drunk for free with a Luxemburgish lady in an Irish pub! Do you ever feel like getting away from uni but can’t think of a good enough excuse? Well RAG is the answer to all your problems. The Raise and Give Society offers a range of once-in-a-lifetime experiences for you to take part in, all in the name of fundraising for charity! Besides our signature hitchhiking events, Lost and Jailbreak, we give you the opportunity to trek to the top of Mt Kilimanjaro and watch the sunset from the peak of Africa, explore the Inca wonders of Machu Picchu and even experience the trill of skydiving. So, if you’re the kind of person who is driven by adventure and want to be a part of UCL’s biggest charity-oriented society, keep an eye out for our upcoming events. With Lost coming up mid-November, who wouldn’t want to be dumped in the middle of nowhere by a blacked-out coach and have to race back to London without spending a penny? It’s all worth it by the end when you’ve had the most unforgettable weekend of a lifetime, while also knowing that you’ve been key towards fundraising for our chosen charities. Last year RAG raised a record-breaking sum of over £55,000 – come and help us break that record again! Vol.III No.I 53

Hey! I am Lewis, a fourth year medical student and the RUMS LGBT+ Officer for 2017/18. The UCL LGBT+ network has been working tirelessly over the summer months to ensure an absolutely PACKED first term of events for LGBT+ students at UCL. I will be putting on events for RUMS LGBT+ students, as well acting as a point of contact for students who need some extra support and guidance. I also work closely with the LGBT+ network at large, and also will be organising many of the LGBT+ BME events throughout the year! Term 1 Events include: Glittoris: The Resurrection 30th September, Phineas Bar Meet The Committee Mixer Tuesday 3rd October, 6pm-8pm Fresher’s Picnic Wednesday 4th October, 1pm Let’s Talk About: Body Image Tuesday 10th October, 7pm-9pm Gender Dysphoria: An Insight into Gender Reassignment Surgery Thursday 16th November, 6pm-8pm and much more! Feel free to drop me an email at lewis.ricketts.13@ ucl.ac.uk, join the RUMS LGBT+ FB group and like the UCL LGBT+ network page for information on future events! Lewis Ricketts, UCL LGBT+ President www.facebook.com/UCLLGBT/ www.facebook.com/groups/1638504863068433/

Wilderness medicine

LGBT

RAG

Sports and Societies

”Trapped under a tree” UCL Wilderness Medicine Society is looking forward to another exciting year ahead! Numerous events are being planned, with a winter trip to the Lake District already taking shape. Hopefully this year the weather will allow us to see “the wilderness” and not just thick mist! Over the summer we have been working on some exciting collaborations. Keep an eye out for our joint event in late November with UCL Hiking Society, alongside our improved workshop series, thanks in part to KCL Wilderness Medicine Society (yes, it’s true, a UCL-KCL collaboration)! Join us for our Hampstead Heath ‘Walking Wounded’ hike on the 7th October: more updates to follow on Facebook. If you like extreme medicine or the outdoors we’d love to meet you! Tom Durham, President


Bumps: the highlight of summer rowing and the light at the end of the long dark tunnel we call Easter. In 2017, all crews put in a solid effort on the water over the sunny weekend, and did our club proud out of the water at the legendary Bumps Party. Some of our members firmly caught the summer rowing bug, and continued the season with the University of London development squad. This took them to major regattas including the Metropolitan Regatta at Dorney Lake (the site of the 2012 Olympics!) and Henley Women’s Regatta. Those that didn’t row took part in the summer social scene, putting in a strong appearance at Henley Royal Regatta’s Mahiki tent. Special mention goes to Ollie Pfeiffer, for escorting home a certain committee member from Henley to Holloway. Other members shifted their sights from the erg to the bike, and we have a platoon of men and women cycling from London to Paris in under 24 hours in aid of Anthony Nolan this October (If you’re interested, hit up our JustGiving page with £1,500 goal: RUMSBC cycle LDN to PARIS) We can’t wait to welcome our returning members and see some new, fresh faces at our first Sports Night!

RUMS Hockey’s main season ended in March, so many may think there is little to report since the last marvelously well-edited edition of the RUMS Review. Admittedly, there has been little that could be described by SUUCL as a ‘core activity’. We had an excellent Alumni Day in June, culminating in a stunning victory by the infamous green team over the aged and work-weary doctors. Attention then turned to RUMSHC’s many other talents. We retained the RUMS T20 (Cricket) trophy in wonderful style, with a Notable Man of the Match performance by Tom Chambers (he can add this to the many statistics he likes to frequently bore us with). This is all the more worrying given Tommo’s shortening odds for 2017-18 Golden Stick, as the bookmakers react to Rob Tuckwell’s ever-increasing age/BMI and the inability of anyone else to score. Our only hope is that coach Asif Rais’ (#RaisYourGame) patented four-week fitness plan sees a turnaround in Rob’s pre-season form. Elsewhere, club-member tendencies to go on foolishly long cycle adventures continued. Dom Blauth-Muszkowski, not satisfied with his five weeks on a bike last summer, instead spent five weeks in a silent monastery. I am not sure this will see quite the same take up within the club. Our diversification to stick-free activities looks to continue with an old-school Sports Day, complete with egg and spoon and sack races, planned ahead of the arrival of the Freshers and our return to the astro. As ever, we are very keen to welcome new faces from any year and ability. Get in touch, especially if you have an interest in cricket, cycling, silence, 3-legged races… and hockey of course.

Tintin Larson, RUMSBC President

Fred Vivian, RUMS Men’s Hockey President

New year, new me? Here’s a recap of last term’s activities and a glimpse of what we have to look forward to.

RUMS Badminton

RUMS Men’s Hockey

RUMS Boat Club

Sports and Societies

Hello! Are you the next Lee Chong Wei? Did you do a bit of badminton for PE? Or are you just looking for a friendly club to get to know some fellow medical students? We at RUMS Badminton take pride in the inclusive nature of our club- with well over 150 members and a growing number of alumni, there is a reason we are the biggest club in RUMS! We welcome all abilities; whether you’re always found with a racquet in hand, or are completely new to the shuttlecock, we want you! We have many exciting social events throughout the year, from the Fresher’s Meal to Social Tour, and a visit to the All England Championships. We also host many opportunities outside of the sport itself. ‘BadEdu’ is a tutorial initiative run by members for members, for students in both pre-clinical and clinical phases. Medical school is a whole new kettle of fish compared to A-levels; we will be here to show you the ropes and help you become the best you can be. Why should you join us? Joining a RUMS club enables you to make friends in all year groups and become familiar with what lies ahead, whilst also providing support and advice to younger members. Come and talk to us at the Fresher’s Fayre or drop us a message on Facebook. Join the RUMS Badminton family - we promise you won’t be disappointed! Patrick Man, RUMS Badminton President 54

Vol.III No.I


When the previous edition was published back in May, RUMS FC was rejoicing after triumphs in both the inaugural Varsity game and Lumsden Cup. And, despite a sobering result in the club’s first foray into cricket at the T20 day, spirits remained high to send-off the year at President’s day. With the sun shining at Shenley, we said farewell to the final years (the often self-proclaimed ‘golden generation’) for everything they’ve done for the club and, similarly, to our President Girish Murali, following an excellent year under his powerful leadership. Since then, the club’s many members have set off on summer scouting missions ranging from Colorado to Bolton. A special shout-out goes to Josh Bryan for taking pre-season training to the next level by cycling from Lands’ End to John O’Groats, raising thousands of pounds for the charity Epilepsy Society in the process. For those of us less aerobically inclined, pre-season training at Regent’s has gruellingly returned, and with it the return of regular Sports Nights. Before we know it, Fresher’s week and the start of the new season will be upon us. We look forward to welcoming a new year of footballers to the club at our trials, and to another great year of success! Ben Barker RUMS FC President

Spectrum is a charity established in 1982, run entirely by medical school student volunteers. We aim to provide both a befriending service to children who have special needs and a small respite to their families. Working within Camden, paired volunteers visit fortnightly to take their linked child out on fun activities. From swimming to the cinema to the zoo, the list is endless. The highlight of the year is our annual residential trip to Hindleap Warren, an outdoor centre. We spend the weekend on site with a schedule full of activities: rock climbing, archery, zip wiring and more! Throughout the year, we also endeavour to organise two further group trips. Are you interested in volunteering?

We look forward to seeing you soon!

Hello everyone! Since the last issue of RUMS Review, RUMS Women’s Hockey have said goodbye to five of our wonderful (now) F1s, hosted our third Alumni Day, and been to watch some of the recent World Hockey Championships at our home ground, Lee Valley. With September rolling around, preparations for the coming season are now well underway, kicking off with our inaugural mixed Sports Day on Wednesday, which features all of the old classics such as egg and spoon, sack race and tug o’ war! We have big plans for the year ahead, with our first XI hoping to retain their varsity title over GKT in March, and some BUCS promotion targets for the firsts and seconds, while the thirds hope to build on their first victory at the end of last season! We look forward to welcoming many new freshers into our midst in a few weeks time, starting with our taster day on 27th September followed by an induction into Sports Night… Thanks to everyone for an amazing past season, in particular Emily Croft for making everything run so smoothly for the club, and I look forward to all of the fun commencing again in the coming weeks!

Khushboo Khatri, President

Chloe Hall, RUMS Women’s Hockey President

Being a part of Spectrum is truly one of the most rewarding experiences and you will create life long memories. Not only will you learn new skills, but you will also create a unique bond with both your child and their families. You can even join the committee to help run the charity!

Some of the aforementioned final years post RUMS FC’s first ever international win against Arsenal Chennai, featuring questionable vests and even more questionable hairstyles.

Vol.III No.I 55

RUMS Women’s hocKey

Spectrum

RUMS Football Club

Sports and Societies

If you are interested in joining, be sure to visit us at the RUMS Fresher’s Fayre, or for more information, visit our website (www.rums-spectrum.org. uk) or our Facebook group “Spectrum RUMS”.


medicine made clear

eureka

eureka

NEW!

“The perfect all-in-one textbook” (Eureka Obstetrics & Gynaecology)

“A must buy for all medical students” (Eureka Endocrinology)

“Another classic Eureka title, this is the book UCL medics need” (Eureka Gastrointestinal Medicine)

“A refreshing take on medical textbooks” (Eureka Neurology & Neurosurgery)

“An absolutely amazing book” (Eureka Gastrointestinal Medicine)

“Another winner for me!” (Eureka Obstetrics & Gynaecology)

Coming Soon

Eureka App-books! To order visit www.eurekamedicine.com quoting code RUMS17 for your 15% discount and free delivery. Offer valid until 31.12.17. www.facebook.com/eurekaJP

@EurekaMedicine

15% discount

RRP £22.95

Special Price

£19.50

including free delivery


FO

Sports and Societies

by Asha Dave

RUMS Freshers of the Year – Where are they now?

For this issue’s return of ‘Fresher of the Year (FoTY): Where are they now?’, I caught up with Josie Baker, RUMS Women’s Hockey social secretary, to take a trip down memory lane and figure out whether she has acclimatised to life as the medical school’s resident dancing banana.

Vol.III No.I 57

What is your favourite moment from fresher year?

I think it’s tough to pick out a single best moment because there are so many, although a few do stand out. One was when my Ramsay corridor and I had a Friends-style Christmas basketball competition in this random court behind Tottenham Court Road, in which both teams got enjoyably competitive (although it did lead to someone getting a minor nose bleed …). Another collection of favorite moments would be the postRUMS night out chats that my hockey club mates and I had throughout the year. These would take place in my tiny Ramsay room with a cup of tea and some drunken food; they actually kept their own toothbrushes in my room within the first month!

out of living in London while you actually have the time to; I’d recommend going to the National Gallery and British Museum, as both are free and are so close to UCL. I would also just say to make the most out of every opportunity possible; if someone you know invites you to do something with them, go!

What is your favourite thing about RUMS Hockey?

I just love how friendly everyone is. Literally right from the start I felt completely welcomed into the club. I also think as a club we have the most fun (I appreciate I’m slightly biased), but it’s amazing how quickly Wednesdays became my favourite day of the week, and I honestly think that’s owed to the people in the hockey club.

What advice would you have for a fresher starting this September?

What has been your favourite RUMS fancy dress theme or costume?

I would advise getting stuck in to as much as possible and putting your name down for literally everything at Fresher’s Fayre (admittedly I had to do a lot of email unsubscribing within about a month). I also would try and make the most

My favourite theme so far would probably be our hockey pub crawl in second year which had a Nintendo theme. I’m not going to lie, my knowledge of Nintendo is lacking, however, I went with the classic Mario Kart (always a winner) and dressed


TY

Sports and Societies

What have you achieved within RUMS Women’s Hockey since earning the title of FOTY?

In my second year, I was volunteering sec which I really enjoyed. A particular highlight was organising carol singing at Piccadilly Circus tube station. This coming year I’m undertaking the role of social sec, which I can’t wait to start, especially as I’m sharing the role with my flatmate. We’ve already had many a discussion on our extravagant

plans for upcoming socials, although some of our more rogue ideas may have to be reined in by the budget, sadly…

Do you have any aspirations for your role in the club?

To be honest, at the moment I haven’t really thought much further past social sec. However, I’ve really enjoyed being part of the committee this year and it’s quite nice having a minor insight into the running of the club, so I’ll probably end up running for something again next year… maybe treasurer? To increase the budget for those socials!

What has been your most memorable Sports Ball moment?

Hmmm, well when I got my Fresher of the Year award in first year I actually hadn’t been paying attention, so I had no idea what I was going up to get! So it was a nice surprise when I sat back down and someone told me! Also, this year I enjoyed mine-sweeping apple crumbles while everyone was dancing…

Is there anything you would go back and change? Not really, no!

What is your favourite thing about RUMS?

I love how it’s a like a mini community within UCL. When it comes up to exams, older years are just great, whether by giving tutorials or even just having a tea break with you to talk about something that isn’t medicine related. I also love how you never know where a night will lead… (a supposedly ‘tame’ night can lead to staying in Roxy till closing and ending up in Cockfosters). I mean,

wristbands on and I happened to stumble across some hockey people in older years, who ripped my netball wristband off (I was very happy for the decision to be made for me though).

How has RUMS changed you?

I would say that RUMS has given me the confidence that you can only get when you have good friends around you all the time. I think the community that it offers has been amazing and I’m not sure I’d have quite so many funny/crazy stories to tell without it.

Josie Baker

as one of the giant, sneaky bananas. I thoroughly enjoyed ULU-ing as a banana.

it’s saying something that this year I’m living in a house of 6 and we’re all in RUMS.

Talk me through your pre- and post-match rituals

Normally on a Wednesday I go to Sainsbury’s on TCR to grab a meal-deal and some apples (I have made the mistake of Wasabi-ing pre-match and wouldn’t recommend). We then would have a very relaxed warm up and a small motivational speech from the captain, and then start the match! To be honest there isn’t much more to the pre-match ritual…there’s a lot of chatting involved. My favourite post-match ritual involves a ladle of port, some tunes (if someone brings speakers), buying some baklava from the Greek bakery at Southgate and then heading to Sports Night.

What do you think about other UCL and RUMS sports teams?

RUMS Squash is another cracking club (I’m also a member). In first year I went on the NAMS tour to Birmingham with squash and had a great time! I also think netball looks like fun and was thinking of joining in first year. However, at the Fresher’s pub crawl I had both hockey and netball

58

Vol.III No.I


KEYWORKER

LIVING FOR LESS

THREE GREAT LOCATIONS ACROSS LONDON! CAMDEN NW1 Goldsmiths House Single Rooms from £141.61 per week Tel: 0203 202 0381

EARLS COURT SW5 Park House Single Rooms £181.97 per week Tel: 0203 202 0360

HOLBORN WC1 Helen Grahaam House Single Rooms from £184.86 per week Tel: 0203 202 0342

FLEXIBLE CONTRACTS • ALL BILLS INCLUDED • NO HIDDEN CHARGES VALUE FOR MONEY

Our monthly rents start at £615 per month. Optivo specialises in providing good quality and well managed key worker accommodation. Our key worker schemes rents are benchmarked to o�er rates that are up to 20% cheaper than professional landlords in the same areas.

RENT FROM

£615 PER MONTH

WALK TO WORK

All inclusive bills, �exible length contracts, no deposits, no letting agency or inventories fees. Onsite sta� 24x7, communal areas, housekeeping, concierge style receptions are some of the reasons why people choose to stay with us.

info@keyworkeraccommodation.org.uk www.keyworkeraccomodation.org.uk

RUMS Review Vol.III No.I The health & well being issue  
RUMS Review Vol.III No.I The health & well being issue  

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

Advertisement