Genetic testing - Spend a little, save a lot...

So I was reading an article recently about the cost-effectiveness of genetic testing for those at predisposed risks of certain diseases. The cost per test is relatively small, yet no-one in the NHS seems to think this is the case. Surely it is much easier to treat for example hyperlipidemia if it is diagnosed earlier (i.e. manage with statins rather than have to treat a heart attack!).

A recent BBC documentary also looks at the viability of genetic testing. To me it seems rather short-sighted to just dismiss these tests purely on (very poor) financial reasoning. Perhaps it is the ethics of trying to look into the future and have influence over future generations. Who knows, we may even do more harm than good if we remove cofactors which are otherwise of evolutionary significance.

I guess the documentary left me with a single question - would I want to know if I am going to get a genetic disorder later on in life?

My answer is probably no, unless I can then take measures to reduce its effect on me or eliminate it all together.

It's been a while...

Sorry about the lack of posting for the last few weeks. It's the dreaded exams next week so you could say I've been pretty busy! I have learned one thing though - burning yourself out revising won't help.

Don't get me wrong, we do all need to work to pass these exams, it's just that we shouldn't have to kill ourselves with overnight stints to do it. What use will we be as doctors if we have to work overnight to figure out what is wrong with everyone? Not great doctors is my guess.

And while the academic stuff is important, I feel that the OSCE has to be a fairer system for doing things. That way, we're in realistic situations with (sometimes) realistic patients. That should separate the promising among us from the not so promising.

I guess I should probably just man up and get on with a night of cramming, but instead I think I'm just going to sit back with a beer watching the F1 qualifying highlights...



p.s. please feel free to leave comments or let me know what else you want me to blog about!

The apprentice is back!

Us Brits have been treated to a new double-header in the new series of the apprentice. Well with this bunch of mugs as the country's 'best business talent', it was no surprise the country dived into recession as the markets crashed.

It's a wonder any of them managed to arrive at the right place at the right time seeing as some of them don't even know what an orange is.

Then there are the ra-ra gap-yah? brigade. Not exactly my cup of tea. While I'm sure these posh boys and girls have done well working for daddies marketing firm, I doubt any of them could survive in a real job for long.

Infighting. I'm not sure if any of the contestants have worked out that the way to go far in the competition is to win the challenges. One-upmanship will not get your team constant wins.

I may seem as if I'm rambling but I genuinely feel I could do better - if I could be bothered.

The nursing shift!

As promised, I'll now give you an update on what the nursing shift was like.

Well to start with there was waking up at stupid o'clock in the morning (yes I got an early shift...). Once that was over with I just had to find the ward, and where the handover was taking place. A whistle-stop tour of all 24 patients later and off I was trailing the nurse who I was going to shadow and assist.

Thank goodness for nurses.

I never really appreciated all that their job entails until today. It's the simple things (such as the hourly observations) that just stack up and up on top of whatever else the doctors pile on them. Who needs what - and at what time? It also seems that most of the nurses are pharmacists. They dispense all of the medication, know who should be having how much of what, and getting it to the patients on time.

Then there are the not so pleasant jobs. Those jobs none of us would want to do. Clearing up bodily fluids from any orifice you wish to think of. Taking racist comments from elderly patients. Changing the catheters. All things which need to be done (particularly on a gastroenterology ward), but that everyone does their upmost to avoid.

No-one ever thinks about patients who get sick in jail. Well, they need hospital treatment just like anyone else, so there was a prisoner on the ward today presenting a new set of challenges. Such as what would the guard (who was handcuffed to him) do when he went for a scan.

You have to admire the sheer volume of work the nurses do on a daily routine, as well as the technical complexity of some of it (such as working the temperamental equipment). They've also got to be vigilant as to when a patient is deteriorating, and when they need to see a doctor.

 I've come out of this shift with a new appreciation for the profession. And I'm sure you won't hear me say 'but she's only a nurse' for a little while yet, until I'm qualified of course...

Back to halls

The inevitable end to the easter holidays are here. Unfortunately no matter how many bank holidays there are in April/May, we have to go back to uni. Not that I mind being back at uni, it's just the effort it takes to go back. Firstly, there's all the washing I bought back - surely I don't even own that many items of clothing, let alone need to haul them back up to london. Then there's the food shop, it's almost as if the family don't think there are shops in London.

This leaves me in a predicament. It is easiest to get back by train, but then I have to haul my worldly belongings across the tube. Or a coach, but there is only one per day and it leaves at 9am. So I take the only option left, a lift from the old man. A unique experience in which political correctness is left behind, and all of my dads innermost thoughts come out. I'm not exactly sure why they are saved for car trips, he could rant at any time. So an hour and a half later we arrive.

Do you know what? There is no way I would rather get back.

What do you mean there isn't a job?

After five, long, painful and very expensive years at medical school you hear the bad news; 'you haven't got a job'. Luckily we then wake up.

It seems this horror story may soon become a reality, in the UK at least. The UKFPO (UK foundation programme, which organises our first two jobs) has a surplus of students to F1 jobs. Oh dear. After the amount of money the government pays on training us, the effort we have all but in and five years of our lives, it seems we still might not get a job.

According to some this will remove the complacency in some doctors. If they're that complacent they wouldn't pass med school. That is the whole point of our constant assessments, to weed out those not competent to be a doctor. After passing our finals, the least of our worries should be finding a job. What with all the difficulties of the new job and all.

I feel this would be such a missed opportunity for the NHS, as very competent people have to miss the UK net, and jump abroad to find a job. Other countries are loving the prospect - free doctors. I think the only solution to this is to reduce the intake of medical students, because with the age of austerity we are in at the moment, I can't see a sudden increase in jobs any time soon...

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Thank goodness for France

Well thanks to an article uncovered in the guardian today, it seems as if the FFF (french football federation) were looking to impose a limit on players of the french national team by race. It seems the football hierarchy in France believe there are too many players of north african and arabic origins in the french game.

They intended on making this process very secretive, by limiting the intake into french football academies at the age of 12. This would 'level the playing field years later' according to a senior FFF figure. I am not only disgusted by these plans, I am also disgusted at the response of UEFA (the european governing body). They should place a complete ban on the France national team until this mess is sorted, and the guilty party removed.

If this racism was to seek into medicine, there would be an outcry, and rightly so. It is the diversity of doctors that gives the NHS its strength, and coming from a variety of backgrounds will help all members of the community be treated appropriately.

You may hear me slag off britain occasionally, but we will never be as racist as certain french people. For that, I am proud to be British.

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Student finances

We sit on our backsides, do nothing all day and leach money from the government and our family. Not exactly. Many of us find it difficult to support ourselves financially, what with finding a place to live, and not having enough time to get a job. It's not easy supporting an active social life on top of a very active education on such a shoe string budget. It's a shame that NHS grants are being dropped, especially for those greater in need.

And it's only going to get worse. What with trebling the tuition fees and all that. Never mind, I don't suppose the posh ministers want just anyone going to do a degree. I suppose this is their idea of making education more elitist than it already is.

So I'm at med school. To afford this I expect you think that my parents are fat cat CEOs, or doctors, or politicians. Wrong. One parent is an engineer who has been made redundant. The other is a carer (who thanks to local government cuts) has also been made redundant.

Despite the best intentions of those in charge, I managed to get in with a state education and none of 'daddies mates' promising me the work experience to get in. You see, if you really want something in life, you can get it (even if you do have to overcome obstacles in your way)...

The joys of technology

So we've been waiting over the easter break to find out where our hospital placements are when we go back. After a few weeks of waiting, we were told that the link to where we were going would be available on the 28th April - Today.

I check this morning - Nothing
I check this afternoon - Nothing
I check 5 mins ago - This link is not available to students...

Once again I am amazed by the poor communication, and poor implementation of the technology we have. A little technical knowledge can go a long way in making these things work.

Rant over.

Now for the good sides of technology... check out my other post!

The NHS makes it to YouTube

Well, it finally seems as if some parts of the NHS are truly modernising, they've now hit YouTube. With the latest communication to staff about avoiding MRSA being uploaded to that oh-so-popular video sharing site. There has been some questioning as to whether this was a good use of time and resources. If it reduces the spread of MRSA and C-Diff then they can do all the village people remakes they like. Check out the video embedded below.

They've now also done a second video, it seems the first must have been seen as a success then...

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Do we ever really get time off?

As a medical student, all we ever hear about is 'professionalism' and how we must act responsibly 24 hours a day, 7 days a week, 365 days a year. We're not even meant to get drunk once we qualify, as this could cloud our judgement if we are ever needed to help treat someone in public. This leads me to think if we will ever truly get time off to let our hair down again.

You could say that we should just head abroad on holiday with our hard earned money. We still don't get the time off. Have you ever heard an announcement on a plane asking if there's a doctor on board. We are obliged to answer the call for help, even if there is nothing we can do to help, or if it is just a simple vasovagal attack.

I suppose you could say we knew this when we signed up to the job. In fact, no-one mentions how you must live your life by these rules until about 6 weeks into the course. Thanks GMC, thanks a lot.

Actors at work

I've been watching the champions league semi final between Real Madrid and Barcelona, and the large amount of play-acting from the players. It has lead me into thinking how much we all act in our day to day jobs, and how I will inevitably act as a doctor.

I guess all empathising we do is a form of acting, putting ourselves in others shoes. In that respect there will be a lot of acting as a doctor. Then there is the acting all of us do, when communicating with worried relatives. We have to put on a reassuring face, even if we don't have any clue about what's going on.

So should these footballers be aloud to act up to the referee? It is their day job after all. No. Because they're being payed £50,000+ per week to do what they're doing, in comparison, us amateur dramatic doctors get paid a pittance.

Patients are now apparently 'consumers'

At what point did patients become just general 'consumers'? There used to be a unique bond between patients and their doctors, a level of two-way respect. Now, through the commercialisation of health, and the ever increasing red tape, patients are being labelled as 'consumers'. The definition of a consumer is 'a person who purchases goods or services for their own use'. Well I'm not sure about you, but I don't think many people buy a triple heart bypass or a bowel resection out of choice - it is a necessity.

This depersonalisation of patients will inevitably have its effects on the doctor-patient relationship. If patients believe they are just a number, they will perhaps hold back information which could be crucial to a diagnosis or treatment plan. Information that they would otherwise have shared.

I don't think doctors should act chummy and like best friends with patients, as this would cause further conflicts. But I do think that patients deserve to be treated as patients - not consumers...

Who's wedding?

I can't say that I particularly care about the royal wedding, or the royal family for that matter. At an estimated cost of £10 million, I wonder if that money could be better spent elsewhere. Lets start with the classic example - 5000 baby incubators. I don't know why that's always used as a benchmark, but we'll stick with it for now (it would also buy 334 doctors for a year, or 400 cancer operations - based on lower colon cancer surgery).

Is the royal family that important to us. I doubt they save as many lives. Then we have to factor in the £7.9 million cost per year just to keep the royal family afloat. We have a government to make all of the important decisions, so I can't really see the point of them other than for tourists to stand outside the palace hoping that they're inside it.

As for press coverage... would this time not be better spent with something entertaining or at least vaguely interesting. I can see why people would be interested if it was their own family or friends wedding, but that of an unknown stranger, doesn't seem that interesting to me.

Let me know what you think of it, whether you agree it is a waste of money, or if you think there is ab actual point to it...

iMedic with an iLife

What can I say, I'd be lost without my iPhone and my mac, and I know I'm not the only one. As med students, we find ourselves trying to juggle a hectic education with a just as hectic social life. You can't go far in the lecture hall without seeing one of us staring at the 3.5 inch screens of our iPhones, 10 inch screen of our iPads, or tapping away at our MacBooks.

They make everything seem so easy, so effortless and so efficient. They certainly make everything more easy to manage. And they don't look bad either. I've not always had a mac or an iPhone, I used to be more of a Windows man - but there's only so many times I could find documents wiped, unexpected errors stopping me working or random crashes.

There is of course the iPod. These are invaluable for us, whether it being playing music to allow us to relax, or listening to a lecture podcast on the train to make just a little bit more of the otherwise wasted time.

We could of course manage our degrees without iDevices, but what's the fun in that?

My first time in the dissection room...

Well, this was a little while ago, but the memory of it will last a lifetime. It was nothing like I had ever seen before. Two rows of cold metal tables along each side of the room. Each with a dead person, skinned from head to toe. Well it wasn't quite like that. We had a seemingly endless lecture about all of the health and safety red tape, and to prepare us for looking at a dead body for the very first time.

We finally descended to the DR (dissecting room) which was aptly on the basement level. Entering the room, it suddenly felt very cold (conditions have to be monitored to preserve the body). Once in our smaller groups we uncovered the bodies, very slowly, from the feet upwards. It actually took about 45 mins before we had finally uncovered the whole body.

To be honest, the whole thing was a little underwhelming. I'm not sure what I was expecting, but I found myself surprisingly comfortable about the whole thing. Where they are already skinned, I guess it is easier to see them as a separate being to us as they have a very distinctive look. We are all grateful for anyone donating their body to medical science, and I fell it would otherwise be near impossible to learn anatomy in a 3-d sense.

Before we knew it, it was the end of the session and I found myself spraying the body in formaldehyde (a preservative) before tucking the body back underneath it's towels to finish up the session. I feel this always gives great closure to the session, as once you have put the body away, it is easier then to forget about the bodies until next time...

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I'm now on facebook!

Hi guys,

Just a quick one here to let you know I'm now on facebook! So take a look and get liking!

ConDems kill off excellence in the NHS

Well thank you Mr Cameron, Mr Clegg and Mr Lansley. Thanks to your wonderful NHS reforms, the second best paediatric cardiac unit in the country is being threatened with closure. The unit in Southampton shows the excellence that can be found within the NHS, and Dr. Roman's unit has made a profound effect in lengthening and increasing the quality of many children's lives.

I wonder how the three men previously mentioned would feel if their son or daughter needed emergency treatment for a life-threatening cardiac condition. I'm sure they would just pay for it privately I guess. But for those of us that don't have that as an option, the closure of the unit will have larger effects. If this is what they want to do to a unit that is performing well, what do they have in store for 'under-performing units'?

At least the treatment will still be available to the kids who need it most, although they will have doubled waiting times and have to travel to London for it. I'm sure that will make things easier for the parents who will be worried out of their minds about their sick child.

This go's to show that health isn't just about spreadsheets, figures and percentages, it's about the care of sick people and improving the health of a nation. Why is it still ok for firms oweing us millions of pounds in tax escape while vital services are being cut? I think it's time for the ConDems to start getting their priorities right before we end up with a rather disgruntled nation, who's much loved public services have disappeared.

If you want to make a difference, pester your local MP with letters/emails on the subject until they listen.

Also check out my other posts, and sign up to follow me on Twitter

• Too much choice is bad for health
• Amateur transplants
• Make the most of the sun
• Japan earthquake - was medicine ready?

Too much choice is bad for health

The past 15 years have seen the issue of patient choice being highlighted in the mass media as a positive way forward for the NHS. The Labour Party used it as a key point in their manifesto for the election in 1997, when Tony Blair was elected. It is also mentioned as part of the reform of the NHS currently being reviewed in the House of Commons - although many just see it as a cover up for the proposed cuts.

Patient autonomy is surely a good thing for patients; it allows them to make reasoned decisions for themselves. Well, this might be great for medical ethics, but the majority of patients don’t have an expert knowledge of how their bodies work and the effect of treatments upon it. Would it not make sense to have the doctor, who has been put through a great deal of training and has much more experience of these situations make the choice for them?

How can our patients be expected to read, understand and weigh-up the pros and cons of the medical literature regarding their illness? Thanks to the rise of the internet there is a mountain of information on health accessible to the masses, but often they do not have the skills to critically appraise the data and studies they find. Knowledge without understanding is dangerous, as it can lead us to make poor decisions with confidence.

Many patients are unlikely to even find the information they need to make an informed decision. There is an accessible and easy to use site called NHS choices. But first consider that a large proportion of patients that require medical care are elderly, and 60% of over-65’s have never accessed the internet in their lives. This makes their job of assessing how and where they would like to be treated a great deal more difficult.

As far as the tax payer is concerned, it makes no sense to pay a great deal of money to train doctors if they are no longer going to make decisions. Undoubtedly it would be much cheaper to have a nurse hand them a leaflet about each treatment. But why isn’t this happening already? Because the lay person needs an expert opinion, and they don’t want to make a potentially fatal mistake.

Furthermore, a doctor is able to take a much more objective view on the situation, removing as much emotion from the decision as possible. Sometimes the best treatment is not always the most obvious, or one which the patient would ever decide upon.

Of course, all patients will decide that they want the gold standard treatment. Looking at the current NHS budget restrictions, it hardly seems financially viable for every patient to receive the very best (and usually most expensive) care. Rationing of services to those who need it most and will get most benefit is what differentiates the NHS from private healthcare providers, and allows the service to remain free at point of access for everyone - one of Bevans underlying principles of the post war health system.

Then we come to choice over primary care services. GPs are distributed to make sure that there are enough doctors per area, and to meet the needs of the local population. If patients start to choose exactly which GP they see and where, this will undermine the whole system that was put in place. This would inevitably lead to greater waiting times, which can’t be good for the health of the local population.

Waiting times are likely to increase...

An increase in waiting times isn’t exclusive to primary care. As patients get increased choice over where they are treated, the newer, nicer looking hospitals with a good reputation will suffer from exponential growth in lengths of their waiting times. Resources are carefully planned so they will meet the needs of the local population. If people start flocking to certain hospitals from further away, the provision of care will no longer be evenly spread, leading to a distortion to the care that patients receive.

Should everyone be allowed choice over their own health care? Surely some people will be more competent than others. Without a way of distinguishing between these levels of competence, we cannot vary the choices we give to patients. It would be very dangerous to start giving everyone control of their own care, but we can’t deny everyone on the basis that some people aren’t competent either.

Having control over our own care does make the majority of people happy as they have control over that area of their lives. However, I’m not sure this is for the benefit of their health, and is instead a concept used to win over a few extra votes for whichever political party wants to flaunt it. 

Amateur Transplants

Here is the first video that I've posted on the blog. It's by a comedy duo called the Amateur Transplants. They are based here in the UK, and sing a number of cover songs with medical themes. They always make me laugh, I hope you'll find them funny too. This one is about the role of an anaesthetist. Enjoy!

Also check out their website here. Hopefully you'll enjoy their other songs too. Their album 'unfit to practice' is highly recommended. Check out some of my other posts using the links on the right hand side.

Make the most of the sun

As all of us in the UK will know, there is a great danger of getting more than a little tanned in the weather we've got at the moment. Most of us are aware of the links between UV exposure and skin cancer. Less of us are aware that we need the rays from the sun to synthesise vitamin D.

Without adequate sunlight, we will not synthesise enough vitamin D. This could lead to Rickets and Osteomalacia (a bone thinning disorder). It is therefore recommended that you don't cover yourself i sunblock straight away this bank holiday, but instead give your skin 20 mins or so to absorb enough UV to get yourself producing that vitamin D.

Check out these other posts, and follow the blog if you're interested

• Japan earthquake - was medicine ready?
• The horrors that await
• First OSCE
• NHS reforms
• Freshers week

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Japan earthquake - was medicine ready?

2.46pm 11th March 2011. The time in which thousands of Japanese peoples lives drastically altered forever. The question is, was Japan ready for the sudden medical needs of a population rocked by an earthquake of such large a magnitude? And do leading world politicians have an obligation to provide help? It also leaves the question of whether there is a place for emergency medicine as an elective for UK students. Firstly we must look at how to deal with, as prime minister Naoto Kan put it Japans ‘worst crisis since the war’.

It is not the first time Japan has been hit by such ground breaking tremors. The Kobe earthquake of 1995 killed 6,433 people, and that only had a magnitude of 7.2, in contrast to this months which reached 8.8. The crucial difference between the two earthquakes can be observed in the succeeding tsunami of the second quake washing away any hope of a quick recovery. So far, over 10,000 people have been confirmed dead with a further 17,440 people missing and with half a million people still homeless, medics have their work cut out in keeping the medical surge at bay.

There is then, of course, the unprecedented threat of radiation escaping from Fukushima nuclear plant, possibly burdening a generation of Japanese doctors with the aftermath of disease caused by the nuclear fallout. Iodine-131 will cause cancer within a few year if ingested or inhaled. If the Iodine-131 does escape, oncologists will be overawed with new challenges for decades to come. 

Prophylactic measures have already been taken for those in high risk areas. Previously, the Japanese government had stockpiled potassium iodide pills for this eventuality. These are in limited supply though, and are only being distributed to those at greatest risk. 

Furthermore, help is being received from the British government which has deployed 63 ‘relief specialists’ to help with the search and rescue across Japan. The problem is, according to the BBC, only 4 of these people are doctors. With an estimated 20,000 injuries, are such a small number of specialists able to even begin to scratch the surface in helping this small but hugely significant country recover?

International financial support is no doubt evident, with close neighbour China providing $4.5 million worth of humanitarian aid. Moreover even countries with their own political and economic problems have jumped at the opportunity to support Japan, with Afghanistan pledging $50,000 to support relief efforts. It seems the nation described by the UN as ‘generous in its support to others’ is reaping the benefits of its past generosity. The main problem is that there are simply not enough medics and nurses to administer the medical supplies which are arriving. 

This opens the debate of whether it is feasible to create electives in disaster medicine to support the currently minuscule specialty of disaster medicine. Many physicians offer assistance in these situations, but are they equipped to deal with the situation? Although no specialist in disaster medicine ever wants to use their knowledge to its full potential, disasters will always occur. 

Disaster consultants do have a role in preparing countries such as Japan for these situations. Without their work, the damage would have been significantly larger. Thanks to their work, Japanese people are in a constant state of preparation for ‘the big one’.   Everyone knows what to do should the earthquake alarm go off, and with thanks to ingenious engineering, they can cope with smaller quakes. It was not possible to have foreseen and prepared for the tsunami in the same way though, due to our lack of knowledge on how they work.

The specialty of disaster medicine is a competitive one, and with UK medical students finding it difficult to gain experience through electives, maybe it could be introduced as a BSc. This would allow students to get a grasp of the specialty, and gain experience in what is often an inaccessible branch of medicine.

Then again, it is an inaccessible specialty for a reason. In a world where AIDs is killing 1.8 million people per year (2009 figures published by UNAIDS), is it justifiable to increase spending on what an epidemiologically insignificant cause of death? Although everyone has sympathy for Japan and all loss of life is significant, it makes you wonder whether there are bigger fish to fry first.


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• The horrors that await
  
• The first OSCE
  
• NHS reforms
  
• Freshers week

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The horrors that await

When I start back at uni after easter, I have the one thing that all of us are dreading - the first nursing shift. I'm envisaging 8 hours of hell, having to clear up other people and do all the jobs that the real nurses don't want to do.


Don't get me wrong, I think the nurses do a great job, and without them hospitals would stop to function pretty quickly. I don't think they are paid well enough for doing the things that are expected of them, and it not something I could envisage doing on a daily basis.


To make things worse, I have possibly the worst ward to be a nurse on - the GI ward. Not general infantry, but instead gastrointestinal. Basically I'll be looking after people with stomach and gut problems, looks like I'll be clearing things up from both ends then. 


Still, it will give us an insight into how hospitals work. I expect to find that the nurses are the workhorses of the ward, being carers, communicators, organisers, cleaners and taking regular observations of the patients. All whilst maintaining a smile and dealing with the 'banter' that is dished out by some of the patients. 


I'll update you on how it went, once I've done it. Follow the blog using the google followers link on the right hand side to find out how I get on!

I'm now on twitter!

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The first OSCE

Well that must have been the most terrifying thing I have ever done as a student, my first OSCE. For those of you that aren't medics, it's the practical exam that tests us on how we interact with patients, and get tested on examining mock patients. I would even go as far to say that the idea of it was even more intimidating than the interview that got me here in the first place. 


I had visions before of me making inappropriate remarks to the examiner, whilst I nervously laughed my way to failing. Instead, the whole thing was rather unremarkable, once I was able to slip into pretend doctor mode, the whole experience was less threatening than an average day in uni, it was even nearly enjoyable.


After an unsuccessful attempt at taking blood pressure (I saw the examiner giving me a 0 for the reading I got...) the rest of the stations involved basic life support, gaining consent and pointing out some basic surface anatomy. I would even go as far to say that it was nearly enjoyable to actually put into practice the skills I'd been learning for the previous few months.


I guess at the end of the day, this was the reason that we all joined med school, to do the jobs that doctors do. None of us really joined for the endless sleep-inducing lectures on the endocrine system or to learn so many anatomical names that we'd become fluent in latin. We joined to become doctors, and this gave us our first real taste.


For your information, I passed the OSCE in the top quarter of students, not that I'm bragging...


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The NHS reforms

I would like to have a bit of a rant and publish my disgust at the proposed health reforms in the UK. Firstly, it has been sprung upon us despite both the conservative and liberal democrats stating in their manifestos that there would be no major shake-up of the NHS. Secondly, how did they pick out GP's (family doctors to those readers in the US) as the ultimate controllers of the complete budget? They have no experience in managing budgets of this magnitude, and no real desire to either.


Then we come to the main aim of the conservatives - privatisation of the NHS. They want to promote competition, which will end up in parts of the health service being sold of to the highest bidder. Farewell to patient care coming first then. Furthermore, the cuts in doctors, nurses and beds can hardly be the way for the country to deal with an ageing population, and the demands that come with it.


I welcome the pause for consultation in the progress of these reforms, I just hope that they actually listen to what people have to say.

Freshers week - a retrospective look from someone with a liver in recovery

What can I say about freshers week? Well, it was a fortnight to begin with. A riot of introductory lectures, signing up to every society and sports team under the sun, awkward introductions to people you don't know, generally getting lost, buying fancy dress, getting drunk in fancy dress, stumbling back to halls in fancy dress with the new love of your life (ok, I made the last one up).


I have to say it was one of the most enjoyable two weeks of my life, even if my bank account did take a bit of a hit. It was a great way to introduce yourself and get to know the people that you will be spending a great proportion of the next 5 years with. Not that we all made a great first impression. Let's just leave it that one person spent their first night of university outside of the door of their flat, curled up in the foetal position with a number of fosters cans dotted around, some full, some not so full...


Well, we all survived the mayhem that was the first fortnight, even if our livers are now paying the price. And I can confirm a common thought about medical students - none of us are able to dance.

The first post...

Hello everyone,


I guess you're reading this because you have an interest in medicine, education or are just bored. Hopefully I won't rant on too much, as overall, life as a med student isn't all bad (no matter how much I moan). I'm not a professional journalist, nor am I a professional blogger, so please don't slate my work too much. If you've got any questions or topics you'd like me to blog on leave me a comment and I'll see what I can do.