The Journal

Today arrived my copy of the studentBMJ. This delightful publication is full of articles designed to be of interest to medical students in the UK. You'd think that obvious from the title "British Medical Journal." However, all is not as it seems.

What frustrates me is that the studentBMJ doesn't just publish articles from UK students and doctors and academics(...) but they publish things from all over the world. This is fine until you read some of the crap that they have the cheek to publish.

Take two issues ago, for example. There was a letter from some Polish students proclaiming how we should "Sponsor a Polish medical student". The article continued...

"Although medical education in Poland is free, students still struggle to fund their studies and many of them drop out..."

Sound familiar? You could be forgiven for thinking that Poland is a typo which was originally supposed to read British (apart from the free part). I'm not for one second suggesting that people in Poland have it as good as we do in the UK; I appreciate that it's far from it. However, to publish such a letter in a publication primarily aimed for a UK audience, an audience themselves struggling to fund themselves through medical education, is simply absurd. Students in the UK are in record amounts of debt, have to pay ridiculous tuition fees and it is true that many will drop out because of this.

To take a slightly different angle, just look at the university recruitment rates for 2006/2007. For the first time in 100 years (slight exaggeration, but you get the point) applications via UCAS have dropped by around 3%. Normally they rise by quite a lot. I'm sure that there's some kind of rational explanation for this other than the fact that from 2006/2007 students are charged £3000 a year tuition feed? No? Oh.

The Poland article annoyed me. But not as much as the attached studentBMA news did. This is normally a good read, you're kept up to date with things that are happening and is genuinely interesting. However, there was one small sentence that bugged me. The sentence mentioned how medical students are struggling to develop their practical skills because of "competition from other health care students". Good point, but...

What? Does that mean nurses? Physios? OTs? The article stopped there. I want to hear more about how and why nurses and other health care students are being trained to do my future job. It seems nobody has the guts to speak out about this.

One of the questions I was asked at all three of my medical school interviews was "Why do you want to be a doctor and not a nurse?". Well, my answer was simple. You get to spend the day making life-or-death decisions about people's lives rather than wiping shitty arses all day and cleaning up vomit.

Why was I not told that if I got a nursing degree I could become a doctor? Then I would be finished and working next July, with less than half of the debt that i'm going to have, AND with a nice NHS bursary every month.

I'm confused and disillusioned.

Exams

The exams this year have been impossible. I really don't know where they pick the questions from. Oh, wait. Perhaps they're all from UMAP.

Last year I travelled to Manchester to join in on a GMC consultation (my Profs told me that the GMC had never consulted on anything before) on the future of medical education. One of the questions was whether or not there should be a national exam, similar to the US system. Nearly everybody in that room said that there should be no national exam. They stated many reasons, but the one that stuck in my mind was that the delivery of the medical curricula should be unique to each medical school. If not, then surely we should just pool everyone's resources and stick an enormous medical school in the middle of the country. It'd make sense. Academic staff are always in short and using the vast array of experience that the staff in this country have would create some amazing doctors.

But that would be boring. The medical school I go to, without being specific, teaches us a lot of things about Patient Centred Care, social aspects of medicine and how we should always consider the patient's viewpoint. I dare say that in certain medical schools in a fairly large city in the south east don't learn about these things at all. That's where our schools differ. It makes things interesting, and I believe will eventually but is in great competition with each other over which doctor is best. I believe that the unique things that each medical school brings are important, and should be preserved.

So this brings me back to UMAP. Surely a bank of questions shared between medical schools is one step closer to a national exam? I know that the exams won't be the same in each school, but the essence that I can be tested on a question writted by the Professor of Herbology at St. Andrews (we don't do any herbology by the way, and I doubt they do either) alarms me a little. I think that that is perhaps what we have seen in our exams this year. The 'theme A' exams on Monday and Tuesday were the hardest things i've ever seen, and I hadn't heard of half the things mentioned the questions!

Writing original and challenging questions that fit within the curricula is hard. But should we really support the GMC's ideal of an Űber national exam by participating in UMAP?

I think not.

Elusive X-rays

Image: Random Google search

Last week, I had a chest X-ray done. I was told by my GP to go to a local walk-in centre where they do X-rays, and to pop back in a week to discuss the results. I was weary. When someone says "walk-in centre" to me I immediately think of droves of spotty, sneezing chavs fighting over who's next. I was surprised. The walk-in centre was clean, tidy and the reception staff were helpful. I was the only person there save a morbidly obese lady who had come for a hip X-ray. We chatted about the weather and in ten minutes I had had my X-ray done and I was on my jolly way. The radiographer said I should go back to my GP in two weeks. She was rude.

I hate rudeness. There are few excuses for it. One of them is if the person that you are being rude to has been rude to you. I had not been rude. In fact, I always try to be overly pleasant. Anyway, I digress. The fact that the radiographer was rude wouldn't have normally bothered me, it's something that you've got to live with. However, I don't think that there is any excuse whatsoever for health-care professionals being rude. Imagine if i had been a poorly old man, on my last legs having a chest X-ray to confirm a lung cancer. I would be scared, nervous, and I would probably appreciate seeing someone with a caring attitude. Perhaps her attitude would have changed? But that's not the point. For all she knew I was attending for an X-ray to see if I had something lie...mmm...what could I have had? Perhaps Tuberculosis? I could have been worried. I am good at hiding such things.

Anyway, the experience of the walk-in centre was pleasing. I would have thought that the fact one could walk into a building and have an X-ray, a humble X-ray, within ten minutes would have been impossible in today's NHS. Obviously I was wrong. Perhaps the NHS deserves some credit?

Today I went back to the GPs. I explained that I had come to see if my results were back, and I explained that the GP said a week and the radiologist said two. The receptionist looked as she had heard it all before. She then told me that when she had a CXR (that's medical speak for a chest X-ray) she was waiting three weeks for the result. The practice nurse was there too. She said that if I rang her tomorrow with my details, she would chase everything up and they would hurry up with my results. Hmmm. Perhaps this will work. Perhaps not. The moral of the story is that one should not have to chase around like this for results. And i'm sure that the practice nurse has got better things to do with her time too. X-rays don't take two weeks to report on. Especially ones like mine which will no doubt be obviously fine and dandy.

Oh well. Anyway, the second exam today was just as impossible as the first. Perhaps I will have to resit? Heres hoping not.

Student Selected Craponents

One of the features of all medical curricula in the UK are student selected components. They differ in designation from Uni to Uni, most call them Student Selected Modules or Special Study Modules. At my medical school they're called student selected components, or SSCs.

I haven't really enjoyed my final pre-clinical year at med-school. The whole routine thing we have going is getting kind-of boring and I feel that i'm ready to be thrust upon the general public. One of the long standing thorns in my side this year have been the student selected components. The GMC require that all students do a specific number of these modules (they recommend 33% of the entire course!) and that they are to 'broaden [our] horizons'. And they succeed in doing that. The problem that I have with them is that they just aren't relevant to what we came to university for. Take my last three SSCs. I did "Presenting yourself effectively with digital technologies", "Medical Databases" and "Digital Media: Technology for innovation". I enjoyed these SSCs. However, while each tried to gather together even the loosest connections to medicine and how they may be relevant in our up-and-coming careers - I think it's fair to say that i'll never use the skills I gained from them when i'm on the floor of the A&E at 4:00am giving a heart massage to a 67 year old with a heart attack.

We recently received an e-mail telling us that it is time to select our SSCs for year 3. Looking through them, it seems that they are much more clinically orientated and most of them look very exciting. Especially the A&E ones.

I think i've a good chance of being allocated to them too. Why who, after two years of learning about the sick role, would want to spend three weeks in one of the country's roughest and toughest A&E departments dealing with major trauma when you could be all wrapped up and warm learning about clinical audit from a Nurse Specialist?

I feel like a real medical student now. Or not.

Where have the police gone?

I don't like the police. I don't know exactly why, but I just feel a shiver run down my spine and an enormous amount of resentment whenever I see a police officer. I have never been in trouble with the police, and whenever I have had a 'dealing' with them, I think I can say that the one's that I have spoken to were quite nice. Nonetheless, they are far from being my favourite people.

And what I saw tonight did not help my attitude towards them.

When I applied to medical school, I was a bit lost. I hadn't done full A-level biology which meant that I could only apply to few medical schools. The ones I did apply to, I had no idea about. Anyway, that's for another time. One way or another, I ended up in the city with the highest crime rates in the country; that same city which is constantly being branded Britain's "crappest town". In case you can't guess which one it is, i'll give you a clue. It begins with H, has L at the end and has L and U in the middle, in no particular order.

It seems coincidental, to say the least, that in this city, with such high crime, I have never seen a police officer on the beat (with the exception of a few drunken nights out). However, that rule was broken today. If you ever have to ask the question "Where are the police?", I have an answer. They are all in Subway on Cottingham Road.

I was walking home from Jacksons and saw two police officer going back to their van with a sandwich. Fine, I thought, everyone's entitled to a break. But then the back doors opened. There were a total of nine officers sat in the van eating their Subway. At least they're watching the calories.

Since coming to Hull i've witnessed three incidents that resulted in a call to the police. One of those times was me speaking on the phone. On none of these occasions did a police officer even bother to turn up. Yet it seems that in this crime ridden city there is still justification for nine officers to borrow a black mariah and take a trip to Subway. I dare even say that if there was a mugging (in fact, we've seen an attempted rape on this road) they wouldn't have budged.

Oh well. I suppose that's quite a meaningless post to start this blog off. But I think it needed saying. Wasn't there an experiment recently to see if increasing bobbies on the beat decreased crime rates? If I recall correctly there was, and it did, but was stopped a few weeks later because they didn't have enough time to complete their paper work.

Oh, and why spastic dysuria I hear you cry? Well, i'm not poking fun at what sounds like a terrible medical condition. However, during revision it seems that some poor souls do actually suffer from said condition.

Terrible.