Surge in demand for medicine degrees

I read this article in The Telegraph the other day.

According to David Willetts, the Universities’ Minister, the level of competition among sixth formers for places to study medicine was so high that he was encouraging more people, particularly girls, to apply for other courses like engineering. This is because last year around 4,800 students with straight As at A-level failed to get in to British universities and of those the largest number, around 1,800, were those applying for medicine.

It is thought that there is an increasing interest for medicine because of the high tuition fees and the increasing pressure on students to secure well-paid jobs in the future.

His comments were attacked by head teachers of private schools who warned that ‘the NHS was failing to fund enough places on medical courses despite repeated complaints over a shortage of highly-trained doctors.’

I was one of the lucky ones and am now studying medicine at university, but it was not easy and if you want advice on how to improve your chances of getting a place, click on the link below and have a look at this great new book, Get Into UK Medical School 2015, for sale on Amazon now.

 

Stephen’s Story

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Stephen Sutton is an amazing teenager from Burntwood, a town close to where I live. He’s 19 and wanted to be a doctor like me, but sadly he developed bowel cancer when he was 15. Despite everything he carried on with his education, getting amazing A level results, and applying to Cambridge to study medicine. However, just after his interviews he found out his cancer was incurable, but instead of feeling sorry for himself he decided to make the most of the time he had left. In just over a year he has done some really amazing and inspirational things, including giving a speech at 10 Downing Street, appearing as an extra in an episode of Doctors, skydiving, breaking a world record and raising over £2 million for his charity, The Teenage Cancer Trust. You can read a lot more about him on Facebook or his website, www.stephensstory.co.uk here, and if you feel inspired to make a difference, then please donate to his charity today and help him reach his new target of £5 million.

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Malaria Vaccine Trial Brings Hope

On Tuesday ITV news announced that a malaria vaccine, developed by GlaxoSmithKline (GSK), and trialled in Ghana, has almost halved the number of cases of malaria in children and could be for sale in Africa within a year.

According to ITV, GSK said it is planning to release the drug to market at the reduced price of $5 per vaccine. Although this cost is still expensive for millions across the Sub-Saharan region, it is relatively cheap and a major breakthrough in the fight against this costly, deadly disease.

The trial is one of the biggest ever undertaken and the results show that the vaccine could save millions of lives each year. 15,000 people took part in it, across seven African countries, including Ghana, Kenya, Tanzania, Malawi and Mozambique.

Professor Tsiri Agbenyega told Lawrence McGinty, from ITV news that they ‘have reached a “eureka moment” in the development of just such a vaccine – the first in the world against a parasite.’ His hospital in Agogo is one of 11 centres where trials of the malaria vaccine are being carried out.

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Although the full results are not yet available, the results are encouraging at this half-way point, as the vaccine nearly halves the number of episodes of malaria in children aged between 17 months and 5 years. For every 1,000 children vaccinated, 941 cases of clinical malaria were prevented over 18 months of follow-up.

 You can read more about it on ITV news here.

Holocaust Memorial Day 2014

image from: http://www.wlv.ac.uk/images/holocaust%20logo_s.pngToday is Holocaust Memorial Day and the theme this year is Journeys. All around the world today there are events that will bring us together with our neighbours, that will strengthen bonds of respect, and will enable us to pledge to take a step towards creating a safer, better future.

As an ambassador for the Holocaust Education Trust, I’m going to be sharing the inspirational journey of Holocaust survivor Kitty Hart Moxon and my recent experience of  Auschwitz at a special school assembly on Friday.

If you want to take a step and learn about the multitude of Journeys that people were forced to undertake, in fear of what would be found at the end, then you can pledge your support here.

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If you want to find out more about the millions of people murdered in the Holocaust, under Nazi persecution and in the subsequent genocides in Cambodia, Rwanda, Bosnia and Darfur, you can watch the Holocaust Memorial Day 2014 youtube video here.

Euthanasia for children in Belgium

Last year I wrote about the euthanasia of a 44 year old Belgian transsexual, Nathan Verhelst, which you can find in my blog here. Although Belgium first legalised the right to euthanasia for adults in 2002, recently its Senate voted to extend the law to children who are terminally ill, and suffering unbearable physical pain. Many Belgians support this new draft bill as they believe those children must have the right to decide about their own end of life, but there are also opponents against it, who see it as a slippery slope.

Paediatrician and supporter of the bill, Dr Gerlant Van Berlaer, says, ‘We are not playing God – these are lives that will end anyway. Their natural end might be miserable or very painful or horrifying, and they might have seen a lot of friends in institutions or hospitals die of the same disease. And if they say, “I don’t want to die this way, I want to do it my way,” and that is the only thing we can do for them as doctors, I think we should be able to do it.’

However, Christian Democrat senator, Els Van Hoof, disagrees, and fought successfully to restrict the bill to children with terminal illness suffering unbearable physical pain. ‘In the beginning they presented a law that included mentally ill children,’ she says. ‘During the debate, supporters of euthanasia talked about children with anorexia, children who are tired of life – so how far does it go?’

You can read more about it in this BBC magazine article here. You can also hear more about it by listening to BBC Radio 4′ s The Report – Right To Die programme here.

It certainly raises some difficult ethical questions, and I can understand why euthanasia is illegal in Britain. However, in the Netherlands, euthanasia is already legal for children over the age of 12, if they have the consent of their parents, and if the Belgian bill is passed in the lower house of parliament, Belgium will be the first nation in the world to lift all age restrictions. 

 

Manchester Medical Student – a worldwide internet hit

I read in the Independent news here the other day about a medical student, Tom Leach, who has won an award for his medical blog.

“One day I went into the library and there was a queue for the photocopier where people were copying my notes,” said Dr Leach. So, in 2009, he decided to create a website, almostadoctor.com. He originally only shared his medical lecture notes online with his fellow medical students at Manchester University, but they passed them onto others and soon his website became so popular with medical students around the world that it has now been voted by medical professionals as a global industry innovator, alongside Ben Goldacre and Sir Bruce Keogh.

Now it is used by thousands of students, with hundreds of articles, blogs and course notes contributed from students and doctors around the world.

Dr Leach, now 26 and working in Australia, said: “It’s like the Wikipedia of medicine, with doctors as editors to verify the content, but it’s written in a simple way.”

You can find his blog here.

 

Government publishes ‘blueprint for trustworthy’ NHS

Today Jeremy Hunt outlined the measures that the government are going to take following the Francis Report into the Mid-Staffs scandal at Stafford Hospital. You can read about them here.

Some of them are outlined below:

• Hospitals will have to publish details of whether they have enough nurses on wards. From April, patients will be able to see the numbers on a new national safety website.

• Hospitals will have to produce quarterly reports on how they are handling complaints and clearly set out how patients can raise them.

• There should be a legal duty of candour on organisations to be open and honest about mistakes.

• A criminal offence of wilful neglect to hold staff to account.

• A “fit and proper person’s test” so managers who have failed in past will be barred from taking up posts.

• A care certificate to ensure healthcare assistants and social care workers have the right skills and training.

• Every patient should have the names of a responsible consultant and nurse listed above their bed.

However, some people do not think the government has done enough and that the legal duty of candour should include all errors – at the moment the government has only said it will apply to mistakes that cause death or severe harm although it is going to consider whether to extend that to include moderate harm. Also, the inquiry wanted the duty of candour to apply to individuals not just organisations.

The Francis Inquiry made 290 recommendations in total. The government has claimed it has accepted all but nine of them. However, of the 281 recommendations the government says have been met, one in four have not been accepted in full. For example, the inquiry called for a system of registration for healthcare assistants, but the care certificate being introduced falls short of that.

However, Robert Francis QC said he was happy that the government’s response was a “comprehensive collection of measures”.

 

Surgeon jailed for negligence & nurse found guilty of mis-conduct

Yesterday David Sellu, a consultant surgeon, was jailed for 2 and a half years for manslaughter after he failed to act quickly enough to examine and operate on a patient he had diagnosed with a rupture in his bowel. The judge said that the surgeon should have prescribed antibiotics and looked at abdominal scans earlier. Although there was a chance that the patient would die even if he had received treatment, the risks were increased by the delay in action.

Elizabeth Joslin, a lawyer for the Crown Prosecution Service, said: ‘David Sellu’s care fell far below the expected standard, with terrible consequences. Prosecution of doctors for gross negligence manslaughter is rare and the threshold for criminal prosecution is high, but this doctor’s actions were not mistakes or errors of judgment, but negligence so serious that he has now been convicted of a criminal offence.

You can read more about the case in the Guardian here

I thought it was quite interesting that also in the news this week, Janice Harry, chief nurse at Stafford Hospital between 1998 and 2006, was given a 5 year caution, but was still found fit to practice for her part in the Mid-Staffs scandal.

A Nursing and Midwifery Council panel heard that during some night shifts, a single nurse was looking after 17 patients on a ward. It said Mrs Harry should have been focused on staffing levels but she was distracted by ‘training, targets and other matters‘.

The panel told her ‘you had effectively closed your mind to your direct operational responsibilities and had limited yourself to the strategic role. You had the professional responsibility for every nurse in the Trust….you had in the past placed patients at risk of harm.

You can read more about the case here

I think that both these cases show how important it is that doctors and nurses should always put the patient first, and I think it is a good thing that there are stricter controls in place now to ensure that bad practice does not happen in the future. However, it has made me realise just how big a responsibility medicine is, and I will have to make sure that I am always focussed on the patient first and not distracted by other things like targets. I also think it shows how important it is for everyone involved in caring for a patient to work as a team, and to report anything that falls below standard.

Ada Lovelace Day

Today is Ada Lovelace Day, a worldwide event to promote female role models in the STEM subjects (Science, Technology, Engineering and Maths). Ada Lovelace Day encourages people to talk about women scientists and engineers that have inspired them, with the hope that more women will be encouraged to work in these areas. You can read more about it in this Guardian article.

Ada Lovelace was the world’s first computer programmer in 1842, well before computers were even invented. Her friend, Charles Babbage came up with the idea for an Analytical Engine and he asked Ada to translate his lecture notes for him from French to English. However, she did much more than that.

Suw Charman-Anderson, the founder of Ada Lovelace Day, said: ‘Ada wrote what is essentially a computer program. She wrote a description of how the machine could be programmed using punched cards to calculate Bernoulli numbers, a complex series of numbers. She broke the process for calculating the numbers down into small formulae and then she described how you would code those formulae into punched cards, so it could be worked out by the machine. She understood that the Analytical Engine could actually be used, given the right algorithms, to create music or to create art.’

Ada’s mother was responsible for making sure she had an education in maths and the sciences, after her father, the poet Lord Byron, left them when Ada was only a month old. Sadly, Ada died of cancer of the uterus, aged just 36, and her work wasn’t recognised until much later after her death. Now she is recognised as being more than 100 years ahead of her time.

You can read more about her here.

Since I became interested in studying medicine, I have learnt about the historical role of women in medicine, such as Elizabeth Garrett Anderson, the first female British doctor, Florence Nightingale and Marie Curie. During the past year, I’ve shadowed two really good female doctors, Kirsty Armstrong and Sue Heyes, who have both shown me what women can achieve in medicine now, here and in Malawi, and I can’t wait to become a doctor and hopefully inspire others like they inspired me.

Read about more inspiring women in science, technology, engineering and maths here.

Ethics of Euthanasia

This week I was shocked to read a BBC news article about the euthanasia of a 44 year old Belgian transsexual, who was so unhappy with his sex change that he wanted to die. Two doctors made the necessary decisions that he was within his rights to choose euthanasia, saying: ‘Patients must be capable of deciding for themselves. They must be conscious and have to give a “voluntary, considered and repeated” request to die.’

Nathan Verhelst was legally killed on September 30th. I wonder if he might have felt differently in a few months, if he had had more counselling and psychological help.

One of the things I found particularly shocking about this case was that it didn’t make the headlines. In Belgium, euthanasia is not very controversial and MPs there are even now deciding whether to lower the age limit to make euthanasia available to under-eighteens. You can read more about that in The Independent news article here.

I believe that this could be the start of a very slippery slope. Can a child make the decision whether it is better for them to live or die? Do the child’s parents have the right to decide to kill their child, even if it is for humane reasons?

It is questions like these which make me glad that euthanasia is illegal in this country. I feel especially strongly about it, having visited the death camps at Auschwitz, where euthanasia was taken to horrifying extremes.

Since the Harold Shipman case, there are now much better regulations in place to ensure that doctors can’t kill their patients, and doctors have to be revalidated every 5 years to ensure they are doing the best for their patients.

As a doctor, I would always want to do the best for my patients without causing them harm. However, I know that I shall have to make some difficult ethical decisions, such as whether or not to withdraw treatment for a terminally ill patient (Extraordinary medical care), or whether to give a drug to relieve pain, knowing that it might cause the patient to die sooner (the Doctrine of Double Effect).

You can find out more on this BBC ethics website which sets out the arguments for and against euthanasia and assisted suicide really clearly.

 

The General Medical Council and Tomorrow’s Doctors

The General Medical Council have recently published a news article about the failure to prosecute 4 doctors who held management positions at Stafford Hospital, because of a lack of evidence against them.

They are currently working with the Department of Health: ‘…to see what more can be done to increase appropriate accountability when things go wrong. In particular we have been exploring a number of changes to our powers to make our fitness to practise procedures more effective. We want to be able to hold doctors to account where they have harmed patients or put them at risk, even if they have subsequently shown insight and can claim they are no longer a risk to patients. We also want to have a right of appeal against panel decisions by the Medical Practitioners Tribunal Service – this would allow us to act when we believe the panel has been too lenient. We hope these changes will form part of the Law Commission’s current wide ranging review of the law governing the regulation of health care professionals.

You can read the article here.

The GMC also sets standards for teaching, learning and assessment and they have issued a document called Tomorrow’s Doctors for medical students which sets out the knowledge, skills and behaviours that medical students must learn at UK medical schools and be able to demonstrate.  

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Obamacare

I’m interested, reading in the BBC news here, about the new Affordable Care Act (ACA) that President Obama has just introduced in America.

Mr Obama said the ACA would be “life changing for the 15% of Americans who don’t have health insurance. Tens of thousands of Americans die each year just because they don’t have health insurance. Millions more live with the fear that they’ll go broke if they get sick. And today, we begin to free millions of our fellow Americans from that fear.

There’s another interesting article about it here, which gives the view of a young American woman.

I find it hard to believe that until now seven million Americans couldn’t afford health insurance and many died instead of getting access to life-changing care. 

It makes me really appreciate our NHS which is free for everyone at the point of delivery.

Fall in hip replacement death rates news

It was interesting to read this article today about recovery after hip replacement operations. 

According to a study of more than 400,000 patients, in The Lancet recently, death rates after hip replacement surgery have fallen by half in England and Wales between 2003 and 2011. This is mostly due to elderly patients being fitter now and also because there is better physiotherapy after the operation, with patients encouraged to start walking the day after surgery. Other reasons include the use of a spinal anaesthetic which is likely to lead to fewer complications and specific treatments to stop blood clots after surgery.

The patients most at risk after hip replacement surgery are those with severe liver disease or people who have had a heart attack, have diabetes or renal disease. Surprisingly overweight people tend to have a lower risk of death than those who are not overweight.

I think this article shows how important post-operative care is, and also the importance of a good multi-disciplinary team. The role of physiotherapists is just as important as the role of surgeons and anaesthetists in ensuring good recovery.

 

Great news which will save a life every 3 seconds

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I was really excited to read in the news here that Justine Greening, the international development secretary, has announced that the UK will support the Global Fund to Fight Aids, Tuberculosis and Malaria over the next three years with a pledge of £1 billion, if the overall target of $15 billion is met from other governments and donors. Barack Obama has promised $1.65 billion for 2014 and Sweden, Norway, Finland, Denmark and Iceland have each pledged $750 million. Now, other governments like Australia, Canada and Germany will hopefully follow suit and match the UK’s offer.

If they do, it means that the UK will be able to deliver 32 million mosquito nets with the potential to protect over 64 million people (equivalent to the entire UK population) and save a life every 3 seconds. They will also be able to fund lifesaving anti-retroviral therapy for 750,000 people living with HIV and TB treatment for more than a million people. The Global Fund is estimated to have saved more than 8.7 million lives since it was set up.

I am particularly happy about this announcement as I feel I have played a small part in it myself. Back in March this year, I wrote to my MP asking him to ask Justine Greening to increase Britain’s support for the Global Fund. You can read my letter to him here.

I received a reply here and also an invitation from Jeremy Lefroy to go to Westminster to make a presentation to the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (APPMG), which you can read about here.

I am really proud of the part I have played in this news today, and I hope that one day soon there will be no more malaria in the world.

 

Kidney checks could save lives

I was really interested in the news here  and here about kidney checks saving around 12,000 lives a year, as I just spent a week at Southampton and Portsmouth hospitals shadowing consultant nephrologist, Kirsty Armstrong. Lydia Spilner’s life could have been saved if her acute kidney injury (AKI) had been prevented through the provision of basic clinical care, such as hydration. You can read more about her case here.

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DFID investment to save millions of lives from malaria and other diseases

Today the UK Government announced an investment into pioneering partnerships to save millions of lives from the world’s most deadly but preventable diseases including malaria.

The Department for International Development (DFID) is investing £138 million over the next five years into nine public-private partnerships to support the development of new drugs, vaccines, insecticides and diagnostic tools to prevent, diagnose and treat malaria, HIV, TB, diarrhoea and other neglected tropical diseases.

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You can read more about it in a DFID press release here and in Malaria No More’s policy section here. I think it’s really important to continue to develop new technologies to fight these deadly but avoidable diseases. You can support my fundraising for Malaria No More at my Just Giving page here.

Malarial mosquitoes more attracted to smell of humans

A study published a few days ago has found that malaria-carrying mosquitoes are more likely to bite humans than mosquitoes which don’t carry the malaria parasite, because they are attracted by our smell.

It is already known that female anopheles mosquitoes are attracted to the chemicals in human body odour, to help them find the blood they need to grow their eggs; but, if they are carrying the malaria parasite, the chance that they will bite humans increases.

James Logan, from the London School of Hygiene and Tropical Medicine, and his team of scientists used nylon tights, filled with foot odours, to attract both malarial mosquitoes and ordinary uninfected mosquitoes. They found that the malaria-carrying mosquitoes were three times as likely to try to bite as the uninfected ones. Logan believes that it is the parasite which is changing the way the mosquito behaves, to try to complete its life cycle, which can be deadly for humans.

According to the New Scientist, ‘understanding the mechanisms used by the parasite to change mosquito behaviour could help efforts to predict the spread of the disease. It could also lead to new ways to stop it, such as new types of insect traps.’

James Logan said, ‘We could develop a lure that would target malaria-infected mosquitoes. If that’s possible, we’ll be targeting the most dangerous mosquitoes in the world.’

I think it’s good news that more people are trying to stop malaria spreading, in many different ways. It’s going to take more than one solution to stop this disease.

If you are interested, you can watch an interesting video about it on the BBC News here.

Climate change could bring malaria to Britain

In this Guardian article, leading health experts are predicting that there is a real risk that malaria and other mosquito-borne diseases could soon be found in the UK. 

Salt marshes used to protect coastal regions and increased flooding, due to global warming, means that the UK is becoming an attractive habitat for mosquitoes.

Health experts, at the annual public health conference of the Chartered Institute of Environmental Health this week, are urging governments to “act now before it is too late”, as a growing body of evidence proves that what were once thought of as tropical diseases are being found ever closer to the UK. In 2011, Greece reported a case of malaria.  

Perhaps the threat of malaria in their own back garden will make politicians and scientists put more emphasis on finding a vaccine for this disease which is already killing 1,500 children every day…

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