A Patient is just as responsible as their Doctor

The Patient’s Duty:

Deutsch: Ein Arzt beim Abhorchen der Lungen mi...

–       Know how to communicate effectively with medical staff.

Rudeness will not aid or speed up your care, and there is no 100% success rate for any Doctor, a diagnosis can change based on further tests or second opinion. You are as much responsible for your own body and health as your Doctor is, they will do their job in aiding your health, but you should do the same.

–       Know your rights.

I, as have many others, have experienced problems with Doctors who are reluctant to make referrals or give prescriptions, and instead of having a “better safe than sorry” attitude have an “it’s probably not that” attitude. Well, would you rather a suspicious lump shown up in an ultrasound not be tested further because it “probably” isn’t cancer, would save some funding and the GP’s precious time?

No, it is better to test again to get a clearer picture and confirm that it is definitely rather than “probably” not cancer. The most recent story pertaining to this issue was this article about a lady whose husband could have been diagnosed with Alzheimer’s much sooner. The Daily Mail is awful of course, but I found the story interesting.

This BMJ article ‘A horse or a zebra?’ describes a medical student who diagnosed himself correctly, but was told by the GP that this diagnosis was unlikely and would not refer him for testing. This is why sometimes insisting, and knowing your rights, can help you reach a positive outcome quicker, you have to stand up for your health.

Prevention is always better than cure, the funding used on tests to aid early diagnosis, vaccinations, and necessary prescriptions save money in the long-term, and can result in less long-term or chronic conditions that require lifelong medications or treatments.

–       Know when to call NHS Direct instead of an ambulance or going to A&E.

I have heard laughable stories of Continue reading

The Difficulties of Getting Into Medical School

English: Insulin type syringe ready for inject...

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Medical Schools are not looking for why they should accept you; they are looking for why they shouldn’t. That may sound cynical but it’s an irrefutable fact that many candidates exceed the entry requirements, yet not all of them can gain an interview or offer of a place. So how do the Universities differentiate between one candidate and another?

Work experience

Are you well informed about the actual demands or pros and cons of being a Doctor? Can you prove it in your UCAS application and talk about it at Interview? Regardless of your age or educational level, work experience is often the thing which differentiates one candidate from another. It demonstrates a hands-on desire to learn about your intended career path, and that you are entering Medicine for the right reasons; because you are aware of what it means to be a Doctor, what the job entails, not because you saw something on Grey’s Anatomy and thought it might be “cool”.

You do not have to have traveled to Kenya to help blind children see again, or have found a cure to cancer, but it often seems that a lot of candidates who are accepted to Medical School have volunteered abroad. What of those who cannot afford to do so? Is it not good enough to have volunteered weekly at a soup-kitchen or been a dedicated fundraiser for your favourite charity? There is a lot one can do without leaving the country and Medical Schools are aware of this.

This is not to detract from the hard work and help many applicants have given to other countries, or to suggest their journey was for the sole purpose of making their personal statements more exciting. But unfortunately this misperception does exist in some form, with some applicants feeling they must pay to go abroad, or be the next Mozart with a musical instrument, and otherwise risk their application being less competitive.

GCSE

Medical Schools must establish how good you look on paper. Some institutions apply significance to GCSE’s; the University of Liverpool School of Medicine states that you must have 9 GCSE’s at grade C and above. You could have gone on to achieve a First Class degree in Biochemical Engineering, but if even one of your 9 GCSE grades is below a C you can forget about applying to Liverpool. It is arguably fair that mature or graduate applicants should meet the same requirements as school-leavers, but with exam retakes being frowned upon by Medical Schools, and even recent academic excellence not compensating for prior GCSE grades, what hope is there for older applicants?

A-Level

Some establishments focus more on A-Levels. Typically grades AAA in Biology, Chemistry and a third subject (for example Physics or Mathematics) are expected, though A*A*A*A*(a) would undoubtedly make an applicant stand out from the rest. If any applicant, be they school-leaver or mature/graduate, does not meet this requirement then this limits their choice of Medical Schools. As an example let us consider an applicant who achieved grades ABC in non-scientific A-Level subjects, then later went on to achieve A*A*A* in science based A-Levels, even then this candidate would not be suitable for UCL Medical School, whom only acknowledge the first set of A-Levels undertaken by the applicant and ignores any later A-Level grades, regardless of academic excellence or the fact they are not retakes. In many ways this is demonstrative of the dreaded feeling that ‘you only get once chance’ with education and pursuing your dream, and leaves many mature/graduate applicants feeling regret over past grades, or not choosing medicine sooner, and that it is ‘too late’ to improve or compensate. This is why Access Medicine courses such as the one at The College of West Anglia can offer a way for mature students to prove their academic ability and suitability to Medicine.

Graduate and Mature Students

I have heard many successful graduates with 2:1 or 1st class degrees say they wish they had never taken a degree, simply because they feel it makes applying to Medical School all the more difficult. Graduates are typically judged more harshly than school-leaver applicants, as if it is a flaw they did not choose or enter Medicine sooner. This is not true for all establishments, some of which are more ‘Graduate friendly’, and realise that applicants who have already succeeded at a degree are often mature, experienced, and able to work hard at a higher academic level, offering a fresh perspective from their chosen subject.

If you are a graduate with a non-scientific degree, this is where selecting medical schools to apply to becomes difficult. Every Medical School is drastically different in their attitudes to mature applicants, ranging from hostility and disapproval to respectful acceptance; some only accept graduates with a science degree, and in general any lower than a 2:1 grade is unacceptable regardless of whether the applicant is entering a Traditional 5 year programme, or accelerated 4-year Graduate entry.

Mature applicants are usually expected to have everything a school-leaver has and more. What can you offer to the Medical School, academically and personally, that a younger applicant might not? This is where you must ‘sell yourself’ in your UCAS Personal Statement, and prove that you have a more in-depth feel for the demands of a career in Medicine, or sophisticated methods for dealing with stress and pressure (which can be backed up by your C.V).

Admissions Tests

The UKCAT (the UK Clinical Aptitude Test): dreaded by many, a walk in the park for others (regardless of their academic ability) invites polar opinions from applicants and Medical professionals alike. Many Doctors agree that the UKCAT does not determine who will or will not make a good Doctor, and that the test should be abolished. Others argue its merit in objectively seeking stronger applicants using a score system, and claim that it is fair because it cannot be revised for; it is not about a candidate’s knowledge, only their ability to think rationally and logically under the pressure of time constraints. Some Medical Schools automatically reject applicants who score below a certain threshold, regardless of their academics or work experience, and invite anyone scoring above a certain amount to interview.

Made up of four sections: Verbal Reasoning, Quantitative Reasoning, Abstract Reasoning and Decision Analysis, none of which refer to or contain anything ‘clinical’, this test can play a large role in an applicant’s chances of securing a place at Medical School, so even if you wonder how seeing a pattern in a load of jumbled Abstract shapes relates to your ability to learn Medicine and care for patients, this will most likely be the test you undertake.

Other admissions tests include the GAMSAT (Graduate Medical Schools Admissions Test) which is over five hours long, and based around a candidate’s scientific knowledge, as well as their literate ability, the BMAT (BioMedical Admissions Test), testing aptitude and skills, scientific knowledge and writing ability. For more information on admissions tests see: wanttobeadoctor.co.uk.

Re-applicants

If you are unsuccessful in securing an interview or place at Medical School, should you try again? This depends on your ambition, whether or not you have at least considered alternative careers, what your financial or family situation is, and whether or not you can improve upon your application. Think from an admissions perspective; they have to reject those that do not meet the requirements, and even many who exceed them, there simply are not enough places to go around. There are applicants who have been unsuccessful for four academic cycles then gained a place on their ‘last try’. There is always hope, but the applicant must be willing to improve.

The harsh truth about Medical School is that it can be subjective, and the line between one applicant who exceeds the entry requirements and is rejected, and another in the same position who is accepted, can be blurry. An applicant can meet the academic/personal requirements yet be rejected without even an interview from one Medical School, yet gain an offer from a Medical School typically deemed to be even more competitive.

The best advice any applicant can follow is to research and select their medical school choices very carefully, contact the admissions teams directly, and be aware that there is no easy way into Medical School just as there is no easy way to complete a Medical degree. If you do not like a challenge, or can find no ways to self-improve, then perhaps Medicine is not the right career choice.

Note: Aspects of this post are opinion based and tongue-in-cheek, but any references to a specific Medical School’s entry requirements are accurate at the time of writing.

Where would you most like to go?

Having just gotten back from Orlando, Florida, where temperatures soared even among indecisive thunderstorms, I’m now craving an arctic adventure. One day, further on in my medical career, I’d love to work and help out at the Inuvik Regional Hospital, of which I’ve heard good things, how it challenges future doctors on their electives, and has a superb E.R department and team. I’d be happy to go there during the 24 hours of perpetual daylight in one season, or 24 hours of night that the local’s are accustomed to during their drastically contrasting summer and winter, because either would be exhilarating and challenging. I want to feel the crunch of untrodden snow under my boots, the bite of cold on my nose and cheeks, and appreciate stepping into the warmth of indoors after an adventurous day snapping pictures of the vast lakes and landscapes. I wonder what wildlife is there, and whether you’d need a guide to avoid dangerous creatures.

NHS: Let Them Eat Cake! [Latest Health News in Brief]

NHS Reform. The NHS has its flaws but if you privatise it you are essentially minimising patient care but maximising corporate competition. This belittles the principles of Medicine and healthcare, making it all about profit, money and marketing, rather than caring for people. The only people who win in a Privatised and essentially fragmented NHS are the companies that compete for a stand in Healthcare, whose products and service are not the best but cost the private sector less.

Privatising the NHS is essentially saying “Let them eat cake!” In Marie Antoinette’s world, sure, let the patients eat cake when what they really need is quality healthcare.

I agree with assisted suicide; euthanasia is the kindest gift to offer someone who is in the most extreme circumstance, without any quality of life, and with great suffering. Zürich has voted similarly: click to see news story.

Social networking has become more than just social, it is used in Medical schools, some of which in the UK give out smart-phones to students so that they can carry digital textbooks. There are many pros, but I wonder about the cons; for example, will it deter students from being intuitive or self-sufficient if they rely upon a mobile device for the answers to a correct dosage, will it bias the diagnostic process?

Twitter ‘vital’ link to patients, say doctors in Japan: Click   

Lines between plastic surgery and beauty treatments are diminished, but what by? I believe it is the easier access to cosmetic surgeries and procedures which make them less taboo, more easily attainable and therefore more likely that someone will be inclined towards them (the sheep effect; everyone else is doing it so why not you?). Click here for details.

Obese pregnant women are being given Metformin, usually for diabetics, to reduce the risk of obesity in their babies.

Casualty fan saves baby’s life with skills learned from show:http://tinyurl.com/5ux23q4

Monkey HIV vaccine ‘effective’ I really hope this can give us some insight into a way to cure human HIV victims, and yes I say victims because no one chooses to have HIV/AIDs, however they contract it. I remain dubious, because many ‘cures’, or proposed ones, have been and gone. I’m just glad the research continues, and we’ve gotten so far with extending the lives of HIV victims, delaying full AIDs.

Doctors want a decision on the NHS, but the wrong choice could cause further disarray. Personally I am opposed to the NHS reform, but I wanted to hear the other side of the argument so I went to the Royal Society of Medicine debate; arguments for the reform revolved around increased efficiency, quality of products and care, as well as time management. However, I’m doubtful of that, increased corporate competition will commodify health, and prioritise profit over care.

How Superbugs attack; The research carried out at BMC Systems Biology discovered genes responsible for MRSA‘s grown resistance to the Methicillin antibiotic. As a type of Staphylococcus aureus, it is of interest to my upcoming lab project, where I will measure the rate of growth in bacterial resistance. A toxin taken from the skin of a bullfrog has proven effective in destroying MRSA.

I got accepted

Kawaii Sushi Cross Stitch

Image by plushoff via Flickr

I got accepted to study Medicine (Access) somewhere, can’t say where yet as need to hear back from all the places I applied to (I’ve applied via the Graduate route too).

I also wanted to post some of the things I’ve been writing lately about Face Transplants, Japanese Kawaii culture, etc, but can’t because they’ve been submitted to Goldsmiths and I’m not sure what the rules are on publishing your work when it hasn’t been marked yet. Plus, if they do one of their random plagiarism checks, and find my work here, they may think I’ve plagiarised from Cityshy, without realising I AM Cityshy.

I’m still writing about the psychological impacts of technology, the implications of it being an extension of our selves, and tearing apart post-human theorems. I still work as a Care Giver to the elderly, a hospital volunteer on a surgical ward, and will be graduating in May, so I feel productive despite being busy all the time.

This post is mainly just to fill the void.

“You’d make an excellent Doctor”

A thoracic surgeon performs a mitral valve rep...

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Received the nicest compliment today from one of the elderly people I care for, they said there’s something special about me and that I’d make an excellent Doctor.

Also…at the Hospital I volunteer at I found out I’ve been assigned to the Surgical Ward! Very beneficial, especially because I dream of being a surgeon some day.

EX2512exza

Call an ambulance

Apologies to people I am subscribed to, and those in my blogroll, I simply haven’t had any time to read as much or comment lately, let alone write any lengthy posts for my own blog.

What’s my excuse? As well as the huge dissertation article, separate project, double modules at university, commuting to London, and continuous research in my “spare time”, I also work as a carer. The timetable has filled up this week, I’m no longer under mentoring.

Ms Anonymous, a new care receiver I met today, seemed well and able, apart from having a poor memory (I had to remind her each time she asked what time lunch was, and that she had already had breakfast). But, as I and another girl (who does not work for the same care branch as I) were preparing lunch, we heard an almighty crash. We ran to Ms Anonymous’ bedroom to find her crumpled on the floor. She had tried getting out of bed unassisted, and tripped on her Zimmer frame.

We had to call an ambulance fast, because she said she thinks she had broken her leg. We couldn’t take risks, especially seeing as she had a hip replacement recently, and was hospitalized a long time with an infection also. I made sure we kept her still, but comfortable with pillows, and called her son as well.

The ambulance arrived to pick her up, and I hope she will be alright once out of hospital. That’s all I will write for now, it’s important to keep track of these things. Am heading out later for an evening appointment with a different care receiver, hopefully they are faring well, it’s a shame when bad things happen.

A young male cat

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On a brighter note, I saw a very cute cat today who kept me company when I was waiting out in the cold.

Aloe can help survival during severe blood loss?

Heart diagram with labels in English. Blue com...

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Just found one of my older LiveJournal posts, it was just a DRAFT of thoughts:

Jan. 16th, 2010 at 6:41 PM

Aloe can help survival during severe blood loss?
www.nationalreviewofmedicine.com/issue/2004_09_15/clinical11_16.html

I initially searched into this mainly because I was wondering whether panic/increased heart rate sped up blood flow (and therefore blood loss), (and therefore one’s demise), OR, does the quickened blood flow aid the situation, seeing as the heart’s natural response to blood loss is to speed up and release adrenaline as a reaction to lower available oxygen and/or volume of blood itself. Does speeding up of heart rate and blood flow enable the remaining oxygen to be distributed in a way that attempts to simulate the regular amounts.

It is mentioned that aloe increases circulation, and the rats that were injected with it during severe blood loss lived longer than rats that were injected with regular saline. However, the improved circulatory function does pose the risk of obstructing coagulation. Therefore aloe could be useful to prolong a patient’s life, whilst further treatment/aid/procedures are taken to stem the blood flow, or a transfusion is made.

So, is the natural rush of adrenaline, which is automatic in the situation of severe blood loss, helpful? Or is it an inevitable symptom, induced by hemorrhagic shock, which essentially speeds up one’s demise?

Heightened heart rate and blood flow BUT lower blood pressure.

Heightened
blood flow but lower oxygen and blood volume.

If the heart slowed dramatically rather than speeding dramatically once heavy blood loss is induced, the lowered blood pressure would have an intensified impact…therefore it could be theorised that the over-compensation the heart makes in speeding faster is an attempt to normalise the body and pump oxygen to the parts that need it most.

HOWEVER, with wounds, such as those on major arteries, like the jugular, the heavier blood flow would result in a quicker death.

(Original post can be seen here: LiveJournal)

£92.40 for charity in just one day

This baby is one month old.

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Well, I counted up all the coins and notes I collected on Monday, plus some of my own donation fund, and it adds up to £92.40. Which is absolutely amazing for one day of fundraising on my own. There was another £25 people already donated online, which means I’ve exceeded the £100 target.

Here is why I’m doing it:

Harlequin-type ichthyosis is the most severe form of congenital ichthyosis. Swelling to the eyes, ears, and other appendages, mean that the babies born with this skin disease have difficulty seeing, breathing, or even moving.

The texture of the skin means it cannot bend where soft skin usually can, it’s cracked texture is agonising and means the babies are prone not only to infection from the bleeding exposed cracks, but from hypothermia also.

Medication such as Isotrex, which improves their quality of life, are essential. But with your help, further treatments can be found, and you will be contributing to the life-time care that Harlequin sufferers require.

Please click here for more info: http://www.justgiving.com/RNoakes

I can’t update, fear of failure :(

The All-Nighter

Image by Spitefully via Flickr

Not properly anyway. Until Monday’s disastrous clinical aptitude exam is over. I’m not expecting to pass because it was years ago that I had to do any maths, and even with these past couple of months revision, the time limits in the exam are the real problem.

I can do the calculations, I’m not thick, but with 1 minute per 4 questions, I need more time to prepare.

Really nervous about Monday, but all I can do is keep studying like I have been. UKCAT just isn’t my thing, give me a proper medical exam and I would do better, or a complex analytical essay. I’ve done more challenging things than this before, but it’s sometimes the “simple” but very time-limited things like this that get to me.

The thing that lets me down is the panic when it comes to time limits and maths. I came out of school years ago with a very good grade, but even so, I still feel hopeless.

Eat shit? The Human Centipede

Promotional poster for The Human Centipede (Fi...

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One of my best friends, Marie, stayed over this week and watched The Human Centipede (directed by
Tom Six) with me.

The worst (best) part was Dr Heiter, played by Dieter Laser. He was truly creepy looking, and his acting made you feel like perhaps he was this scary in reality too. The film was about his being a surgeon; he used to separate conjoined twins, but then becomes fixated with joining living things.

Naturally, this leads to his ideal of a human centipede, connected by sewing their mouths to each others butts, so that they share one digestive track. Implausible in the long-term, and hilarious, so I was glad when one of the three victims died from infection. That was the most medically accurate part.

The film was not scary, but hilarious. I just couldn’t stop laughing at what idiots the characters are. One of the two female leads had the chance to escape, but hides instead of smashing the window to escape straight away. And the Japanese guy, played by Akihiro Kitamura, who is also a captive, actually stabs Dr Heiter with a scalpel, but only in the foot and leg. He goes crazy and bites him, but instead of using his chance to kill the crazy Doctor, or knock him unconscious at least, he chooses to just attempt to run away (difficult with two girls surgically attached).

I had no real sympathy for the characters because their survival instincts were poor, I like it when characters truly try their best and are beaten down, but these three were mainly moronic and therefore deserved it. The very few chances they had to escape they wasted completely.

As ridiculous as this film was, it’s worth watching because it’s one of the funniest films I’ve seen in a long time, and wasn’t too badly shot.

Doctors and dentists with HIV/AIDs

Abacavir - a nucleoside analog reverse transcr...

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It’s something I’ve looked into before, but I found an interesting article tonight:

Click here to see

I have deep sympathy for anyone that contracts the disease, but particularly those who simply could not prevent it; rape victims, babies born with it, etc. What makes matters more complex is when someone within Healthcare has this disease. As stated in the article I linked, there are regulations on declaring positive test results, and prohibitions when it comes to surgeries, sutures, and any situation that may pose a risk of transmission.

In short, it is not legal to fire a doctor or dentist for having HIV or AIDs, but their career is effectively over nonetheless. What a terrible thing for them, to have gone through so much schooling and hardship only to be brought down by a disease. In any other walk of life they may continue relatively as normal; because improved medication generally means a higher quality of life, and the delay of full-blown AIDs stemming from testing HIV positive.

But it is necessary, for others safety, that transmission risks are minimised. I must admit I would prefer to be treated by a doctor or dentist whom was not HIV positive, and it would be nothing against the person. A disease shouldn’t dehumanise anyone. I just know that if I were HIV positive I would never want to risk infecting others, and would certainly never want anyone to infect me either.

The best thing anyone can do is protect others, ourselves, and encourage the progression of medical research.

End of my boring rant.