Book Review

I've been really busy with school recently and haven't had the time to write anything for a while, so I thought I would post a quick book review to keep you all updated.

I was in my school library the other day looking for a Biology textbook when I stumbled across the "Succeeding in your Medical School Interview" guide by Tony Edgar and Matt Green. After hearing about some pretty horrific interview experiences, I decided it would be a good idea to read it.  The book is published by BPP Learning media in association with BPP school of health, and the format contrasts most of the other books I've read. Each chapter is separated under subheadings with bullet points and a quick summary section at the end of each chapter, making it an incredibly easy read. It takes you through the interview process, explaining what medical schools are looking for and has 9 guided practice questions with ideas on how to structure your answers and show your interest in medicine.

I've seen advertisements from companies which offer training days for interviews, with some of them costing over £300! However, personally I don't think they're worth the money when there are so many books such as this guide offering exactly the same information, but at a fraction of the price.

The book is part of a series under the School of Health, I plan on reading some of the other books over the next couple of months, and would definitely recommend it to anyone hoping to study medicine in the future!

Why Medicine?

On my first day back to school, starting in a new sixth form, I was promptly handed a piece of paper with a series of questions relating to my choices regarding university. One of the questions that stood out to me was " Why do you want to study medicine?" Although there is nothing peculiar about this  simple question, I was taken aback by the fact that I only had 4 lines to write on. 4 lines to explain why I wanted to dedicate my life to an often heart rending job consisting of long hours, high pressure and endless studying. I managed to produce a rather succinct but slightly vague answer, and wanted to write one of more detail, and so today I shall be discussing why I want to study medicine.

1. A Life Time of Learning
One of the factors that first ignited my passion and enthusiasm for medicine was its dynamic and consistently progressive nature. A quick glance at any newspaper or site will instantly show you that the world of medicine is rapidly changing for the better. New and innovative technological advances such as CRISPR, liquid biopsys and brain organoids are making the medical field exciting, pushing the boundaries of what we previously thought was possible. As a result, a career in medicine involves a life time of learning, in order to keep up to date with the latest developments. Furthermore, you are provided with numerous opportunities to apply your new found knowledge to "real life" problems, in order to change the world for the better. In addition, by becoming a doctor, you gain access to opportunities to join in this scientific revolution, researching unexplored areas, creating new treatments and eradicating diseases that were once looked upon as death sentences.

2. Greater Perspective on Life
 I think that one of the greatest misconceptions about a career in medicine is the idea that qualifying as a doctor instantly results in a glamorous lifestyle. The reality is rather different. When you study medicine, you don't commit yourself to a job, but to an entirely different way of life. The working hours are long, exams are constant, pressure is high and the work is often emotionally distressing. As I discussed in my last blog post, during my two weeks of working in histopathology, I was initially shocked by the merciless nature of disease and the tragic implications it caused. However, I also found the experience to be rather humbling, and now I believe I have a greater understanding of the fragility of life.

3. The Opportunity to Make a Difference
After contemplating studying  medicine for the past few years, in 2015, I decided that it was the career I most definitely wanted to pursue. Before I started Year 11, my grandma was diagnosed with acute myeloid Leukaemia, suspected to have been caused by previous radiotherapy she received. The prognosis was not hopeful, and she sadly died after a 2 week stay in hospital. Although the doctors and nurses were unable to save her, their empathy, altruism and genuine kindness helped to improve her quality of life towards the end, and reduce the shock for my family. Their behaviour is one of the contributing factors in my desire to be a doctor, no matter how experienced or qualified I become, it will be impossible to save every patient, but it will always be possible to make a positive difference to somebody's life.
4. The Ethos of Medicine
One of my favourite aspects of medicine is the ethos and moral values which all doctors strive to uphold and emulate. Integrity, professional, caring for others and looking past social conflicts, providing help for all those who require it. These are the key pillars that support a relationship of trust between doctors and patients leading to an improved quality of care. Although it may sound slightly vague and ambiguous, I see a great deal of honour in being  doctor, a career I could love and be proud of.
5. The Responsibility
Medicine is stressful, it's a fact which can not be contended, and one which you must consider carefully if you are thinking of a career in medicine. Personally, I tend to thrive under pressure producing a higher quality of work than I would when at ease. Working in the medical field comes with great responsibility, as your actions not only effect you, but also the team members you work with, your patients and their family. All of your work must be completed to a high standard and the simplest mistake could have catastrophic consequences. However, I believe that this high pressure environment would help me to lead a successful career.

E-cigarettes. A quick fix or a ticking time bomb?

In the past few years, the use of e-cigarettes has become increasingly common, with shops dedicated to vaping popping up in the majority of UK towns. Designed to help smokers quit, e-cigarettes deliver the nicotine craved by users and release a cloud of water vapour in order to replicate the appearance and feeling of smoking. In general, this new alternative is regarded as safer than the use of traditional cigarettes due to the absence of tar and some other harmful chemicals. However, in recent months I have been strongly irritated by the way in which e-cigarettes have been marketed as
safe and harmless, when in truth they have the potential to cause multiple health problems.

Do you notice the similarities?

E-cigarettes still contain the drug nicotine, which has been proven to be strongly addictive, causing withdrawal problems such as depression and feelings of agitation. Evidence suggests that it can have negative impacts on those with existing heart problems, and increases the risk of complications during pregnancy. Furthermore, some e-cigarettes contain formaldehyde, a substance used in antifreeze and building materials, proven to increase the risk of cancer.

Introduced to the American market in 2007, e-cigarettes have been used for a relatively short period of time, and so their long-term health risks remain unknown. Although they have the potential to be relatively safe, the uncertainty surrounding their use is worrying.

To make matters worse, the sale of e-cigarettes is incredibly uncontrolled, with 68% of sales made in the UK being illegal. The inability to control the sales and therefore quality of the product, only increases the potential risks to public health. In addition, a recent article published by the BBC stated that "40% of sellers targeted in an operation by trading standards in England" were found to be illegally selling e-cigarettes to under 18's. The easy access, low costs and alluring flavours such as bubble-gum, chocolate and pink lemonade, entice young people into using the devices even if they had not previously been smokers, putting the future generation's health at risk. The problem is not limited to the UK, but stretches across the pond to America, with a recent study by the CDC stating that "a quarter-million youth who had never smoked a cigarette used e-cigarettes in 2013".

With so little research into the long term health risks this new trend poses, it is impossible to say whether or not e-cigarettes truly are a quick fix to tobacco smoking, or a ticking time bomb in the public health sector.

The Harsh Reality of Medicine

As I told you in my previous post, I've spent the last two weeks on work experience in the histopathology unit of a local hospital. Prior to this, I thought I had a relatively good understanding of what being a doctor entails. I had been warned of the long working hours, the academic challenge, the tremendous responsibilities and I knew that not every patient can be saved. However, I underestimated the impact the utter human tragedy witnessed in this gruelling yet immensely rewarding career would have on me.

On my first day, despite being taken on a tour of the mortuary, I kept a stern face and was fully able to accept the concept of death as a natural and unavoidable occurrence. Inured and composed I continued with the work I had been assigned. However, yesterday I observed a change in my typical response to tragedy. The doctor I have been working with showed myself and another student cases from an account on forensic science and post-mortems, at first I was, once again,unaffected by the deaths recalled in the book. However, we soon turned over the page onto a section discussing still born babies who had been victims of deformities. As my eyes looked over photos of innocent victims of diseases such as Harlequin-type ichthyosis, cyclopia and encephalocele, the reality of medicine really hit home as I began to question the injustice inflicted upon the pure and helpless individuals. I find it difficult to put my new found feelings into words, at the time I showed no emotional response and continued to listen to the cases, but I feel that I need to write this blog post in order to acknowledge that emotion I felt. Perhaps it was a moment of vulnerability, perhaps realising that I would be unable to save some patients in the future but only provide support for their families, made be feel weak and helpless, out of control, an image I did not typically associate with medicine at the time.

By no means has this experience discouraged me from persuing my dreams of being a doctor, if anything, I now feel more inspired to reach my goal.

The experience was not all doom and gloom, whilst in the pathology laboratories, I was allowed to observe the rewarding aspect of medicine.  In one particular incident, I observed the 'cut-up' of two breasts, removed from a patient who had undergone a double mastectomy the previous day. One out of eight women will be diagnosed with breast cancer in their lifetime, making it a major disease in the Western world, and a disease which has had a personal impact on members of my family, making this case particularly intriguing. Within the labs, lymph nodes and sections of the breast surrounding the tumour were removed and converted into slides which were later sent up to the consultants for analysis. Fortunately, the cancer was not metastatic and the operation had been successful in saving the life of this particular patient.

After my experience in the pathology unit, I would definitely consider this area of medicine as a future career pathway. Pathology underpins the basis of all medicine and the consultants, although often have very little patient contact, determine the prognosis and treatment of the individual. They have a great  responsibility and play such a vital role in medicine, making it a challenging yet fascinating career choice.

Book Review- Getting into Medical School

Despite it being the Summer holidays, the weather has been pretty miserable here in Wales (not a huge surprise). Rather than retreating to my room and binge watching Netflix, I decided I would try to put my time to good use and start some further medical reading.
I was given the book Getting into Medical School (2015 entry) by the headmaster at the sixth form I'll be joining in September and thought I'd recommend it as a good read for anyone aspiring to pursue a medical career. Instead of just looking at the importance of good grades, James Barton and Simon Horner address topical medical issues such as childhood obesity, MRSA and private medicine, focussing on how questions around these subjects could be approached at university interviews. They also include a section on the structure of the National Health Service along with reforms and recent challenges, personally I found this particularly interesting as it includes all of the jargon and specific details you need for your interview without being over complicated. The book provides advice on UCAS application, BMAT and UKAT testing and a list of further medical reading texts, which I'll hopefully be able to look at in the future.
I'll be going on a two week work placement in the Pathology unit of my local hospital beginning next week and should be able to write a blog about it for you soon, until then I hope you have a great week and enjoy the brief moments of British sunshine.
- Olivia x

The Impacts of The EU Referendum on The NHS

Tomorrow evening, on the 23rd June 2016, the future of the United Kingdom will be placed in the hands of the British Public as they decide whether to remain within the European Union or to leave. Too young to vote, and still undecided on the matter, I have no preference towards the leave or remain campaign. However, as a student wishing to study medicine in the future, the possible impacts of the vote on the NHS concern me. The referendum has highlighted the ugly side of politics, with both the leave and remain campaign manipulating statistics and playing on fear in a desperate attempt to convince the public towards their case. Therefore, I have attempted to sift through the propaganda and create a non biased analysis of the ramifications that both remaining in and leaving the EU could cause.

The EU's Role in The NHS

• Founded in Maastricht, Netherlands in November 1993, the European Union has both supported and influenced the NHS. According to the NHS European office "Whilst health policy and the organisation, financing and management of healthcare is a national responsibility of member countries, the EU also undertakes health-related activities, in particular, by supporting co-operation between member states in order to protect and promote public health and to enable the free movement of people around the EU"The referenced "health-related activities" include EU- wide public health works such as building awareness of HIV/Aids and cancer, anti-smoking campaigns and controlling public health threats such as communicable diseases.
• The single market rule allows health care staff to work anywhere within the EU due to the recognition of professional qualifications. In the UK,135,000 EU migrants work within the NHS and care sector, providing public services and contributing to the Government's  tax  base.
• The EU provides the public with the European Health Insurance Card (EHIC), entitling them to medical care in European Economic Areas including Iceland, Switzerland, Norway and Liechtenstein. However, the individual may be charged for medical expenses which occur.

If We Leave 

The vote leave campaign push the slogan claiming that "£20bn a year or £350m a week" is sent to Brussels by the UK, which could otherwise be spent on the NHS, improving public services. If the statistics are true, EU expenditure equates to the cost of a new hospital development each week.  In addition, former mayor of London, Boris Johnson, said that Brexit  would help put an end to long waiting hours in A&E by increasing available funding and reducing the pressures of an increasing population, partially caused by EU immigration. However, the chair of the Statistics Authority states that the figures produced by the leave campaign could be "potentially misleading". Furthermore, the Institute for Fiscal Studies calculated that the UK's net contribution for 2014 to the EU was actually only £5.7bn.
During the campaigning process, Priti Patel, the minister of employment said that "the EU is putting the NHS under threat" as 288,000 new immigrants per year cause "unsustainable pressure on our resources". In spite of her claim, I do not believe immigration will be the downfall of the NHS, but instead has been used to evoke fear amongst the public. In the UK,immigrants from the EU contribute £5bn to the economy each year, broadening the tax base and thus providing money for health care. If we were to vote out, a reduction in immigrants could reduce the money available for public services, leading to potential cuts in the NHS. In addition, the trade uncertainty could reduce the funding of public services.

If we Remain

Leading the remain campaign, David Cameron has warned that the out campaign is misleading and that leaving the EU could be very problematic for the health sector. The campaign states that directing money spent on EU contributions towards health would reduce aid to poor regions and payments to farmers.  By  remaining within the EU, we partially ensure £1.4 bn in research grants and guarantee health care for British citizens within other EU countries.
The out vote is ultimately a very daring leap into the dark, the economic uncertainty it creates irrefutably threatens the sustainability of the NHS, with 9 out of 10 economists saying brexit will damage the economy. Simon Stevens, the chief executive of the NHS certified that it "would be very dangerous if at precisely the moment the NHS is going to need extra funding... the economy goes into tailspin and that funding is not there". Therefore, although brexit has the potential to increase funds, it is an uncertainty and the remain vote creates more stability for the future of the NHS.

The impacts of TTIP

The Transatlantic Trade and Investment Partnership (TTIP) is a proposed trade agreement between the European Union and the United States, set up in the hope that increased trade will result in economic growth. According to the Independent, one of the aims of TTIP is to "open up Europe's public health, education and water services to US companies." Ultimately, this has the potential to result in the privatisation of the NHS and as a result of Investor State Dispute Settlements (ISDS), third party companies could sue the UK Government if NHS contracts are lost. 
Conversely, Trade Minister, Lord Livingston, told a journalist that "The idea that this will lead to privatisation of the NHS is not true." In addition, the Government claims that TTIP could add £10bn to the economy due to the removal of import tariffs on American goods, providing money for NHS Investment.  However, even though the plan is strongly supported by Labour, UKIP,  the SNP  and Liberal Democrats, all of the parties have expressed caveats over the NHS.


The outcome of the referendum will greatly affect my generation and those to come, please use your vote wisely and base your decision on logical facts rather than the scaremongering tactics used by politicians.

GCSE Revision tips

Although exam season may be over (cheers enthusiastically) I still think this post is needed for everyone preparing for a career in medicine. We're all so used to hearing that we need good grades, however during the lead up to my IGCSE exams I noticed that so many people have never specifically been taught how to revise. Having survived year 11, I thought that I'd share my favourite revision tips with you.

Whiteboards













If I've learnt anything from my exam experience, it's that paper can become really expensive, especially if like me, you use about 5 packs each week. However, whiteboards are a great alternative. In almost any supermarket you can pick up a whiteboard and pens for a couple of pounds, not only is it better for the environment, but it also makes revision more varied, so you don't get bored as quickly. It's particularly useful for subjects like history or geography where you need to draw mind maps or write out case studies.

Apps

Although the majority of teachers and revision guides would tell you that you should put your phone away during revision, I actually think that they're incredibly useful if used properly. The best way to check if you have revised thoroughly is to test yourself, but it's always quite time consuming to write out all of the questions for a topic, making apps a better alternative
My Favourite Apps
1. Busuu- The best way to learn a language is through practice of speaking and writing rather than mindlessly learning vocab for hours on end. Busuu is a social network style language learning site/app, which allows you to learn grammar and send written answers to native speakers to be marked. I used this quite a lot in the lead up to my French writing exam, the site provides 12 languages to learn, including Spanish, German and Italian.
2. Gojimo- The self testing exam preparation app is great practice for short answer exam questions for subjects such as biology, chemistry and physics. However, because it is a relatively new app, the range of exam boards isn't that great, for example I sat AQA IGCSE sciences, for which there were no questions.
3.Quizet- A teacher first introduced me to this app 3 years ago and I have been using it ever since. It provides digital flashcards that you can fill in and then be tested on. Originally I only used this for French, but this year I found it quite useful for learning history dates and other definitions.

Stairs
For subjects like Biology, you need to know quite a lot of information for a particular topic, which you can quote from the syllabus in order to gain full marks on long answer questions. Instead of writing it out again and again, I like to write out a sequence of events, such as the malarial cycle or sexual reproduction in plants, onto separate flashcards. After shuffling them up, try to place them back in the correct order, with the stages progressing going up each stair. After you can do that, turn the cards face down, and at each level, try to state what is written on the card without looking. Although it may seem slightly odd, and may annoy other people in your family, if you are a kinaesthetic learner this will be really useful.

Timelines
For subjects like History, it's really important to have a good idea of how events progressed over a period of time. By writing out timelines and taping them onto a wall to read, it is so much easier to answer exam essays because you can go through chronologically, showing the examiner a greater extend of understanding. In addition, during the exam you remember the events which followed each other, aiding the revision process. 

Running

I'm sure you are probably sick of hearing it, but running or any other form of exercise is one of the best things you could do before revising. Although on the night before a big test it may be the last thing you want to do, exercise stimulates the hormone epinephrine, which increases awareness and therefore increases your ability to focus. In addition, the refreshed and energized feeling you get motivates you to study. So before your next exam, leave behind the books and go and explore your local running tracks.






Start Early!!!
Procrastination is the kryptonite of all students. Even if you feel like your exams are far away, they quickly approach leaving you stressed and panicked as you cram in 2 to 3 years of work. In order to avoid the last minute struggle, begin your revision early. For your GCSE exams, your revision should really begin by the Christmas holidays, even if you only revise for 2-3 hours a day, it soon adds up and makes life so much easier during exam time.



Good Luck!