Monthly Archives: February 2017

Making applying to Med School a little less daunting…

I thought I would do something a little different and more relaxed this week, and share with you what I’m doing towards application to medical school, and where I’m currently at with it. Suddenly, UCAS has been sprung on us at school, with lessons on how to use ‘Unifrog’ – a website which helps categorise universities and helps you see what each university can offer,  the booking of open days and study skills lessons about how to avoid plagiarism. It has taken me a while to realise how I think is best for me to progress with my application, and I thought I would share it in the hope it will at least help somebody consider their own!

Something I have been doing for a while, and would recommend to everyone, is keeping a word document with prospective ideas of what to include in my personal statement. Any interesting thoughts, articles or books I’ve read and found fascinating, alongside events I’ve attended I have kept a record of here. Just incase I forget about how interested I was, or exactly how many things I have been dong related to medicine. However most importantly, I have kept a log of my work experience, and for each day written a little on how I found it, what I thought and learnt from it, and then what I want to take away with me, and perhaps apply to future situations. For me, this has been crucial, as each time I add to this document I reread what I have previously written, and it reminds me of everything I have forgotten I’d learnt.

Similarly, it is never too early to be taking a look at University websites and league tables, and booking for open days are also now (mostly) available. I know that at the moment, I’m not entirely sure where I want to end up, and am incredibly keen to ‘feel’ a university and city as opposed to scroll through a website. I live surrounded by fields and farms, and I know that potentially moving to a city will be a big change for me, one which I’m excited for, but I definitely feel like I want to end up living and working somewhere I’m comfortable. Consequently, I think visiting universities is important, and am more than happy to miss a few days of school in June/July to ensure that I am happy with my choices! Having said that, I don’t think my Dad is too keen on all the petrol…

Another thing I think is important to mention, is that you don’t have to know. Everyone is new to this process so take your time getting to grips with new lingo, the application process and being confident in your decisions. Personally I would rather take longer over a decision and make sure I feel its the right one for me, than rush into something because all my friends are doing it. Take your time and read around – starting early means that you’re in no rush to make important decisions.

Please don’t take this blog post as gospel, and don’t suddenly panic if you haven’t started thinking about  applications. This is just what I’m doing and what I feel is working for me, and I have shared it only in the hope that it may help other people. I am not ready to apply for medical school by any means, just merely dipping my toe in the water to see what exactly the process I have to undertake in the future is. I want to wish everyone good luck with their future applications and with their journeys towards becoming a doctor. 🙂

 

Nature’s Medicine Cabinet – from Root to Remedy lecture

At the Cambridge Medicine Masterclass earlier this month, I listened to a lecture led by Sonja Dunbar, and was truly intrigued. If I’m honest, it was the lecture I thought I would be least interested in, as I expected it to focus on herbal remedies and the likes, yet it was much more medicine focused.

66% of all drugs have their origins in nature, and infant 80% of people in underdeveloped countries rely on traditional remedies from plants. Thus, their used simply cannot be ignored. Yet, what was a really interesting proposition was why are so many compounds in plants beneficial to humans? It is absurd to think that plants exist for our benefit, there are abundant defences to stop us using them. Spikes, thorns, bristles and chemical poisons all with the intention of helping the plant live longer, and protect the plants form those who are likely to eat it. A key example of this is the classic stinging nettle. These contain histamine, responsible for the itching felt after a sting and acetylcholine, a neurotransmitter. These are contained in a trichome, a specialised ‘hair’ in plants which is very similar to a hollow needle. Alongside this, stinging nettles contain Leukotriene, which promotes information and causes blood plasma to leak out of the membrane and lysosomes to swell, and serotonin. All of these chemicals are pumped in you your body when you are stung by a nettle.

Holly

This leads us to the scarcity-accessibility hypothesis, where a plant in an environment where it is more likely to be eaten, for example when other plants are scarce is likely to have the most defences. Examples of such plants  are Holly and cacti, both of which have visible mechanical defences – holly with its spiked leaves, and cacti with their needle-

cacti-needles_3cc3cf1c0f513010like spikes.

An interesting example of a plant which attempts to deter you form eating it, is the chilli. Chill is detected by TRPVI, the same receptor as vanilla, and vanillin and capsaicin are in fact structurally very similar. However, vanillin cannot get through the cell membrane, yet capsaicin can, and therefore binds to the receptor and tigers the brain into thinking you’ve eaten something hot. For most humans, this would not be a pleasurable experience and would put you off eating a chilli again. However, it gets better. Chilli’s receive no benefit from being eaten by mammals, as we grind and crunch seeds up due to our molars. Their seeds are therefore broken apart and cannot germinate to produce more plants. Although, birds eat chilli’s and don’t seem to find them hot. Why? Because birds don’t crush or grind the seeds, simply pass them through their digestive system and disperse them. They can travel great distances in a short space of time meaning that very little competition between the plants remains, and so birds do not find chilli’s hot, as the plant benefits from being consumed.

So, what are some examples of plants used in medicine? Foxgloves, contain digitoxin which helps to controlyour heart rate. It is a cardiac glycoside which interferes with sodium-potassium pumps, calcium ions and polarisation. In a high dose, it causes irregular heart rates, yet in a low does, it is very useful. Thus, from digitoxdigoxinstructurein digoxin has been developed, with less side affects and thus less associated dangers than the ‘pure’ substance, but with a very similar chemical structure.

Similarly, Aloe Vera contains 98.5% water, mannose-6-phosphate sugars and a collagen triple helix. It can be used in the treatment of thermal and radiation burns. It has been known to reduce swelling, stimulate faster tissue synthesis and help keep the wound clean and hydrated due to the high water content. Thus, it is used in many suncreams, after suns and in a gel to help prevent wounds from infection.

The lecture also spoke about the 2015 Nobel Prize in physiology or medicine. In 2013 there were 198 million cases of malaria, and is a disease which can easily escape detection due to the life cycle of the parasite. Theparasite enters liver cells where it can replicate for 2 weeks without detection. Eventually, the liver cells rupture and release the parasite, which consequently goes on to infect red blood cells. Here, the parasite escapes detection by wrapping itself in the cell membranes of cells from the organism – which will not be recognised as something harmful by the immune system. Cinchona  is an example of an early malaria remedy, which was so heavily sought after the plant nearly went extinct. Artemisinin also treats the fever of malaria, and with cold extraction, reduces 100% of the parasite load in monkeys and mice – incredible. Consequently, the death toll form malaria in the past 15 years has declined by 50%, and it is great to see the Nobel Prize being awarded for a medicine being developed for disease in underdeveloped/developing countries. This is because it takes around 12 years and £1.2 billion to take a drug to market, not something which is affordable to such counties, but malaria is a disease which takes millions of lives, and so any advancements could save countless lives.

What I learnt from this lecture is that biodiversity mattersin the hunt for new drugs. There are still plants we don’t know exist, and plants we do know exist but don’t yet recognise their uses. In destroying the biodiversity of our world, for example by deforestation, we could potentially be destroying cures for diseases. The ecology of the world we life in is important to allow us to survive, and while plants don’t exist for out benefit, they are incredibly useful.

(Source: Sonja Dunbar, Nature’s Medicine Cabinet Lecture, Cambridge University)

A Pharmaceutical Lecture by Gwenan White

Hello!! A couple of days ago I attended a pharmaceutical based lecture at my school, spoken by a woman who works for the company AbbVie, a comparatively small company specialising in virology, immunology, neuroscience and oncology. It was far more interesting and relevant to me than I initially thought it might be, and I took away some key lessons which I thought I would share with you.

It typically takes around 12 years to bring a medicine to life – over a decade of isolating compounds and mixing constituents and clinical trials. What interested me within this process was the use of animal testing. Animal rights are something I feel strongly about and if I’m honest, I’ve always been opposed to their use in science. However, recently I attended a lecture on the ‘naked mole rat’ (hopefully a blog post to follow!) and then this lecture, which has made me consider the benefits and boundaries of using animals in science. While I won’t dwell on the use of the naked mole rat too much as it is something I’d like to write about later, it was a talk which demonstrated to me a clear ethical and moral use of animals in research. In the pharmaceutical industry however, it is not always clear how these animals may react to the drugs within their systems. Although, it was emphasised to me that as few a animals as possible are used with the most effecting but least affective (in terms of side affects) treatment option primarily. Or surrogate models can be used preventing the need for animals. This showed me the diverse range of steps needed to take a medicine to market, and that medicines must not only be effective and ethical but also cost effective.

The ethos of the AbbVie  in the talk was that they aim to combine the expertise and stability of traditional pharma with the focus, culture and innovative spirit of biotech. This really summed up the state of modern science and medicine for me, we are in a stage where we a gradually moving away from the reliable treatments and options for those which may be slightly more risky but give patients better quality of life post treatment. For instance, when watching the BBC documentary ‘Hospital’ last week I was captivated by the innovative treatment of a 98 year old man. He first, had a compressed heart valve inserted into his heart through a blood vessel in his leg, which was then synchronised with the contraction of his heart using a screen. However, the incredible surgical techniques didn’t stop there, he later had a wire mesh inserted into an artery which led to his brain to remove a clot causing him a stroke and possible brain damage. This being a thrombectomy, which if carried out within 6 hours of a stroke results in full blood flow and a reduced risk of brain damage. Similarly, in the same documentary a new treatment method was used to treat an 18 year old girl with Sickle Cell disease, where her immune system was depleted using chemotherapy and radiotherapy allowing her to engraft bone marrow with a match of only 50%. This is an incredible feat. Linking this back to the lecture, it is through combining new ideas and treatment methods with the stability of old ones which medicine can and is advancing.

Like much of the news these days, the talk did also mention that out current healthcare system is not sustainable – we have an ageing population and more than 1/4 of people in the UK have a chronic illness. All of which need treatment and all of which costs money. A statistic which was raised is that every 36 hours 1,000,000 people pass through the NHS, and we do not have a healthcare system which can deal with that demand. What we do have however, is new means of empowering patients to look after themselves – who hasn’t seen an advert for an online GP? Or advice from the NHS website? What is crucial is that doctors need recognise the role of the patient in their own treatment – diet and lifestyle choice can hugely influence what treatment a person may later need, but also knowing when and when not to see a doctor of GP is crucial. The NHS does not, essentially, have time to waste. Having said that, there should be no ‘fear of finding out’ what the doctor has to say, and people should not avoid the GP Surgery because they are scared they are ill – they should act quickly and potentially save their own live, or give themselves years. If not, at least just peace of mind.

So these are some of the key ideas I took from a pharmaceutical lecture I thought would just be about the development of drugs, which was actually much more patient focused for an industry which is not allowed direct patient contact – charities and organisations on patient’s behalf must be used instead. Therefore, I would encourage everyone to attend some science or medicine based lectures, and not to be afraid to take notes. Taking notes is what I’ve found has really allowed me to write up and reflect on what I’ve learnt, and that’s definitely worth more than a few snide comments. I hope you’ve found this interesting and hopefully I will write more reflections on lectures in the future.

Delays in the NHS

Today, I read a rather shocking article by the BBC, entitled ‘The 10 Longest Hospital delays exposed’. The NHS is obviously a system which needs revamping, reorganising and millions of pounds invested in it to help it run. However, I found this article a very negative approach to what is happening. While yes, there is a chronic bed shortage and hospitals are overrun, there are still millions of people being treated each day.

The article does however, highlight again what I became aware of after watching the BBC documentary ‘Hospital’. This being, that many patients are occupying a bed in a hospital when waiting for a place in a care home, cottage hospital or specialised clinic. Consequently hospitals are ‘filling up’ as patients keep being admitted each day, but few being discharged. The links between these healthcare services are shown to be fractured, as sometimes communication between clinics, hospitals and care homes is not as frequent as necessary.

Aside from this however, the article does present key issues in the NHS. The greatest rise reported being 449 in a mid Yorkshire hospital. The graph clearly shows that the number of patients who see themselves as ‘stranded’ in hospital with nowhere to go for care when discharged, is on the rise, as has been clearly on the rise since 2014, and doubling the number of patients delayed in 2016 compared to that 2010.

For me, this highlights that many older patients who require access to care packages, including nursing home places and help in the home for daily tasks, such as washing and dressing, aren’t receiving this help. Quite possibly in the time that it takes for these links to be made, lives could be saved if other patients had access to these beds. The article also states that ‘Over the past four years, the number of older people getting help from councils has fallen by quarter, while the NHS district nursing workforce has shrunk by 29% in the past five years.’ To me, this screams lack of funding, and is an example of how cutting funding of the NHS has caused a cut in services, which has hindered the functioning of not only hospitals.   Aside from this, its is incredibly important to remember that these elderly people should also have dignity, and lives as independent and healthy as possible – this is not just being confined to a bed in hospital, unstimulated.

Restoring faith however, the article does mention that councils will be spending £16 billion this year on social care. This should help to reinstate the links between the services provided and provide those who should not be in hospital with adequate care elsewhere, and those who need hospital care access to that. Initially, this article sparked my anger, because I believe that the NHS is an incredible service which saves millions of lives, and to pick out the negatives is not necessarily representative. However, I am not naive enough to think that it is without its problems, but a system which deser

ves saving. Thank you for reading 🙂

This is the link to the BBC article…

http://www.bbc.co.uk/news/health-38896155

Medicine Masterclass – Cambridge

For me, yesterday was a truly inspiring day. I attended the Cambridge masterclass for Chemistry (natural sciences) in November, and can honestly say while an interesting day it proved that Chemistry is definitely not what I want to pursue. The recent medicine day however contributed greatly to my desire to be a doctor, with 3 medicine based lectures. It was entirely useful as it gave a quick taster of the ‘science’ aspect of medicine, what information lectures may contain and even how to approach studying medicine.

Lecture 1: How blood goes around the body (Dr Dunecan Massey)

Lecture 2: Nature’s medicine cabinet: from root to remedy (Sonja Dunbar)

Lecture 3: Pain and lessons from the naked mole rat (Dr Ewan St. John Smith)

We experienced 3 scientific lectures and an admissions lecture. While the day was a little daunting as I went alone, it was easy to meet likeminded individuals and learn about why they want to study medicine, alongside what they thought of their work experience. I also found the Q&A sessions with students useful in asking the ‘real’ questions and hearing the honest answers from people with first hand experience of the process. What did I learn from the day? While a lot about naked mole rats and intestines and the interesting aspects of botany, these were not the most significant aspects. It confirmed that I will happily walk into a day of lectures on medicine, and that it is truly a career I am interested in. Not only because of the people I will meet but because of the science behind it. Having the knowledge to be able to improve and save lives is an incredible opportunity and one I’m certain that as a future doctor, I will cherish.

I recommend the Cambridge Masterclasses to any student considering medicine or Cambridge, as they are an incredible opportunity to experience both the course and the city. I think the University has an incredible and unique teaching style, and it is definitely one I would to to consider further in the future. I am hoping to decipher the notes I made in the lectures and blog them in the future, so keep a look out!