Could the appendix be responsible for Parkinson’s Disease?

Approximately 1 in 500 people within the UK are diagnosed with Parkinson’s, a neurodegenerative disease that causes the loss of brain cells which are responsible for producing dopamine. However, the disease’s symptoms only begin to present themselves after 80% of these cells, located within the substantia nigra region of the brain, have been lost. As dopamine is usually responsible for regulating our body movements, a lack of it can bring on symptoms such as slow movement, tremors and speech issues – key characteristics of Parkinson’s.

Now shocking new evidence by US scientists may change our outlook of this disease altogether: the origins of Parkinson’s could actually be located outside the brain, within our digestive system. For many years we have thought of the appendix as an insignificant organ; yet only recently have scientists discovered a link between it and the brain of a sufferer: both contain alpha synuclein,  a toxic protein involved in killing brain cells. Interestingly, the study highlighted how those who had had their appendix removed were at a 20% lower risk from developing Parkinson’s. From these compelling findings, the theory being proposed is that the gut is a ‘breeding ground’ for this protein, which then travels up to the brain via the vagus nerve, causing the onset of dangerous consequences.

However, one of the researchers, Dr Viviane Labrie, said:

“We’re not advocating appendectomy* as a form of protecting against Parkinson’s Disease. It would be much more wise to control or dampen excessive formation of  alpha synuclein to tune down the overabundance or potentially to prevent its escape.”

Nevertheless, this new finding is a step forward according to Claire Bale of Parkinson’s UK, who believes understanding its origins will ultimately allow us to develop treatments, and potentially ‘prevent it altogether’.

Isra Ahmed

 

Sources:

https://www.bbc.co.uk/news/health-46050744

https://www.nhs.uk/conditions/parkinsons-disease/causes/

https://www.parkinsons.org.uk/information-and-support/what-parkinsons

*removal of the appendix

Goodbye Veganism, a Flexitarian Diet may be the key way forward

Love meat too much? Despite the claimed health benefits of becoming Vegan or Vegetarian, it may not be an easy option for everyone, and so an alternative diet is now being encouraged: Flexitarianism. Put simply, it’s embracing a plant-based diet with an occasional intake of meat. People following this diet may also be known as ‘Casual Vegetarians’, as a majority of their diet follows the same basis as a Vegetarian’s, substituting most of their usual meat intake for other healthier protein sources, such as lentils and tofu.

Scientists have announced the importance of embracing this varied diet, especially during a time of increasing climate change, food wastage and pollution. A new study by the IPCC recently highlighted the serious impacts of our food industry: eutrophication due to the over-use of fertilisers, causing an increase in pollution within rivers and driving climate change. Deforestation to make space for animal feed crops has only fuelled this, boosting the rate of CO2 released into the air and potentially pushing our world’s resources to the brink. In order to combat this, the authors of the study stressed the need to change farming practises, as well as our food wastage habits. They also believed the need to alter our food choices mirroring a Flexitarian diet, as significantly reducing our meat intake could decrease agricultural greenhouse gas emissions by more than 50%.

Dr Springmann, the lead author, stated:

“In the past there has been lots of invest in the stable grains like maize and corn, but now we really need to move it to the crops we need more of. We also looked at increasing the efficiency of water use, and we looked at better monitoring and recycling of fertiliser – lots of it is lost and it runs off into rivers and causes dead zones in the oceans.”

Not only does a Flexitarian diet benefit the environment, it is also healthier for us – processed meat has often been linked to cardiovascular disease and cancer, due to its high salt and fat content. However, cutting it off completely might deprive us of essential proteins, iron and Vitamin B12. So for when we do eat meat occasionally, ideally it should be organic or free range in order to reduce our intake of potentially-harmful chemicals. This diet may also be useful for diabetics or those struggling with obesity, reducing BMI and blood glucose levels as well.

The key method is balance – tailoring the food production industry to suit a diet containing a substantial quantity of vegetables and grains (which are high in iron and protein content), as well as a smaller yet nutritious portion of meat can “result in keeping healthy both planet and people”.

What do you think? I hope you enjoyed this post and comment your thoughts below!

Isra Ahmed

 

Sources:

https://www.bbc.co.uk/news/science-environment-45814659

https://www.ecowatch.com/flexitarian-diet-2612835966.html

https://www.bbcgoodfood.com/howto/guide/what-flexitarian-diet

https://theflexitarian.co.uk/flexitarian-diet-2/.

Medical Breakthroughs of 2017

Part 1: A focus on genetic disorders

As we enter a year of promising new medical advancements, from the introduction of the first Proton Beam Therapy centre in the UK to Artificial Intelligence that can analyse heart scans, I thought I would provide a summary highlighting the amazing achievements doctors and scientists accomplished last year in the world of genetics.

Huntington’s Disease

This neurodegenerative disease damages nerve cells within the brain. Experts at UCL have created an experimental drug (which is injected into the spinal cord) that aims to silence the gene responsible for creating the damaged protein huntingtin. Usually, this protein is essential for brain development; however, an error in its DNA can lead to the synthesis of a faulty version that kills brain cells. Huntington’s Disease has for many years taken numerous lives and with symptoms appearing around the ages of 30-50, the disease can affect movement, behaviour and cognition. Yet the introduction of this exciting new therapy holds promise for many sufferers, and according to Professor John Hardy:

 “I really think this is, potentially, the biggest breakthrough in neurodegenerative disease in the past 50 years.”

Haemophilia

Many of you would have read about this genetic disorder in your Biology textbooks, and now a new gene therapy has been introduced for Haemophilia A (which is the most common form). People with this version of the disorder are unable to produce clotting factor VIII, thus hindering the coagulation cascade process that is vital for clotting wounds. The therapy works on the basis of transmitting genetic instructions for factor VIII to the patient’s liver using a genetically-engineered virus, which acts as a vector. Although it is currently quite expensive and there is still a lot more research to be done, 11 out of 13 people who have been trialled so far are now off conventional treatment, and are able to produce higher levels of the protein required to stop bleeding.

“To offer people the potential of a normal life when they’ve had to inject themselves with factor VIII every other day to prevent bleeding is transformational.” – Prof John Pasi

Sickle Cell Anemia

And finally, scientists made news when using cutting-edge treatment to alter the DNA coding for sickle-shaped red blood cells. By removing the bone marrow of a French teenager who suffered the defect, they used a virus to inject it with the correct genetic code, before replacing it back. This altered the production of haemoglobin within the cells, re-correcting the shape of red blood cells to healthy, biconcave disks instead of crescents. The procedure has proved to be relatively successful, as “so far the patient has no sign of the disease, no pain, no hospitalisation. He no longer requires a transfusion so we are quite pleased with that.” (Philippe Leboulch, March 2017)

 

Hopefully, if successful, these pioneering treatments will save countless lives all over the world – it is truly amazing to witness cutting-edge science and technology and the incredible workforce behind this all! I hope this was an interesting read, and please keep tuned for part 2, where I will talk about other major accomplishments in the world of medicine. In the meantime, please rate and comment your thoughts below!

Isra Ahmed

 

Sources:

http://www.bbc.co.uk/news/health-42402420

https://www.hda.org.uk/huntingtons-disease/what-is-huntingtons-disease

http://www.bbc.co.uk/news/health-42308341

http://www.bbc.co.uk/news/health-42337396

http://www.bbc.co.uk/news/health-39142971

Tips for students considering Medicine

Having submitted my UCAS application, and eagerly awaiting a (hopefully positive!) response from the universities I applied to for Medicine, I thought I would share some tips for younger students who are considering this as a potential career.

You may be a Year 12 student who is fully committed to the idea of pursuing medicine – but what next? It is no lie to say that applying for medicine is a very tough process; there are a multitude of things to balance including work experience, volunteering, extra-curriculars and most importantly, EXAMS. However, it is only the start of the year, you may think there is little to worry about – but is best to start early. Down below I’ve illustrated some points that many of you will want to start thinking about:

Work Experience

This is an important one that can not only inform your choice to pursue medicine, but can also provide an accurate insight into what a day-to-day life of a doctor really entails. It is best to start applying now due to the competitive nature of these placements. For me, personally, shadowing doctors was an extremely valuable experience, confirming my aspirations to become a doctor. It was a chance for me to admire the hard work that doctors undertake for their patients and the community, as well as enlightening me to the truly breath-taking and innovative science of curing people. But it can also open up your eyes to the challenges of medicine, allowing you to make an informed decision of whether this is the right career for you. Not only that, Medical Schools love to hear about this in your personal statements and interviews. It is very important to reflect upon your experiences – try to keep a diary! What you learnt and any skills gained out of it is far more important than what you actually did. It is also best to search the requirements of any universities you are considering, as some require a minimum amount of work experience.

Volunteering

Another thing to start this year is volunteering – whether it be at your local care home or the hospice. However, if you are really unable to get hold of any care-related volunteering opportunities, then it is ok to talk about any other jobs you have as long as you can relate the skills and experiences to medicine. Volunteering is a rewarding experience as you can apply the skills you learnt from work experience, such as empathy and communication. It is a chance to develop these skills further, and see how they impact you as a person and future medical student. Medical schools emphasise on the need for long-term commitment (on a regular basis) to show that you are a motivated and determined individual – so it is best to start applying now if you aren’t already volunteering. Again, you should try to keep a diary and reflect upon your experiences. It will also be helpful for you later on when you start writing your personal statement.

Choosing you Medical School

This is probably one of the most difficult decisions I have every had to make in my life! Perhaps the most priceless advice I can give is to start attending open days as they can give you a reliable idea of what the university campus, course style, accommodation and student life is like at the university. I also highly recommend looking into the style of teaching – PBL, Integrated, Case-Based Learning and Traditional. Enjoy the concept of lectures and a highly scientific course? Go traditional (eg. Oxbridge). Prefer more self-directed learning and group work? Try any problem-based learning course (PBL). Want early clinical exposure? Time to do some research! Another aspect to account is the admissions process – different universities will weigh up your GCSEs, UKCAT/BMAT and personal statement differently.

Admission Tests

Start looking into which admissions test you might need to take – currently most medical schools require the UKCAT. The UKCAT may seem quite difficult to revise for – but try to start looking into the types of questions and techniques on how to master them within the time limit. The key is to keep your revision slow and steady so that you can build up your preparation. The BMAT is more scientific on the other hand, so you may want to dust up your GCSE/AS knowledge (including GCSE Physics!) as you get closer to the time. There is still a long time though till these exams, so don’t panic if you haven’t started revising.

Extra Reading/Curricular

Just some final advice is to keep up-to-date with the current news (Reliable websites such as BBC Health and BMJ are good). Also, do you have any hobbies or interests? Any wider reading or achievements? Try to start thinking about these.

 

Hopefully that was quite helpful and kept your interest despite being a long read! I hope that this has inspired or been of any value for Year 11/12 students currently unsure on how to tackle the next stage. Please rate and comment on your suggestions below and good luck!

Isra Ahmed

 

Are we more likely to survive heart surgery in the afternoon?

Does our body clock really affect the safest time for us to not only conduct heart surgery, but to survive it as well? Well according to some new research, our circadian rhythms may have the power of dictating this.

Every cell in our system follows a daily rhythm, with the Suprachiasmatic nuclei (SCN) located in the brain taking the lead and acting as the master clock. Our SCN is controlled by light signals which receptors pick up in the eyes, allowing it to maintain a 24-hour pattern (eg. more melatonin is made during the night, making us sleepy). Dr John O’Neill said, “…just like every other cell in the body, heart cells have circadian rhythms that orchestrate their activity”.

According to recent studies, our heart has been found to induce maximum performance during the afternoon. Whereas in the morning (between 6-9am), there is an increased risk of a heart attack  due to thicker blood, stiffer blood vessels and a higher blood pressure; the patient’s heart can be the most vulnerable at this time. Consequently, with stronger cardiac muscle and increased bpm during the afternoon, this seems to be the safer option of the two as the heart is more likely to withstand the pressures of surgery. Statistics already support this new evidence, with around 54 out of 298 morning patients experiencing adverse reactions post-surgery. The figure is reduced to almost a half for afternoon surgery.

Dr O’Neill, supports this claim, saying:

“Our cardiovascular system has the greatest output around mid/late-afternoon, which explains why professional athletes usually record their best performances around this time.”

Furthermore, the surgeon’s own body clock could affect their performance in the morning, leaving them feeling quite tired and more prone to mistakes. It is only later on in the day when the levels of our stress hormone, cortisol, start rising, boosting the surgeon’s alertness (apart from a dip straight after lunch).

Open heart surgery can be a very stressful experience for the heart, as the organ is stopped and oxygen supplied to it is reduced. Therefore, anything which can minimise this stress could be a potential finding for doctors, helping us to improve survival rates and reduce complications after surgery. Professor Bart Staels adds, “If we can identify patients at highest risk, they will definitely benefit from being pushed into the afternoon and that would be reasonable.”

Hope you enjoyed, please rate and comment your thoughts below!

Isra Ahmed

 

Sources:

http://www.bbc.co.uk/news/health-41763958

http://www.bbc.co.uk/news/health-27161671

Stomach rumbling? You may not be hungry…

Many of you will have faced this all-too familiar embarrassment when out in public. But surprisingly, research shows that your stomach’s growls don’t necessarily mean you’re hungry, and nor does the sound always come from the stomach.

The reason we can often hear rumbling noises (scientifically known as ‘borborygmi’) is due to activity within the soft muscles of the stomach and small intestine. When peristalsis occurs, a process that churns and pushes food down the gastrointestinal tract using muscular contractions, the growling noise is initiated. The enteric nervous system (located within the gut) gives rise to fluctuations of electrical potential known as ‘Basic Electrical Rhythm’ (BER). These electric rhythms, though slower than the contractions of the heart’s cardiac muscles,  allow the small intestine and stomach to carry out peristalsis. The small intestine produces 12 rhythms per minute, a rate four times higher than the stomach.

From this we can explain why the stomach growls even when we’re full. However, as we already know, these are still heard on an empty stomach. The reason these noises are intensified when we’re hungry is due to the lack of contents (ie. food and fluids) within our system to subdue out the sound. The enteric nervous system is at work once again when receptors signal to the brain the lack of food within our system; electrical waves known as ‘migrating myoelectric complexes’ (MMCs) are generated and this time, they lead to hunger contractions. This clever process searches and clears out the whole of the gut for any remaining food particles, mucus or bacteria accumulated within an area. Furthermore, the hormone Motilin may have a play in this. When we have low blood sugar (around 2 hours after eating), our intestines start to send signals that it is not getting enough nutrients to function.

The solution? To fill our stomachs! Unfortunately the way we eat can also have an impact on our stomach’s growling schedule. Eating too quickly, talking whilst eating or drinking water whilst exercising can lead to too much air being swallowed. This excess air loiters around in the small intestine, adding to the obnoxious sound already being sung out by our stomachs (as well as causing flatulence!). But once we satisfy our stomachs, the digestive muscles can refocus their energy from squeezing and pushing the air pockets around to breaking down food. Therefore, it is always advisable to eat slowly to minimise the amount of air being swallowed.

Hopefully that answered any questions about why our stomachs rumble. Hope you enjoyed, and please rate and comment below!

Isra Ahmed

 

Sources:

http://health.howstuffworks.com/human-body/systems/digestive/stomach-growling1.htm

https://www.scientificamerican.com/article/why-does-your-stomach-gro/

http://www.webmd.com/a-to-z-guides/features/why-does-my-stomach-growl#1

At what point does HIV become AIDS?

One question that has always intrigued me is why not everyone who carries HIV goes onto developing AIDS? I decided to research into this, and found that the contraction of HIV triggered the destruction of CD4+ cells, a type of white blood cell (also known as T-helper) that are an integral part of our immune system.

Most healthy people have a CD4+ cell count of approximately 800-1,200 per mm3 of blood. This high cell count is important as CD4+ have the vital role of instructing other cells to carry out their duties within the immune system; they also alert CD8 cells of any foreign pathogens, so that they can destroy these harmful particles. Without these cells, it would be difficult to maintain the human body’s health, leaving it vulnerable to even the simplest of infections.

HIV causes the gradual reduction of CD4+ cells over a long period of time, and it can take as long as 10-12 years for the cell count to fall to below 200, a point at which the carrier is defined as having AIDS. The immune system will be severely weakened, opening up its doorway to life-threatening diseases, such as neurological complications and cancer. It is therefore the vulnerability to other infections, not AIDS itself, that causes death. However, this time span can vary, dependant on the lifestyle of the carrier, and whether or not he receives treatment (in the form of antiretroviral medications, which are designed to preserve CD4 cells). Nevertheless, due to malnutrition and the unavailability of these drugs in poorer countries, AIDS can be triggered a lot more quickly in these areas, reducing life expectancy.

Now going back to the question of why not everyone with HIV develops AIDS, we can look into what prevents the CD4+ cell count from reducing in the first place. People who are fortunate enough to be ‘long-term nonprogessors’ are those who either have a slow decline of CD4 (Viremic Controllers), or those who don’t even experience a decline of CD4 (elite controllers) – even after 10 years, they will have less than 50 HIV particles within 1ml of their blood. This is surprising, since a typical person would’ve had hundreds of thousands of HIV in a single ml. So what makes those few individuals lucky?

Perhaps the explanation for this lies in genetics – these elite controllers are fortunate enough to have immune systems that modify the HIV into a ‘less fit’ variant, preventing it from reproducing rapidly (as they are unable to drive themselves into cells and integrate within their DNA). This results in lower levels of immune activation, reducing HIV replication, and hence the depletion of CD4 cells. Protective alleles, such as HLA B*5701, are found within 90% of elite controllers, proving that it is down to our genetics as to how our immune systems respond to the development of AIDS, not the virus itself.

Despite that, the ability to control HIV results from a combination of both genetic and environmental factors – this single explanation is only an “important clue”, according to Stephen Migueles, a National Institutes of Health researcher.

Hopefully with further research and studies we will be able to understand how certain immune systems control HIV better than others. I hope this was an enjoyable read, and if so, please rate and comment your ideas about this interesting topic!

Isra Ahmed

Sources:

http://www.news-medical.net/health/When-Does-HIV-Become-AIDS.aspx

https://www.scientificamerican.com/article/hiv-aids-controllers/

Volunteering in lessons

A few months back, I started to help out Year 8s in their maths lessons at my school, once a week. Though it wasn’t very medical-related, I decided to give it a shot because I knew the skills gained from this experience would be beneficial for my personal statement, and ultimate goal of becoming a doctor!

Interestingly, I found that assisting children with their work mirrored the duties doctors had to undertake, and the attributes required to accomplish them successfully. Some of the skills gained from this were:

  • Decision-making skills – Though Year 8 Maths may seem easy, I haven’t touched upon some of the topics in years so to work out answers for the students, whilst explaining how it works, was often quite a task for me. There was even an instance where me and a Maths Graduate helper were confused on a question, so we both worked together to find a solution. In terms of being a doctor, it’s a lot like working on your feet to make a quick diagnosis!
  • Confidence – I was taken out of my comfort zone, having to go up to pupils and check if they were ok, whilst answering any questions. Even though this task may seem easy, it was quite nerve-wracking at first, especially since I am quite a shy person. I felt this experience helped to boost my confidence, which is a vital attribute of a doctor who needs to communicate with strangers
  • Responsibility – As the Maths set I was working with required special attention, the teacher trusted me to help them by providing the children with sufficient support and correct advice. Working with a teacher meant that I was treated like an adult, giving me independence but also enforcing the responsibility of many children who were reliant on any help
  • Dealing with difficult situations – There were many scenarios of children being extremely disruptive and unwilling to learn, but as cheesy as it sounds, a doctor never gives up on his patient! Resilience is often required in these situations, as there is always a temptation to surrender to their bad attitudes, and stop trying. Therefore, to resolve these situations, I would often try out a different technique, or resort for help by another volunteer/teacher; however, I would never shout at them as this could aggravate their behaviour. This is a good representation of the struggles doctors have to deal with when working with non-cooperative patients!
  • Empathy – One particular student was getting bullied by the whole class, so I decided to step in by informing the teacher, who suggested I could be her point of contact if she ever needed advice and support. I happily agreed to this as I understood how difficult it was for her; and it is important, not just for doctors, but for any human being, to help those in need.

To sum up, I have actually found this to be more helpful than any other work experience because not only did it kick me out my comfort zone, but it accurately represented life at a hospital.

I have also been told by many medical application advisors that if it is difficult to organise any work experience, or find somewhere to volunteer, things like these also carry some weight in the personal statement as they will often provide you with real-life skills.

Isra Ahmed

First Human Head Transplant

This year in December, they are aiming to undergo the first ever human head transplant (project HEAVEN), which in medical terms is known as cephalosomatic anastomosis, with a 90% chance success rate.

The Italian surgeon hoping to accomplish this is Sergio Canavero, who has even found a volunteer: 31 year old Russian Valery Spiridonov, who has spinal muscular atrophy, causing him to be bound to a wheelchair and limiting basic activities such as eating or even breathing.

Image result for valery spiridonov and sergio

The surgeon will have to cut off his head, and then attach it to a healthy body, which would have come from a newly brain-dead person. The whole procedure could take 36-72 hours and will cost around £11 million.

After taking anaesthesia, the patient’s body will be cooled to 10°C; this is stop all bodily functions and to allow cells to last for this long without oxygen.

In order to carry out the procedure, a team of 150, 80 of them surgeons, will severe his head from his spinal cord, between the C5 and C6 vertebrae (which have a key role in neck mobility) using a diamond blade.

The frames clamping the two bodies together will separate, and the heads will be lifted, with Spiridonov’s head literally being deposited on top of the donor’s body.

The first thing that will be joined together are the head-body arteries, so that blood can recirculate the brain again. After that, the windpipe, gullet, spine, gastrointestinal tract and muscles will be reattached – all of which have been successfully operated before, so most of this will be basic surgery knowledge.

He will then fuse the two spinal cords together, using electric shocks and a glue-like substance called polyethylene glycol (which has previously been tested on animals to grow spinal cord nerves). However, only around 10-20% of the nerves will be reconnected, only giving the patient basic movement if the transplant is successful. Another option is to use olfactory ensheathing cells, which enclose the axons (the inner section of a nerve cell that carries the electrical impulse) of olfactory receptor neurons (sensory cells that specialise in smell), supporting the process of neurogenesis and reconstructing synapses.

When the patient’s head has been stitched onto his new body, he’ll be put in a coma for 4 weeks, to allow healing; electrodes will be used throughout, accelerating the regrowth of the dendrons and axons. And then obviously he will be given strong immunosuppressant drugs, to prevent rejection.

If it’s successful, after waking up, he should be able speak with their old voice, and even move.

He’ll have to spend some months in rehab, using a virtual-reality simulator, or hypnosis, so that he gets used to his new unfamiliar body.

However, obviously there’s doubts – puppies, monkeys and rats have all been tested on – and the longest they’ve ever survived is a week. Many say that the surgeon has simplified fusing the spinal cords together – and should be charged with murder if the operation fails.

What do you think about this exciting new development in science? Is it ethical, and do you think it will succeed? Please rate and comment your opinions below!

Isra Ahmed

Image result for head transplant

 

Sixth Form Medical Work Experience

Taking bloodBetween Monday, 19th to Thursday, 22nd December 2016, I undertook some exciting work experience at Lincoln County Hospital. After only just coming back from Medlink, I was buzzing to get a first-hand experience of life as a doctor.

Specifically designed for lower sixth form students, this 3.5 day course intended to help us gain an insight into the work a doctor does on a daily basis, and the skills required to undertake challenging tasks. We were also given helpful sessions in small groups on how to perfect our personal statements, and ace the UKCAT/BMAT and interview process; a clinical skills workshop got us taking blood and suturing skin (from fake skin of course!).

Application Process

On the first day, whilst being given advice on the application process, I found that like Medlink, the idea of empathy and resilience was highly emphasised.  It is vital for any potential medical student to understand the ability to have confidence, even when things get difficult, whilst maintaining a healthy work-life balance. Also, don’t be afraid to point out your weaknesses, just be prepared to talk about how you overcame them.

Whilst discussing, we found that there were many different reasons people wanted to apply – the variety in the career, the prospect of discovering new things that may have an impact, the life-long learning process, and having a chance to undertake research and reaching the pinnacle of cutting-edge technology – all these ideas are very good examples to include in your personal statement, as long as you don’t mention the cliché phrase: “I love science and helping people!”.

Infection Control

After this engaging session, we learnt a bit about infection control, by isolating patients to either protect other patients from getting infected (ie. diarrhoea spreading from faeces’ sprays) or to protect the patient from infection (eg. chemotherapy). At the current moment, Clostridium Difficile is roaming around hospitals, which lives in the human bowel and can cause diarrhoea if the ‘good bacteria’ that usually keep it in check are killed off (by antibiotics). It is important, therefore, to observe good hand hygiene by thoroughly washing your hands, to prevent infection spread.

Watching Surgery

Later on in the afternoon, we visited the operation theatre and got to watch two orthopaedic surgeries!  Experiencing the process of anaesthesia and watching the surgeons operate was an amazing first-hand experience to actually learn how doctors manage to stay calm in intense situations, using social interaction, scientific knowledge and practical skills (surgery is a lot like carpentry – the use of drills, saws, hammers and cauters to burn tissue were frequent). One thing that surprised me was the huge role the anaesthetist had to undertake – as well as injecting the patient with the chemicals and muscle relaxants to make them unconscious, their blood pressure (which gets very low), oxygen, CO2 and breathing rate was constantly monitored and recorded throughout. Even though the actual operations were relatively small, with a girl’s toe bones being straightened and a nail being removed from a man’s leg, it was interesting to learn about the standard procedures undertaken – such as using iodine (which immobilises bacteria and viruses on skin) to clean the limb, a tight band to restrict blood flow and hence prevent excessive bleeding during the surgery, and finally making sure I stood behind the a line where dirty air was getting filtered out.

Wearing my scrubs, all ready for surgery!

However, the main thing I learnt from this was the idea of having a ‘multidisciplinary team’; I cannot stress enough the significance teamwork had in surgery, whether you were a surgeon or scrub nurse – being able to communicate effectively and having chemistry with your teammates could be between a matter of life and death. Also, as an anaesthetist, empathy is needed as you need to comfort the patient, and act as human as possible! They must let the patient know what they are doing (never take them on by surprise), and if there are any difficulties. Once again, the role of communication will help put the patient at ease, relaxing them and speeding up the process – it also allows you to undertake the procedure safely, and makes sure they’re not in excessive pain or allergic to any damaging substances.

Personal statement and interview

I won’t go into detail here but some tips for the statement (which we learnt on the 2nd day) is to get it checked by people you don’t know on ‘The Student Room’ and use the ‘Medic Portal’ for more advice. Another thing, that some people may overlook, is to have an extra-curricular element just to add interest, and perhaps show off some other unique skills.

For the interview, one thing I would recommend is to familiarise yourself with the ‘Four Pillars of Ethics’ and to look into the idea of ‘capacity’ – whether or not a patient can make decisions. You will be tested on these things, and the interviewer will assess your reasoning for your arguments so perhaps challenge yourself with a few scenarios at home!

Doctor Shadowing

Later on in the day, I was assigned to a foundation doctor (F2) in the Medical Assessment Unit (MAU) – an area designated for patients after A&E. From the start of placement, I sensed the stressful and busy atmosphere, with doctors quickly moving from one patient to the next. Quite surprisingly, the F2 I was shadowing had to get through so much paperwork, something that required organisational and management skills to make sure the correct forms were filled in for the patients (listing their medication), ready for their transfer to another ward. Patience and tolerance was a virtue my doctor seemed to have – at one point, she lost all her patient’s details so had to remain calm and resolve the issue. However, it is important  to have effective communication and good ICT skills because at one point, due to a senior not informing her of his absence, she ended up having to go around the hospital trying to find someone to sort out a paperwork issue – this unnecessarily lengthened up the process and a patient, who had severe asthma, was forced to wait for her even though she was in considerable pain. When we finally got to this patient, I found that as well as the necessity to consider patient history, you should also have empathy; the husband of the patient was clearly distressed so by making conversation, it was a way of relaxing him, preventing him from panicking his wife. Everything you do as a doctor has a chain reaction – even if it is something little, it could lead to a (hopefully!) positive outcome.

Clinical skills

On the 3rd day, as well as watching a GP presentation (did you know that 80% of GPs are female?), which expanded my medical knowledge, we got a taster session in clinical skills, by learning how to take blood from a plastic arm, inserting a cannulation (used to deliver fluids to veins), trying out a peak flow respiratory device and suturing (the art of stitching skin to close up wounds).

Taking Blood using a butterfly needle:

Using a butterfly needle to take blood

Suturing (Vertical and Horizontal line stitching):Vertical and horizontal line stitching

Medical Schools

On the 4th day, we discussed the types of medical schools (31 overall) – when deciding where you want to apply, consider the cost of living (London is more expensive), teaching style (PBL, Traditional or Integrated), the application process, the course structure (some universities offer intercalated degrees), location, student satisfication and perhaps even how they teach anatomy. A good website to use is medschools.ac.uk and remember, as a backup, a good option is to take a gap year or do biomedical sciences, as some universities automatically transfer the top students to medicine.

 

If you’ve managed to get to the end of this post, I hope it was an interesting and helpful read – please comment and rate! Also, if you’re interested in surgery, I will be writing another post about a work experience opportunity I undertook in orthopaedics, where I will go into more detail about the work they do, and the skills I’ve learnt.

Thank You

Isra Ahmed