Happy International Day of Radiology

Happy International Day of Radiology!

It's a day to celebrate the value of radiology in the detection, diagnosis and management of diseases. This year's focus is on brain imaging and all the progress we have made over the last 40 years.

I'm really enjoying my new specialty and it's nice to see it promoted.

Celebrate well!
Moc

Autumn Cleaning

Six years of medical school notes. Time to recycle

Bloody anecdote

After a long struggle against the incredible veinless man, I managed to get enough blood for all many tests we wanted to do. Just as I was withdrawing the needle, though, the plunger of the syringe popped out and flew across the room. Blood splattered all over me, the patient, the bed, walls and floor. Nurse walked in just then, surveyed the scene and concluded that I must have just killed the patient.

Colleagues

Titilayo, Princess, Gugu, Shiny, Girlie, Bongie...

Nurses have the best names EVER!

Moya Moya

When you're asked to review a journal paper containing medicalese that you've never even heard of ("bilateral encephaloduroarteriosynangiosis augmented by bifrontal encephalogaleo-/periosteal synangiosis", anyone?), you know its going to be an interesting week.

Cardiology emergency - no students allowed!

Spent in the echocardiology lab. The teaching was good and we were learning quite a lot. Midway through examining a patient, however, the doctor was called urgently to the next room. A lady had become unresponsive following surgery to replace one of the valves in her heart, and it was looking likely that she may need be to resuscitated. "Run, please doctor!" the panicked secretary whispered after summoning him. My fellow med student and I followed in the hope that we could learn first-hand how such an emergency is managed by the healthcare team. Unfortunately, when we arrived the curtain surrounding the bed was shut it our faces. "We must respect the patient's dignity", one of the staff said.

I accept that she wanted to call the most experienced healthcare staff and that if we were inside we may have been getting in the way, but we are senior enough now to recognize this, which is why we wanted to observe from a distance. Besides, we also may have been able to predict and fetch any equipment that may be needed during treatment. Respecting the patient's privacy and dignity is of course essential, but I don't see how us watching would have been compromised this, or indeed the care delivered to them. And in my six years at medical school, aside from the more sensitive topic area of gynaecology, out of hundreds of patients I can count on one hand the number of patients that have refused my presence in the consultation or examination room.

In the hyper-aware state an emergency renders you, it would have been a tremendous learning opportunity for a situation we are bound to experience as junior doctors next year. What a pity we weren't allowed to be a small part of it this time around.

A little publicity

These are two of the recruitment posters for the Assiut Students' Scientific Association 2005 Tropical Medicine Summer School. Comes highly recommended.

PhD meeting

Today was the PhD information session. The Prof in charge told us a little about the program, but the overwhelming impression was that this year the whole process is a bit of a mess. The opportunity was in response to the General Medical Council's Modernising Medical Careers directive, which recommends that med schools give willing and able students the chance to coming a PhD with their medical studies. But the College's response seems to have been late this year, and many of the divisions that would potentially have med students are as confused as we are about how we apply. Nevertheless, this week I'll look at all the webpages of each of the research groups offering a studentship, and if I find any that are dong an interesting developmental neurobiology project I will find out more. The Medical Research Council's Clinical Sciences Centre have their PhD interviews next week, so I'd better get cracking! As expected though, my mum is against me doing the studentship before finishing med school. And most of my friends think the same. What do you think?

PhD opportunity

Guess what? Just as I handed in the project, and thought I was done with labs, we got a surprise email from the head of undergraduate medicine. Apparently, Imperial are offering a number of fully funded intercalated PhD studentships to med students. I've always intended to do research after I qualify, so this sounds like a perfect opportunity to enter the world of academic medicine. There's an information session being held on June 3rd, so I'll definitely go to that to find out the details. I'm not sure how happy my parents will be about this latest venture though - if successful I won't finish med school and start work as a doctor till 2010!

I'll keep you updated.
Moc

Medic humour

An economics student, a med student and a law student were asked to learn the telephone book of their town.

The economics student asked 'What will be my profit of this?'
The law student questioned 'Why should I do this?'
The med student just gulped before asking quietly 'How much time have I?'

Electives advice

Last week, we had a talk about our electives. In our final year at university, we get to spend two months learning medicine anywhere in the world. So, I've got to decide and organise where I'd like to go. I'll be leaving in July 2006, but because the paperwork takes so long, I need to start thinking about it now. The thing is, I really don't know where to go - there's too much choice. Right now, I'm trying to decide whether to go to a developing or developed country. We had presentations from older students who had travelled to New Zealand, India, Thailand, the US, Greece, Malawi and South Africa. Do you think it's worth visiting somewhere where medicine is practised in a similar way to that in England so I can get lots of relevant experience, or to go somewhere where I'll have a totally different adventure and see a different spectrum of diseases? Any ideas would be very very welcome. At the moment I'm thinking about a French speaking western African country, Malaysia, India, China or the USA. Where would you go? Oh, I forgot to mention that we'd also get quite a lot of time to go travelling. :o)

Listen up, readers

I bought a new CD player last week. It's quite good and can also play mp3 and wma files. It means that I can now and can now listen to music and Dr Goljan's pathology lectures on the move. I started from the beginning again with cell injury on the way to College yesterday morning.

Medsin activities

Tonight Imperial Medsin, part of the global network of medical students, has its launch party for World AIDS awareness week, and it promises to be a lot of fun. Later on there'll be a series of talks on the disease's impact across the world, as well as a candlelit vigil. People (me included), seem a lot more receptive to the planned events this year, perhaps because the incidents of STDs has risen sharply in the UK these past few years. I don't think I'll go to many of the events, but I support the cause nonetheless.

Moc

Official USMLE information

I've just been browsing the USMLE official website. Here's some important information to take into account when revising. I hope it helps.

Moc

"Some questions test the examinee's fund of information per se, but the majority of questions require the examinee to interpret graphic and tabular material, to identify gross and microscopic pathologic and normal specimens, and to solve problems through application of basic science principles."

USMLE study schedule

Yeesh, the BSc is getting intense. I'm working hard, but unfortunately that means that I've been neglecting my USMLE studies for a few weeks. The USMLEs are a series of exams that all doctors that have qualified abroad but wish to practice medicine in the USA need to take. I was in America in the summer of 2003 as part of an international exchange with the University of Delaware, and really loved it. It's my dream to spend some time practicing there. Though I found the attitudes of a small minority of people in the USA sometimes disconcerting, the majority of citizens are really nice and interesting, as well as being some of the most innovative and hard-working people in the world. So I really really need to study. What do you think of my schedule for the second-half of November?


14th: HY Neuroanatomy (the developing nervous system and congenital disorders), Webprep Biochem lecture 1
15th: HY Neuranatomy (The adult brain MRI images), Webprep Biochem lecture 2 and additional reading
16th: HY Neuroanatomy (Finish HY book), Webprep TCA cycle lectures
17th: Neuroanatomy (Qbook questions), Biochem catch-up reading
18th: HY Biostatistics (Introductory chapters), Webprep Biochem (Hexose monophosphate shunt lectures)
19th: Other commitments - College deadlines!
20th: HY Biostatistics chapters 4-7
21st: Webprep Biochem (Lipid synthesis and storage)
22nd: HY Biostatistics chapters 8-9
23rd: Webprep Biochem (Lipid synthesis and storage II)
24th: HY Biostatistics
25th: Visual Processing essay
26th: HY Biostatistics
27th: Webprep (Anatomy in early embryology)
28th: Webprep (Anatomy in early embryology II)
29th: Anatomy in early embryology revision - weak subject!
30th: Alzheimer's and Dementia (College lecture)

Medical answer?

Here's my answer to the question I posed last week:
Q: Which of the follwing circuits repesents the lowest resistance pathway and why?
a) cerebral circulation
b) coronary circulation
c) renal circulation
d) hepatic circluation
e) pulmonary circulation

I think the answer is e) because the pulmonary system:
Has many many parallel pathways (branching)
Is relatively short
Has low muscular tone
But my circulatory system physiology is terrible, and when I was discussing it with Shobhit yesterday we considered coronary as well. Any other ideas?

Medical quiz

A quick question for you, that's been bugging me for absolutely ages. I found it on a brilliant forum for students preparing for the USMLEs. I don't remember learning this in first-year physiology lectures. Help!

Q: Which of the follwing circuits repesents the lowest resistance pathway and why?
a) cerebral circulation
b) coronary circulation
c) renal circulation
d) hepatic circluation
e) pulmonary circulation

First impressions of Egypt

Hi all
I tried to send this mail a couple of weeks ago, but I think lots of you didn't get it, so I'm resending it. It explains why we're all here. Enjoy, and reply sooon.
Moc


Hi folks

How are you? Sorry it's taken a long time to get in touch. I'm staying in quite a small town at the moment, and have really bad Net access. This is only the second time I've been online since arriving here a week ago, and the connection is pretty slow. Anyway, where am I? In Assiut (or Asyut), Egypt! I know I didn't get in touch with lots of you before I left, but the trip was a completely last minute thing. A couple of weeks ago I was surfing the Net and randomly came across a chance to complete a Tropical Medicine Summer School for three weeks, starting on July 1st. There was to be a week's travelling all over the Pharaonic sites afterwards, and it seemed like a great chance to have a holiday, learn some tropical medicine, meet great people from Egypt and the rest of the world, and to improve my Arabic. The details are here. Check it out. So I called up some of my buddies from med school, and two of them (Sho and H) were free during July. Just as we were organising all that, another friend told me about a summer school in Cairo beginning on August 1st, and seeing as I was in Egypt anyway, and that we have four months holiday this summer, I thought why not go to that as well. Unfortunately Sho and H won't be able to come for both programs, but the Cairo school should be great fun too.

Anyway, after some last-minute packing the three of us got here a week and a half ago, only to have a few problems at the airport. I already had a visa from London, but even then they confiscated my passport for 'security' for twenty minutes. Then it was my friends' turn. The problem is there is next to no signposting at Cairo International, and people here don't queue. After twenty minutes they were told to buy their visas from somewhere else and join the back of the line again. Almost two hours after landing we were out of the airport, and following a bit of bargaining we took a taxi to the main train station, as the training was beginning the next day so we needed to get to Assiut asap. Riding a taxi in Cairo is an exhilarating experience though, even more than taking a rickshaw in Mumbai! The drivers here all treat other vehicles as moving objects in a high-speed slalom course, to be claxoned and cursed whenever a close shave is avoided. Hypertension and great entertainment is guaranteed every time, but you know, we haven't seen a single accident so far.

Within the first hour we were already introduced to the unusual habit of tipping (HK was asked for 'baksheesh' for being handed a paper towel in the airport toilets), but buying anything here involves bargaining, a skill so frustrating but so much fun that I'll tell you about it at length later.

Once we got to the Ramses Station we were tired and wanted to get second class a/c seats. We were told they weren't available, and to try another office where 3rd class tickets were being sold. These were also unavailable, and we were now ushered to the first class booths. Alas they were all gone, and we were pointed to the queue for sleeper seats, at $50 per person. Catching on, we managed to grab hold of a tourist police officer, and finally got the seats we wanted (v cheap with an ISIC card – definitely bring one if you're visiting). Taking the 10pm train we reached Assiut at 3am, to be met by four of the summer school coordinators. They are all really nice, and are rooms are fine. As for the town itself, after a week and a half Assiut is still a bit of an enigma. It's on the banks of the Nile, geographically centrally placed and with good transport links to the rest of the country. The fact that it isn't a tourist city (Lonely Planet lists the orphanage(!) as one of the tourist attractions – insensitive, huh?) and that there isn't too much to do is more than made up for by the Egyptian students' company and the other medics on the course. There are twenty of us in total, (a Frenchman, three Ukrainians, five Slovakians, a Czech, two Canadians, an Indo-Bulgarian, a Dutch woman, a Colombian and two Poles and the three of us from London), and we're having a great time. We've formed a special bond and are often up talking until three in the morning. I'll tell you much more about them over the following three weeks.

Every day there's a social program organised by the ASSA team, usually involving sitting by the Nile and later a restaurant outing, which can feel a bit repetitive, but there is always a fun twist. I sometimes feel that the Egyptian students are doing too much for us and that we are taking up all over their evenings, but it being the summer holidays these guys just don't sleep at night, when it’s nice and cool.

Getting from place to place in Assiut, and quite a bit of Upper Egypt, however is a mission. In the 1980s Assiut, and the university in particular, were hotbeds of a religious uprising, and the guy that killed Sadat had strong links with the university. Though this is now long forgotten and all the Copts I've spoken to (there's a very large Coptic community here) say they suffer no prejudice at all, there remains a massive police presence in town, and they keep an eye on things from these five metre turrets scattered round the city. Wherever we go we are followed at a discrete distance but by a truckload of officers, three for each student. We know they are there for our safety but it gets tiring pretty quickly and we’re always discussing strategies to evade them.

The medical program itself is brilliant. On our first day we were a bit apprehensive, as the hospital is a typically underfunded place with overworked doctors and patients queuing on the stairs and corridors, but the teaching is amazing. The team here is genuinely honoured that students from all over the world have chosen Assiut to complete their training, and are always willing to teach. I think we've had more personal teaching here than in all our third year firms back home. They struggle with most of our names though, and it’s always interesting how they pronounce them. My friend H decided to use the name his godfather gave him, Joshua, to make things a bit easier, but it caused even more havoc. The first doctor, after struggling once, said “Oh, that is too difficult. We must make it easier. I will call you Shoo. Shoo, you are welcome to Egypt”. Classic

I went diving yesterday. I’d never done so before, but the sports facilities here are amazing, and I thought it would be fun to give it a try. The only problem is that the boards here are seriously high. Wee attempted jumping from the second highest board and the air-time was just incredible. Screaming when diving is expected here, so I did so when I jumped, only to find I was in the air for so long I was out of breath about two thirds of the way down, and had to breathe again, just as I hit the water, and swallowed half the pool. Arrrrrrrrrrrrgh…..breathe…bre…splash, splutter. It was great fun, but my ‘unique’ technique was agony for my bruised backside.
Oh, a word of advice - don't try a sheesha pipe prepared for an Egyptian. They're lethal! Relaxing with a water pipe is a big part of many Egyptians’ lives, and the Assiut students have taken us to ‘kahwas’ quite a few times. I decided to try it for the first time a couple of days ago (in fact, the first time I ever had taken any form of tobacco) and after one puff I spent the next morning recovering. Also, it's the single biggest route of transmission for TB in these parts, but I only found that out yesterday.

Anyway folks, I’d better be off, as I need to get some sleep. The university is hosting the fourth Pan Middle Eastern Games for disabled athletes, and these guys only get going at midnight, once their competitions for the day are finished. They all gather their wheelchairs in the courtyard outside our dorms and chat and laugh for a few hours. They’re all really welcoming and we’ve joined them a few times. And once the travelling circus/dance troupee join us next week things will be even more lively.

Take care y’all, and hope to hear from you very soon. We have quite a bit of time off this week and it’d be good to hear what you’re all up to. Oh, and remember to let me know what you’d like from here.

Yours,
Moc

Results

Hey folks

Just received my results, and I’ve passed all my third year exams, but without the honour of a merit or distinction. It’s a bummer. Don’t get me wrong, I’m relieved to have passed, but I always try and do the best I can and though I berate myself for this, it hurts when others have put in more effort and have got better results than I have. What if I don’t do the best for a patient because I haven’t learnt an important concept or how to manage an important illness. In my med student guise, those are the type of things that keep me up at night. At least I can now enjoy my summer though.

Results day is always interesting though. There are students that run from the building and open their envelopes in privacy, those that openly cry, having performed far better worse than they anticipated, those that allow themselves a quick smirk or grimace and the stoical statues. I allowed myself a bit of a long grimace. Most people don’t show too much emotion though. I guess it’s because in med school we’re all too competitive. Agree?

Moc

Welcome and thank you

Hello and thanks for stopping by my page. My name’s Moc, and this is my first ever blog. Thank you for reading it! I hope my site will be a fairly frequent update on my daily activities, and act as an outlet to my thoughts, experiences, hopes, dreams and rants. I’ll try to keep it as true and as honest as possible. Please feel free to post any comments or suggestions (I’d love constructive criticism) and I’ll do the best I can to improve the blog. Enjoy.


First of all, a little about me. I’m 21 years old, and am a fourth year med student at Imperial College in London, UK, having just passed my end of year exams. We’ve just started our holidays, therefore, and in our three month vacation I plan to go to Egypt to a summer school on tropical medicine, to prepare to take the Step 1 USMLE exam (an American medical licensing exam) and to finally learn to drive. In the meantime, however, I’m going to have some fun. London is an amazing city, and even though I’ve lived here all my life, I’ve seen so little of it. I still consider South and East London the dark side of the capital. Hopefully I’ll catch some of the less well know treasures it has to offer. Any ideas?


Being a Londoner, and having to commute to hospitals all over the city as part of my training I have chosen to live back at home this year, with my parents and little sister. She’s seventeen years old, and currently slacking for her A-levels, with the ultimate dream of being a dentist. I’m not sure how interested you all are about home life, and I don’t intend to write about it too much, but human relationships are fascinating, so let me know if you’d like to know more.


Personality-wise, I’m not really sure how to describe myself. I love meeting new people, especially those with a different background to mine. I’m very interested in other cultures and traditions and the way other people live their lives. As a result, I also enjoy travelling, and over the past few years have been fortunate enough to travel to the USA, Canada, Tanzania, Madagascar and Germany. They’ve all been brilliant experiences and if I have time, I’ll try and type up all the notes I made to remember it all.


Even though I’m gregarious with new people, though, I’m quite introverted most of the time. I feel quite comfortable spending time alone, but sometimes I feel I isolate myself too much. I have lots of friends, but I want to be closer to some of them. In fact, one of my aims this year is to meet fewer people but to try and establish a closer bond with them.


I love reading, and sitting down with a good book is one of my favourite hobbies. I enjoy all forms of the written word, and have recently started to explore African literature, but from a very callow starting point. At the moment I’m enjoying Nigerian master Chinua Achebe’s ‘Things Fall Apart’. My favourite books include the hilarious ‘Vanity Fair’ by William Thackeray, Vikram Seth’s ‘A Suitable Boy’, a tale of partition and love in 1940s India and ‘The Woman in White’ by Wilkie Collins. Sweeping epics are my thing.


I have a passion for sport, though with my current body habitus I’m more of an armchair fan than an active participator. Cricket, cycling and football (or soccer) are my favourites, and I’m avidly following the European Championships in sunny Portugal.


Finally – medicine. It’s my degree subject and my future career, but I’ve lost the love I used to have for it. Where is the passion, where is the intensity, I ask?? Sometimes I am overwhelmed by how privileged I am to be a doctor in training, to be learning about the beauty of our bodies and acquiring the skills to help save lives, but this has recently dimmed. By reflecting upon what I have learned and conveying this in writing to you all I hope this passion will be rekindled; and for my readers, a medical student’s training is certainly never dull! I’ll keep you updated in the endeavours it takes to be the best doctor you can be, the latest medical advances and amazing bodily facts. One field I will probably discuss in depth is neuroscience. I love neuro. And this year I will have the opportunity to deepen my understanding of what we know about the intricacies and functional diversity of the brain, as I complete a Batchelor of Science in the subject. I hope I may even have the chance to personally contribute to our search for neuroscientific knowledge. It promises to be an exciting time of growth and discovery, and I’ll keep you all updated.


Once again, thank you for reading, and please feel free to leave comments.


Moc