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Medical students and professionals sharing their thoughts and experiences.
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The Arterial Highway

Metaphors and analogies have long been used to turn complex medical concepts into everyday ones, albeit with fancy terminology. Having been involved with many 3D animations on the topics of Blood Pressure, arteriosclerosis, cholesterol and the like, we find that often a metaphor goes a long way to building understanding, credibility and even compliance with patients. One of my favorite analogies is what we call the arterial highway. Much like their tarmacked counterparts, arteries act as conduits for all the parts that make your body go. A city typically uses highways, gas lines, water pipes, railways and other infrastructure to distribute important materials to its people. Your body is much the same, except that it does it all in one system, the cardiovascular system. This is used to deliver nutrients, extract waste, transport and deliver oxygen and even to maintain the temperature! The arteries can do all these things because of their smart three-layered structure. Our arteries consist of a muscular tube lined by smooth tissue. They have three layers named – the Adventitia, Media and Intima. Each is designed with a specific function and through the magic of evolution has developed to perform its function perfectly. The first is the Tunica Adventitia, or just adventitia. It is a strong outer covering over the arteries and veins. It has special tissues that are fibrous. The fibers let the arteries flex, expanding and contracting to accommodate changes in blood pressure as the blood flows past it. Unlike a steel pipe, arteries pulsate and so must be at once be flexible, and strong. Tunica Media - the middle layer of the walls of arteries and veins is made up of a smooth muscle with some elasticity built in. This layer expands and contracts in a rhythmic fashion, much like a Wave at a baseball game, as blood moves along it. The media layer is thicker in arteries than in veins, and importantly so, as arteries carry blood at a higher pressure than veins. The innermost layer of arteries and veins is the Tunica Intima. In arteries, this layer is composed of an elastic lining and smooth endothelium - a thin sheet of cells that form a type of skin over the surface. The elastic tissue present in the artery can stretch and return, allowing the arteries to adapt to changes in flow and blood pressure. The intima is also a very smoothe, slick layer so that blood can easily flow past it. Every layer of the artery has developed evolutionary traits that help your arterial system to maintain flexibility, strength and promote blood flow. Diseases and conditions like high cholesterol or high blood pressure, diabetes and others prevent the arteries from doing their function well by creating blockages or increasing the stress on one or more of the layers. For example, high blood pressure causes rips in the smooth lining of the Intima. Anybody who has experienced a pipe burst in a house knows that the damage can be extreme and can never fully be restored. Understanding the delicate functions of the arterial structure gives good incentive to treat them better. Conditions like high blood pressure, high cholesterol and lifestyle diseases such as diabetes create tears, holes, blockages, and can disrupt the functions of one or more layers. Getting patients to visualize the effect of bad eating habits on their anatomy helps to increase patient compliance. In modern society, the concept of highways goes hand in hand with the concept of traffic jams. Patients understand that the arterial highway is one that can never be jammed.  
Mr. Rohit Singh
about 5 years ago
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The NEW Birmingham Students Medical Leadership Society

Who are we? This society has been formed by a core group of clinical year medical students at the University of Birmingham. We are hoping that lots more healthcare students at UoB will join us soon. This society is open to any student who has a keen interest in healthcare management – Nurse, physio, BMedSc, Medical student, Business student, dentist and pharmacist are all welcome. Why do we exist? Healthcare has become more complex. To ensure that patient’s receive the most effective treatments then healthcare services need to be organised effectively. This might be your role one day and you won’t receive any formal training in management theory or on team working and leadership skills from the University – knowledge that is essential to providing the best care for our patients. Studies have shown that clinicians who have received management training and who take an active role in managing the departments they belong to have achieved significantly decreased complication and mortality rates. What do we plan to do? 1) Raise awareness amongst healthcare students about the opportunities to be involved in healthcare management in their future careers. 2) The society hopes to act as an intermediary between healthcare students keen to make contacts with likeminded individuals in other course and years. We intend to have regular social events that allow everyone to practice their essential networking skills while at discussions over coffee, nights out, games of golf or away day visits to conferences and organisational visits. 3) The society will be holding lectures given by eminent professionals from all areas of healthcare management – The NHS, DoH, Armed forces, private organisations, think tanks, consultancy firms and leading researchers. 4) The society aims to help students foster essential leadership and team working skills that will be required in their future professional roles. These skills will be developed informally and during seminars and workshops. These skills will then be put to the test in high stress situations like Paintballing, laser tag and outdoor activities. 5) The final main aim of this society is to help students make contacts with clinicians and researchers who are working on improving healthcare systems and who need healthcare students to help with research. We hope to develop a network of contacts who are willing to provide research and audit opportunities to keen students. Are you interested in joining the Birmingham Students Medical Leadership Society? Then please email the committee at: med.leadership.soc.uob@gmail.com Or join us on Facebook: https://www.facebook.com/groups/676838225676202/ Or come find us at the MedSoc Freshers fair in September. The Student medical leadership society (SMiLeS) useful resources!!! Why is it important? student BMJ 2012;345:e5319 http://www.leadingsystemsnetwork.com/pdf/Management_Matters.pdf http://www.bmj.com/rapid-response/2011/11/02/improving-performance-nhs http://www.bmj.com/content/345/bmj.e5015 http://www.ncbi.nlm.nih.gov/pubmed/?term=healthcare+reform Undergrad oppurtunities http://www.diagnosisltd.co.uk/ http://www.ihi.org/offerings/ihiopenschool/Pages/default.aspx http://www3.imperial.ac.uk/business-school/programmes/msc-health-management?gclid=CPTQy6bCwLgCFS3HtAodZ1sAtQ http://medicalleadership.net/committee/ http://www.lead-in.co.uk/ http://www.ihi.org/offerings/IHIOpenSchool/Chapters/Pages/SQLA.aspx Foundation year opportunities http://www.stfs.org.uk/faculty/leadership Future career opportunities http://www.leadership.londondeanery.ac.uk/home/fellowships%20in%20clinical%20education http://www.nuffieldtrust.org.uk/get-involved/harkness-fellowship Higher Education http://www.surrey.ac.uk/postgraduate/courses/business/healthcaremanagement/ http://www.open.ac.uk/health-and-social-care/main/study-us/leadership http://www.manchester.ac.uk/postgraduate/taughtdegrees/courses/atoz/course/?code=05855 http://www.brunel.ac.uk/bbs/mba/mba-specialisations/healthcare-management http://www.birmingham.ac.uk/students/courses/postgraduate/taught/social-policy/health-care-policy-management.aspx http://www.birmingham.ac.uk/schools/social-policy/departments/health-services-management-centre/index.aspx Free Learning/ Relevant organisations http://www.qficonsulting.com/healthcare/qfi-healthcare http://www.tocthinkers.com/ http://www.tocthinkers.com/2012/05/qa-performance-improvement-for-healthcare-leading-change-with-lean-six-sigma-and-constraints-managem.html http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/theory_of_constraints.html http://www.dbrmfg.co.nz https://www.google.co.uk/search?q=theory+of+constraints&rlz=1C1CHMC_enGB501GB502&oq=Theory+of+con&aqs=chrome.0.0j69i57j5j69i65j0j69i62.4977j0&sourceid=chrome&ie=UTF-8 http://en.wikipedia.org/wiki/Theory_of_constraints http://www.york.ac.uk/che/ http://www.ihm.org.uk/ Relevant Journals http://www.bmj.com/highwire/filestream/342359/field_highwire_article_pdf/0/bmj.c5072.full.pdf www.civitas.org.uk/doctors/index.php http://www.bmj.com/highwire/filestream/342359/field_highwire_article_pdf/0/bmj.c5072.full.pdf http://www.hsj.co.uk/# http://www.bjhcm.co.uk/ book list http://www.amazon.co.uk/Performance-Improvement-Healthcare-Constraints-ebook/dp/B005RWFOSE/ref=sr_1_1?ie=UTF8&qid=1374945477&sr=8-1&keywords=Performance+Improvement+for+Healthcare http://www.amazon.co.uk/s/ref=nb_sb_ss_i_0_6?url=search-alias%3Ddigital-text&field-keywords=goldratt&sprefix=Goldra%2Cdigital-text%2C142&rh=i%3Adigital-text%2Ck%3Agoldratt Final Summary Did you know that you may not just work for the NHS, but also help to run it? The new Medical Leadership Society aims to foster leadership skills in healthcare students through talks from NHS leaders, the DoH and even the Armed Forces. We provide a way for you to learn about being a leader and influencing policies in the NHS, and our talks and events will serve as an excellent platform for you to start making influential contacts within areas that interest you. You’ll also practice those leadership skills in an array of activities, including paintballing and laser tag!  
jacob matthews
about 5 years ago
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So you want to be a medical student: READ THIS!

There are so many sources for advice out there for potential medical students. So many books, so many forums, so many careers advice people, and so many confusing and scary myths, that I thought it might be useful to just put up some simple guidelines on what is required to become a medical student and a short book list to get your started. I am now in my 5th year at university and my 4th year of actual medicine. Since getting into Medical School in 2009 I have gone back to my 6th form college in South Wales at least once a year to talk to the students who wanted to become medical or dental students, to offer some advice, answer any queries that I could. This year, I tried to to do the same sort of thing for high achieving pupils at my old comprehensive, because if you don't get the right advice young enough then you won't be able to do everything that is required of you to get into Medical school straight after your A-levels. Unfortunately, due to some new rules I wasn't allowed to. So, since I couldn't give any advice in person I thought that a blog might be the easiest alternative way to give young comprehensive students a guide in the right direction. So here goes... How to get into medical school: You must show that you have the academic capacity to cope with the huge volume of information that will try to teach you and that you have the determination/tenacity to achieve what you need to. To show this you must get good grades: a. >8A*s at GCSE + separate science modules if possible = you have to be able to do science. b. >3A’s at A-Level = Chemistry + Biology + anything else you want, as long as you can get an A. 2. You must have an understanding of what Medicine really involves: a. Work experience with a doctor – local GP, hospital work experience day, family connections, school connections – you should try to get as much as you can but don’t worry if you can’t because you can make up for it in other areas. b. Work experience with any health care professional – ask to see what a nurse/ physio/ health care assistant/ phlebotomist/ ward secretary does. Any exposure to the clinical environment will give you an insight into what happens and gives you something to talk about during personal statements and interviews. c. Caring experience – apply to help out in local care homes, in disabled people’s homes, at charities, look after younger pupils at school. All these sorts of things help to show that you are dedicated, motivated and that you want to help people. 3. Be a fully rounded human being: a. Medical schools do not want robots! They want students who are smart but who are also able to engage with the common man. So hobbies and interests are a good way of showing that you are more than just a learner. b. Playing on sports teams allows you to write about how you have developed as a person and helps you develop essential characteristics like team work, fair play, learning to follow commands, learning to think for yourself, hand-eye co-ordination etc. etc. All valuable for a career in medicine. c. Playing an instrument again shows an ability to learn and the will power to sit and perfect a skill. It also provides you with useful skills that you can use to be sociable and make friends, such as joining student choirs, orchestras and bands or just playing some tunes at a party. d. Do fun things! Medicine is hard work so you need to be able to do something that will help you relax and allow you to blow off some stress. All work and no play, makes a burnt out wreck! 4. Have a basic knowledge of: a. The news, especially the health news – Daily Telegraph health section on a Monday, BBC news etc. b. The career of a doctor – how does it work? How many years of training? What roles would you do? What exams do you need to pass? How many years at medical school? c. The GMC – know about the “Tomorrow’s Doctor” Document – search google. d. The BMA e. The Department of Health and NHS structure – know the basics! GP commissioning bodies, strategic health authorities. f. What the Medical School you are applying to specialises in, does it do lots of cancer research? Does it do dissection? Does it pride itself on the number of GPs it produces? Does it require extra entry exams or what is the interview process? These 4 points are very basic and are just a very rough guide to consider for anyone applying to become a medical student. There are many more things you can do and loads of useful little tips that you will pick up along the way. If anyone has any great tips they would like to share then please do leave them as a comment below! My final thought for this blog is; READ, READ and READ some more. I am sure that the reason I got into medical school was because I had read so many inspiring and thought provoking books, I had something to say in interviews and I had already had ideas planted in my head by the books that I could then bring up for discussion with the interview panel when asked about ethical dilemmas or where medicine is going. Plus reading books about medicine can be so inspiring that they really can push your life in a whole new direction or just give you something to chat about with friends and family. Everyone loves to chat people – how they work, why they are ill, what shapes peoples' personalities etc and these are all a part of medicine that you can read into! Book Recommendations Must reads: http://www.amazon.co.uk/Trust-Me-Im-Junior-Doctor/dp/0340962054/ref=sr_1_1?s=books&ie=UTF8&qid=1374240729&sr=1-1&keywords=trust+me+i%27m+a+junior+doctor http://www.amazon.co.uk/Rise-Fall-Modern-Medicine/dp/0349123756/ref=sr_1_1?s=books&ie=UTF8&qid=1374240763&sr=1-1&keywords=the+rise+and+fall+of+modern+medicine http://www.amazon.co.uk/Selfish-Gene-30th-Anniversary/dp/0199291152/ref=sr_1_1?s=books&ie=UTF8&qid=1374240793&sr=1-1&keywords=the+selfish+gene http://student.bmj.com/student/student-bmj.html http://www.newscientist.com/subs/offer?pg=bdlecpyhvyhuk1306&prom=1234&gclid=CLT0tZ3Wu7gCFfLHtAodWwUAyA http://www.amazon.co.uk/Man-Who-Mistook-His-Wife/dp/B005M1NBYY/ref=sr_1_3?s=books&ie=UTF8&qid=1374240909&sr=1-3&keywords=the+man+who+mistook+his+wife+for+a+hat http://www.amazon.co.uk/Better-Surgeons-Performance-Atul-Gawande/dp/1861976577/ref=sr_1_1?s=books&ie=UTF8&qid=1374240987&sr=1-1&keywords=better+atul+gawande http://www.amazon.co.uk/House-Black-Swan-Samuel-Shem/dp/0552991228/ref=sr_1_1?s=books&ie=UTF8&qid=1374241124&sr=1-1&keywords=the+house+of+god+samuel+shem http://www.amazon.co.uk/Bad-Science-Ben-Goldacre/dp/000728487X/ref=sr_1_1?s=books&ie=UTF8&qid=1374241298&sr=1-1&keywords=bad+science+ben+goldacre Thought provokers: http://www.amazon.co.uk/Complications-Surgeons-Notes-Imperfect-Science/dp/1846681324/ref=sr_1_1?s=books&ie=UTF8&qid=1374241026&sr=1-1&keywords=atul+gawande+complications http://www.amazon.co.uk/Checklist-Manifesto-How-Things-Right/dp/1846683149/ref=sr_1_1?s=books&ie=UTF8&qid=1374241049&sr=1-1&keywords=atul+gawande+checklist http://www.amazon.co.uk/Brave-New-World-Aldous-Huxley/dp/0099518473/ref=sr_1_1?s=books&ie=UTF8&qid=1374241067&sr=1-1&keywords=aldous+huxley http://www.amazon.co.uk/Island-Aldous-Huxley/dp/0099477777/ref=sr_1_1?s=books&ie=UTF8&qid=1374241093&sr=1-1&keywords=aldous+huxley+island http://www.amazon.co.uk/Mount-Misery-Samuel-Shem/dp/055277622X/ref=pd_sim_b_4 http://www.amazon.co.uk/Psychopath-Test-Jon-Ronson/dp/0330492276/ref=sr_1_1?s=books&ie=UTF8&qid=1374241180&sr=1-1&keywords=the+psychopath+test http://www.amazon.co.uk/Drugs-Without-Minimising-Harms-Illegal/dp/1906860165/ref=sr_1_1?s=books&ie=UTF8&qid=1374241197&sr=1-1&keywords=drugs+without+the+hot+air http://www.amazon.co.uk/How-Win-Friends-Influence-People/dp/0091906814/ref=sr_1_1?s=books&ie=UTF8&qid=1374241222&sr=1-1&keywords=how+to+win+friends+and+influence+people http://www.amazon.co.uk/Bad-Pharma-companies-mislead-patients/dp/0007350740/ref=pd_bxgy_b_img_y Final Final Thought: Just go into your local book shop or library and go to the pop-science section and read the first thing that takes your interest! It will almost always give you something to talk about.  
jacob matthews
about 5 years ago
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Obesity Part 1 – Fat Kid in a Fat Society

Introduction to Obesity One of my favourite past-times is to sit in a bar, restaurant, café or coffee shop and people watch. I am sure many of you reading this also enjoying doing this too. People are fascinating and it is intriguing to observe: what they do; how they act; what they wear and what they look like. My family and I have always observed those around us and discussed interesting points about others that we have noticed. When I first came up to visit Birmingham University my family all sat in a coffee shop in the centre of Birmingham and noticed that on average the people walking past us looked much slimmer than what we were used to seeing back in south Wales. Now, when I go home it is more painfully obvious than ever that the people in my home region are much, much heavier than they should be and are noticeably bigger than they used to be even a short number of years ago. This change in the population around me is what first made me seriously think about obesity, as a major problem affecting the world today. Nowadays obesity is all around us! It is noticeable, it is spreading and it should worry us all. Not just for our own individual health but also for the health of our society. Obesity affects everything from the social dynamic of families, to relationships at school or work, to how much the NHS costs to run. Obesity is a massive problem and if we as a society don’t start getting to grips with it, then it will have huge implications for all of us! I am currently in my 5th year at medical school. While I have been here I have taken a keen interest in obesity. The physiology, the psychology, the anatomy, the statistics and the wider affects on society of obesity have all been covered in curriculum lectures and extra curriculum lectures. I have taken part in additional modules on these subjects and sort out many experts in this field while on hospital placements. Obesity is fascinating for some many reasons and I thought that it would be a great topic to write some blogs about and hopefully start some discussions. Warning For my first blog on the topic of obesity I quickly want to write a bit about myself and my battle with weight. Everyone’s favourite topic is themselves, but I like to think that’s not why I have written this and I hope it doesn’t come across as a narcissistic ramble. I don’t intend to try and make myself come off well or suggest that I have all the answers (because I know very well that I don’t) and I hope it doesn’t come across like that. I want to write a bit of an autobiography because I wish to demonstrate how easy it is to go from a chunky kid to a technically obese teenager to a relatively fat adult without really realising what was happening. Chunky Child to Fat adult While planning this blog I realised that my Meducation profile picture was taken when I was at my all time fattest. At the graduation ceremony at the end of my 3rd year at university after completing my intercalation I was over 19 stones. At 6 foot 2” this gave me a BMI of >33 which is clinically obese. I had a neck circumference of >18”, a chest circumference of 48”, a waist of >40”, a seat of >52” and a thigh circumference of >28” per leg. Why do I know all of these rather obscure measurements? Partly because I am quite obsessive but mainly because I had to go to buy a tailor made suit because I could no longer buy a suit from a shop that I could fit into and still be able to move in. The only options left to me where massive black tent-suits or to go to a tailors. After the graduation I sat down at my computer (whilst eating a block of cheese) and compared my face from the graduation photos to pictures I had taken at the start of university and the difference in shape and size was amazingly obvious. I had got fat! I realised that if I had a patient who was my age and looked like me with my measurements then I would tell him to lose weight for the good of his health. So, I decided that finally enough was enough and I that I should do something about it. Before I describe how I got on with the weight management I will quickly tell the back story of how I came to be this size. I have always been a big guy. I come from a big family. I have big bones. I had “puppy fat”. I was surrounded by people who ate too much, ate rubbish and were over weight themselves, so I didn’t always feel that there was anything wrong with carrying a bit of tub around the middle. When I went to comprehensive school at age 12 I had a 36” waist. I thought I carried the weight quite well because I was always tall and had big ribs I could sort of hide the soft belly. Soon after arriving at the new school I had put on more weight and for the first time in my life I started to get bullied for being fat! And I didn’t like it. It made me really self-aware and knocked my confidence. Luckily, we started being taught rugby in PE lessons and I soon found that being bigger, heavier and stronger than everyone else was a massive advantage. I soon got my own back on the bullies… there is nowhere to hide on a rugby field! This helped me gain my confidence and I realised that the only way to stop the bullying was to confront the bullies and to remake myself in such a way as that they would be unable to bully me. I decided to take up rugby and to start getting fit. I joined a local club, starting playing regularly, joined a gym and was soon looking less tubby. Reflecting (good medical jargon, check) on my life now I can see that my PE teachers saved me. By getting me hooked on rugby they helped get me into many other sports and physical activity in general and without their initial support I think my life would have gone very differently. Rugby was my saviour and also later on a bit of a curse. As I grew up I got bigger and bigger but also sportier. I started putting muscle on my shoulders, chest and legs which I was convinced hid how fat I actually was. I developed a body shape that was large but solid. I was convinced that although I was still carrying lots of excess weight I no longer looked tubby-fat. When I was 14 my PE teachers introduced me to athletics. They soon realised that I was built for shot putt and discuss throwing and after some initial success at small school competitions I joined a club and took it up seriously. At this age I had a waist of about 38” but was doing about 3-4 hours of exercise almost everyday, what with rugby, running, gym, swimming and athletics – in and out of school. My weight had by now increased to roughly 15 stones and my BMI was over 30. I was physically fit and succeeding at sport but still carrying quite a lot of fat. I no longer thought of myself as fat but I knew that other people did. Between the ages of 14 and 18 I started to be picked for regional teams in rugby and for international athletic competitions for Wales. My sporting career was going very well but the downside of this was that I was doing sports that benefited from me being heavier. So the better I got the heavier I wanted to become. I got to the stage where I was eating almost every hour and doing my best to put on weight. At the time I thought that I was putting on muscle and being a huge, toned sports machine. It took me a while to realise that actually my muscles weren't getting any bigger but my waist was! By the time I had completed my A-levels I was for the first time over 18 stones and had a waste of nearly 40”. So, at this point I was doing everything that I had been told that would make me more adapted for my sport and I was succeeding but without noticing it I was actually putting on lots of useless excess weight that in the long term was not good for me! During my first year of university I gave up athletics and decided that I no longer needed to be as heavy for my sports. This decision combined with living away from home, cooking for myself and walking over an hour a day to and from Uni soon began to bear fruit. By the summer of my first year at Uni, aged 19, I had for the first time in my life managed to control my weight. When I came to Uni I was 18 stone. After that first year I was down to 14 stone – a weight I had not been since I was 14 years old! I had played rugby for the Medical school during my first year but as a 2nd row/back row substitute. These positions needed me to be fit and not necessarily all that heavy and this helped me lose the weight. During my second year I began to start as a 2nd row and was soon asked to help out in the front row. I enjoyed playing these positions and again realised that I was pretty good at it and that extra weight would make me even better. So between 2nd year and the end of 3rd year I had put on nearly 5 stone in weight and this put me back to where I started at my graduation at the end of 3rd year. The ironic and sad thing is about all this that the fatter, less “good looking” and unhealthier I became, the better I was adapted for the sports I had chosen. It had never occurred to me that being good at competitive sports might actually be bad for my health. The Change and life lessons learnt At the beginning of my 4th year I had realised that I was fatter than I should be and had started to pick up a number of niggly injuries from playing these tough, body destroying positions in rugby. I decided that I would start to take the rugby less seriously and aim to stay fit and healthy rather than be good at a competitive sport. With this new attitude to life I resolved to lose weight. Over the course of the year there were a number of ups and downs. I firstly went back to all the men’s health magazines that I had stock piled over the years and started to work out where I was going wrong with my health. After a little investigation it became apparent that going running and working out in the gym was not enough to become healthy. If you want to be slim and healthy then your diet is far more important than what physical activity you do. My diet used to be almost entirely based on red meat and carbs: steak, mince, bacon, rice and pasta. Over the year I changed my diet to involve far more vegetables, more fibre, more fruit, more salad and way less meat! The result was that by Christmas 2012 I was finally back below 18 stones. The diet had started to have benefits. Then came exams! By the end of exams in April 2013 I had gone back up 19 stones and a waist of >40”. I was still spending nearly 2 hours a day doing weights in the gym and running or cycling 3 times a week. Even with all this exercise and a new self- awareness of my size, a terrible diet over the 3 week exam period had meant that I gained a lot of fat. After exams I went travelling in China for 3 weeks. While I was there I ate only local food and lots of coffee. Did not each lunch and was walking around exploring for over 6 hours a day. When I got back I was 17.5 stone, about 106kg. My waist had shrunk back down to 36” and I could fit into clothes I had not worn in years. This sudden weight loss was not explained by traveller’s diarrhoea or any increased activity above normal. What made me lose weight was eating a fairly healthy diet and eating far less calories than I normally would. I know this sounds like common sense but I had always read and believed that if you exercised enough then you could lose weight without having to decrease your calorie intake too much. I have always hated the sensation of being hungry and have always eaten regular to avoid this awful gnawing sensation. I had almost become hunger-phobic, always eating when given the opportunity just in case I might feel hungry later and not because I actually needed to eat. The time in China made me realise that actually I don’t NEED to eat that regularly and I don’t NEED to eat that much. I can survive perfectly ably without regular sustenance and have more than enough fat stores to live my life fully without needing to each too much. My eating had just become a habit, a WANT and completely unnecessary. After being home for a month I have had some ups and downs trying to put my new plans into action. Not eating works really easily in a foreign country, where it’s hot, you are busy and you don’t have a house full of food or relatives that want to feed you. I have managed to maintain my weight around 17.5 stones and kept my waist within 36” trousers. I am counting that as a success so far. The plan from now on is to get my weight down to under 16.5 stones because I believe that as this weight I will not be carrying too much excess weight and my BMI will be as close to “not obese” as it is likely to get without going on a starvation diet. I intend to achieve this goal by maintain my level of physical activity – at least 6 hours of gym work a week, 2 cardio sessions, tennis, squash, cycling, swimming and golf as the whim takes me. BUT MORE IMPORTANTLY, I intend to survive off far fewer calories with a diet based on bran flakes, salad, fruit, nuts, chicken and milk. I am hoping that this very simple plan will work! Conclusion Writing this short(-ish) autobiography was quite cathartic and I would really recommend it for other people who are trying to remake themselves. Its helped me put my thoughts in order. Over the years I wanted to lose weight because I wanted to look better. This desire has now matured into a drive to be not just slimmer but healthier; I no longer want to be slimmer just for the looks but also to reduce the pressure on my joints, to reduce the pressure on my cardiovascular system, to reduce my risks of being fat when I am older, to hopefully reduce the risk of dying prematurely and to some extent to make life cheaper – eating loads of meat to prevent hunger is expensive! I hope this blog has been mildly interesting, but also informative of just how easy it is for even a health conscious, sporty individual to become fat in our society. I also wanted to document how difficult it is to lose weight and maintain that new lower weight for any prolonged length of time. At some point I would like to do a blog on the best methods for weight loss but that may have to wait until I have found what works for me and if I do actually manage to achieve my goals. Would be a bit hypercritical to write such a blog while still having a BMI yo-yoing around 32 I feel! Thought for the day 1 - Gaining wait is easy, becoming fat is easy, losing fat is also technically easy! The hard part is developing AND then maintaining a healthy mental attitude towards your weight. The human body has evolved to survive starvation. We are almost perfectly made to build up high density fat stores just in case next year’s crops fail and we have to go a few months on broth. I will say it again – We are designed to survive hard conditions! The problem with the modern world and with modern society is that we no longer have to fight to survive. For the first time in human history food is no longer scarce… it is in fact incredibly abundant and cheap (http://www.youtube.com/watch?v=-Z74og9HbTM). It is no surprise that when a human body is allowed to eat want and how much it craves and then do as little activity as possible, that it puts on fat very quickly. This has to be one of the major ironies of our age – When the human race has evolved society enough that we no longer need to have fat stores in case of disaster, that we are now the fattest humans have ever been! 2 – The best bit of advice I was ever given is this: “Diets ALWAYS fail! No matter what the diet or how determined you are, if you diet then within 2 years you will be the same weight or heavier than you are now. The only way to a healthy body is through a healthy LIFESTYLE CHANGE! You have to make changes that you are prepared to keep for a long time.”  
jacob matthews
about 5 years ago
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66

Current Social Media Guidance

Hello & Welcome! You may have already read my blog on 'My Top 5 Tips to use Social Media to Improve your Medical Education' and if so you will have an idea of what 'Social Media' is and how it can be harnessed to improve medical education. There are also features that could improve health promotion and communication but today I would like to focus on where we have to be careful with these resources. In my last blog I circumnavigated the drawbacks of social media in medicine so that I could give them the full attention they deserve in their own blog today. But its not all doom and gloom! I also hope to give you a brief overview of the current social media guidance that is available to doctors and medical students and how we can minimise the risks associated with representing ourselves online. But firstly, what actually is social media and why do i keep blogging about it? If you are new here I recommend giving 'Social Media' a quick google, but the phrase basically includes any website where the user (i.e. you) can upload information and interact with other users. Thats a definition of the top of my head, so don't hold me to it, but most people would agree that this definition includes the classic examples of Facebook, Twitter, YouTube, Linkedin etc, but there are many many more. These sites are important to us as (future) health professionals because they can be both used and unfortunately abused. However, several medical bodies including the General Medical Council and the Royal College of General Practitioners agree that these resources are here to stay and they shouldn't (and probably couldn't) be excommunicated. With this in mind, there has been much guidance on the topic, but as you are about to find out a lot of it is common sense and your own personal discretion. Before you read on, I'd like to forewarn you that I try and keep things lighthearted with this topic. I'll hope you can excuse my levity of the situation, especially if any of the original authors of these guidelines end up reading this post. But as I am sure you are aware, this is a dry topic and hard to digest without the odd joke or two... British Medical Association - Using Social Media: practical and ethical guidance for doctors and medical 2011 The BMA guidance is the earliest guidance originating from a major medical body that i've come across. That said, I have not done a proper literature review of the subject. This is a blog, not a dissertation. But still, the BMA gives an early and brief summary of the problems facing health professionals using social media. Key points such as patient confidentiality, personal privacy, defamation, copyright and online professionalism are covered and therefore it is a nice starting point. It is also quite a short document, which may appeal to those who are less feverent on the subject. On the other hand, I personally feel that the BMA guidance does social media an injustice by not going into the great benefits these resources can yield. There are also no really practical tips or solutions for the drawbacks they've highlighted to students. Read it for yourself here or just google 'BMA Guidance Social Media' Royal College of General Practitioners - Social Media Highway Code Feb 2013 The RCGP guidelines are my favourite. After a cheesy introduction likening the social media surge with the dawn of the automobile they then take a turn for the worse by trying to continue the metaphor further by sharing a 'Social Media Highway Code'. Their Top 10 Tips that form the majority of the code don't look to be much more than common sense. However, each chapter there after dissects each of their recommendations in great detail and provides practical tips on how to make the most from social media whilst protecting yourself from the issues raised above. As I mentioned earlier, the RCGP recognise the inevitability of social media and they acknowledge this in the better part of their introduction. They make a great point that older doctors have a responsibility to become technologically savvy, whereas younger doctors who have grown up engrossed in social networking probably have to develop their professionalism skills more than their older colleagues (I'm aware this is a generalising statement). Either way, the RCGP highlight that everyone has something to take away from this set of guidelines. Read it for yourself here or google; 'RCGP Social Media Guidance,' but be warned, this is one of the more lengthy documents available on the topic. General Medical Council - Doctor's Use of Social Media April 2013 The GMC guidance kicks off with a little summary of the relevant bits of 'Good Medical Practice.' Again, nothing much that isn't common sense. That being said, they then go on to write that 'Serious or persistent failure to follow this guidance will put your registration at risk,' which sounds ominous and probably warrants a quick flick through (do it now! - the PDF is at the bottom of their page). Reassuringly, the GMC does not try and place a blanket ban on social media. They give a 'tip of the hat' to the benefits of social media and then go on to outline all the drawbacks as many of the guidance already has. Asides from the issue of anonymity there is really nothing new covered and the GMC actually gives a lot of autonomy to doctors and medical students. However, the GMC are, in many ways, who we ultimately answer to and so you would be a fool not to revisit the issues they cover in their version of the guidance. As I mentioned, the GMC brought online anonymity to the forefront of our minds. Should we, shouldn't we? A lot of health professionals believe that the human right to a private life extends to the right to have anonymity online. However, before we go into this any further lets take a closer look at what the GMC actually says... If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the view of the profession more widely. As you can see, the use of the phrase 'Should also identify yourself by name' gives some room for manoeuvre and is a world apart from what could have been written (i.e. you must). To those who believe their human rights are being infringed, perhaps a solution is to stop identifying yourself as a doctor online, although I appreciate this can be difficult if you are tagged in certain things. There are a number of good points why doctors shouldn't be anonymous online and it is certainly a must if you are in the trade of offering health promotion via the world wide web. However, I can see the point of those who want to remain anonymous for comical or satirical purposes. A quick google of the topic will reveal that the GMC has said that they do not envisage fitness to practice issues arising from doctors remaining anonymous online, but from the temptations that arise from running an anonymous profile such as cyber-bullying and misinformation. Read the GMC guidance yourself here. National Health Service (Health Education) - Social Media in Education May 2013 The NHS-HE guidelines are high quality and cover the entire scope of what social media means to medicine. There are several key issues that I haven't encountered elsewhere. This set of guidance is written from a managerial, technical perspective. It doesn't really feel aimed at doctors or medical students but it gives such an overview of the subject that I thought it was worth including. If you feel brave enough, read it for yourself here. Conclusion To my knowledge, these are the current key guidelines for the use of social media in medicine. I hope you have found this blog useful in providing a quick summary of a topic that is becoming increasingly swamped with lengthy guidelines. In the future we need to see material produced or delivered that educates health professionals in how to use social media, rather than regurgitating the pros and cons every couple of months. I think webicina is a good example of a social media 'training course,' . There should be more material like this. Perhaps this is where I'm headed with my next project... As always, if you have anything to add to this blog, please feel free to add to the comments below. I will be able to take difficult queries forwards with me to the Doctors 2.0 conference next week! If you are a student and interested in coming to the conference in Paris next week you should get in contact with me directly (@LFarmery on twitter). Also, it would be a great help if you could fill out my very quick pilot survey to help me understand how doctors and medical students currently use social media. Also see my website Occipital Designs LARF Disclaimer The thoughts and feelings expressed here are those produced by my own being and are not representative in part or whole of any organisation or company. Occipital Designs is a rather clunky, thinly veiled, pseudonym. If you would like to contact me please do so on Twitter...  
Dr. Luke Farmery
over 5 years ago
Foo20151013 2023 w5wmg1?1444774074
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622

Exam Survival Guide

1. Sleep (I realize I’m posting this at 12:30 am…) (http://www.helpguide.org/life/sleep_tips.htm) I know there’s a popular perception of sleep deprivation going hand in hand with working hard or succeeding academically. However, that is only true if you’re working very last minute, and don’t care about retaining the information–you basically just want to get through your upcoming test/assignment. I would like to clarify that, although learning about 10 months of material in 2 weeks is overwhelming, it is NOT last minute because whatever you’re working on right now, you’ll have to remember in 2 weeks for your exam. Besides the exam, if you’re studying medicine, you need to remember most of these things for the rest of your life. In order to retain that information, you need to stay alert, well rested and motivated. Prolonged sleep deprivation can make you feel very ‘CBA’ very fast. 2. Stay Energized Sleep is only one factor in staying motivated and alert; another is staying energized¬–in a healthy way. Simply put: if you feel well, you’ll work well. Eat well: difficult, I know, when you’ve got so little time to spare; but as much as you can, try to eat more whole foods (aka things that don’t come in wrappers or have their own commercial) and keep a balanced diet (too much of anything is usually not good). Everyone snacks while they’re doing exams, but try to find a vice that won’t put you in a sugar coma (some good examples include berries and other fruits, nuts, carrots with hummus to dip in, granola bars, etc). Note: drinking tea is also an excellent way to stay energized! Stay active: Again, I know something like this is difficult to keep up in normal everyday life, let alone during exam stress. Even if it is just for 15-20 minutes, some cardio (note: the more strenuous the workout in a short period of time, the more benefit you’ll get) is a fantastic ‘eye-opener’ (I learned that phrase while learning how to take an alcohol history and now I really like it)! No one wants to go for a run in the morning, but after you get past the first 2-3 minutes of wanting to collapse, your body starts to feel really grateful. This is the BEST way to stimulate your senses and wake yourself up. I promise it’s better than any energy drink or cup of coffee you could have. Take small breaks: SMALL breaks!!! About 10 minutes. Every once in a while, you need to get up and walk around to give yourself a break, have some fresh air, grab a snack, but try not to get carried away; try to avoid having a short attention span. 3. Make Lists I cannot stress enough how counterproductive it is to overwhelm yourself with the amount of work you have. Whether you think about it or not, that pile is not going anywhere. Thinking about it won’t wish it away. Stop psyching yourself out and just get on with it– step by step. Making a list of objectives you need to accomplish that day or week is a great way to start; then, cross them out as you go along (such a satisfying feeling). Being able to visualize your progress will be a great motivator. Remember: it is important to be systematic with your studying approach; if you jump around between modules because they’re boring you’re just going to confuse yourself and make it hard to remember things when that exam comes Note: I have a white board in my room where I write my objectives for the week. Some days it motivates, some days it I want to throw it out the window (but I can't reach the latch)… 4. Practice Questions Practice questions are excellent for monitoring your progress; they’re also excellent at scaring you. Do not fear! This is a good thing, because now you know what you’re missing, go back and read up on what you forgot to take a look at, and come back and do the questions later. Then give yourself a sticker for getting it right ? Practice questions are also great for last minute studying too because they can help you do what I call “backwards studying”–which is what I just described: figuring out what you need to learn based on what the questions look like. 5. Be realistic Set realistic goals for yourself; most importantly, set realistic daily goals for yourself so that when you get all or most or even some of them done you can go to sleep with a level of satisfaction. Also, you need to pick your battles. Example: if you suck at neuro, then one module’s loss is another’s gain. Don’t spend too much time trying to get through one thing, just keep moving forward, and come back to it later 6. ‘Do not disturb’ Facebook, twitter, instagram, youtube, whatsapp, texting, pinterest, meme websites, so many fantastic ways to kill your time… Do yourself a favor, save them for your breaks. If someone is dying or on fire, they will most likely call you, not text you or write on your wall; you do not need to check your phone that often unless you're expecting something time sensitive. 7.Don’t Compare Everyone studying in your program is going to be stressed about things; do NOT let it rub off on you. You know those moments when you hear a peer or a prof/tutor describing something you have never even heard of, then you start panicking? Yeah, don’t do that. It happens to everyone. Instead of worrying so much, just go read about it! Simple solution right? What else are you going to do? Plus, a lot of the time other students seem to know more than they need to about certain things (which I can tell you right now, doesn’t always mean they’re doing better than you; knowing random, very specific factoids doesn’t mean they can bring it in clinic. Everyone can pull a Hermione and know a book inside out, but this is not necessarily the hallmark of a good doctor), what’s it to you? Worry about yourself, be confident in your abilities, and don’t trouble yourself with comparing to other people 8.Practice for Practicals Everyone is afraid of practical exams, like the OSCE (at any rest station you're likely to find me with my head in my hands trying to stabilize my breathing pattern and trying not to cry). The best way to be ready is to practice and practice and practice and practice. It’s like learning to drive a car. At first you’re too aware of your foot on the gas, the position of your hand on the wheel, etc; but, after driving for a little while, these things become subconscious. In the same way, when you walk into a station, you could be so worried about how you’ll do your introduction and gain consent, and remembering to wash your hands, and getting equipment and and and and and; the anxiety affects your confidence and your competence. If you practice enough, then no matter what they throw at you, you will get most of the points because the process will be second nature to you. Practice on your roommates, friends, family members, patients with a doctor's help...when appropriate... Even your stuffed animals if you're really desperate. DO NOT leave practicing for these practicals to the last minute; and if you do, make sure you go through every thing over and over again until you’re explaining examinations in your sleep. NOTE: When I'm practicing for OSCE alone, I record myself over and over again and play it back to myself and criticize it, and then practice againn. 9.Consistency You don’t necessarily have to study in the same place every day; however, it is always good to have some level of routine. Some examples include: waking up/sleeping at the same time everyday, going for a run at the same time every day, having the same study routine, etc. Repetition is a good way to keep your brain focused on new activities because, like I said before, the more you repeat things, the more they become second nature to you. Hope these tips are of some use to you; if not, feel free to sound off in the comments some alternate ways to get through exams. Remember that while exams are stressful, this is the time where you build your character and find out what you’re truly capable of. When you drop your pen after that final exam, you want to feel satisfied and relieved, not regretful. Happy Studying ?  
Mary
over 5 years ago
Foo20151013 2023 hx1v0d?1444774073
4
87

Who is oPortfolio aimed at?

This is a post about oPortfolio - a project that Meducation and Podmedics are collaborating on. We have a Kickstarter project and would love your support! Students? Junior Doctors? Senior Doctors? Over the last two days we've been asked by lots of people who oPortfolio is for. Some people want it for students, others to replace junior doctor systems, and some for revalidation purposes. The simple answer is that it's for everyone going through their medical careers from student to consultant and on to retirement. Challenges There are two challenges to building a system that's relevant for such a wide variety of people. The first is to make something that has all the features that are needed for all the people. We are strong believers in self-directed learning and want that to be at the core of oPortfolio. We want people to be able to build their own personal portfolios, keeping a log of everything they want to - their own personal space for reflection and learning. oPortfolio should be something that you find useful at all stages, and that's crucial to our vision. The second challenge is working with existing ePortfolio systems, and to have functionality that deaneries and Colleges need to adopt our platform if they want to. Making a system that is incompatible with existing systems, or that involves doctors still having to use other horrible software defies the whole point of what we're doing. If a user's oPortfolio has to be manually copied & pasted into another system, everyone loses out. This, therefore, also has to be a large consideration as we move forwards. At all times, we will have to balance these two challenges up against each other. Conclusion oPortfolio is for everyone. It certainly won't have all the features that everyone needs from day one, but our aim is to build a solid base everyone can use, and then expand it from there. With regards to who we give our initial focus to, it will be the people who support us on Kickstarter. They are showing genuine support for what we're doing, and therefore deserve to be prioritised. That only seems fair. Please support us today. Thank you.  
Jeremy Walker
over 5 years ago
Foo20151013 2023 1j29ioq?1444774070
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101

Will oPortfolio do XYZ? You're asking the wrong question...

This is a post about oPortfolio - a project that Meducation and Podmedics are collaborating on. We have a Kickstarter project and would love your support! The Wrong Question Lots of people have been asking "will oPortfolio do XYZ?". As an open-source software developer I always find that a strange question, because there is very rarely a yes or no answer - the answer is pretty much always "it could do". Most people aren't used to having software made for them. Especially in the NHS, people have to live with often outdated systems that are enforced on them. Change involves committees and boards that they have no real access to. The open source world is very very different. You get to choose what features you want in the product - you simply need to ask. With oPortfolio, we are going to be guided by what doctors and students want. If a feature matters to lots of you, then we're going to work hard to get it in ASAP. If only one person wants it, then it's less likely to get priortised. Right now, the quickest way to get your voice heard is to support us on Kickstarter. When we reach our total, we'll be emailing everyone who's supported us to ask what the most important features are. If you want to make sure you're heard - that's the best way to do it. The Right Question In case you're wondering, a better question is "How can I help you get XYZ into oPortfolio?". Open Source is about people collaborating to make something better, expecting nothing in return. We'll write the code, but your input, support and guidance is what will make this happen. Will oPortfolio do XYZ? Quite simply, yes it probably will, if you drum up some support for the idea and come and talk to us about it. Please support us today. Thank you.  
Jeremy Walker
over 5 years ago
Foo20151013 2023 y4lule?1444774066
1
1829

Staying Active with Diabetes

Many know that engaging in regular physical activity and exercise will tremendously improve one’s health and overall well-being. This goes the same, if not tenfold, for individuals suffering with diabetes. However, before rushing in a high intensity or physically straining physical régime, consult with your diabetes care provider. Make sure to discuss your plans take note of any precautions that may be needed to be made prior or during these activities. It will be interesting to know that individuals with type 2 diabetes who do participate in some exercise (even at work) reduce their risk for heart disease. Remember that a physical examination that focuses on the signs and symptoms of diseases affecting the heart and blood vessels, eyes, feet, nervous system, and kidneys must be made in advance before any extensive work out plan takes into action. Any strenuous strength training or high-impact exercise is generally not recommended for people with uncontrolled diabetes. Such strain caused by these exercises can weaken blood vessels in the eyes of patients who suffer from the common diabetic complication known as retinopathy. High-impact exercise can also injure blood vessels in the feet. In fact, diabetes can contribute to foot problems in several ways: diabetic neuropathy; which is a nerve disorder that causes numbing and pain in the hands, legs and feet as well as damage to internal organs; also poor circulation to the feet is another problem that can be associated due to diabetes. Keeping this in mind it is imperative to keeping your feet healthy, investing in some great therapeutic footwear like these can be a great step in moving toward healthy feet! One thing is for sure, physical activity can increase the health in anyone’s life. Always make sure to take care of your body and take the extra precautions needed in order to maintain proper health.  
Camille Mitchell
over 5 years ago
Foo20151013 2023 1fflsju?1444774064
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1914

My Grandfather's Complimentary Medicine - The secret to a healthy old age?

Complimentary medicine (CAM) is controversial, especially when it is offered by the NHS! You only have to read the recent health section of the Telegraph to see Max Pemberton and James LeFanu exchanging strong opinions. Most of the ‘therapies’ available on the market have little to no evidence base to support their use and yet, I believe that it has an important role to play in modern medicine. I believe that CAM is useful not because of any voodoo magic water or because the soul of a tiger lives on in the dust of one of its claws but because modern medicine hasn’t tested EVERYTHING yet and because EVERY DOCTOR should be allowed to use a sugar pill or magic water to ease the anguish of the worried well every now and again. The placebo effect is powerful and could be used to help a lot of patients as well as save the NHS a lot of money. I visited my grandfather for a cup of coffee today. As old people tend to do we discussed his life, his life lessons and his health . My grandfather is 80-something years old and worked as a collier underground for about 25 years before rising up through the ranks of management. In his entire life he has been to hospital twice: Once to have his tonsils removed and once to have a TKR – total knee replacement. My granddad maintains that the secret of his good health is good food, plenty of exercise, keeping his mind active and 1 dried Ivy berry every month! He takes the dried ivy berries because a gypsie once told his father that doing so would prevent infection of open wounds; common injuries in those working under ground. It is my granddad’s firm belief that the ivy berries have kept him healthy over the past 60 years, despite significant drinking and a 40 year pack history! My grandfather is the only person I know who takes this quite bizarre and potentially dangerous CAM, but he has done so for over half a century now and has suffered no adverse effects (that we can tell anyway)! This has led me to think about the origin of medicine and the evolution of modern medicine from ancient treatments: Long ago medicine meant ‘take this berry and see what happens’. Today, medicine means ‘take this drug (or several drugs) and see what happens, except we’ll write it down if it all goes wrong’. Just as evidence for modern therapies have been established, is there any known evidence for the ivy berry and what else is it used for? My grandfather gave me a second piece of practical advice this afternoon, in relation to the treatment of open wounds: To stop bleeding cover the wound in a bundle of spiders web. You can collect webs by wrapping them up with a stick, then slide the bundle of webs off the stick onto the wound and hold it in place. If the wound is quite deep then cover the wound in ground white pepper. I have no idea whether these two tips actually work but they reminded me of ‘QuickClot’ (http://www.z-medica.com/healthcare/About-Us/QuikClot-Product-History.aspx) a powder that the British Army currently issues to all its frontline troops for the treatment of wounds. The powder is poured into the wound and it forms a synthetic clot reducing blood loss. This technology has been a life-saver in Afghanistan but is relatively expensive. Supposing that crushed white pepper has similar properties, wouldn’t that be cheaper? While I appreciate that the two are unlikely to have the same level of efficacy, I am merely suggesting that we do not necessarily dismiss old layman’s practices without a little investigation. I intend to go and do a few searches on pubmed and google but just thought I’d put this in the public domain and see if anyone has any corroborating stories. If your grandparents have any rather strange but potentially useful health tips I’d be interested in hearing them. You never know they may just be the treatments of the future!  
jacob matthews
over 5 years ago
Foo20151013 2023 1f9109k?1444774063
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1817

Criticizing the NHS - Can students do this productively?

In this month’s SBMJ (May 2013) a GP called Dr Michael Ingram has written a very good article highlighting some of the problems with the modern NHS’s administrative systems, especially relating to the huge amount of GP time wasted on following up after administrative errors and failings. I personally think that it is important for people working within the NHS to write articles like this because without them then many of us would be unaware of these problems or would feel less confident in voicing our own similar thoughts. The NHS is a fantastic idea and does provide an excellent service compared to many other health care systems around the world, but there is always room for improvement – especially on the administrative side! The issues raised by Dr Ingram were: Histology specimens being analysed but reports not being sent to the GP on time or with the correct information. Histology reports not being discussed with patient’s directly when they try and contact the hospital to find out the results and instead being referred to their GP, who experiences the problem stated above. GP’s are being left to deal with patient’s problems that have nothing to do with the GP and their job and have everything to do with an inefficient NHS bureaucracy. These problems and complaints often taking up to a third of a GP’s working day and thereby reducing the time they can spend actually treating patients. Having to arrange new outpatient appointments for patients when their appointment letters went missing or when appointments were never made etc. Even getting outpatient appointments in the first place and how these are often delayed well after the recommended 6 week wait. Patients who attend outpatient appointments often have to consult their GP to get a prescription that the hospital consultant has recommended, so that the GP bares the cost and not the hospital. My only issue with this article is that Dr Ingram highlights a number of problems with the NHS systems but then does not offer a single solution/idea on how these systems could be improved. When medical students are taught to write articles for publication it is drummed into us that we should always finish the discussion section with a conclusion and recommendations for further work/ implications for practice. I was just thinking that if doctors, medical students, nurses and NHS staff want to complain about the NHS’s failings then at least suggest some ways of improving these problems at the same time. This then turns what is essentially a complaint/rant into helpful, potentially productive criticism. If you (the staff) have noticed that these problems exist then you have also probably given some thought to why the problem exists, so why not just say/write how you think the issue could be resolved? If your grievances and solutions are documented and available then someone in the NHS administration might take your idea up and actually put it into practice, potentially reducing the problem (a disgustingly idealist thought I know). A number of times I have been told during medical school lectures and at key note speeches at conferences that medical students are a valuable resource to the NHS administration because we visit different hospitals, we wander around the whole hospital, we get exposed to the good and bad practice and we do not have any particular loyalty to any one department and can therefore objective observations. So, I was thinking it might be interesting to ask as many medical students as possible for their thoughts on how to improve the systems within the NHS. So I implore any of you reading this blog: write your own blog about short comings that you have noticed, make a recommendation for how to improve it and then maybe leave a link in the comments below this blog. If we start taking more of an interest in the NHS around us and start documenting where improvements could be made then maybe we could together work to create a more efficient and effective NHS. So I briefly just sat down and had a think earlier today about a few potential solutions for the problems highlighted in Dr Ingram’s article. A community pathology team that handles all of the GP’s pathology specimens and referrals. A “patient pathway co-ordinator” could be employed as additional administrative staff by GP surgeries to chase up all of the appointments and missing information that is currently using up a lot of the GP’s time and thereby freeing them to see more patients. I am sure this role is already carried out by admin staff in GP practices but perhaps in an ad hoc way, rather than that being their entire job. Do the majority of GP practices get access to the hospitals computer systems? Surely, if GPs had access to the hospital systems this would mean a greater efficiency for booking outpatient appointments and for allowing GPs to follow up test results etc. In the few outpatient departments I have come across outpatient appointments are often made by the administration team and then sent by letter to the patients, with the patient not being given a choice of when is good for them. Would it not be more efficient for the administrative staff to send the patients a number of appointment options for the patient to select one appropriate for them? Eliyahu M. Goldratt was a business consultant who revolutionized manufacturing efficiency a few years ago. He wrote a number of books on his theories that are very interesting and easy to read because he tries to explain most of his points using a narrative – “The Goal” and “Critical Chain” being just tow. His business theories focussed on finding the bottle neck in an industrial process, because if that is the rate limiting step in the manufacturing process then it is the most essential part for improving efficiency of the whole process. Currently, most GPs refer patients to outpatient appointments at hospitals and this can often take weeks or months. The outpatient appointments are a bottle neck in the process of getting patients the care they require. Therefore, focussing attention on how outpatient appointments are co-ordinated and run would improve the efficiency in the “patient pathway” as a whole. a. Run more outpatient clinics. b. Pay consultants overtime to do more clinics, potentially in the evenings or at weekends. While a lot may not want to do this, a few may volunteer and help to reduce the back log on the waiting lists. c. Have more patients seen by nurse specialists so that more time is freed up for the consultants to see the more urgent or serious patients. d. An obvious, yet expensive solution, hire more consultants to help with the ever increasing workload. e. Change the outpatient system so that it becomes more of an assembly line system with one doctor and a team of nurses handling the “new patient” appointments and another team handling the “old patient” follow up appointments rather than having them all mixed together at the same time. I am sure that there are many criticisms of the points I have written above and I would be interested to hear them. I would also love to hear any other solutions for the problems mentioned above. Final thought for today … Why shouldn’t medical students make criticisms of inefficiencies and point them out to the relevant administrator? If anyone else is interested in how the NHS as a whole is run then there is a new organisation called the Faculty of Medical Leadership and Management that is keen to recruit interested student members (www.fmlm.ac.uk).  
jacob matthews
over 5 years ago
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614

Thinking of learning 3d anatomy? Think again.

Article has moved. Please go to Kenhub, to read the whole article and find out why learning anatomy with 3d tools is not always the best option.  
Niels Hapke
over 5 years ago
Foo20151013 2023 38zku8?1444774057
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1816

The BioPsychoSocial Model of Disease comes to life

The biopsychosocial model of disease existed in my notes... an excuse to get out the colouring crayons and draw a diagram, but ultimately another collection of facts that needed to be digested then regurgitated in the summer exams, something to be fitted in around learning about the important stuff - the science. But the biopsychosocial model has come alive for me recently, now I realise what an impact the later two components, psychological and social, can have on patients. As a former medical student and now full time patient, the model really means something to me now. In the 1977 paper in Science, George Engel introduced the biopsychosocial model: "The dominant model of disease today is biomedical, and it leaves no room within it's framework for the social, psychological and behavioural dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching and a design for action in the real world of health care." Following some conversations on Twitter recently and from my own experience at medical school and now as a patient, I wanted to explore my thoughts on this model. Twitter, in the wonderful way it does, recently introduced me to the Disabled Medic blog, which among many other great posts, has also explored the biopsychosocial model, and I would recommend a read. The biopsychosocial model shows the influence that emotions and social circumstances have on physical health, which is important. But while conversations about the model focus on the way it can be used by healthcare professionals (very important!), it needs emphasising that the model can provide a framework for patients to look at/after themselves. The model highlights the psychological and social causes of disease, but more optimistically, it can show that there are a range of treatments for disease, from the medical to the social and psychological. A diagnosis of a long-term health conditions is often simultaneous with loss of control. There are limitations to the success of medications, treatments and surgeries. And in receiving these, we are relatively passive as patients, no matter how engaged we are. The biopsychosocial model looks at our biological, psychological and social needs, and how these factors influence our overall health. Establishing that these factors affect our health is only the first step. As patients, when psychological and social factors are brought in to the equation, it becomes clear that we ourselves have some power to help ourselves. By framing our health in this more holistic way, as patients we are not as powerless as suggested by the medical model. Through self-management we can make positive changes to our own psychological and social situations, which can in turn benefit our physical biological health. To return to the traditional ground of the model - healthcare professionals.... One strength of the model is that it places psychology side beside its (generally considered) more superior counter-part, biology. I hope that by seeing the biopsychosocial model in action, physicians can appreciate the detrimental psychological impact of a diagnosis, and the assumption of "it is all in the mind" can fall by the way side. By integrating all three elements, the model shows that neither is independent of the others, so it can't be all in the mind, because other factors, biological or social, will be involved to some degree. For me personally, the biopsychosocial model makes me look at what a 'life' is. One of the attractions of medicine is saving lives. Without getting too deeply into philosophy or ethics, I just want to explore for a second what saving a life really means for me, as a patient. I still believe that A&E staff heroically save lives. But I have come to realise that a life is more than a swiggly line on a heart rate monitor. My counsellor has been just as heroic in saving my life, through addressing my emotions. My life is now something I can live, rather than endure. With saving lives being a key (and honourable) motivation among medical staff, it is important that we can allow them to save lives as often as possible, and in many different ways. It may not always be through emergency treatment in resuscitation, but if we embrace the biopsychosical model, they can save lives in many more ways. When there is a limit to the effectiveness of the biological approaches to an ill person, and they can't be returned to the land of the healthy, medical science becomes unstuck. Within the biopsychosocial model, the issue of doctors not being able to do anything is slightly less. As I mentioned in my post about making the transition from medical student to patient, I went to medical school because I wanted to make people better. But I was only being taught one way to make people better - drugs and surgery. If we really embraces the biopsychosocial model, doctors could make a difference, even if their standard tools of drugs aren't available because they could turn to psychological and social support. This isn't to say that all clinicians have to be counsellors or social workers - far from it. But an awareness and appreciation of their contribution to the management of a patient is important, as well as an understanding of the basic principles and skills such as motivational interviewing. In 2013, I don't think I can talk about social in this context without mentioning social media. It was not was Engel originally meant in 1977, but social media has become a vital social tool for patients to manage their health. Ignoring anxieties and postural problems associated with sitting at a screen seeing everyone else's photo-shopped lives, it is undeniable that social media is a big and good resource that can empower patients to take responsibility and manage their own health. To see the best examples in action, take a look at Michael Seres and his blog, Being a Patient Isn't Easy to see a whole new meaning to the social in biopsychosocial! I am still very grateful for the biological expertise of my medical team. Don't get me wrong - it's a good place to start and I wouldn't be here writing this post today if it wasn't for the biological support. But with chronic illness, when you are past the dramatic relapses, the biological isn't enough.... The biology has allowed me to live, but its the psychological and social support I have received that has allowed me to live. Anya de Iongh @anyadei www.thepatientpatient2011.blogspot.co.uk  
Anya de Iongh
over 5 years ago
Foo20151013 2023 1dsv9xf?1444774054
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131

oPortfolio - A Better Portfolio For Medics

What's the problem? Since I first started working with doctors, one of the main complaints I've heard is about electronic portfolios: "It's so slow", "It's really ugly", "It's basically unusable", "It crashed the day before submissions!", "It's SO unintuitive" I've heard all of these things from different doctors at different stages in different specialities in different locations. Write a tweet about ePortfolio and the odds are you'll have it retweeted and replied to numerous times within minutes. There's clearly a real problem here, and a real frustration among doctors! What's the Solution? Over the last two years I've spent lots of time talking to a variety of doctors about this and have come to the conclusion that a new modern, robust solution is needed. We need software that is fresh and intuitive to use, that doesn't get overloaded and that has the features that people actually want! The Meducation team agrees, and so we've partnered up with our friends at Podmedics to make this a reality. We are making oPortfolio - the Open Portfolio - an open-source system guided by the needs of the trusts, deanaries and colleges, but with a firm focus on the doctors who will be using it. Over the next few days we'll be launching a kickstarter project to let you support what we're doing. In the meantime, please sign up on our website to receive updates about what we're doing!  
Jeremy Walker
over 5 years ago
Foo20151013 2023 4ktnps?1444774050
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Poo transplants

When is it medically advisable to eat some one else's poo? When you need a poo transplant. Poo transplants could be the solution to one of the biggest problems facing the NHS today- the bacterial infection Clostridium difficile. C.diff, as it's known to its friends, infects about 18,000 people in England and Wales every year and is involved in the deaths of about 2000 people. C.diff typically arises due to imbalances in the normal gut bacteria. The gut is like a city, a city with about 100 trillion bacterial residents happily munching away on a banquet of bowel contents. The average person has about 1000 different types of bacteria in their gut, and about 3% of healthy adults have C.diff in that mix. The C.diff doesn't cause them any problems because its numbers are kept in check by the other gut bacteria. However treatment with broad spectrum antibiotics such as clindamycin, cephalosporins, ciprofloxacin and co-amoxiclav, can disrupt this happy community- killing off vast swathes of bacteria but crucially not the C.diff. Given free rein the C.diff multiplies rapidly and produces toxins which damage the gut. In some people this causes mild diarrhoea and abdominal pain, in others it can lead to torrential diarrhoea, perforation of the colon and death. Traditional treatment includes stopping any broad spectrum antibiotics and possibly prescribing antibiotics which target the C.diff such as metronidazole or vancomycin. However with antibiotic use comes the risk of resistance. Moreover our current approach isn't entirely effective and about 22% of patients treated suffer a recurrence. This can result in a cycle of illness and hospital admission which is costly to the patient and the hospital. So it's time to start thinking outside of the box. Cue the poo transplant. The thinking goes like this- if the cause of the problem is disruption to the normal community of gut bacteria, why not just pop those bacteria back in to crowd out the C.diff? Simples. Practically, the first step is to identify a donor, usually a close relative of the patient, and screen them for a range of infectious diseases and parasites. It's also advisable to make sure they haven't recently consumed anything the intended recipient is allergic to, before asking them to make their "donation". You then pop it in a household blender and blitz it down, adding saline or milk to achieve a slurry consistency. Next you need to strain your concoction to remove large materials- one medic in the UK uses coffee filters. Top tip. Then you're ready to administer it- about 25ml from above (e.g. via nasogastric tube), or 250ml from below. Now, its important to note that poo transplants are still an experimental treatment. To date only small case studies have been carried out, but with 200 total reported cases, an average cure rate of 96% and no serious adverse events reported to date, it's worth carrying out a large trial to assess it thoroughly. Poo transplants- arguably the ideal treatment for a cash strapped NHS. It's cheap, plentiful and it seems to work. Now to convince people to consume someone else's poo... Bottoms up! FYI: This was first posted on my own blog. Image Courtesy of Marcus007 at de.wikipedia [Public domain], from Wikimedia Commons  
Dr Catherine Carver
over 5 years ago
Foo20151013 2023 8mqjwi?1444774048
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2844

An amazing incident

It's been a while since I've added any thoughts to this blog. In that time I have finished my Obs/Gynae placement, I have spent a week on labour ward, and done my first week of my 4th year surgical placement. All the while cramming in revision between various activities and general staying alive measures. This, I feel, is how most people who are sitting their final written exams are spending their time, so I don't feel so alone. I just want to bring to the attention one amazing incident that happened on my labour ward week. I was on a night shift, there wasn't a lot going on. Absolutely everyone was knackered, the registrar who'd been on nights for the past week was just chatting to me. I have never seen someone look so tired. The emergency alarm went off and a lady had a cord prolapse, which is an obstetric emergency with a high foetal mortality rate. Now I think it's amazing that the doctor went from nearly falling asleep to switched on 'surgical-mode' in an instant, successfully performed the C-section, delivering the baby in about a minute, then went back to being absolutely knackered and let the SHO close up the wound. It just really impressed me and I felt it was something worth sharing. Actually I was incredibly surprised that I enjoyed Obs/Gynae. Women's health was a placement I was dreading, it was my last major knowledge gap and I didn't have a clue what it was going to be like. If my tutor for the block does read this, thank you for all your help and getting me involved in everything. I would encourage other students who are going into it and feeling any level of apprehension to just throw yourselves into it and give 110% effort. It is a great placement for practicing transferable skills (this is important to remember, especially if you don't have any desire to go into it you CAN transfer and practice skills from elsewhere!) and getting heavily involved in patient care. Also I'd like to point out the Mother and Baby were fine :)  
Conrad Hayes
over 5 years ago
Foo20151013 2023 xc9z4h?1444774045
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2872

Undergraduate Co-Ordinators: Help or hindrance?

Thanks to those who read my last post. I was encouraged to hear from my colleagues at Med school that the post sounded very positive and hopefully. A few of them queried whether I had actually written it because there was a noticeable lack of sarcasm or criticism. So... the following posts may be a bit different. A little warning - some of what I post may be me playing "Devil's advocate" because I believe that everything should be questioned and sparking debate is a good way of making us all evaluate what we truly think on a subject. With no further a do, let's get on to the subject of today's post .... An Introduction to Clinical Medicine The previous year was my first as a clinical med student. Before we started I naively thought that we would be placed in helpful, encouraging environments that would support us in our learning, so that we were able to maximize our clinical experience. My hope was that there would be lots of enthusiastic doctors willing to teach, a well organised teaching schedule and admin staff that would be able to help us with any difficulties. I hoped these would all be in place so that WE medical students could be turned from a bunch of confused, under-grad science students into the best junior doctors we could possibly be. It seems that medical school and the NHS have a very different opinion of what clinical medical teaching should be like. What they seem to want us to do is 1) listen to the same old health and safety lecture at least twice a term, 2) re-learn how to wash our hands every 4 weeks, 3) Practicing signing our name on a register - even when this is completely pointless because there are no staff at the hospital anyway because the roads are shut with 10 inches of snow most of the time, 4) Master the art of filling in forms that no one will ever look at or use in anyway that is productive, 5) STAY OUT OF THE WAY OF THE BUSY STAFF because we are useless nuisances who spread MRSA and C.Dif where ever we go! How we all learn medicine and pass our exams is any ones guess! Undergraduate Co-Ordinators - Why won't you make life easier for us? While at my last placement I was elected as the 3rd year student representative for that hospital. While I was fulfilling that role it got me wondering what it is that Under-grad Co-Ordinators actually do? I thought this may be an interesting topic of debate. 1) Who are they and how qualified are they? 2) what is their job description and what are they supposed to be doing? 3) Are they a universal phenomena? or have they just evolved within the West Midlands? 4) Does anyone know an under-grad Co-Ordinator (UC - not ulcerative colitis) who has actually been more benefit than nuisance? 1) UC's as a species are generally female, middle aged, motherly types who like to colonize obscure offices in far flung corners of NHS training hospitals. They can normally be found in packs or as they are locally known "A Confusion of co-ordinators". How are they qualified? I have absolutely no idea, but I am guessing not degrees in Human Resource Development. 2)I am fairly certain what their job should involve: 1) be a friendly supportive face for the poor medical students; 2) organise a series of lectures; 3) organise the medical students into teaching firms with enthusiastic consultants who are happy to give them regular teaching; 4) ensure the students are taught clinical skills so that they can progress to being competent juniors; 5) be a point of contact for when any students are experiencing difficulties in their hospital and hopefully help them to rectify those problems to aid their learning. What do they actually do? It seems to be a mystery. I quite regularly receive emails that say that I wasn't in hospital on a certain day, when I was in fact at another hospital that they specifically sent me to on that day. I often receive emails saying that my lectures are cancelled just as I have driven for over an hour through rush hour traffic to attend. I sometimes receive emails saying that I, specifically, am the cause of the whole hospitals MRSA infection because I once wore a tie. I never receive emails saying that such and such a doctor is happy to teach me. I never receive emails with lecture slides attached to them so that I can revise said lectures in time for an exam. I NEVER receive any emails with anything useful in them that has been sent by a UC! Questions 3 and 4, I have no idea what the answers are but would be genuinely pleased to hear people's responses. The reason I have written this blog is that, these people have frustrated my colleagues and I all year. I am sure they are integral to our learning in some way and I am sure that they could be very useful to us, but at the moment I just cannot say that they are as useful as they should be. To any NHS manager/ medical educator out their I make this plea I am more than happy to give up 2 weeks of my life to shadow some UC to see what it is they do. In essence I want to audit what it is they do on a day to day basis and work out if they are a cost-effective use of the NHS budget? I want to investigate what it is they spend their time on and how many students they help during a day? I would like someone with a fresh pair of eyes to go into those obscure offices and see if they can find any way of improving the systems so that future generations of medical students do not have to relive the inefficiencies that we have lived through. I want the system to be improved for everyone's sake. OR if you won't let a medical student audit the process, could you manager's at least send your UC's to learn from other hospitals where things are done better! If we (potential future) doctors have to live by the rule of EVIDENCED BASED MEDICINE, why shouldn't the admin staff live by a similar rule of EVIDENCED BASED ADMINISTRATION? Share good ideas, learn from the best, always look for improvements rather than keep the same old inefficient, pointless systems year after year. My final point on the subject - at the end of every term we have to fill in long feedback forms on what we thought of the hospital and the teaching. I know for a fact that most of those forms contain huge amounts of criticism - a lot of which was written exactly the same the year before! So, they are collecting all of this feedback and yet nothing seems to change in some hospitals. It all just seems such a pointless waste. Take away thought for the day. By auditing and improving the efficiency, of the admin side of an undergraduate medical education, I would hope the system as a whole would be improved and hence better, more knowledgeable, less cynical, less bitter, less stressed junior doctors would be produced as a result. Surely, that is something that everyone involved in medical education should be aiming for. Who is watching (and assessing) the watchers!  
jacob matthews
over 5 years ago
Foo20151013 2023 x3l6t5?1444774041
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1921

Anatomy For Life: Calling all Bio / Medically Minded Artists and Students

Introduction Hello and welcome. If you are one of the few who have been following my blog since last year then you may be aware of a certain promise that has yet to be fulfilled... That promise is of a new set of schematic images similar to my Arterial Schematic that seems to have gained some popularity on Meducation. The truth of the matter is that I have actually been working on a separate project since finishing my finals. This separate project has involved making the website and doing some of the design work for 'Anatomy For Life,' an exciting medically-related charity art auction and exhibition. The event is due to be held in Brighton (venue TBC) during National Transplant week (8-14th July) to help raise money for organ donation and body donation via the charity; 'Live Life Then Give Life'. Where you come in... The exciting thing about the Anatomy For Life (AFL) art auction is that we are looking for everyone and anyone to donate. It doesn't matter if you get usually get paid £1,000 per drawing or if you haven't picked up a paintbrush since school. Each and every donation will be displayed on a level playing field, giving the unique opportunity for amateurs to pitch up against the professional medical illustrators out there and vice versa! As long as the artwork donated fits the criteria below you have free reign: Artwork submitted must be (at least loosely) associated with the 'Anatomy' theme. Artwork submitted must be on roughly A6 card (4"x6"). The AFL team recommend a paper weight of 250gsm or above. Create your artwork using any art media you choose on/with the A6 card. Sign the BACK of your masterpiece, but not the front* Donations should be received by the 17th June 2013 *The AFL team will be exhibiting the art work shown and running the auction anonymously. Artists will not be attributed to their donations until after the event via our online gallery. Once you have completed you artwork(s) you should fill out our downloadable information form and provide us with your name, a short bio about you and what inspired your donated artwork. You can also let us know if you want the AFL team to e-mail you a certificate in recognition of your contribution! Some Context... Organ donation is the act of donating ones organs or tissues to help save someone else's life after your own passing. One person can donate enough organs to save several peoples lives, which in the minds of many is a truly admirable feat! Body donation usually refers to the act of donating ones own body to medical education, so that students may continue to learn the real-life anatomy that forms part of becoming a competent doctor or surgeon. Organ donation is currently on the rise in the U.K thanks to the fantastic work of the Organ Donor Register and the charities that support organ donation such as 'Live Life Then Give Life'. However, the U.K still has one of the highest family-refusal rates in Europe for organ donation. It is hoped that by raising awareness of the benefits of organ donation this refusal rate can be reduced either by more people being registered organ donors or by families having more access to information about the topic. We really want to hear from you... If you have something you think might benefit our project please do let us know! Go To Our Main Website Donate Artwork to Us! Tweet to Us on Twitter Like Us on Facebook Thats all folks, LARF  
Dr. Luke Farmery
over 5 years ago
Foo20151013 2023 t9y30l?1444774036
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1802

Gawande-ism

Good morning all, Being new to blogging, it's surprisingly interesting how difficult it is to start! I recently read Atul Gawande's three best selling books and they were an inspiration. I am sure most medic's will be aware of Mr Gawande (http://gawande.com/), the man behind the WHO safe surgery checklist. If you are not, and you want to read something that will really enthuse you about modern medicine, then please do get his books out from the library. I would recommend starting with "Better". The last chapter of "Better" is what prompted me to write this. Gawande has come up with 5 principles for being a "positive deviant" and 1 of them is - Just Write! He believes that to make our lives as doctors/medical students and the world a better place, we should all write down what we have been thinking about, because we may just come up with something that other people can use or just find others who have similar thoughts and will help us build a sense of community together. Although I have made many previous New Years resolutions to start keeping diaries and to keep journals of thoughts. They have always ended fairly quickly. This time may be different. Hopefully I will come up with some more thoughts that are vaguely worth sharing soon. Final thought for now - "Gawande-ism" = the belief that we can all make self-improvements and improve the world around us, little by little.  
jacob matthews
over 5 years ago
Foo20151013 2023 1vfzxkt?1444774033
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449

My Top 5 Tips to Use Social Media to Improve your Medical Education

Introduction Hello and welcome! I am finally back to blogging after having a brief hiatus in order to take my final exams. Whilst the trauma is still fresh in my mind, I would like to share with you the top 5 social media tips that helped me through the dark days of undergraduate medicine. Some of you may have already read my old essay on 'How Medical Students should interact with Social Media Networking Sites' and this document deals with some of the problems with professionalism surrounding the use of social media. This blog will not cover such issues, but will instead focus on how you can use social media to benefit your learning/ revision processes. Top Tip 1: YouTube For those of you who are unaware, YouTube is a video-sharing website. Sometimes the site is overlooked as a 'social media' resource but if you consider the simple definition of Social Networking Sites as 'those with user led content,' you can quickly see how YouTube definitely falls into the social media category. It wasn't until I got to University that I realised the potency of YouTube as an educational tool. It has a use at every stage of medical education and it is FREE. If you are still in your pre-clinical training then there are a wealth of videos that depict cellular processes and 3D anatomy - very useful content for the visual learner. For the clinical student, there are a number of OSCE demonstration videos that may be useful in honing your examination skills. There are also a number of presentations on clinical topics that have been uploaded, however, YouTube has no quality control measures for these videos (to my knowledge) so it may be best to subscribe to a more official source if you like to use podcasts/ uploaded presentations for your revision. Another reason YouTube comes in as my number 1 top tip is because I find it difficult to procrastinate whilst using the site. Sure, you can start looking up music and videos that have nothing to do with medicine but personally I find that having a little bit of music on in the background helps me work for longer periods, which is a definite bonus during the revision period. On the other hand, there are many that find YouTube difficult to harness due to the draw of funny videos and favourite Vloggers (Video Bloggers) that can distract the unwary from revision for hours on end. At the end of the day, YouTube was created for funny videos (predominantly of cats it seems) and not for medical education, and this should be kept in mind if you choose to use it as a tool for your learning. Top Tip 2: Facebook Yes, the dreaded Facebook comes in at number two for me. Facebook is by far and away my largest source of procrastination when it comes to writing / working / revising or learning. It is a true devil in disguise, however, there are some very useful features for those who like to work in groups during their revision... For example, during the last six months I have organised a small revision group through Facebook. We set up a 'private page' and each week I would post what topics would be covered in the weeks session. Due to the nature of Facebook, people were obviously able to reply to my posts with suggestions for future topics etc. We were also able to upload photos of useful resources that one or more of us had seen in a tutorial in which the other students hadn't been able to attend. And most importantly, we were able to upload revision notes for each other via the Facebook 'files' tab. This last feature was invaluable for sharing basic notes between a few close colleagues. However, for proper file sharing I strongly recommend the file sharing service 'Dropbox,' which provides free storage for your documents and the ability to access files from any computer or device with internet. Coming back to Facebook, my final thoughts are: if you don't like group work or seeing what your colleagues are doing via their statuses or private messages then it probably isn't a useful resource for you. If you have the motivation (unlike myself) to freeze your Facebook account I can imagine you would end up procrastinating far less (or you'll start procrastinating on something else entirely!). Top Tip 3: Twitter Twitter is a microblogging site. This means that users upload microblogs or 'Tweets' containing useful information they have found on the internet or read in other people's tweets. Twitter's utility as an educational resource is directly related to the 'type' of people you follow. For example, I use Twitter primarily to connect with other people interested in social media, art & medicine and medical education. This means my home screen on twitter is full of people posting about these topics, which I find useful. Alternatively, I could have used my Twitter account to 'follow' all the same friends I 'follow' on Facebook. This would have meant my Twitter home page would have felt like a fast-paced, less detailed version of my Facebook feed just with more hashtags and acronyms - not very useful for finding educational resources. With this in mind, consider setting up two twitter accounts to tease apart the useful tweets about the latest clinical podcast from the useless tweets about what your second cousin once removed just had for lunch. A friend suggested to me that if you really get into twitter it is also possible to use one account and 'group' your followers so that you can see different 'types' of tweets at different times. This seems like a good way to filter the information you are reading, as long as you can figure out how to set up the filters in the first place. Like all Social Media Sites, Twitter gets its fair share of bad press re. online professionalism and its tendency to lure users into hours of procrastination. So again, use with caution. Top Tip 4: Meducation It would not be right to write this blog and not include Meducation in the line-up. Meducation is the first website that I have personally come across where users (students, doctors etc) upload and share information (i.e. the very soul of what social networking is about) that is principally about medicine and nothing else. I'm sure there may be other similar sites out there, but the execution of this site is marvellous and that is what has set it apart from its competitors and lead to its rapid growth (especially over the last two years, whilst i've been aware of the site). When I say 'execution,' I mean the user interface (which is clean and simple), the free resources (giving a taste of the quality of material) and the premium resources (which lecture on a variety of interesting clinical topics rather than sticking to the bread and butter topics 24/7). One of my favourite features of Meducation is the ability to ask 'Questions' to other users. These questions are usually asked by people wishing to improve niche knowledge and so being able to answer a question always feels like a great achievement. Both the questions and answers are mostly always interesting, however the odd question does slip through the net where it appears the person asking the question might have skipped the 'quick google search' phase of working through a tough topic. Meducation harnesses social networking in an environment almost free from professionalism and procrastination issues. Therefore, I cannot critique the site from this angle. Instead, I have decided to highlight the 'Exam Room' feature of the website. The 'Exam Room' lets the user take a 'mock exam' using what I can only assume is a database of questions crafted by the Meducation team themselves (+/- submissions from their user base). However, it is in my opinion that this feature is not up to scratch with the level and volume of questions provided by the competitors in this niche market. I feel wrong making this criticism whilst blogging on Meducation and therefore I will not list or link the competitors I am thinking of here, but they will be available via my unaffiliated blog (Occipital Designs). I hope the Meducation team realise that I make this observation because I feel that with a little work their question database could be improved to the point where it is even better than other sites AND there would also be all the other resources Meducation has to offer. This would make Meducation a truly phenomenal resource. Top Tip 5: Blogging Blogging itself is very useful. Perhaps not necessarily for the learning / revision process but for honing the reflective process. Reflective writing is a large component of undergrad medical education and is disliked by many students for a number of reasons, not least of which is because many find some difficulty in putting their thoughts and feelings on to paper and would much prefer to write with the stiffness and stasis of academic prose. Blogging is great practice for breaking away from essay-writing mode and if you write about something you enjoy you will quickly find you are easily incorporating your own personal thoughts and feelings into your writing (as I have done throughout this blog). This is a very organic form of reflection and I believe it can greatly improve your writing when you come to write those inevitable reflective reports. Conclusion Thanks for reading this blog. I hope I have at least highlighted some yet unharnessed aspects of the sites and resources people already commonly use. Please stay tuned in the next week or two for more on social media in medicine. I am working together with a colleague to produce 'Guidelines for Social Media in Medicine,' in light of the recent material on the subject by the General Medical Council. Please feel free to comment below if you feel you have a Top Tip that I haven't included! LARF Twitter Occipital Designs My Blog As always, any views expressed here are mine alone and are not representative of any organisation. A Worthy Cause... Also, on a separate note: check out Anatomy For Life - a charity medical art auction raising money for organ donation. Main Site Facebook Twitter  
Dr. Luke Farmery
over 5 years ago