Saturday, 21 January 2012

National Paediatric Conference for medical students

Hey everyone, sorry for what is more of an advertisement than a post but a medic friend of mine from intercalating asked if I could put this up (and I will prob be attending so if you come along you can try and work out which of the conference attendees is secretly Halfadoc ;D!):

Dear Medical Student,
The BSMS Paediatric Society would like to invite you to theNational Medical Student Paediatric Conference (NMSPC) 2012the very first of it's kind.
Theme: "Journey through Paediatrics" National Medical Student Paediatric Conference
Hosts: Brighton & Sussex Medical School (BSMS) Paediatric Society
Date: 5-6th May Bank Holiday (over 2 days)
Venue: BSMS Teaching Building, University of Sussex, Falmer  Brighton
Confirmed speakers:
Great Ormond Street
Dr Sury (Paediatric Anaesthetist)
Mr Kiely (Paediatric Surgeon-
Dr Brierly (Paediatric ITU)
Brighton & Sussex Medical School
Professor Darrell Evans  (Professor of Anatomy- recently on
Brighton & Sussex University Hospital Trust
Professor Mukhopadhyay (Chair of Paediatrics, Subspecialty Respiratory-
Dr Male (Community Paediatrician- Sub-specialist interest Autism)
The conference will also include;
  • Careers talks
  • Inspiring patients and families of patients
  • Workshops (Paediatric related clinical skills, Paediatrics abroad, Hospice care)  
  • Elective booklet (directory of clinical electives in the UK and abroad)
  • Breakfast, lunch & refreshments provided
  • Poster conference (All poster titles submitted by 15th April 2012 will be displayed peer reviewed National prize for the conference will be awarded-further information to come)
Delegate Social
On the Saturday evening we shall also hold a black tie banquet event at Brighton's seafront Grand Hotel with Dr Keir Shiels(from BBC primetime programme “Junior Doctors: Your Life in their hands”) as an after dinner speaker. The ticket price will include a welcome drink, 3 course meal and 1/2 bottle of wine per person (soft drinks will be available).
Keir Shiels who is the after dinner speaker at conference ball
The conference is over a Bank holiday weekend, we have reserved some affordable accommodation options, book early to avoid disappointment;
Smart Seaview 01273 227497
9-12 St. Catherines Terrace,
East Sussex,

Booked for 5th May (1 night) - reserved until the 1st Feb. 

15 bed dorm @ £20.00pp
12 bed dorm @ £21.99pp
10 bed dorm @ £22.99pp
Company Name = BSMS Paedsoc
Reference Number = 5804
  • Early bird Conference & Ball Combined Ticket- £45.00
  • Conference (2 day)-£20.00
  • Conference (1 day)-£15.00
  • Ball-£27.50
These tickets are limited book early to avoid disappointment. Please follow the link to book your tickets
If you have any further questions please contact the committee on: Join our fb group for up to date information regarding the event:
We look forward to seeing you at the 1st National Medical Student Paediatric Conference.
BSMS Paediatric Society 2011/2012

Wednesday, 11 January 2012

Perfecting my gormless look''

Perfecting my gormless look

December 2011:
Hectic. The one word I would use to describe my life over the last few months.  And the reason that this blog has gone far too long neglected.  Why so busy you ask? (And you would ask, if you realised that at my medical school, 4th year is actually one of the easier ones)
Well here is a quick summary of why (bulletpointed, for timesaving ease - yours and mine!)

1. I've just started my Neurology rotation, this is easily the hardest rotation of the year plus the specialist neurology centre is not in the same city as my medical school so we have to do quite a bit of travelling in this rotation which eats into our time further. Plus means I have tried a little bit (not as much as I should sadly) to do some work outside of rotation time in order to get my brain around wellll the brain.

2. Involved in multiple committees at the moment, apparently one position just wasn't enough for me when I applied for things last year ;)

3. University sport.  Totally my own decision admittedly again, but my teams in a real chance of winning our league this year and theres no way I'm going to let them down now after 4 years of us floating at or very near the bottom of the table!

4. Money, money, money.  Once you get to your fifth year of study, the NHS and the student loan company combine forces to steal the food from your mouth.  You are no longer eligible for SLC to pay your tuition fees but you are still eligible for maintenance loan.  Fortunately the NHS step in from this stage and pay your tuition fees for you - fantastic! Wrong.  Very nice in the long term I'm sure, however in the short term the fact that you are getting an nhs bursary technically (even if you are not getting any maintenance money - this is parental means tested) means the SLC give you less maintenance loan.  So long term = less debt. Short term = less money to live on.  Even though our years are far longer than they have been before (2 week xmas, no easter, 3 week summer, party time is over) and so that reduced amount has to stretch much, much further.
The result of this is that many of us have to work more at this stage (in the paid work sense) far more than we did in lower years (especially as we no longer have that long summer holiday to work and use for getting our banks out of the red!)  even though now is the stage that we should be working less.  So paid work has also eaten some of my "spare" time.

5.  A research project that is a complete nightmare.  See posts on dissertation for my love of research at the best of times!  That one was a doodle to get started compared to this one!

So I've not just been watching J.Kyle rather than blogging (tho there has been the occasional bit of that, who needs good television shows :P ) but I'm going to try and get back on top of blogging again now!

Neurology rotations interesting so far, but challenging.  Its definitely composed of quite a few doctors who enjoy grilling medical students to eat for lunch.  Mostly I either a) answer wrong b) saw errrrm i dunno and look gormless or c) look desperately at other students around me for help who tend to avert their eyes to avoid getting dragged into the carnage themselves! Of course there is the very very occasional d) option which is me fluking a correct answer.  However this is very occasional and would probably be more convincing to the interrogating doctors if the answer wasn't accompanied by a questioning upwards inflection to my voice! Still, learning's what the rotation is all about so hopefully by the end of it not all of my right answers will be flukes! Wish me luck :).

Halfadoc xx

Tuesday, 10 January 2012

PATIENT CHOICE: But what if its the "wrong" choice?!

PATIENT CHOICE: But what if its the "wrong" choice?!

November 2011:
So it is drummed into us since the start of medical school, how important it is to take into account patients opinions about their treatments, patient choice, and treating the whole person (holistic medicine).  We are told that getting patients more involved in their management empowers them, makes them more likely to adhere to the treatment plan and so all in all improves the outcome no end...

I met a patient in clinic during my oncology rotation that really challenged that view for me and caused be to really think about the consequences of patient choice.  Don't worry I'm not about to go on a hardline rant saying patients should not be given a choice, obviously I do not believe this at all, anyone with capacity is entitled to live their life how they wish (even if that way involves shortening it), but I think it is good as a student to learn what the ramifications of patient choice (in certain extreme cases) can be and how best to deal with patients when this occurs / they are resistant to what in your opinion is the gold standard treatment plan....

The patient, who was only in her 40's, had presented to her GP with a fungating form of breast cancer (see picture below), this extreme form at presentation virtually guarantees that however aggressive her particular cancer was, she still must have had symptoms/signs that something was wrong  long before she presented.  Below is a picture of what fungating breast cancer looks like, as you can see, something is very obviously wrong; the lump of the patient I saw actually looked a lot more severe than this (and I saw her late on, after she had received some treatment which had apparently improved the lump somewhat).
Fungating breast cancer
So why did this patient present so late? Well she admitted she had a distrust of doctors and conventional therapy, so she sought alternative therapies to cure her condition first.  When these did not work, she did eventually present to the gp, looking a bit like the picture above...  Unfortunately probably due to the late presentation, she was found to already have lung and bone metastases at this point.  This meant her condition was no longer curable but not that there was nothing conventional medicine could do for her.  She was offered chemotherapy to prolong her life and hopefully reduce symptoms.  Initially she was very reluctant because viewed chemotherapy as very toxic even though the form she would be receiving tends to be tolerated very well.  Eventually she did accept chemotherapy and then sods law, she was one of the unfortunate few who do not tolerate that particular form well, and was quite sick.  Naturally this hadn't exactly improved her opinion of conventional medicine!

During the clinic I saw the patient, the consultant was trying his best to help her in a way that didn't involve chemotherapy and that she would be accepting of.  There was a clinical trial open that he thought she would prefer as it does not involve chemo and thought would be a good palliative treatment for her.  This was really good doctoring in my opinion - he was trying to find a compromise in treatment that the patient would be happy with (or as happy as she would be with any type of conventional therapy).  Unfortunately at this point the alternative medicine option reared its head again, the patient wanted to go to a developing country to consult an alternative healer she had heard about there.  However going there would effectively mean she missed out on being in the trial.  The doctor was very patient with her (even though I'm sure some of her views grated against his own personal views) and just gave her the facts but told her the decision was up to her.

I suppose when it comes to it, that patient doesn't have very long left and it is much better that she spends that time doing what she wants to, rather than living a little longer but spending the whole time in and out of trial appointments when she wasn't keen on being in the trial in the first place.

Of course this patient is not alone in her views, or in having such a horribly negative outcome because of them.  Steve Jobs (Apple creator) had his cancer picked up early as it was an incidental finding... however sadly he spent years seeking alternative therapy cures to his cancer before finally agreeing to give conventional therapy a shot.  But as you can tell from his case, an alternative choice is not the sign of low intelligence or lack of decision making capacity, Steve Jobs was obviously highly intelligent and successful.   Basically I guess people have to be free to make their own mistakes - all you can do is give them the information, show them the evidence, but if they choose to ignore that then you have to just help them in whatever ways they will allow you and not let their choices change your standard of care.
A sobering reminder of what the consequences of ignoring medical advice can be