Article Responses: June 2003

LETTERS
There are too many restrictions on medical students
      Aneel Bhangu (June 2003) [full text...]

Deborah White
(June 02, 2003)
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Michael Wilson
(June 09, 2003)
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LIFE
Shit Scared
      Ayesha Nunhuck (June 2003) [full text...]

Max Godfrey
(June 09, 2003)
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Jonathan Hasleton
(June 12th, 2003)
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LETTERS
Are attitudes towards learning changing?
      Kunal Hinduja (June 2003) [full text...]

Stephen J. Goldie
(June 16th, 2003)
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NEWS
UK medical schools may be forced to drop entrance standards
      Rhona MacDonald and Sîan Knight (October 2001) [full text...]

Verity Bradley
(June 18th, 2003)
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LIFE
Medical students and their faith - being a Hindu medic
      Sumita Kini (October 2002) [full text...]

Aarti Sarwal
(June 21st, 2003)
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NEWS
Woman of 46 wins place to study medicine
      Helen Barratt (October 2002) [full text...]

nujhat
(June 25th, 2003)
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LETTERS
There are too many restrictions on medical students
      Aneel Bhangu (June 2003) [full text...]
 

Deborah White (June 02, 2003)
      third year medical student, University of Aberdeen u08daw@abdn.ac.uk

I was shocked to read Bhangu's comment that to introduce yourself as a doctor when you are a medical student is "... another lesson in how things are done differently and not a lesson in deceit."

Introducing yourself as a doctor when you are not one is deceitful. It is also disrespectful and denies the patient any right to make an informed choice regarding their participation in your training.

I have been introduced as a doctor to a patient by one of my clinical teachers. I did not object at the time (as did none of the other eight students in my second year ward group), but was left wondering what this action meant for the patient and for the doctor-patient relationship.

If I had been that patient, I might have wondered why those wearing badges proclaiming themselves to be medical students were being introduced as doctors. I might have wondered why these "doctors" were so hestitant in their examination of the cardiovascular system. I might have wondered what else my doctor wasn't entirely telling me the truth about.

I fear for the ethical development of students who find deceitful behaviour justifiable in order to progress their training. We must all remember how we would feel if we were the patient.

LETTERS
There are too many restrictions on medical students
      Aneel Bhangu (June 2003) [full text...]
 

Michael Wilson(June 09, 2003)
      fourth year student, Dundee University m.r.wilson@dundee.ac.uk

In response to the article (above mentioned) I and many other students will have had a similar experience. To argue the point with the person that holds the ability to pass or fail you would be ethical but stupid. Identification of yourself as a student is an issue that is not easy. White coats are the symbol of the doctor. One consultant I was faced with refused to allow me to sit in on her clinic as I was not wearing one.'How are the patients going to know you from Adam?' On my way to the registrar's room where he was conducting the second half of the clinic I passed several people, including domestics, lab staff and plaster technicians wearing white coats. Most people now accept that white coats are a big source of infection -hence not allowed in HDU or ICU.

As for the the issue of students not being able to get experience in the teaching hospitals, I again totally agree with Aneel. I am at present in a word where written on the front of a patients notes is 'Medical student is not to read these notes or attend with patient in interviews' What happened to the old way of see one, do one, teach one? In my experience that was always the best method for teaching procedures. Now we can go all the way through medical school with out watching a child being born, plastering a broken leg or even taking blood.

I think this is all down to insurance. I am not sure if we have any, what it allows us to do or if anybody is willing to find out. I asked recently if I coud go out with our hospitals Trauma Team to witness how they work and because I was doing a project on them. One of the consultants asked if insurance would cover a student in this situation. I was told that the idea was laughed at.

In conclusion I think that medical students will never learn medicine until they are involved in the day to day running of the ward -like the nursing students. And if Joe public doesn't want to see a medical student in a teaching hospital which is 'free at the point of entry' then he can bogof to private healthcare and stop burdening the NHS with expectations that are not realistic for what he is paying for the service.

(sorry for the language)

LIFE
Shit Scared
      Ayesha Nunhuck (June 2003) [full text...]
 

Max Godfrey (June 09, 2003)
      fourth year medical student, UCL megodfrey@doctors.org.uk

I was very disappointed to read the following words in Ayesha Nunhuck's otherwise very interesting article: "...hatred of the Palestinians by the Israeli state manifested itself in desecration of a children's centre...". I don't blame the author, who may be faithfully repeating the words of the journalist quoted. However, are the editors of the studentBMJ really satisfied that the Israeli government (the ONLY democratically elected government in the middle east) has an institutional "hatred" of the average palestinian, or an official policy of smearing excrement on the walls of childrens' centres? If indeed this ever happened, surely it is the criminal action of an individual.

Whilst I appreciate that this is a STUDENT journal, and students tend towards the left wing, the unnecessary politicisation of medical issues (cf "Trauma surgery: Ballistic trauma" p.188 of the same issue: "from South Africa to Palestine, from Afghanistan to the United States..." - what's wrong with Liverpool and London?!)spoils an otherwise superb journal, and is surely best left to the tabloids.

The Middle East conflict is a complex situation, and, if it is to be covered for any reason by your journal, deserves a fairer and more mature treatment.

LIFE
Shit Scared
      Ayesha Nunhuck (June 2003) [full text...]
 

Jonathan Hasleton (June 12th, 2003)
      Final Year, University of Manchester jonathan@hasleton.com

It is tragic that Ayesha Nunhuck felt it necessary to hijack this article towards her own biased political end.

What is even more distressing is that the editor of the student bmj decided to offer her space in his journal to do this. Is it a coincidence that an editorial published in the BMJ this week suggests that medical editors need effective self regulation due to the the real threat of editorial misconduct? Neither the two clinicians associated with this article nor the editors of the student bmj themselves felt it necessary to check the references used for their validity or indeed their suitability.

Whilst I would not expect this article to be torn from the archives of the student bmj, I would expect a clarification of the political bias that has been perpetrated along with an assurance from the editors of the Student BMJ that they will do their utmost to ensure that their journal is not to be violated by those whose only aim is the perpetuation of hate under the guise of medical advancement.

Should the student BMJ also be asking their contributors if they have any competing interests?

LETTERS
Are attitudes towards learning changing?
      Kunal Hinduja (June 2003) [full text...]
 

Stephen J. Goldie (June 16th, 2003)
      4th Year Medical Student, University of Glasgow Stephen_Goldie@Hotmail.com

In response to the letter by Hinduja and Samuel [1] and their claims regarding apathetic PBL students, I think there are two or three more likely explanations for their results.

Firstly, PBL students will have been unimpressed by the exam revision session used as the incentive to fill out the questionnaire. As PBL students are continually working at a steady pace throughout the year, learning and consolidating their knowledge as they go, the thought of a one-hour cramming session would not appear beneficial in their eyes. I also note that the lecture based students were not offered the revision session: this nullifies any inferences made on the study as it was not carried out in the same conditions for both populations. Perhaps the thought of the revision session actually put the PBL students off completing the form.

Secondly, my experience of the 'New Curriculum' and perhaps university in general is that there seems to be a continual stream of pointless questionnaires slid under my nose. PBL students are not apathetic just bored of filling out forms.

This leads me onto my final point that PBL students are better able to manage their time and think for themselves with regards to what is important in their learning. The majority probably thought their time and efforts would be better spent elsewhere. Harsh but true.

Hinduja and Samuel do not mention in their letter what the point of the questionnaire study was; I assume it was not a deliberate attempt to discredit PBL students?

1. Hinduja K. and Samuel R. Are attitudes towards learning changing? Student BMJ 2003: 11: 211.

NEWS
UK medical schools may be forced to drop entrance standards
      Rhona MacDonald and SÎan Knight (October 2001) [full text...]
 

Verity Bradley (June 18th, 2003)
      6th form student, Skegness Grammar school brigidadowning@hotmail.com

I am a sixth-form student who has recently completed my A-S examinations and I have just embarked upon my A-level studies. The subjects I wish to study are Religious studies, Chemistry and Biology. In response to the article I would like to express my support for the idea of lowering the entry standards for medical schools.

I take enormous interest in my studies and always strive to fulfil and achieve my full potential. However I must add that I believe that this is not always possible. I feel that people need to fully understand the immense pressure students are put under with these constant examinations. I especially feel the the A-S exams cause more (and i emphasise) unnecessary pressure. Why can we not go back to the old A-level system which seemed to work well. I achieved high grades in my GCSE exams and I am predicted to do extremely well in my A-s levels. However contrary to what grades were predicted I believe that I will not achieve such grades. Not because i did not prepare for the exams( because I may assure you I did) but simply because I basically panicked on the day. One exam went wrong and I suffered in the following exams. I know that I should have kept confident for the rest of my exams but I shall tell you why I didn't:

Ever since I was about 8 years old I have dreamt of studying medicine. All my friends and family know that this is all i have ever wannted to do, this may sound cliched but 'I can't imagine doing anything else'. I will not feel as though I have fulfilled anything until I at least get accepted into medical school and am then able to work towards my dream. When I went into my first exam a few weeks ago and felt as though I had not performed to the best of my ability, my heart sank. All i thought about was that now I will not be able to be a doctor, I have no future, my dreams are shattered. However extreme I may sound this is exactly how I felt.

In conclusion, what I am really trying to say is that deep down even though I may not achieve the grades predicted in the summer I know, and my tutors know, that I am well capable of achieving them. And if one predicted A turns out to be one achieved B, should my whole future career plans be decided by one grade I failed to achieve?

LIFE
Medical students and their faith - being a Hindu medic
      Sumita Kini (October 2002) [full text...]
 

Aarti Sarwal (June 21th, 2003)
      MBBS,Govt. Medical college, Patiala, India aartisarwal@rediffmail.com

A very candid straight from the heart article .It doesn't apply only to Indian doctors brought up in another country say UK. With the outside world changing aka modernizing in leaps and bounds everyday, it's hard being an Indian in India these days. When you are far away from home at least you have the picture of the culture as a datum to base your views on, being here everything's that's around is culture and talks about what Indian ness is label you the desi brand. Yes, this is the hard core India in 2003 with the ever diminishing brand of Indian born confused desis.

The very fact that India has still a large number of RMPs ---registered medical practitioners earning handsomely at the cost of their patients in addition to the increasing numbers of medicos being churned out like potato chips from medical colleges scattered all over represents the obsession of Indian culture as a whole with health.

Why go beyond your home----a typical Indian household kitchen works full time as a pharmacy for alternative medicine. Sneeze while enjoying at an evening tea with the Chawla's, the gossip will start from using ginger tea for common cold and go on to haldi (turmeric) milk for fever. While you'll be left wondering about the effectiveness of bitter gourd and fenugreek juice for diabetes don't be surprised if Mrs. Chawla gives you a florid account of how her cousin diagnosed with "some bad brain cancer" was given only 3months to live by the doctor 4 years ago but is now into 4th year of med school thanks to the papaya roots prescribed by a learned man. Leave aside the classifieds of Dr. Mathur who has found an internationally patented recipe for all kind of cancers. Where's FDA?

Being a doctor in India is about wondering whether the mysterious fish ingestion cure for asthma or the Churna(powder of medicine)for epilepsy from the local Hakim/Vaid qualifies enough to be noted down as previous medical treatment. It's about wondering how illogical, absolutely preposterous remedies straight out of witch tales actually get patients cured. Wondering where does faith end and medical science start? Wondering whether they need to be compared in the same world or even in the same dimensions.

NEWS
Woman of 46 wins place to study medicine
      Helen Barratt (October 2002) [full text...]
 

nujhat (June 25th, 2003)
      final year, dubai medical college for women nujhat_m@hotmail.com

Having a mature student among those students who havnt reached that level of maturity is a learning experiance by itself. I have with me in my group ( study group formed by the administration of our college ) whom we would call a mature student. She is in her late forties /early fifties and she has the cutest and most adorable grand daughter i have ever seen. Her children are all studying medicine or have finished medicine with one of them being the most gifted surgeons i have had the pleasure to be with.

Being with her, we ( as in my friends and I) have learnt from her previous experiances with people and the funniest part would be that her daughter is a part of our clinical teaching staff and asks her if "mom" is attending properly of nodding off in the middle :) But most of i learnt that if there is the will there is always a way.She has had her degrees in law and polotical science and econimics :) but her heart set on medicine. And here she is in her final year with us doing her bits starting with anatomy, physiology to the parts of history and examination :)

Yet she has managed her children, her husband, her job and her grand children...