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#81
3562efbddb33cd462d6577a86b589052
2
123

"It’s not art, it’s not science – it’s the same thing" Dr. Mangione

Our most popular tweet this week comes from Forbes contributor, Robert Glatter. Robert discusses how medicine and art are a complementary skill set. EMBED TWEET: https://twitter.com/Meducation/status/394399394210263040 As universities look to improve the selection process for medical school, they are giving increased focus to natural traits that encompass the ideal candidate. In his article Robert looks at how typically “right brain” characteristics, such as artistic flair, are highly valued selection criteria and in some cases rank more favourably than “left brain” thinking. Dr. Mangione, a master of artistic expression and physical diagnosis, agrees that medical students with creative thinking as part of their skillset are likely to excel. Do you agree that this is an important factor to consider when predicting an individual's potential for success in medicine? If not, what traits do you believe are important? The full article can be seen here - it's a very thought provoking read. Nicole  
Nicole Chalmers
about 4 years ago
#82
C4b5ebccea6ed1366c4e56ddc41a0288
4
59

Do hacks really work?

Well I think they do. In 2012 I attended the #digidoc2012 conference in London. This was a conference aimed at bringing clinicians and technology enthusiasts together to learn how better to use technology to help in a clinical setting. Part of the day included tutorials and lectures, but my favourite part was the ‘hack’ session. In groups, we pitched ideas about potential apps which could be created to help different groups i.e. clinicians, patients, providers etc. From this session the initial concept of PhotoConsent was formed. The problem: Medical photography in a hospital setting can be relatively straight forward. A clinician can call up the medical photography department, get them to sort out the forms and details, patient consented, picture taken...done. The main issue with this is the time taken to access the medical photography department. Medical photography in a moderately acute setting or primary care is considerably less straight forward. Issues on how you document the consent, what methods used (verbal or written) and how this is stored need to be considered. There exists some guidance on the matter (see Good Medical Practice: Making and using visual and audio recordings of patients), however actual practice is variable. The added issue of social media and the ease of which images can now be shared can add to the confusion. The solution - PhotoConsent: I am involved in several on-line forums and governance groups. With seeing interactions about patient images in social media and various online clinical groups, I felt a more complete solution was needed which gave better protection and governance for both patients and clinicians. Following the #digidoc12 conference (https://thedigitaldoc.co.uk/), I met some innovative colleagues including Ed Wallit (@podmedicsed). We took this brainstormed idea further and now we have a finished product- PhotoConsent app. PhotoConsent is a new application designed to help you as a clinician to safely and easily take photos of a patient and then obtain the relevant consent for that photo quickly and efficiently. It is currently available on iOS. How does it work? Upon opening the app you can take a photo from the home screen. Once you have confirmed you have the best possible image, you and the patient are shown the consent options. Using PhotoConsent you can choose to obtain consent to use the photo for assessment, second opinion or referral, educational use or publication. In real time with the patient you can then select each consent option to explore in more detail to allow informed consent. This consent can then be digitally signed and emailed to the patient instantly. The image and consent can then be used by the clinician in accordance with GMC guidance. This can be via the app, email or via the online portal: PhotoConsent.co.uk. What makes PhotoConsent unique is that the consent is digitally secure in the metadata of the image. So proof of consent is always with the image. Why should I use PhotoConsent? It is important if taking a medical image of a patient, that consent is obtained and recorded. Written consent is considered the best option. PhotoConsent allows you to take consent with the patient in real-time, forward the patient a copy of the consent so they can stay informed, and be safe in the knowledge that consent is secure within the image metadata. All this is possible through your own iOS device making it convenient and effective for all involved. What is next for PhotoConsent? The first release of PhotoConsent is out, but there can always be progression. In the future I hope to bring the app to the Android platform to make it more accessible to a wider audience. We are also working on expanding the app to include consent for non-medical use. We have a few other ideas but time will tell if these are possible. About the owner: Dr Hussain Gandhi (@drgandalf52) is a GP and GP trainer working in the Nottingham area. He is a RCGP First5 lead, Treasurer of RCGP Vale of Trent faculty, co-author of The New GPs Handbook, owner of PhotoConsent and egplearning.co.uk – an e-learning portal; and a member of Tiko’s GP group on Facebook (@TheVoiceofTGG). All Images taken via PhotoConsent.  
Hussain Gandhi
about 4 years ago
#83
4c7a520df92f7c087275684f8051cdb9
2
735

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
over 4 years ago
#84
Preview
1
93

Asthma Drugs - Antileukotrines (Montelukast, Zafirlukast & Zileuton)

http://usmlefasttrack.com/?p=6083 Asthma, Drugs, -, Antileukotrines, (Montelukast,, Zafirlukast, &, Zileuton), Findings, symptoms, findings, causes, mnemonic...  
youtube.com
over 2 years ago
#85
2f09e0634f8aab8b9f76f478b2fbd689
2
540

I hate being on-call - I’m just not good at sleeping on the job

BOXING Day, 1.30am. “Are you the doctor on call?” I wrenched my reluctant brain from its REM state. “Yes.” “I’m worried about my wife. She’s 16 weeks pregnant and very gassy.” “Gassy?” “Burping and farting. Smells terrible! It’s keeping us both awake. I’m worried it could be serious.” By the time I ascertained that there were no sinister symptoms and that the likely culprit was the custard served with Christmas pudding (the patient was lactose intolerant), I was wide awake. My brain refused to power down for hours, as if out of spite for being so rudely aroused. I have a confession to make. When the Australian Federal Government announced that it was planning to abolish after-hours practice incentive payments, I was delighted. I know, I know, I should have been outraged along with the rest of you. After all, the RACGP predicted that after-hours care would be decimated if incentives were removed. Comparisons were made with the revamp of the UK system in 2004, which led to 90% of the profession opting out of after-hours work. Much as I sympathised, I was secretly rubbing my hands together with selfish glee. Surely this would mean that our semi-rural practice would stop doing all of our own on-call and free me from my after-hours responsibilities? I detest being on call. I loathe it with a passion completely out of proportion to the imposition it actually causes. I’m on call for the practice and our local hospital only once a week and the workload isn’t onerous. Middle-of-the-night calls aren’t all that frequent, but my sleep can be disturbed by their mere possibility, leaving me tired and cranky. If I’m forced suddenly into “brain on, work mode” by a phone call, I can kiss hours of precious slumber goodbye. I love to sleep, but, as with drawing and tennis, I’m not very good at it. I gaze with envy at those lucky devils who nap on public transport and fight malicious urges to disturb their peaceful repose. If I’m not supine, in a quiet, warm room, with loose-fitting clothing, a firm mattress and a pillow shaped just-so, I can forget any chance of sleep. Let’s just say I can relate to the Princess and the Pea story. I bet she wouldn’t have coped well with being phoned in the middle of the night either. If these nocturnal calls were all bona fide emergencies, I wouldn’t mind so much. It’s the crap that really riles me. I’ve received middle-of-the-night phone calls from patients who are constipated, patients with impacted cerumen (“Me ear’s blocked, Doc. I can’t sleep”) and patients with insomnia who want to know if it’s safe to take a second sedative. The call that took the on-call cake for me, though, was from a couple who woke me at 11.30 one night to settle an argument. “My husband says that bacteria are more dangerous than viruses but I reckon viruses are worse. After all, AIDS is a virus. Can you settle it for us so we can get some sleep? It would really help us out.” I kid you not. Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com  
Dr Genevieve Yates
almost 4 years ago
#86
Adfb5f75e4bdcde2950f9a75327fa46f
1
81

Consultantitis - Part 1

consultant NOUN a person who provides expert advice professionally: he acted as campaign consultant to the president [OFTEN AS MODIFIER] British a hospital doctor of senior rank within a specific field: a consultant paediatrician -itis SUFFIX forming names of inflammatory diseases: cystitis, hepatitis (Origin - from Greek feminine form of adjectives ending in -it?s (combined with nosos 'disease' implied) ) You may not be surprised to hear that the way in which I recently heard the term 'consultantitis' used cannot be understood to mean 'inflammation of the senior hospital doctor'. Although, I wish it was. Professionalism, compassion, transparency, teamwork and communication - all terms that appear to be used with an increasing regularity within the NHS. These are concepts that are not merely taught but preached to medical students today. Why? Well it is nit merely the work of a heavily publicised inquiry into a foundation trust, neither is it the upshot of the medical profession's own Voldemort - he who must not be named (except I will name him - Harold Shipman). Is it then an attempt to heal the wounds within our national health service from within? I hope so. Yet, there are countless more 'isms' and other terms being muttered under the breath of healthcare professionals all over the country. 'Consultantitis' is one that fills me with sadness for one reason in particular: it suggests that those at the top are at the core of some of the problems. Ponder over that for a while, I intend to explain myself further in my next blog post. To be continued****.  
Chantal Cox-George
almost 4 years ago
#87
11c5f3eac62f1a98264e228d781ae360
4
2229

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 4 years ago
#88
533c868cc52a394ac92f59ebaaf89d45
5
2314

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 4 years ago
#89
Bdbb48375117ab6d6f2db7cdde3c0819
5
2132

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 4 years ago
#90
24a345bd80a15326cffbc6a2d4317a7d
2
3308

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 4 years ago
#91
Bb4d59716a067a66521234fb0fa1b248
1
126

Come to the Dark Side

“You want to be a medical leader? … Gone to the Dark side have you?” For years medical leadership has been the place to retire to once you’ve done your hard work on the wards. The image of a doctor hanging up their stethoscope, picking up a clipboard and joining the managers “dark side” is all too familiar. Medical leadership, Healthcare management, Clinical lead, Quality lead – these are all ways of describing someone (a healthcare professional) who wants to make a difference, who wants to help not just one patient but every patient in that service. Medical leadership is the zeitgeist! It is a growing field. It is a discipline of the young and dynamic. It is something that is relevant to you all. It is something that you will be expected to show in years to come. As an individual student you can join the Faculty of Medical Leadership and Management (FMLM), do some reading, do a quality improvement project (QIP) and write that you have an interested in medical leadership on your CV. What if you want to do more than just improve your CV? Be an agent for change, found a student’s medical leadership and management society at your medical school! It’s easy! First, find 10 student colleagues – the driven, the politically aware, the idealists, the power-mad and the ones that really care. Step 2 – give yourself a suitably pompous name. Step 3 – register your New “University of X Leaders of Tomorrow” society with you MedSoc or Students Union. Step 4 – Contact the FMLM to let them know you exist and want to join their revolution. Step 5 – Collaborate with the other student Medical Leadership Societies (MLS) around the UK. Step 6 – Hold a social. Step 7 – Find a local doctor who would love to talk about their career and recent success. Step 8 – Invite us all along. Step 9 – Write it on your CV. Step 10 – Leave a legacy. At the present The University of Birmingham Students Medical Leadership Society is in contact with the FMLM and other similar groups at the Universities of Bristol, Barts and Oxford. We are looking to get in contact with every other society in the country. If you are a new or old MLS then please do get in touch, we would love to hear from you and are happy to help your societies in any way we can – we would also love to attend your events so please do send us an invite and we will do our best to attend and advertise it. Email us at med.leadership.soc.uob@gmail.com Follow us on Twitter @UoBMedLeaders Find us on Facebook @ https://www.facebook.com/groups/676838225676202/ Come along to our up coming events… Thursday 5th December LT3 Medical School, 6pm ‘Why should doctors get involved in management’ By Dr Mark Newbold, CEO of BHH NHS Trust Wednesday 22nd January 2014 LT3 Medical School, 6pm ‘Has the NHS lost the ability to care?’ – responding to the Mid Staffs inquiry’ By Prof Jon Glasby, Director of the Health Services Management Centre , UoB Thursday 20th February LT3 Medical School, 6pm ‘Creating a Major Trauma Unit at the UHB Trust’ By Sir Prof Keith Porter, Professor of Traumatology, UHB Saturday 8th March LT3 Medical School, 1pm ‘Applying the Theory of Constraints to Healthcare By Mr A Dinham and J Nieboer ,QFI Consulting  
jacob matthews
about 4 years ago
#92
6b9ce585453268efc7f4737fb018f8aa
6
72

Successful liver transplantation using Facebook

In January 2012 I wrote about a girl who had created a Facebook page because she urgently needed a liver. In August 2004 I had a car accident in Germany, where damaged my limbs and some of my internal organs. That's why I need a liver URGENTLY! Over 26.000 people (family members, doctors, nurses, her friends and students from all parts of the country) followed and liked her page in 3 months. Finally she'd found a suitable liver, and she is fine now. I believe that our generation of health care professionals should be prepared for this and should provide meaningful help, because in the future we can not avoid patients who are interested in social media. E-patients will increasingly use web 2.0 tools as part of their health management and we must respond to that.  
Zoltán Cserháti
almost 5 years ago
#93
9cbf284c0a6de246b172c08f9b711c91
5
160

PBL Problems

Problem Based Learning  
Mary
almost 5 years ago
#94
278
6
107

Choreiform Gait Demonstration

With thanks to the authors and contributors to the NeuroLogic Exam website (http://medstat.med.utah.edu/neurologicexam) and Pediatric NeuroLogic Exam website (http://medstat.med.utah.edu/pedineurologicexam) retain copyright to all material, including movies, and request acknowledgement whenever it is used.  
Dr Alastair Buick
over 8 years ago
#95
30d901eed32e51272e0239ee8f05a874
1
157

Socks, Kiwis and Surgical Removal

I’m a klutz. Always have been. Probably always will be. I blame my clumsiness on the fact that I didn’t crawl. Apparently I was sitting around one day and toddling on two feet the next. Whatever the cause, it’s a well-tested fact that I’m not good on icy footpaths. Various parts of my anatomy have gotten up close and personal with frozen ground on many an occasion. Not usually an issue for a born-and-bred Australian, except when said Australian goes to visit her Canadian family during the northern winter. During one such visit, I found myself unceremoniously plopped onto slick ice while my two-year-old niece frolicked around me with sure-footed abandon. I thought, “There has to be an easier way.” As freezing water seeped through my jeans, providing a useful cold pack for my screaming coccyx, my memory was jogged. I recalled that a lateral-thinking group of New Zealand researchers had won the Ignoble Prize for Physics for demonstrating that wearing socks on the outsides of shoes reduces the incidence of falls on icy footpaths. To the amusement of my niece, I tried out the theory for myself on the walk home. I don’t know if I had a more secure foothold or not, but I did manage to get blisters from wearing sneakers without socks. I love socks. They cover my large, ungainly clod-hoppers and keep my toes toasty warm almost all year round. You know the song ‘You can leave your hat on.’? Well for me, it is more a case of ‘You can leave your socks on, especially in winter. There’s nothing unromantic about that… is there? I’m not, however, as attached to my socks as a patient I once treated. As an intern doing a psychiatry rotation, one of my tasks was to do physical examinations on all admissions. Being a dot-the-i’s kinda girl, when an old homeless man declined to remove his socks so that I could examine his feet, I didn’t let it slide. “I haven’t taken off my socks for thirty years,” he pronounced. “It can’t be that long. Your socks aren’t thirty years old. In fact, they look quite new,” I countered. “When the old ones wear out, I just slip a new pair over the top.” I didn’t believe him. From his odour, I would have believed that he hadn’t showered in thirty years, but the sock story didn’t add up. He eventually agreed to let me take them off. The top two sock layers weren’t a problem but then I ran into trouble. Black remains of what used to be socks clung firmly to his feet, and my gentle attempts at their removal resulted in screams of agony. I tried soaking his feet. Still no luck. His skin had grown up into the fibres, and it was impossible to extract the old sock remnants without ripping off skin. In retrospect I probably should have left the old man alone, but instead got the psych registrar to have a peek, who then involved the emergency registrar, who called the surgeon and soon enough the patient and his socks were off to theatre. The ‘surgical removal of socks’ was not a commonly performed procedure, and it provided much staff amusement. It wasn’t so funny for Mr. Sock Man, who required several skin grafts! From my perspective here in Canada, while I thoroughly commend the Kiwis for their ground-breaking sock research, I think I’ll stick to the more traditional socks-in-shoes approach, change my socks regularly and work a bit on my coordination skills. References: PHYSICS PRIZE: Lianne Parkin, Sheila Williams, and Patricia Priest of the University of Otago, New Zealand, for demonstrating that, on icy footpaths in wintertime, people slip and fall less often if they wear socks on the outside of their shoes. "Preventing Winter Falls: A Randomised Controlled Trial of a Novel Intervention," Lianne Parkin, Sheila Williams, and Patricia Priest, New Zealand Medical Journal. vol. 122, no, 1298, July 3, 2009, pp. 31-8. (This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/58/0c06f058.asp) Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
almost 4 years ago
#96
F1ef89dcd631e968a298907c0591d370
2
41

Money-back guarantees

Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A few years ago, a package holiday company advertised guaranteed sunny holidays in Queensland (Australia). The deal went something like this: if it rained on a certain percentage of your holiday days, you received a trip refund. An attractive drawcard indeed, but what the company failed to grasp was that the “Sunshine State” is very often anything but sunny. This is especially so where I live, on the somewhat ironically named Sunshine Coast. We had 200 rainy days last year and well over 2 metres of rain, and that was before big floods in January. Unsurprisingly, the guaranteed sunny holiday offer was short-lived. There are some things that really shouldn’t come with guarantees. The weather is one, health is another. Or so I thought… “Those capsules you started me on last month for my nerve pain didn’t work. I tried them for a couple of weeks, but they didn’t do nothin'.” “Perhaps you’d do better on a higher dose.” “Nah, they made me feel kinda dizzy. I’d prefer to get my money back on these ones an’ try somethin’ different.” “I can try you on something else, but there are no refunds available on the ones you’ve already used, I’m afraid.” “But they cost me over 80 dollars!” “Yes, I explained at the time that they are not subsidised by the government.” “But they didn’t work! If I bought a toaster that didn’t work, I’d take it back and get me money back, no problem.” “Medications are not appliances. They don’t work every time, but that doesn’t mean they’re faulty.” “But what about natural products? I order herbs for me prostate and me heart every month and they come with a 100% satisfaction guarantee. You doctors say those things don’t really work so how come the sellers are willing to put their money where their mouths are?” He decided to try a “natural” treatment next, confident of its likely effectiveness thanks to the satisfaction guarantee offered. Last week I had a 38-year-old female requesting a medical certificate stating that her back pain was no better. The reason? She planned to take it to her physiotherapist and request a refund because the treatment hadn’t helped. Like the afflicted patient above, she didn’t accept that health-related products and services weren’t “cure guaranteed”. “My thigh sculptor machine promised visible results in 60 days or my money back. Why aren’t physios held accountable too?” Upon a quick Google search, I found that many “natural health” companies offer money-back guarantees, as do companies peddling skin products and gimmicky home exercise equipment. I even found a site offering guaranteed homeopathic immunisation. Hmmm… In an information-rich, high-tech world, we are becoming less and less tolerant of uncertainty. Society wants perfect, predictable results — now! For all its advances, modern medicine cannot provide this and we don’t pretend otherwise. Ironically, it seems the health products with the least evidence are coming with the greatest assurances. A clever marketing ploy that patients seem to be buying into — literally and figuratively. I think we all need to be reminded of Benjamin Franklin’s famous words: “In this world, nothing can be said to be certain except death and taxes.” We can’t really put guarantees on whether it will rain down on our holidays or on our health, and should retain a healthy scepticism towards those who attempt to do so. This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/11/0c070a11.asp Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
almost 4 years ago
#97
A056075c782338964360db479f703015
3
101

Difficulties In Trying To Access Medical Courses

I'm a GP registrar in East Anglia with an interest in continuing medical education. Alex Gordon-Weeks - academic surgical registrar at Oxford - and I are undertaking a project that explores some of the difficulties that doctors face when trying to access medical courses. Doctors complete a number of compulsory and non-compulsory educational courses during and after their medical training. Now that revalidation is compulsory doctors must provide evidence of continuing medical education. Attending courses are an ideal way of maintaining knowledge but they can be expensive and time consuming so it is important that adequate information regarding the course undertaken is provided by the course organisers. To identify areas in which these features could be improved we wish to understand more about the courses that you attend. We have put together a short survey to obtain anonymised information that we can use to improve course provision. We would love for Meducation members to fill it in and would really appreciate your participation. You can take the survey at http://www.surveymonkey.com/s/SSL7286. Thanks!  
craig Sheridan
almost 5 years ago
#98
459d43a90d590708ca5f65a66f5ff594
5
358

Probiotics - There's a New Superhero in Town!

When you think of the term 'bacteria', it immediately conjures up an image of a faceless, ruthless enemy-one that requires your poor body to maintain constant vigilance, fighting the good fight forever and always. And should you happen to lose the battle, well, the after effects are always messy. But what some people might not know is that bacteria are our silent saviours as well. These 'good' bacteria are known as probiotics, where 'pro' means 'for' and 'bios' is 'life'. The WHO defines probiotics as "live micro-organisms which, when administered in adequate amounts, confer a health bene?t on the host". Discovered by the Russian scientist Metchnikoff in the 20th century; simply put, probiotics are micro-organisms such as bacteria or yeast, which improve the health of an individual. Our bodies contain more than 500 different species of bacteria which serve to maintain our health by keeping harmful pathogens in check, supporting the immune system and helping in digestion and absorption of nutrients. From the very first breath you take, you are exposed to probiotics. How so? As an infant passes through it's mother's birth canal, it receives a good dose of healthy bacteria, which in turn serve to populate it's own gastro-intestinal tract. However, unfortunately, as we go through life, our exposure to overly processed foods, anti-bacterial products, sterilized and pasteurized food etc, might mean that in our zeal to have everything sanitary and hygienic, we might be depriving ourselves of the beneficial effects of such microorganisms. For any health care provider, the focus should not only be on eradicating disease but improving overall health as well. Here, probiotic containing foods and supplements play an important role as they not only combat diseases but also confer better health in general. Self dosing yourself with bacteria might sound a little bizarre at first-after all, we take antibiotics to fight bacteria. But let's not forget that long before probiotics became a viable medical option, our grandparents (and their parents before them) advocated the intake of yoghurt drinks (lassi). The fermented milk acts as an instant probiotic delivery system to the body! Although they are still being studied, probiotics may help several specific illnesses, studies show. They have proven useful in treating childhood diarrheas as well as antibiotic associated diarrhea. Clinical trial results are mixed, but several small studies suggest that certain probiotics may help maintain remission of ulcerative colitis and prevent relapse of Crohn’s disease and the recurrence of pouchitis (a complication of surgery during treatment of ulcerative colitis). They may also help to maintain a healthy urogenital system, preventing problems such as vaginitis and UTIs. Like all things, probiotics may have their disadvantages too. They are considered dangerous for people with impaired immune systems and one must take care to ensure that the correct strain of bacteria related to their required health benefit is present in such supplements. But when all is said and done and all the pros and cons of probiotics are weighed; stand back ladies and gentlemen, there's a new superhero in town, and what's more-it's here to stay!  
Huda Qadir
almost 4 years ago
#99
19029b8ec5c364496bcc13bf012dde8e
3
261

Digitalising Textbook initiatives in Africa...But, do the costs add up?

A recent review by World Bank Group has highlighted the enthusiasm for digitalising text books in Africa. Education officials seeking to acquire digital teaching and learning material have come to realise that it is actually quite a challenging and complex process. The procurement processes in comparison to acquiring traditional textbooks is proving to be less cost effective. Currently in Africa a few countries have been ambitious in wanting to roll out digital textbooks, referred to as 'teaching and learning resources and materials presented in electronic and digital formats'. Michael Truanco (Sr. ICT & Education Specialist) for World Bank, makes a clear point about the increasing consideration of the use of free content. Where free content is being used, this means the acquisition of the content is free. But is it really free? The costs associated with piloting small projects in order to introduce digital teaching and learning materials as a way to learn what the related costs are. There are three categories to consider, the costs related to content, the device related costs and ecosystem related cost. Michael highlights the costs related to content which are directly related to the acquisition of content. Although post acquisition - there are other costs to consider, including vetting (for accuracy), contextualising, embedding, classifying and distribution. Device -related costs and other costs which are related includes the end user device which digital teaching materials are viewed on, accompanied with the technical infrastructure. Further costs to consider include the repair and maintenance, replacement, upgrade and security. In order for a device to function efficiently the baseline of electricity needs to be considered. These are the direct related costs to the device, as well as costs associated to the ecosystem. The article does not seek to dampen the initiative of digitalising content but rather highlight the need to consider the finer details in finances, which is a fundamental element within the process of this great initiative. Previous initiatives include the World Bank in Latin America and Africa which sought to provide 'teacher generated content'. The initiative is an excellent one but the reality of digitalising textbook initiatives in Africa may need, further refining in terms of economics and overall financial costings. The question to really ask is whether digitalising textbooks in Africa will have a greater accessibility and outcome than traditional printed format? However, as discussed to achieve this, it will come at a price? But, does the costs outweigh the outcomes? Irrespective of the costs the overall outcome and benefit of digitalising text book initiative in Africa will have a much greater overall impact. Children and adults will be able to access mass content and learning materials in a much more accessible way. Thus, leading to a more effective and positive learning environment. To read more on this topic please feel free to click on the article by Michael Truanco of World Bank (see link below). http://blogs.worldbank.org/edutech/calculating-costs-digital-textbook-initiatives-africa  
helena kazi
almost 4 years ago
#100
28f2922e87ea7cd0d2e1f35355bfdec6
2
167

Creating the Pre-Hospital Emergency Medicine Service in the West Midlands –The Inaugural lecture of the Birmingham Students Medical Leadership Society

Many thanks to everyone who attended the Birmingham Students Medical Leadership Society’s first ever lecture on November 7th 2013. The committee was extraordinarily pleased with the turn out and hope to see you all at our next lectures. We must also say a big thank you to Dr Nicholas Crombie for being our Inaugural speaker, he gave a fantastic lecture and we have received a number of rave reviews and requests for a follow up lecture next year! Dr Crombie’s talk focussed on three main areas: 1) A short personal history focussing on why and how Dr Crombie became head of one of the UK’s best Pre-Hospital Emergency Medicine (PHEM) services and the first post-graduate dean in charge of PHEM trainees. 2) The majority of the lecture was a case history on the behind the scenes activity that was required to create the West Midlands Pre-Hospital Network and training program. In summary, over a decade ago it was realised that the UK was lagging behind other developed nations in our Emergency Medicine and Trauma service provisions. There were a number of disjointed and only partially trained services in place for major incidents. The British government and a number of leading health think-tanks put forward proposals for creating a modern effective service. Dr Crombie was a senior doctor in the West Midlands air ambulance charity, the BASICS program and had worked with the West Midlands Ambulance service. Dr Crombie was able to collect a team of senior doctors, nurses, paramedics and managers from all of the emergency medicine services and charities within the West Midlands together. This collaboration of ambulance service, charities, BASIC teams, CARE team and NHS Trusts was novel to the UK. The collaboration was able to tender for central government and was the first such scheme in the UK to be approved. Since the scheme’s approval 5 major trauma units have been established within the West Midlands and a new trauma desk was created at the Ambulance service HQ which can call on the help of a number of experienced teams that can be deployed within minutes to a major incident almost anywhere in the West Midlands. This major reformation of a health service was truly inspirational, especially when it was achieved by a number of clinicians with relatively little accredited management training and without them giving up their clinical time, a true clinical leadership success story. 3) The last component of the evening was Dr Crombie’s thoughts on why this project had been successful and how simple basic principles could be applied to almost any other project. Dr Crombie’s 3 big principles were: Collaborate – leave your ego’s at the door and try to put together a team that can work together. If you have to, invite everyone involved to a free dinner at your expense – even doctors don’t turn down free food! Governance – establish a set of rules/guidelines that dictate how your project will be run. Try to get everyone involved singing off the same hymn sheet. A very good example of this from Dr Crombie’s case history was that all of the services involved in the scheme agreed to use the same emergency medicine kit and all follow the same Standard Operating Procedures (SOP), so that when the teams work together they almost work as one single effective team rather than distinct groups that cannot interact. Resilience – the service you reform/create must withstand the test of time. If a project is solely driven by one person then it will collapse as soon as that person moves on. This is a well-known problem with the NHS as a whole, new managers always have “great new ideas” and as soon as that manager changes job all of their hard work goes to waste. To ensure that a project has resilience, the “project manager” must create a sense of purpose and ownership of the project within their teams. Members of the team must “buy in” to the goals of the project and one of the best ways of doing that is to ask the team members for their advice on how the project should proceed. If people feel a project was their idea then they are far more likely to work for it. This requires the manager to keep their ego on a short leash and to let their team take credit. The take home message from this talk was that the days of doctors being purely clinical is over! If you want to be a consultant in any speciality in the future, you will need a basic underlying knowledge of management and leadership. Upcoming events from the Birmingham Students Medical Leadership Society: Wednesday 27th November LT3 Medical School, 6pm ‘Learning to Lead- Preparing the next generation of junior doctors for management’ By Mr Tim Smart, CEO Kings Hospital NHS Trust Thursday 5th December LT3 Medical School, 6pm ‘Why should doctors get involved in management’ By Dr Mark Newbold, CEO of BHH NHS Trust If you would like to get in touch with the society or attend any of our events please do contact us by email or via our Facebook group. We look forward to hearing from you. https://www.facebook.com/groups/676838225676202/ med.leadership.soc.uob@gmail.com  
jacob matthews
about 4 years ago