To help with this, a computer program has been developed at the Central Florida College of Medicine, which enables medical students to experience one of the most daunting responsibilities of their new jobs before employment.  Named “MySpaceCase”, which is clearly a poor attempt to paraphrase MySpace.com, so the hip generation will identify with it… FAIL  This technology allows students to be placed on-call at the whim of virtual patients, any one of which can present at any time during the night with a complaint ranging from a productive cough to a full on cardiac arrest.  Additional real life factors like team management, time pressure and angry family members who need to be calmed down (sedation should do it), ensures the students receive a rounded on-call experience to develop the skills they will need on the ward (www.drtribe.com).

So what are the  main benefits of being “Player1” in this game, other than the great amusement of the faculty staff.  Firstly, it may slightly alleviate the first time nerves when it’s for real.  Secondly, it should greatly improve the students problem solving capabilities under pressure as well as during the night (we only go to school during daylight).  Most importantly, it will provide the students with an opportunity to develop coping strategies for working with fatigue.  Tired Dr’s make more mistakes.

For instance, the NHS released data on an approx 6% increase in death rates which correlates to the first Wednesday in August each year… The time when there’s a fresh intake of Junior Doctors.  Similar studies have been carried out in the USA and have reached the same outcome (  Obviously, they have deemed it a phenomenon which requires further investigation as this avoids pinning the blame on new medics.  However, if this is the case and there are more deaths as a direct result of a fresh batch of sleepy inexperience, then any learning tool which can provide an insight into the unknown would be most welcome (Dr Jen et al)

More info at:  http://www.nhs.uk/news/2009/09September/Pages/Rise-in-deaths-linked-to-new-doctors.aspx

For the past few weeks just before the snow started I’ve been regularly popping down to the Jubilee and New Course in St Andrews to get good use out of my links ticket.  I popped on the base layer, t-shirt and an outer layer and give the starter a fright as I’m the first guy he’s seen all day.  He gives me a strange look as I take the scorecard and head for the first tee with a parting comment of “you’ll end up with the flu son”.  Hmmm, an empty golf course and an infection that’s passed from person to person… Sounds safe to me.  However I should get the last laugh as it’s cold and my first tee shot could very well hit the starter’s box

I don’t get the fuss about the temperature though, it was around 3-4 degrees, which felt about 0.  As long as your dressed correctly it’s all good, and you have the added bonus of an empty course in St Andrews which is a rare privilege.

Also, I had to resist the temptation to jump over the small wall onto the old course and play the middle 6 of that; I suppose I will save that treat for a summers day in 2010 before the Open takes over the town.

It’s a great moment when things just come together.  I’ve seen it happen to other people in many walks of life as well as St Andrews; I enjoy watching people in my class gain a sudden confidence when they realise they have what it takes to deal with a medical situation without previous practice.  The flood of lectures in second year have recently resulted in a massive increase in understanding of my Big Picture.  This culminated in a really cool ward round where I conducted two patient histories and a respiratory examination with confidence.  It was nice not being “tall and quiet” on a ward round for a change.

Even though I (we all) complain about some of the lectures and their relevance to real life, my confidence in the teaching methods of my lecturers are regularly restored through moments like this.

P.S.  I’ve placed my say in the suggestion box for teaching to take the form of the above picture

I thought I would end the long break from blogging with a topic that is regularly in my thoughts… the topic of body bequeathal, a subject that is still taboo in modern society; mainly due to religion and media scaremongering.

The procurement of bodies to meet the demand of medical schools who teach anatomy via dissection is a demand that has until recent years outstripped supply.  Nowadays, due to the Anatomy Act of 1984 and subsequent updates, medical students have the opportunity to gain anatomical knowledge directly from a cadaver rather than a drawing from Grays Anatomy.

I believe this to have the following advantages:

• Gives the student a real 3-D interpretation of the human body
• Visual representations of disease processes
• Introduces students to the concept of patient death early in their career
• Book illustrations show things spaced out for ease of understanding, but inside the body things are unbelievably “jam packed” …  Takes the wonder out of why cancer growth kills
• Gives medical students a real picture of lifestyle factors in health

Back in the 1800’s, cadavers could only be attained by waiting for someone to visit the gallows as their punishment for murder (Murder Act 1752).  Two problems here… not a lot of hangings and virtually no women (I’ve been told some of their anatomy is different).  Therefore the students were only getting part of the picture; the result is  a generalised approach to all medicine as well as treating men and women as a similar entity (when we all know women are weird).  As cadavers became more accessible, medicine, especially surgery began to become more scientifically accurate.  This has lead to doctors being able to tell the abnormal from the normal with great accuracy.  Can you imagine a doctor without a superb anatomical knowledge trying to read an MRI scan… “Diagnosis… erm, dunno, there’s a big thing in the middle”

Digressing slightly, to further illustrate the benefit of the current situation, I would direct you to the TV show “A Necessary Evil,” where the story of “Burke and Hare” was explored.  These two guys made a small fortune by supplying bodies to an Edinburgh Medical School to meet the demand of its head Anatomist Dr Robert Knox in the 1820’s.  Little did Knox know (or did he?) that these “likely lads” were grave robbing to keep their customer happy… Until they realised it would be quicker and easier to just Murder people, hence more money and a fresher corpse.  However, I think they only got away with killing 17 because they were “cleaning the streets” in those times.

Essentially, donating your body to medicine means that you can teach the living how to save the dying once you’re dead.  I can say for sure that the cadaver’s I’ve learned from in my first 18 months as a medical student have provided me with knowledge that will outstrip any book or lecture series in the world.  So I say to the people who intend to donate their bodies, “you can rest in peace knowing that it’s almost certain you will contribute to saving a life (or many) in the future.”

Therefore it is my opinion that body bequeathal basically lays the first stone in a huge foundation of anatomical knowledge for an aspiring physician.

Ref:  Garment et al, Let the Dead Teach the Living: The Rise of Body Bequeathal in 20th-Century America, Academic medicine, Oct 2007, Volume 82 – Issue 10 – pp 1000-1005

http://www.youtube.com/watch?v=03OPcn80Uzs

Befroe any lobbying peer groups get on my case, drink driving is not a funny matter and I don’t encourage it………… but I nearly peed myself watching this:)

Enjoy

600m above Lysefjord

As far as my summer holidays have been concerned, Norway wasn’t at the top of my list…. I’d invisaged Japan or Brazil or something crazy like that:-)

I’m currently on an island called Idse on the SW coast of Norway (near Stavanger) where I’m 30 minutes drive from the nearest shop.  My girlfriends parents own a christmas tree farm which runs into a sizeable amount of acres where they also grow their own fruit and veg.  If any other provisions are needed they just hop to one of the other nearby farms and they can lay their hands on eggs, strawberries, milk etc…  All they’re missing is a feudal overlord

Even though I’ve been working hard with physical training so I can keep up with the kids at sport next semester, it’s turned out to be the best break in years.  I’ve been able to train in the baking heat with an extraordinary view of the local mountains and fjords.  My daily activities incorporate things I’ve never done before, these include Sailing a small speedboat and strangely enough, painting the outside of a wooden house (yip a house).

However, my parents have just arrived to stay with us and get to know Suzanne’s parents more closely (lol, possibly to arrange my marriage); it’s like running after children as the two dads get drunk and the mothers look through old photo albums while looking on disapprovingly.   Luckily I have a night off tomorrow when the “young ones” go for a grill party at a log cabin by the fjord, where Suzanne’s brother and his friends will delight in trying to do what they failed to do a couple of years back……. Get me hidiously drunk….. I’m a light-weight, but when someone tries to get me wasted, my liver (alcohol dehydrogenase) kicks into overdrive and just says no.

I think I can imagine building a house on this land with Suzanne and retiring to a Norwegian country GP practice; the relaxing life has too much of a call to ignore, with the prospect of golf and sailing to whisk the hours away. After my experience in St Andrews I think the most refreshing thing about Idse is that they are “better off” than the snooty kids in St Andrews but don’t act like superior beings, just because they don’t have to pay their own bills.   Anyway, only a few days left here before I’m back to the busy roads and crazy worlds of my siblings and their many children:)  The only refuge is I have another week off and a few games of golf arranged, surely I’ll win one:-P

Should we give up our cars?

Due to the expensive nature of studying in St Andrews I’ve recently been forced to sell my car and start using the bus as my main mode of transportation.  When I foresaw this moment I didn’t imagine it would be too bad; after all, the government has been praising the money it’s been putting into correcting the previous flaws of the public transportation system and how it cuts back on carbon emmisions.  

Well it’s been a week now and I was so irritated by the first experience I think I’ll prefer to stay in the house…… here’s why.

1.  I had to attend a training session 5 miles outside the centre of Aberdeen, so like a good eco-warrior I got on the bus and proceeded to tour around half the industrial estates in Aberdeen picking up any stragglers who had to work late.  Hence adding 30 minutes onto a 7 minute car journey.

2.  After spending years travelling by car it can be pretty disconcerting belting along a country road on a bus at 50 mph without a seatbelt in sight…… it’s mental!!!!!

3.  The journey cost me £5 return which is fucking rediculous….. ignoring insurance, tax and MOT costs, the car journey would have been £3.

4.  The bus stop was at least 10 minutes walk from my destination.

5.  I had an hours wait for the “hourly” service I just missed, so while I waited every “arsewipe from the place where someone moved a rock on tracksuit hill” drove past in his Corsa (1.1L engine with a loud exhaust!!!!!!!) and tried to stare me out.  “Look where your going, knob.”   I kept imagining a cow landing in-front of him while he wasn’t looking:-)  Nothing against cows, although I do fancy a steak……. would also cut some carbon emmisions via the “backside Methane.”

So overall, including the wait for the return service I spent an extra 2 hours on the bus than I would have in the car.  What makes it worse is that I only trained for 2 hours so not worth it.  Anyway, I’d better stop blogging and get on with reading the latest autotrader…….. can’t keep this up for long.

Due to the exam setup in the Medical School we have another midterm exam on the 13th April.  Although this format allows us to scrub 100 marks off the final end of semester exam, it does mean I have to sit indoors studying when the weather has been glorius this week.  Also, shifting the equilibrium towards study is the fact that I am sooooooo far behind this semester as the course stepped up a gear as well as me attending several nights out, two stag nights (one a weekend abroad) and a wedding.  All of this meant I missed a lot of classes; if you miss a class that lasts an hour you have to spend two hours catching up…… that’s my theory. 

So while sitting at the PC procrastinating, I’m having a little rant as I want to play sport outdoors but I have the whole of muscle physiology, Pharmacology, Metabolism and not to mention the anatomy of the entire upper and lower limbs.

Suppose I’d better get started and overcome this idiopathic apathy:-(

Looks like the teachers at Sunday Schools around the world were correct when they said, “interferin with yersel is the devils work.”  Why, well research recently completed at the University of Nottingham has shown a correlation between excessive sex or masturbation in 20-40 year old men and the development of prostate cancer in later life.  

Medical and personal histories were taken from both 431 men who developed prostate cancer and 409 control subjects without prostate cancer.  Among the men who developed cancer, 34% had masturbated frequently in their 20′s and 30′s compared to 24% in the control group.

The statistical link is supported by the theory that prostate cancer cells seem to be fuelled by excessive sex hormones that can also result in a high sex drive, hence possibly linking a high sex drive with a need to release that sex drive and prostate cancer.

However, after consulting my old Sunday School teacher, further research may need to be done on whether the guy gets prostate cancer before he goes blind:-) 

Other findings:

• 59 percent of the men in both groups said that they had engaged in sexual activity (Sex or Self-love) 12 times a month or more in their 20s.  This fell steadily as they got older, to 48 percent in their 30s, 28 percent in their forties and 13 percent in their 50s.
• 39 percent of the cancer group had had six female partners or more, compared with 31 percent of the control group.
• Men with prostate cancer were more likely to have had a sexually transmitted disease than those without prostate cancer.

Source: Dimitropoulou et al; sexual activity and prostate cancer risk in men diagnosed at a younger age; Brittish Journal of Urology; Jan issue 1 (p178-185)

The OSPE (Objective Structured Practical Examination) began by observing  the faces of the 9am cohort; similar to knowing the score of a football match by looking at the sullen faces of the supporters, thankfully by this marker things looked OK.  I started at station 5 of 6 and jumped straight into the anatomy of the back by pointing out the muscle groups and spinal cord features on the cadaver.  Station 6 was history taking where I did everything but hug the woman with the sore ankle as she was a dynamite actress:-)  Also, I finished the interview the second the bell went, impeccable timing.  Blood pressure was at station 1 and thanks to the professor who reminded me to use alcohol gel so I didn’t fail.  

Then came the two freebies wonderful Bute Lecturers gave us in station 2 & 3 which were Eportfolio and hand washing respectively.  Finally I finished with CPR……….. this one was quite funny as when I completed my first CPR cycle I stopped and said….. “I’d continue this until help arr…” when the lecturer interupted and said “oh, please do continue.”  So a little more tiring than I expected:-)

Overall I think the Bute just wanted everyone to pass the first one as it’s more hassle than it’s worth to reassess a load of hungover students:-)