Students stuck in medical school for seven years? - Amazon Web ...

New 2013 FY exams
Aademic quartile rankings
and white space
questions scrapped in favour
of new assessment
methods
Page 4
Bart’s students to be among the
first to pilot new scheme
Neha Pathak
In six months, the Medical School
Council will be voting on new proposals
that will rob students of their
freedom. The course will be effectively
extended to seven years, with students
being forced to complete their
first year as a doctor at their current
medical school. This complete overhaul
of the foundation programme
could be piloted as soon as 2016.
Currently, medical students apply
for a two-year post during their final
year at medical school with the choice
of any deanery in the UK. Under the
Will tuition fees kill
the modern doctor?
Alex Isted examines the
long-term impact of rising
tuition fees on access to
medicine
Page 8
new proposals, the national programme
for foundation year one (FY1) would
be scrapped. Instead students would
compete within their medical school
for affiliated posts within a designated
area. Foundation year two (FY2)
would require a separate application.
In 2008, the ‘Tooke Report’ was published
in response to an apparent failure
of the system to adequately train junior
doctors and guarantee jobs. It strongly
criticised the government’s approach to
Modernising Medical Careers and was
met with widespread support from the
medical community. The new proposal
is based on its recommendation to ‘uncouple’
the foundation years so that FY1
NHS reforms
is linked to medical schools while FY2
merges with subsequent ‘core training.’
Potential advantages of the newly
proposed system would include
guaranteed foundation posts and improved
patient care by training new
graduates in familiar hospitals. On
the other hand, it commits students to
working in a particular region upon
medical school entry thus removing
the choice that makes medicine
an attractive career for many people.
One shocked first-year student,
who wished to remain unnamed,
said, “I can’t believe we haven’t been
told about decisions that could imprison
us within the system, the city
David Fisher warns that
the newly devised GP consortium
may be doomed
to failure due to rash government
decisions
Page 10
the
medicalstudent
The voice of London’s Medical Students
Students stuck in medical
school for seven years?
and the institution. With friends and
family outside of London, I don’t
want to delay life by another year.”
Professor Roberts, Dean for Students
at Barts & The London, supports
the idea - “we would prefer a
system whereby the medical school
would have responsibility for the FY1
year. The reasons why you choose a
medical school in London still stand.
One year won’t make a difference.”
However he admits, “This is prolonging
the course by a further year.” Combined
with a near-mandatory BSc, medical
school could take up to seven years.
Sadly, the Medical School Council
was unavailable for comment.
Student protests
Were the protests student
activism at its best,
or simply an excuse for
mindless anarchy? Follow
the debate
Page 11
Features
Culture
Doctors’ Mess
February 2011
Dean prioritises students
in foundation programme
shakeup Page 6
The Wellcome collection.
A destination for the incurably
curious Page 12
The alternative means of
intoxication the cool(?)
kids are into Page 14

2
News
Hannes Hagson
GKT MedSoc VP
Greetings all! South of the river everyone
is hard back at work and working
hard at play after a (for most) not
very long Christmas break. At the time
of writing we are in the midst of that
oldest of traditions - RAG Week (January
28th to February 4th). As always it
is looking like it will be a great week
filled with early mornings, late nights,
snakebite and RAGging (whichever
kind you prefer). There will also be a
RAG Jailbreak on March 5th which I
would recommend everyone to check
out! The end of January also saw this
year’s MedSoc Musical Theatre production:
‘The Little Shop of Horrors’
(interview found on page 13). March
8th is a date to remember as it is the
date of the KCL Fashion Show. It takes
Laura Brenner
BL
It’s been a crazily busy start to the New
Year here at BLSA. With several big
projects on the go we’re looking well
on the way to vastly improving our
facilities. After many months (and in
reality…years!) of planning and lobbying,
we look set to secure funding
for our beloved Griffinn Bar in Whitechapel!
In much need of some refurbishment
and TLC;; work is planned
to start in the last term with an aim to
be ready for Freshers 2011 and will include
a brand new food service area
and reception (not forgetting the bar).
We’ve had some excellent events recently
including our infamous Toga and
Tequila night and an incredibly successful
BL Panto of Cinderella (complete
with Ugly Sisters from GKT, Imperial
and UCL!). Up next are our most excellent
BLAS Cultural Show and RAG
Fashion show at Fabric which are set to
draw in a massive crowd hoping to catch
Luke Turner
SGUL
What a start to the academic year. After
a wildly successful ‘Freshers Fortnight’
we thought: was it time to chill
out and settle into everyday University
life? Wrong! We took part in the
NUS marches against tuition fees, we
witnessed medical students become
engaged in public demonstrations, disproving
the “political apathy” that student
groups have apparently come to
expect of us. Whilst all of this was going
on, it was still business as usual at
George’s. We saw our medics Revue “3
star sell out” Edinburgh show. Soon after
this we saw Diwali show and Fashion
show, raising £1,230 and £5,760
respectively. SGUL Isoc brought us
an incredibly successful Charity week
raising an impressive £10,369 for Islamic
relief. By Christmas, Revue
were back again with their incred-
place at the Hoxton Pony in Shoreditch
and all money raised goes to RAG. A
truly must-attend event. On the 16th of
April all GKT medics halfway through
their degree have something else to look
forward to: The Halfway Dinner. It will
take place in the Wren Room at The
Grange, St Paul’s, and should be one of
the great highlights of the year. ‘Golly!’
I hear you say, ‘where can I find out
a glimpse of some honed and toned BL
Fitties all in the name of charity. We’re
also running our first ever ‘Bart’s Got
Talent’ on the 11th Feb which showcases
some amazing BL talent…
along with some of our more unique
skills. Definitely not to be missed!
Sadly, our wonderful Warden, Sir
Nicholas Wright will be leaving us in
the summer. After ten incredibly successful
years here at BL, he has won
ible seasonal show “the GleeMC.”
On the sports front we have been
holding our own with an undefeated
title for our women’s rugby
team and a great a start to the year
for our women’s boat club Fresher
VIII, taking the Alom cup title.
So what is next? Well a huge RAG
fortnight is around the corner packed
with events, both old and new. If
“We are in the midst
of that oldest of traditions:
RAG week.
As always it is looking
like it wil be a
great week filled with
early mornings, late
nights, snakebit and
ragging”
more?’ – it’s easy: just search for ‘GKT
Halfway Dinner 2011’ on Facebook or
if you’re one of those individuals with
“too much integrity” for social networking,
simply get in contact with
one of us at MedSoc and we’ll let you
know all you need to know. For now,
that is all, and thus I shall simply leave
you by saying: See you in Guy’s Bar .
“Sadly, our wonderful
Warden, Sir Nicholas
Wright will be leaving
us in the summer. After
ten incredibly successful
years here
at BL he has won a
very special place in
our hearts and will be
sorely missed.”
a very special place in our hearts and
will be sorely missed. In other words
, he leaves a bloody ginormous pair
of shoes to fill! Interviews have taken
place with shortlisted candidates and I
am confident that the college will make
a decision on his successor very soon.
I hope you all enjoy the rest of the first
edition of the new “medicalstudent”
and remember: your presidents are here
to help so make sure you use them! .
“On the sports front
we have been holding
our own with an undefeated
title for our
women’s rugby team
and great a start to
the year for our women’s
boat club Fresher
VIII, taking the
Alom cup title.”
that isn’t enough we have the play (A
view from the bridge), Tooting show,
George’s got talent and the musical
(Footloose) all coming up this term.
Finally I would like to finish by
saying how thrilled I am to see the rebirth
of the “medicalstudent” newspaper
and to say a big thank you to
all of those who made it happen .
Editor-in-Chief
February 2011 medicalstudent
News Editor: Ken Wu
news@medical-student.co.uk
John Hardie introduces the revived
medicalstudent
Congratulations on finding
a copy of the newly
re-launched Medical
Student newspaper. After
a two-year hiatus spent wandering
the tundra of London’s Kafkaesque
administration, we’ve
managed to emerge relatively unscathed.
In the annals of the paper’s history,
two years is but a drop in the
ocean. In 1774, the London Advertiser
announced the launch of the
‘Medical Magazine’. The publication,
written for medical students
and the general public, contained
“Judicious criticisms on authors of
the highest credit.” Although the
paper has gone through numerous
name changes, I’m sure you’ll agree
that the writing quality established
by this “society of gentlemen” has
prevailed through to the present day.
The Medical Student newspaper is
older than The Times, The Guardian
and the Daily Telegraph. Therefore,
before you read on, politely address
the person you find clutching one of
The Editorial Team
Editor-in-chief
John Hardie
GKT
News editor
Ken Wu
ICSM
Features editor
Neha Pathak
RUMS
Sub-editors
Bibek Das
Hannah Harvey
Lucia Bianchi
Hayley Stewart
Radhika Khanna
Martha Martin
Giada Azzopardi
Treasurer
Alexander Cowan-Sanluis
the filthy aforementioned rags and direct
them to the far superior 80.9 grams
of newsprint you are currently holding.
To become part of this glorious lineage,
simply email editor@medicalstudent.co.uk
with your articles and
comments. Whether you had your first
major scoop by the time you left preschool,
or whether you’ve never penned
an article, we’d love to hear from you.
So…I’m sitting with palpitations
from a minor caffeine overdose
- sun threatening at the horizon
– and the issue still isn’t ready for the
7 a.m. print deadline. Two hundred
and thirty seven years later and the
editor still hasn’t learnt his lesson .
Comment editor
Sarah Pape
GKT
Culture editor
Robyn Jacobs
ICSM
Doctors’ Mess editor
Abe Thomas
BL
Photographers & Illustrators
Alan Liu
Naoko McCabe
Alexander Karapetian
Sam Lee
Storm Lonsdale
Richard Berwick
Peter Ziegler

medicalstudent February 2011 3
News
ICSM dominates
Ken Wu
News editor
Adrenaline
Following the huge success of ‘999’
in October, ULU Medgroup launched
its second event of the academic year,
‘Adrenaline’ on the 1st February at
Tiger Tiger. With all of the London
medical schools in attendance, the
event proved to be an overwhelming
success once again. With DJs in two
rooms playing the usual assortment
of club tunes, it was a thoroughly enjoyable
night for everyone, with many
students describing it as “absolutely
epic”. The event further strengthened
the unique and historic bond
shared by all five medical schools.
As always, the old inter-medical
school rivalries came into force, especially
concerning the ticket sales.
ICSM absolutely destroyed the opposition,
selling 225 tickets in advance
which accounts for 60% of all advance
ticket sales. Barts came a respectable
second, selling 114 tickets in advance.
RUMS only managed to sell a meagre
16 tickets in advance whilst St Georges
sold only four more at 20 tickets. Students
from GKT were noticeably absent
although they were suitably excused
this time since ‘Adrenaline’ clashed
with the GKT RAG week. However,
the actual ticket sales put students from
RUMS and Georges in a slightly more
sociable light with numerous people
from both schools as well as Imperial
Graduate medics buying on the door.
In total, 510 people attended the event.
Anil Chopra, the ULU Medgroup
chair, commented that the event was
“an absolutely great effort” and that
he was “impressed with St Georges
since all of their 1st and 2nd years had
exams next week”. By contrast the 1st
and 2nd years from ICSM had a lecture-free
morning the following day
so most students were quite happy to
party the night away without the fear
of a hungover lecture in the morning.
Jeeves Wijesuriya, the event organiser,
also said that the night was “a huge
success that will hold us in good stead for
the future” and wanted to “congratulate
all who were involved and thank everyone
who helped sell tickets, were on the
door and all who came to the event”.
‘Adrenaline’ also proved to be a
financial success, making a healthy
profit of £700, which is currently funding
the production and printing of the
revived ‘medicalstudent’ newspaper.
Plans are underway for a summer event
to be organised by ULU Medgroup so
expect another unforgettable evening
coming to a medical school near you .
Negin Damali Amiri
RUMS Senior President
We at RUMS are truly excited to see the
rebirth of ‘the medicalstudent’ newspaper.
It has been an amazingly busy year
for us. After our recent fantastic sellout
at the 2010 Winter Ball we’re now
set to prepare for what promises to be
yet another successful event (the Summer
and Finalists’ Balls). Hot on our
agenda for this term, and the next, are
the effect of the rising tuition fees on
widening participation and the future
of NHS bursaries. We’re also looking
into how the proposed changes to the
UKFPO application process will af-
David Smith
ICSM President
It is an absolute pleasure for me to
welcome you to the first issue of
‘the medicalstudent’ since 2008!
It has been a very busy few months for
us at ICSMSU since term started back
in October. We have held numerous
events, most notably Freshers’ Fortnight,
which was incredibly successful
thanks to the hard work of Mike and
his social team. An unprecedented 256
freshers bought a ‘passport’ which gave
access to all events over the two week
period. We have also hosted black tie
balls, comedy nights, University Challenge
trials, numerous bops, a boat
party and many more social events.
RAG has run its first event of the
year, the Halloween Collect, and special
mention must go to Hamish and his
team for their incredible work in raising
a record total of £15,177. We are
greatly looking forward to reclaiming
our crown as the number one medical
Anil Chopra
ULU Medgroup Chair
Hello and welcome to the first issue
of the new and improved ‘the medicalstudent’.
I believe the last time you
saw this would have been the summer
of 2008. I would like, firstly, to say
thank you to John and all the team for
getting this publication back up and
running. I hope you will agree that as
London medical and dental students,
this is a fantastic asset. The point of
the new newspaper is not only to report
on current affairs relevant to
medical students, share knowledge and
advertise events but also to try and recapture
that old medical school spirit.
Less than 30 years ago, there were 12
medical schools in London, each with
their own identity, their own strengths
and their own traditions – some of the
old clan claim that the modern medical
school has “lost its soul”;; I don’t
think they could be more wrong … and
this is where ULU Medgroup come in.
Medgroup is a network made up of
the Unions of the five London medical
schools. We meet monthly to dis-
fect our finalists in the coming years.
Last but not least with our current curriculum
undergoing a review, student
representation has been central in the
past few months. Our AGM will be
happening on the 21st of March 2010
and I am looking forward to seeing as
school in the RAG stakes this term!
This year has also seen the Reynolds
Bar undergo the first stage in its
renovation, thanks to extremely kind
donations from Imperial College Union
and Imperial College Commercial
Services. The next stage in the redevelopment
involves plans to convert
the downstairs meeting room into an
alcohol free common room in a move
that will hopefully bring us closer
to catering for all of our students.
cuss current issues and work together
to resolve them. We share best practice
and use the knowledge and past experience
to constantly maintain the high
calibre of doctors that London produces.
We also co-ordinate social events
such as ‘999’ and ‘Adrenaline’ and
I’m sure those of you who came found
them to be great nights. The money
raised from these socials has gone
into the production of this newspaper.
The focus for Medgroup over the
coming weeks will be preparation for
the BMA Medical Students Conference
due to take place in Edinburgh
“Hot on our agenda
for this term, and
the next, are the
effect of the rising
tuition fees on widening
participation and
the future of NHS
bursaries”
many of you there as possible. Remember,
this is your chance to share your
opinion with us on some of the key issues
affecting us all and for us to listen
and take action. Enjoy the rest of
the year and please drop me a line with
any comments, queries or questions .
“This year has also
seen the Reynolds
Bar undergo the first
stage in its renovation,
thanks to extremely
kind donations
from Imperial
College Union and
Imperial College Commercial
Services.”
It is a great shame that the bar has
been subject to some negative press
coverage of late, especially considering
the huge strides that are being
made this year to reverse some of the
trends mentioned. It was an extremely
unfortunate piece, hugely exaggerating
practices which had already died
out and painting individuals in an unfavourable
light. Fortunately we have recovered
from this setback with our bar
intact and live to fight another day! .
“The focus for
Medgroup over the
coming weeks will be
preparation for the
BMA Medical Students
conference due
to take place in Edinburgh
on the 1st and
2nd April and promoting
our campaign for
this year.”
on the 1st and 2nd April and promoting
our campaign for this year. The
Medgroup campaign, headed by Tharani
Mahesan from GKT and David
Hobden from St Georges, will focus on
student welfare and specifically access
to welfare services within your medical
school. We believe that this is an
important issue for medical students
in particular, particularly with students
who are on placements. If you would
like to be involved with Medgroup or
would be interested in coming to any of
our meetings, please do get in touch .

4
News
New selection method to the UK Foundation
Programme set to begin for students
graduating in 2013
Bibek Das
Sub-editor
In November 2010, the initial pilots of a
new selection method to the UK Foundation
Programme were completed. This
new method is comprised of an Educational
Performance Measure (EPM) and
a Situational Judgement Test (SJT). If
further piloting demonstrates that these
selections methods are an improvement
on the current system, they will
be used for applicants to the Foundation
Programme beginning in August 2013.
The current ranking system of medical
schools in the UK for selection to
Foundation Schools uses a combined
score derived from answers to a set
of white space questions (weighted
60%) and an academic quartile ranking
(40%) provided by the applicant’s
medical school. This score is then
used to allocate applicants to one of
several foundation schools, which applicants
rank according to preference.
The Medical Schools Council had
been commissioned by the Department
of Health (DH) to carry out an appraisal
of the current system of selection. This
revealed concerns about ‘the reliability,
validity, comparability, NHS consultant
time required, possible plagiarism
and the longevity of the current online
application system’. Following on from
this, a Project Group was commissioned
by the DH to appraise all the possible
options for a new selection programme.
After nine months of consultation
and literature reviews, this group,
chaired by Professor Paul O’Neill,
head of Manchester Medical School
and Professor of Medical Education,
recommended that a new selection
method should be piloted. The EPM
would replace the current quartile
rankings and the SJT would replace
the current white space questions.
The EPM is aimed at assessing
medical students’ performance
throughout medical school. This may
encompass separate scores for clinical
skills and written knowledge and
aims to be ‘more robust than quartiles,
with all schools providing scores
to a standard specification’. The SJT
will be an invigilated multiple-choice
test based on situations that applicants
will face as foundation doctors,
and will not require prior revision.
Professor O’Neill, in an online interview
with Nick Deakin, co-chair of
the BMA Medical Students Committee,
explains why this will be a fairer
system for medical students: ‘In the
current system, academic quartiles are
done differently by different medical
schools in a way that is not known to
everyone. The EPM will replace that
with a transparent framework consistent
between medical schools.’ Furthermore,
‘the concerns about white space
questions are that they’re done in a two-
Tackling the last taboo
in student welfare
Oliver Woolf
Guest writer
Doctors don’t need doctors right? Not
according to Medgroup who have been
working on plans to increase access to
important welfare services that Medical
students can often miss out on due
to their working hours. There is great
stigma attached to mental health issues,
with many students unwilling or
unable to seek help. Fears can range
from how others will view them, ‘fitness
to practice’ issues and the impact
it might have on a future career.
The GMC states that in order to demonstrate
fitness to practice, students
should seek medical or occupational
health advice, or both, if there is a
concern about their health, including
mental health. So what barriers exist?
Students are often unaware of the
wealth of services available to them to
deal with welfare issues. Advice and
counselling services can offer both
week period and there are concerns that
these might not be [the students’] own
words, that they are done collaboratively
or they had help. The SJT has now
been used more widely across postgraduate
training such as in General
Practice. It looks at people’s judgements
and their likely behaviour in situations
that they will encounter as F1 doctors.’
Details of the framework of the assessments
used to calculate the EPM remain
unclear. Furthermore, the weightings
of the EPM and SJT scores have yet
to be decided. Later this year independent
experts will be commissioned to offer
advice on the best way to do this.
Small-scale pilots of the SJT have
been completed at Cardiff, Cambridge
and Keele Medical Schools. The results
from these pilots will be out be analysed
and will help inform a larger pilot
of 8-10 medical schools which will
run in Spring 2011. The pilots, involving
only final year medical students,
comprise an invigilated test of approximately
65 SJT questions completed
practical and health support which users
would agree has been invaluable.
“More than 50 per
cent of medical students
admit that they
have sought help
for depression or
other mental health
problems”
Another fear might be how understanding
a consultant will be if you
say: “I need to take some time off for
mental health reasons.” Students who
were interviewed but wished to remain
anonymous said they were “worried
whether my consultant will accept
this reason” whilst others stated that
it would feel like “admitting defeat”.
within 2 hours. If medical schools agree
to pilot SJTs, there is no obligation for
students to take part. However students
are strongly encouraged to take part to
increase the reliability of the findings
as well as being a beneficial experience
since SJTs are being increasingly used
for selection into speciality training.
Nick Deakin stated the position of
the BMA is that any changes should
only come in to place ‘if they are shown
to improve the system as it stands now,
and if they have the confidence of students’.
Professor O’Neill replied that
there would be no change ‘unless we
can show that it is a definite improvement
on what we currently do. The
proposed alterations are about how the
score is actually devised rather than how
people are actually matched to posts.’
Medical students can express their
views on the new system on the ISFP
website. For now, however, Professor
O’Neill states that ‘nothing will
change, other than intense piloting
and evaluation of the proposals’ .
It is well known that medical students
are at increased risk of encountering
mental health issues during their
course, the BMA says that more than
50 per cent of medical students admit
that they have sought help for depression
or other mental health problems.
Access to services is often a big barrier.
BLSA president Laura Brenner said:
“It’s time to really get the message out
February 2011 medicalstudent
Research in
brief
Robyn Jacobs
Culture editor
ICSM: Anti-prostate cancer protein
discovered. Researchers have discovered
an intracellular protein that suppresses
the growth of prostate cancer
cells. There research can be propel
led into future treatments of the disease.
Published in Cancer Research.
BL: Heart attack paradox solved. Folic
acid lowers homocysteine levels which
should, theoretically, prevent heart attacks.
Research shows that the mechanism
of action is the same as that of
Aspirin, so folic acid may provide no
extra benefit. Published in the current
issue of the Public Library of Science.
GKT: Research shows that low selfcontrol
in children leads to physical
health problems. Research by KCL,
Duke University and the University
of Otago showed that children with
lower self-control were more likely
to have physical health problems, financial
difficulties and a criminal record
regardless of their background.
RUMS: Breast is best? Current guidelines
suggesting that breast feeding is
best for the first 6 months of a child’s
life is being questioned. The Child Institute
of health at UCL has published a report
saying that exclusive breastfeeding
could lead to iron deficiency anemia and
coeliac disease. Published in the BMJ
St Georges: Artesunate combined with
cancer drugs to improve efficacy. In vitro
studies have shown that Artesunate, a
commonly used anti-malarial combined
with cancer drugs make them work
more effectively than when used alone.
Treatment breaks were also shown
to improve success levels. Published
in International Journal of Cancer .
there that these services are available”.
She went onto raise the issue of
out-of-hours services for those on outfirms:
“it hasn’t been possible up until
now to support those on placements
outside London so well but this is something
we are looking to change”. Issues
regarding funding prevail but there is
clearly a case here for more to be done.

medicalstudent February 2011 5
News
Are iPhone apps replacing
Rahul Ravindran
Guest writer
traditional lectures?
Currently, more and more hospitals are
using the iPad as a source of medical
knowledge. Described as a “medical bible”,
it brings into question the value of
learning vast amounts of knowledge at
medical school, especially with yearly
“reductions” in course material deemed
“too difficult” by the GMC. Why do
we spend such a large proportion of
our time learning things which can
be looked up in a matter of seconds?
Surely if medical students were taught
only concepts and were able to look up
anything that was easily accessible it
would save us years of time in training?
Imagine clinics where the symptoms
a patient presented with were
all fed into a computer. Software
could be designed, with the aid of
senior clinicians, to create a ‘checklist’
of signs the doctor should look
for in order to arrive at a diagnosis.
“Why should we
spend so much time
memorising this
much when the information
is easily
accessible?”
Pictures of the signs could be shown
on the screen to avoid any confusion
and there could be ‘tick-boxes’
for the clinician to make sure they
go through everything systematically.
Then the computer could suggest
the appropriate tests to exclude certain
conditions and eventually come
up with a diagnosis and treatment
plan. This seems to be what students
learn for the majority of their clinical
years but why should we spend so
much time memorising this much when
the information is easily accessible?
More and more resources are becoming
electronic, an example is the
Oxford Handbook of Clinical Medicine
recently being available on the
iPhone: do we really need to memorise
the causes of hyponatraemia when
this information can be sought within
seconds? A direct consequence of
less memorising would be drastically
shorter training times, which means
less cost to the taxpayer. Following on
from this we could have more doctors,
so waiting times would also be reduced.
Another benefit is that the latest
guidelines could be incorporated directly
into the database of information. If
trials suggest that hypertension medication
should be altered then the computer
would tell the doctor exactly what to prescribe
based on the information about
the patient. Doctors would also easily
be able to share information across the
country, commenting on side effects of
drugs directly onto a database rather
than having to fill out a card about it.
There are, unfortunately, some drawbacks
to this system. First of all, with-
out having a broad foundation it is very
difficult for doctors to make progress
in science. Medicine is such a dynamic
field that can always be improved upon.
It would be naïve to think of ‘scientists’
and ‘clinicians’ as two separate groups
of people with no overlapping in role.
Medicine should be considered an
art as much as a science. A computer
can be given data and come up with a
solution, but patients can present in certain
ways that can be identified by a senior
clinician that can’t be broken down
into words. With experience we develop
a way of seeing patients as a whole
and not simply the sum of their symptoms.
This is described as Gestalt psychology
– an example is in endocrinology,
where the physician gets a ‘sense’
of problems patients have before they
even start explaining their symptoms.
While medical students are required
to learn vast quantities of information,
it is justified. Patients come
to their doctors to help them with
their problems and no computer is
able to offer the reassurance of a human.
There is a place for computeraided
diagnosis in medicine but our
knowledge base is a pillar our patients
can lean on and put their faith in .
Minimum alcohol pricing: the
real price of alcohol on students
Hannah Harvey
Sub-editor
In view of the millions of pounds spent
on public health warnings about the
dangers of alcohol, surely by now the
NHS ought to be reaping the benefits
of such investment. With an exponential
growth in the demands placed on
liver services, groaning transplant list
and a resource starved NHS, the sobering
truth is that the aftermath of happy
hour, seems distinctly sour. Alcohol
damage is projected to cost the NHS in
excess of £2.7 billion by 2015 . 35% of
all A&E attendances in Britain are alcohol
related, rising to 70% in peak times.
As media friendly topic, alcohol has
a unique versatility in terms of possible
narrative angles. Alcohol may fill
barrels and bellies, but it also fills columns,
TV scheduling slots, satisfies a
demand for health ‘news’, and supports
the sales-driven media machine of contemporary
British society. Regrettably,
instead of acting as a guardian of public
interest and debating the real issues
surrounding alcohol, sensationalist stories
about binge drinking predominate.
At a governmental level, alcohol has
begun to successfully permeate the political
agenda. The recent introduction
of minimum pricing to alcohol has created
a media frenzy and although its
effects are minimal, especially at the
student level, it is certainly a positive
sign. Making alcohol more expensive
and less ubiquitous will perhaps not
deter the seasoned alcoholics, nor the
affluent, but will inevitably result in a
more generalised reduction in drinking.
The increasing tobacco prices serve
as a perfect example of a highly effective
control mechanism. The worry is
that the positive repercussions for alcoholic
liver disease will be offset by
damage to the health of the economy.
Today’s economic gains from the alcohol
industry are bound to feel great,
just like the effects of alcohol in the
bloodstream at the end of a long week.
What we overlook in both instances,
is the price we will pay tomorrow .
Alex Nesbitt braves the
might of the Atacama
On the 2nd of March, I’ll
be packing my bags, saying
farewell to the other
Sabbs in our office at
UCLU, and will head to Heathrow
to catch my flight to Santiago, Chile.
I’ll then be catching an internal flight
and taking a coach trip to a little
town called San Pedro de Atacama,
situated in the vast Atacama Desert.
I’m taking this trip to embark on a
challenge unlike anything I’ve done before,
just to see if I can do it and raise a
bit of money for charity whilst I’m there.
The Atacama Crossing
takes place at
altitudes between
2400m and 3000m,
adding to the burden
of dealing with the
40°C temperatures
expected. It has
been running since
2004”
This challenge is the Atacama
Crossing, one of the 4 Deserts series
of 250km footraces. They have been
rated one of the toughest endurance
races on earth by Time magazine,
and each consists of 250km run over
seven days across the Atacama, Sahara
and Gobi Deserts, as well as the
Last Desert, the Antarctic Peninsula.
The Atacama Crossing takes
place at altitudes between 2400m and
3000m, adding to the burden of dealing
with the 40°C temperatures expected.
It has been running since 2004,
ICSM SU
responds
to the Daily
Mail exposé
ICSMSU (Imperial College School
of Medicine Students’ Union)
and Imperial College Union do
not condone the excessive consumption
of alcohol. For those students
who do consume alcohol, we encourage
responsible drinking. For example,
we have dedicated pages about
alcohol on the Union’s website which
encourages students who drink to
stay within the recommended limits,
and warns of the dangers of excessive
drinking (see www.imperialcollegeunion.org/information-and-advice/
health-wellbeing/alcohol and http://
www.union.ic.ac.uk/limits/). We also
offer extensive welfare services for all
students, including any student with a
problematic relationship with alcohol.
and has over 20 nationalities represented
by the 140+ participants each
year. It will be a great experience, but
will most likely be a painful one too,
and I’m sure the blisters on my feet
will be a sight to behold once I’m back.
I’m taking part to raise money for a
charity that I volunteered with a couple
of summers ago, called Cheka Sana
Children’s Trust. They are based in
Mwanza, Tanzania, and run a residential
centre for street children and a football
academy. They’ve also been building
a nursery, but that has had to stop
because of a lack of funds. I’m hoping
to raise some money to go towards that,
and am well on my way. My Justgiving
page is www.justgiving.com/alexsatacamacrossing
or you can search
Alex Nesbitt on Justgiving if you feel
like donating;; every little helps! I’ve
seen first-hand the great work that they
do, and I’ll be thinking of them as I
push through the pain in the desert! .
He kinda wished he hadn’t forgotten his
Tom-Tom
Wednesday nights are an opportunity
for members of sports teams to socialise
with the rest of their club. The
vast majority of students do not drink
to excess and many students who do
not drink alcohol take part in the festivities
of a Wednesday night. That
said, we do our best to ensure that
any drinking that does take place is
in a safe and controlled environment.
The buckets are a precaution for anyone
who has had too much to drink.
The Union has stewards who work
alongside external doormen, bar staff
and security staff, to help ensure the
safety of the students in the building.
Any student who may have had
too much to drink is looked after by
the stewards, who make sure that they
are taken home safely. This year, a
group of students volunteered to help
with stewarding and we were delighted
to accept this help. We have a zero
tolerance stance if any club is seen
to be encouraging rowdy behaviour
or excessive drinking, and any such
club is heavily fined by the Union.
We also run numerous alcohol-free
events throughout the year such as quiz
nights, comedy performances, movie &
ice cream nights, and cultural nights .

6
Features
Maria Knöbel
Guest Writer
Once upon a time in a “land of poor
sanitation”, there was a medical student
called Cinderella. She was
“beautiful, intelligent, and quickwitted.
Quintessentially Barts… She
had four ugly sisters Listeria, Gonorrhoea,
Salmonella, and Flu. one
from Imperial, one from UCL, one
from GKT, and one from St. Georges.
Horrible girls. Horrible institutions.”
So read the opening narration for
a pantomime staged by the drama society
at Barts & The London Medical
School this year. Everyone is familiar
with this harmless rivalry exhibited
amongst the medical schools of London.
For many, it is so natural that no
one stops to consider its origins. Was
it always this way? When did it begin?
A Duelling Start
Rivalry amongst the medical
schools in London dates
far back to their foundations.
In 1826, to the great disapproval of
the elite, London University (now University
College London) was founded
with the support of non-Anglican
Christians, Jews, and Utilitarians.
It aimed to differentiate itself
from the religious nature of the Universities
of Oxford and Cambridge.
King’s College London was founded
almost immediately after in 1829 to
create a religious Anglican institution
in response to UCL. ‘Duel Day’,still
celebrated at King’s College annually
on the 21st of March, marks the date
of the famous duel in 1829 between
the Earl of Winchilsea and the Duke
of Wellington—both patrons of the
newly established King’s. The Earl
of Winchilsea wanted King’s to admit
only members of the Church of England
and accused Wellington of being
too supportive of the Catholic cause.
No blood was shed. both the Earl and
the Duke, fired, deliberately missed,
shook-hands, and reconciled. However,
King’s and UCL clearly got off
on the wrong foot from the cradle, and
thus was the beginning of a rivalry
that was to last into the next century.
This verse of a satirical song set
to the melody of the British national
anthem provides good insight into
how the religious and secular division
from the beginning was cen-
tral to the rivalry of the institutions:
The lyrics condemn the secular nature
of “the Godless University of
Gower Street”, and sentence it to
fall without protection of the church.
UCL’s non-religious nature also
played a key role in the jostle for the
position of third oldest university in
England - a title King’s also laid claim
on. Although UCL was founded 3
years before King’s, it was unable to
obtain a Royal Charter due to its secularity
and also because it claimed
the title “university”. King’s College
received its Royal Charter the same
year it was established, simply because
it provided Anglican education
and didn’t seek to become a university.
In truth, the word “university”
didn’t feature in its original charter at
all. However, neither institution was
able to confer their own degrees until
the establishment of the University of
London in 1836, of which they both became
colleges. In the meantime, students
sat exams to receive degrees of
Oxford or Cambridge. Tough times.
Today in the spirit of fairness, despite
having achieved royal charter
first, King’s only claims to be
the fourth oldest university in England
on their official website and
leaves UCL to claim third position.
Soon after the formation of the University
of London, there was a period of
rapid expansion and other institutions
began to join. One of the early birds to
join was St. George’s Hospital Medical
School, which had already been teaching
medicine since its establishment
in 1733. Other smaller medical colleges
in London continued to exist independently
of the University for over
150 years, and it wasn’t until the 1990s
that all the current big medical schools
of London as we know it came into existence.
The nineties saw the formation
of Barts and The London in its current
structure from the fusion of the London
Hospital Medical School, Queen
Mary & Westfield College, and the
Medical College of St. Bartholomew’s
Hospital (which had been teaching
medicine since 1123, making it the
oldest surviving hospital in England).
Then Imperial College School of
Medicine was formally established by
merging St Mary’s Hospital Medical
School, Charing Cross and Westminster
Medical School, the Royal Postgraduate
Medical School, and other medical
bodies. Still within the same decade,
the current UCL Medical School was
formed from the University College and
Middlesex School of Medicine and the
Royal Free Hospital School of Medicine.
And finally, King’s College Medical
School was reborn from King’s College
Hospital and the United Medical and
Dental Schools of Guy’s and St Thomas’
Hospitals. It was a busy decade for
alliances. When the nineties were over,
we were left with our current big five.
Fun and Games
Any medical student at any medical
school, will more often than not
be extremely loyal to their institution,
and be all too eager to dish out less
than flattering remarks about their
rival universities. There is the famous
George’s song, now revamped
and modernised, that quite cheer-
fully denigrates the other schools:
The legend behind the song is that
‘I don’t want to go to Mary’s
I don’t want to go to Bart’s
And they say the Royal Free, is
not the place to be
And Tommie’s is a place for
high-born fairies
UCL’s a dump in central London
King’s is a hovel on the strand
ON THE STRAND!
I’d rather go to George’s,
To merry, merry George’s
‘Cos George’s is the finest in the
land, ‘Cor Blimey!’
St. George himself wrote the original
words in celebration after heroically
slaying the great dragon. Allegedly,
there are two more verses to
the song that are shrouded in secrecy.
In the years since, other London medical
schools have created their own
songs, or re-written the George’s song
in retaliation. One slightly ruder version
of the song that GKT graduate Lucas
Rehnberg was delighted to sing for
me, replaces lines four onwards with:
February 2011 medicalstudent
Features Editor: Neha Pathak
features@medical-student.co.uk
The Godless students of Gower
Street and other stories
‘King’s College lads arise!
New Universities
Shall quickly fall;;
Confound their politics,
Frustrate their teaching tricks,
O, Church! on thee we fix
Maintain us all.’
All this rivalry
is just fun and
games, and we all
get along dandy.
Or do we?
A MODERN DAY RAG
King’s Vs Imperial
In keeping with tradition, King’s can be found at the centre of RAG rivalry.
Bored with their long-standing competition with UCL, they have moved onto
ICSM (more affectionately known as ‘Gimperial’). However, they seem to
be lacking in the planning (or brain) department.
In 2009, KIng’s planned their biggest raid of Imperial (think Grafitti et al)
but made the schoolboy error of announcing it on facebook. Naturally
the ‘Gimps’ discovered it, brought in security and had them promptly
disciplined. Good work.
The following year, ICSM retaliated. They tactfully invaded a King’s
lecture theatre and “improved” the powerpoint presentations. Much to
the lecturer’s surprise, the audience was met with ‘GKT Scum’ scrawled
across a slide. And if King’s are still wondering about those “missing
signs” a little birdie tells me that they’re safe at ‘Gimperial’ now...
The popular parody musical duo Am-
‘And George’s are a bunch of high
class w**kers
UCL is f***ing boring
And King’s is a hole on the Strand
ON THE STRAND!
I’d rather go to Guy’s!
To Merry, merryGuy’s!
And fornicate my f***ing life
away ‘Cor Blimey!’
ateur Transplants consisting of Dr.
Adam Kay and Dr. Suman Biswas who
both studied medicine at Imperial, have
also written songs ridiculing their rival
London medical schools. Their song
“Snippets” mocks the competence of
consultants at King’s, and “Careless
Surgeon” plays on the popular stereotype
of Barts students not knowing any
anatomy. Finally, in case you were beginning
to think some were spared, “Always
Look on the Bright Side of Life”
ridicules every other medical school.
But we clearly love it. Amateur
Transplants have had huge success
amongst medical students and frequently
performs live at the very medi-

medicalstudent February 2011 7
Features
cal schools mocked in their songs.
All this rivalry is just fun and games,
and we all get along dandy. Or do we?
One particularly
inspired episode
saw Reggie the lion’s
painful emasculation
by UCL
students with a tin
opener.
The heads of Imperial College and
UCL thought so. In 2002, they hatched
a plan to merge and form a London “super-university”.
The plan was to potentially
create the “greatest university in
the country, attracting more research
funding than Oxbridge and competing
with global giants like Harvard.”
But within weeks the idea was torn to
shreds by opposition from academic
staff, as many saw it more as a takeover
from Imperial rather than a merger.
In an interview to The Guardian, Sir
Derek Roberts (the then acting provost
of UCL) admitted to feeling disappointed
at the animosity expressed by the
staff of the institutions. “An enormous
amount of antipathy and ill-feeling has
been generated by various groups. I am
quite disgusted and amazed,” he said,
disheartened. UCL reacted particularly
strongly by forming an anti-merger
committee and websites such as www.
saveucl.net and www.cucl.org which
focused on attacking Sir Richard Sykes
(the then rector of Imperial College) one
of the proposers of the merger. It is evident
that rivalry amongst the London
institutions doesn’t end with students,
and that academic staff share similar
feelings. Nonetheless, Dr. Michael
Schachter, a Senior Lecturer at Imperial
believes that “at staff level there is
at least as much co-operation as rivalry
on a wide range of issues. We exchange
ideas with colleagues across London
and the UK, and beyond, all the time.”
Reggie gets ‘Ragged’
Historically, student rivalry amongst
the colleges was centred on their mascots.
UCL had a wooden tobacconist’s
sign of a kilted Jacobite Highlander
called Phineas Maclino as their mascot
(originally stolen from outside a shop in
Tottenham Court Road), while King’s
had Reggie the lion. Both mascots
were victims of repeated kidnapping
attempts after the Second World War.
Some famous incidents include Reggie’s
abduction by UCL students to be
transported to Inverness, and then unceremoniously
dumped in Surrey. One
particularly inspired episode saw Reggie
the lion’s painful emasculation by
UCL students with a tin opener. It took
a team of engineers and medics to skillfully
restore him to his previous glory.
After repeated kidnapping incidences,
the hollow copper lion was eventually
filled with concrete and chained
to the wall to thwart further attempts.
The great RAG of 1922 saw the battle
between King’s and UCL reach a
zenith. King’s captured UCL mascot
Phineas and ignored a deadly serious
ultimatum for his return. Hundreds
of UCL students were ferried to Aldwych
in furniture vans and hundreds
more swarmed out of the nearby Underground
station and descended upon
the King’s quad. Although King’s were
expecting them and had Phineas surrounded
by a personal bodyguard of
engineering students armed with rotten
fruit and vegetables from Covent
Garden Market –they had no chance.
Part of the King’s College stone balustrade
was torn down in this siege
and police were called in to enforce a
truce. As with most previous RAG incidents,
the situation was resolved in
good spirits amongst students. However
the press widely reported on the
“premeditated and deliberate aspect to
the violence” as well as on the collapse
of the balustrade. The College authorities
didn’t seem too disapproving and
simply demanded students from both
Colleges to share the bill for repairs.
The 1927 RAG was characterised
by a fortnight of revelry. UCL captured
Reggie and filling him with rotten
apples before surrendering him
back to King’s. The following morning
a group of King’s students marched
into UCL chanting ‘For Reggie!’ to
capture the preserved body of UCL
founder Jeremy Bentham, and provokingly
paraded him outside UCL. Un-
Even today, UCL claim more ‘sense and science’ as the 4th best university in the world. Image from KCL archives.
surprisingly, hostilities continued a
week later with a rotten egg, fruit, and
vegetable fight in the UCL quad resulting
in police shutting the gates and trapping
many (including Reggie) inside.
Somehow at least six students were
injured during this violent exchange
of rotten foodstuffs and taken to University
College Hospital for treatment.
The intercollegiate wars continued
in this way until the mid 1950’s (only
interrupted briefly by World War II).
Modern antics between the London
medical schools tend to occur on a much
smaller scale and involve a lot less fruit.
Nick Constantinou, a graduate from
Imperial recalls delightedly how in retaliation
to Imperial stealing Jeremy
Bentham’s “picked head”, a contingency
of King’s students “dressed in scrubs
and wearing surgical masks stormed
into SAF [the medical building at South
Kensington campus] and trashed it!”.
Clearly, students are less creative today.
From religious rivalry, the big five were born; the devil’s spawn? Illustration by Gemma Goodyear.
Happily ever after...
Asked if the rivalries ever had a negative
impact, Dr. Schachter argues “Of
course whether it is football or university
people like to compete and think
they are doing better than the people
down the road, and this can be quite
positive. In general most of the rivalry
is harmless and fun, these days it
very rarely gets malicious, less than it
did 20+ years ago.” Nowadays university
league tables also play a key role
in rivalry as Professor Tom MacDonald
suggests. “Currently, we make lots of
jokes about Georges because they are
below us in the pecking order, but this
may not always happen and do not fool
yourself into thinking that UCL and
IC students don’t think they are better
than [Barts].” However he believes that
‘London medicine’ and London medical
schools are together a very strong brand
and this bond is represented by the organisation
called London Medicine
“which speaks on behalf of all medical
schools, apart from Imperial which
thinks it is too grand.” But as Professor
MacDonald points out, the ties that
bind us together are stronger than what
separates us, and everyone is proud
of being part of London medicine .

8
Features
Alexander Isted
Guest Writer
The debate in Parliament and in the
media about tuition fees has focussed
on whether or not the increased tuition
fees levied on graduates is a fair
solution to the problem of higher education
funding (at a time when the government
faces a large structural budget
deficit)! While this debate is certain
to continue, a more fundamental issue
arises for the medical profession – will
higher tuition fees undermine modern
medicine, by undoing years of progress
in shaping the doctor of today?
A steep climb
There was a time when the term ‘doc-
tor’ painted an image of an elitist, upper-middle
class, privately educated
individual. Characteristics such as arrogance
and self importance were deemed
acceptable in a bygone era in which patients
took a passive role in deciding
treatment. Doctors’ advice was taken as
Gospel and the social hierarchy implicit
in a consultation went unquestioned.
This kind of doctor is fortunately becoming
a distant memory. Today’s doctor
is a friend;; someone that the patient
can relate to and should feel respected by.
One of the most important factors
in facilitating this change is a widened
base of medical student recruitment
which now represents a far broader
cross section of society, encompassing
men and women from all ethnicities
and socioeconomic backgrounds. This
has largely been achieved via university
access programmes to ensure that the
best students are encouraged to apply
and are subsequently selected, regardless
of their school or financial status.
Now in its seventh year, King’s College
London’s Extended Medical Degree
Programme (EMDP) takes in students
from London’s ten lowest-performing
non-selective state schools, offering a
six-year degree in which the first two
years of a typical five-year course are
extended to three. The students are
required to pass the same exams with
the same pass marks so no double
standards are applied. Since the success
of the EMDP program at King’s,
the Universities of Southampton and
East Anglia have begun similar pro-
grams. St George’s University has developed
an “adjusted criteria scheme
[which] considers student applications
to study medicine in relation to the
peer group within which they studied”.
This means that pupils from state
comprehensives who achieve grades
that are 60% greater than the average
for their school will automatically
be offered a medical school interview.
Medical students themselves are
also getting involved in dispelling
myths. UCL’s ‘Target Medicine’ Outreach
Scheme, for example, sees current
medical students visiting non-selective
state schools to speak honestly
about their experience at medical school
and give school pupils the confidence
to pursue medicine as a career.
These programmes, combined with
increasing financial support in the form
of scholarships and bursaries, have led
to the gender and ethnic makeup of to-
February 2011 medicalstudent
Will tuition fees kill the ‘modern’ doctor?
Shackled to looming debt, the medical student has so far to go. Illustration by Gemma Goodyear
The estimated
total debt will be
£70,000.
day's medical profession. The GMC
medical register shows that at present,
practising doctors in the UK are compromised
of 58% men and 42% women,
and in terms of ethnic background, 35%
are white British, 10% are white non-
British, 19% are Asian and 3% are black.
It is not just the changes in the social
background, gender and ethnicity
of doctors which has modernised the
doctor-patient relationship. The manner
in which the core teaching principles
of autonomy, beneficence, nonmaleficence
and justice are taught and
practised today has radically changed.
There is greater emphasis on producing
well-rounded doctors with good
communication skills as well as having
a strong intellect. The GMC’s ‘Good
Medical Practice’ guidelines stress
that “to fulfil your role in the doctorpatient
partnership you must be polite,
considerate, honest [and] treat patients

medicalstudent February 2011 9
Features
with dignity”. Furthermore, access to
medical information via the internet
has developed a patient body that would
increasingly like to play a more active
and informed role in their health care.
Changes in the medical school curriculum
have, in response, placed
greater emphasis on communication
skills: videotaping clinical interviews,
writing reflective essays and
implementing the Calgary Cambridge
pathway. This emphasises the importance
of doctors communicating effectively
as well as understanding or
relating to the experience of an individual
which is, arguably, achieved
by having doctors from as broad a
range of backgrounds as their patients.
However, the uphill struggle to create
a more representative body of doctors
continues. The number of privately educated
students gaining places at medical
school is still disproportionately large.
Even now medical school applicants
from private school have roughly 66%
chance of getting a place compared to
the state school applicant’s 50% chance.
A costly change
In order to combat the current economic
deficit, the coalition government has
devised new legislation on student tuition
fees, based partly on the Browne
review. They have recommended an
upper limit of £6000 and a cap at £9000
when universities comply with specific
requirements. The actual fees would be
determined at the discretion of the university,
with the Browne review’s suggested
pay back scheme for graduates.
This was a major compromise made
by the Liberal Democrats given the
Abe Thomas
discusses the
controversial
foundation
programme proposals
in an exclusive
interview with the
Dean of Students.
Think back to when being
a doctor was the most secure
job in the world. A
time when we were told
that there will always be sick people
and you’ll never have to worry financially.
Today, thousands are qualifying
without being guaranteed a first
job in the UK. As Dean of Students
for Barts & the London, Professor
Mike Roberts is involved in the Medical
School Council’s decision-making
process in which he aims to represent
the views of the medical school
importance of student support in their
election campaign and has been met
with great hostility. 57 subsequently
elected MPs signed the National Union
of Students’ ‘Vote for Students’ pledge
against any increase in fees during and
in support of putting pressure on the
government to introduce a fairer alternative.
Signatories included the now
Deputy Prime Minister Nick Clegg
and the Secretary of State for Business
Vince Cable. During the lead up to the
controversial vote on the Bill, much of
the student anger was directed towards
the Liberal Democrats for apparently
‘selling out their principles’. Despite the
large scale demonstrations leading up to
the Commons vote, the legislation will
come into effect in September 2012.
A poor medic
For medical students applying for the
2012/13 entry, the estimated total debt
will be £70,000. This is almost twice
the previous £45,000, not considering
the additional cost of studying for
an intercalated BSc. Students applying
to study in London will also have to
consider additional living expenses. For
some this will not impede their decision
to study medicine, but for many, particularly
poorer students, the total debt
will be a major deterrent to applying.
The government has been criticised
for poor communication to prospective
students regarding details of the new
fees system, as many students do not
realise that there are no up-front costs.
As it is, applying to medical school
has never been harder. Increasingly
higher grade requirements including the
new A* grade, months of work experi-
ence, additional application exams such
as UKCAT and BMAT and evidence
“Ultimately, this
legislation is a
damaging move”
of a wide range of extracurricular activities
have made the process more and
more difficult. The entrance criteria are
among the toughest for any degree in
the country. These factors combined,
make the idea of applying to study
medicine seem unachievable to many.
Factor in a dept upwards of £70,000
and the process is even more daunting.
The month of student demonstrations
from the tenth of November
to the ninth of December has clearly
highlighted that the fees will be a
likely deterrent. With images of riot
police, burning placards and smashed
windows at Whitehall, this was the
first major political demonstration of
the new generation. Senior individuals
in the medical education system
are now split between a wish to keep
their student bodies happy, an obligation
to increase funds and a need
to maintain high teaching standards.
Professor Sir Nicholas Wright, Warden
of Barts and The London School
of Medicine and Dentistry, believes
that “the prospects of attracting debtaverse
prospective students from lower
income families - whatever bursary
scheme comes into being - will be very
low and will do little to widen access to
medicine”. However, Professor Sir John
Tooke, Head of UCL Medical School,
observed, “without an increase in student
fees, universities would be un-
The Browne Review 2010
aka The Independent Review of Higher Education Funding and Student
Finance. The review was chaired by Lord Browne Madingley (former chief
executive of BP) and spent £68,000 on research. It makes several
recommendations for the future of higher education funding in England:
. The £3290 cap on annual tuition fees to be scrapped and
universities should decide on the maximum amount
. The fees to be paid up-front by the government
. Students to pay 9% of earnings above £21,000 (previously £15,000)
. The option of graduate tax was considered and rejected;it did not meet
the required time-frame and unfairly discriminates on the basis of merit
. ‘Forgivable loans’ to be offered for more costly courses and those
deemed to have “significant social return”; this includes medicine.
able to balance the books”. He also observes
that “on the plus side [increased
fees] will ensure universities attend far
more to the quality of the student experience.
[We are] committed to providing
value for money and minimising
the impact of the change in funding
on widening access to medicine”.
However, the British Medical Association
disagrees and is campaigning
against the rise. Nick Deakin, executive
member of the ‘BMA Medical
Students Committee’, has said;; “the
BMA does not find the proposal that a
graduate will still be paying back tuition
fee loans up to 30 years after finishing
their studies acceptable. Ultimately,
this legislation is a damaging
move that will place substantial financial
barriers in front of the next generation
of students, particularly those
from low and middle-income families”.
What now?
Over the next decade, poorer students
Seven long years in medical school
and students alike. His enthusiasm
for the new proposals was infectious.
The new proposals mean that foundation
year one will be linked to a student’s
medical school while FY2 will
be incorporated into subsequent ‘core
training’. This would mean that students
controversially cannot apply to a different
region for their first year as a doctor.
Speaking of the current system, he
says, “we have found over a number of
years that our students are disadvantaged
as they are almost forced out of
the local area. It seems to us that the
system is just there to satisfy EU employment
law more than anything
else.” He emphasised that a new system
needs to be in play that not only
caters to the NHS but also to the educational
needs of the foundation doctors
and that this is best achieved by
“keeping local contact with students
rather than Bart’s and the London FY1
doctors working in over 60 different
hospitals scattered around the UK”.
So who is at an advantage with the
current system? In theory, the better
foundation schools are able to recruit
the best doctors in the country and not
just from the local area. But on the other
end of the spectrum, “other areas will
end up getting students and graduates
who are bottom end of the skills section.
Not a good thing for a NATION-
AL health service”. He argues, “it’s better
to have a range of skills rather than
some really good doctors in one hospital
and really bad doctors in another”.
The new system aims to offer more
educational support to weaker doctors;;
ergo producing better UK graduates.
“The big disadvantage of the current
system is that is provides a dislocation
between the undergraduate training
and the undergraduate trainers.”
Under the new proposals, foundation
placements would be dependent on
your medical school. Some argue that
this, rather unfairly, means that a 17
year old A-level student would have to
decide, not only what part of the country
he wants to study in but also where
he would be for his first job as a doctor.
Professor Roberts counteracts this with
a persuasive argument - “It protects
jobs. You can guarantee jobs for every
student in the local area.” This is especially
important in the context of rising
tuition fees. He did state, however, that
the borders of deaneries would need to
be modified to make sure that the number
of graduating medical students is the
same as the number of jobs available.
And what about the patients? Do
they benefit? “Having students familiar
with the hospitals, familiar with
the firms, they can start on day one
with confidence instead of them not
knowing the hospital and not knowing
the doctors. The prescription charts
are different, arranging for a CT scan
is different, even antibiotics used
will see medicine as even more unattainable
Conversely, it may be that
newer philosophies of patient care may
now be too engrained in the medical
psyche to allow doctors’ characteristics
to revert back to the old fashioned,
doctor-centred approach. Universities
must continue widening access to the
broadest range of students possible in
order for the medical profession to be
representative of the population. In the
words of Professor Sir Nicholas Wright,
Warden of Barts and The London, “I
suppose the take-home messages are
(1) never, ever believe anything a politician
says;; (2) make sure, without endangering
life or property, that the
Government knows exactly what medical
students think about this;; (3) keep
your nerve – a medical career is worth
it, and finally (4) don’t be frightened
to seek help - most medical schools
have schemes to help students in financial
trouble, and we are thinking hard
about what else we can do. So keep
in touch with your Dean and his/her
mates – he/she is there to help you.”.
vary between hospitals...This variation
in undergraduate training across
the country is very bad for patients.”
He also talks about a group of students
that are not always considered.
“One of the big disadvantages currently
is that there are students who
have health, social and academic problems
and we want to support those
students which are impossible to do
if they’re in Yorkshire, for example.”
The Medical School Council is voting
in six months to decide the future
of the foundation programme. Although
the prospect of upheaval seems
daunting, Professor Roberts has outlined
that there are advantages to consider
– for the students, the doctors
who train them, the patients, and the
NHS at large. Currently, all we can
do is wait with baited breath and hope
that all UK graduates can one day
be guaranteed a job after their long
slog to qualifying. Fingers crossed..

10
Comment
David Fisher
Guest Writer
Titanic NHS reforms
The NHS is steering towards an iceberg
of ill-conceived change. Unless it recalibrates
its compass it is going to sink. The
Government is under pressure to solve
two problems: to cut the budget deficit,
and to improve healthcare services in
the NHS. Both are colossal issues and
demand an overhaul of the system. The
proposed answer is to dissolve primary
care trusts, a mistake Unison has described
as, “of Titanic proportions.”
The proposed changes will shift accountability
for purchasing £80 billion
of healthcare to competitive markets,
freeing fiscal forces to save money. GPs
will supervise, ensuring appropriate allocation
of resources. There are many
services that could be improved or become
more widely available - if competition
were injected into the system.
Currently few incentives exist to shorten
waiting times for scans. Drugs, such as
Avastin are denied from NHS patients,
but can be purchased privately. The
government believes engaging with the
private sector is the way to rectify this.
However an outcry of opposition
from the medical profession has met
the recommendations for reform. They
are nervous about a conflict of interest
Imperial versus the Daily Mail
Guest Writer
Odhran Keating
As some of you may be aware, the Daily Mail
published an article entitled “Pass the sick bag:
Students have always got drunk, but the nihilistic
antics of these Imperial College medics
should worry us all”. Purporting to reveal the “sickening”
behaviour of some members of ICSM sport clubs, reporters
infiltrated the Reynolds Bar. Traditional home of
‘Sports Nights’, members of the clubs congregate and celebrate
or commiserate over the day’s results. What caught
the Mail’s attention was the provision of orange buckets in
case of student vomiting. They condemned these drinking
habits, labelling them incompatible with a medical career.
Imperial College took swift action, releasing a statement
that it “does not encourage or condone excessive drinking”.
Furthermore, students are no longer allowed to buy alcohol
in jugs and the provision of orange buckets is banned.
The Imperial College Union will also be organising campaigns
to remind students of the risks that excessive alcohol
consumption holds for their health and their careers.
where they must decide which treatments
should be made available to their
patients, balanced against the cost. They
also believe that dealing with an establishment
the size of the NHS in such a
rash way is negligent and potentially
destructive, protesting that it is unrealistic
to reform the NHS as a means
to cut the deficit. Healthcare quality
should not be sacrificed on the altar
of economic recovery. A more longterm,
considered approach should be
able to preserve standards in the NHS,
whilst providing economic return.
“If the system fails, it
will be virtually impossible
to reverse the
changes”
The rush to implement these changes
is also worrying. The Bill was only
introduced to Parliament on 19th January,
yet primary care trusts are already
being scaled down. Unlike the rest of
the Government’s plans, the NHS proposals
were not included in the election
manifesto. The House of Commons
Health Committee published a report
on 18th January 2010 examining the
proposals. They concluded that institutional
reorganisation was “subject to
little prior discussion and not foreshadowed
in the Coalition Programme”.
Surely it would have been prudent to
have had a few consortia test the system
before the rest of the country implemented
the changes. 141 consortia have al-
ready entered the “pathfinder scheme”,
representing half the country. Consequently,
if the system fails, it will be virtually
impossible to reverse the changes.
It would appear the Government has
performed inadequate research about
the ramifications of their plans. We are
left wondering what else they may have
overlooked, and whether the fast pace of
headstrong change will leave no time to
rectify mistakes. In particular, it is unclear
how the system will work during
the transitional period, between the closure
of primary trusts and the finished
opening of GP consortia in April 2012.
Undoubtedly, the economy needs
to be improved, and the NHS needs
reform. The National Health Service
Act in 1946 expressed the duty of the
Government, “to provide or secure
the effective provision of services”. A
commission ought to be appointed to
investigate whether the private sector
renders better healthcare than the
public sector. Conceivably, introducing
market forces to the NHS will be the
most efficient way of achieving this. It
will cost money to undergo this transformation,
but the current economic
climate should not frighten us from
what will inevitably be a cost-cutting
exercise. Now is the time to begin the
process of reforming the NHS, but it
should not be initiated rapidly under
pressure to save money. Unlike the
current plans, it would not imminently
save billions from the budget, but in the
long term it would assure us of much
higher care standards that are simultaneously
economically sustainable.
But what have the Daily Mail actually exposed? An article
written in Felix, the student newspaper, interviewed
many students who felt that the article was sensationalist.
Professor Laycock of the Faculty of Medicine is quoted
saying “I certainly don’t think that our students are any
different from many of their peer group”. Indeed many
of the comments left underneath the online version of the
article seem bemused, with one reader posting: “It’s student
life, practically a right [sic] of passage. Get over it”
This would not be the first time the Mail has
courted controversy, notably with Jan Moir’s article
on the death of Stephen Gately. The paper has
also taken a recent swipe at Oxbridge students taking
part in the “Valley Rally” at Val Thorens ski resort.
Now if the students involved, their faculty heads, or
even the general public don’t see the article as indicative
of the moral collapse of 21st century medics, what
point is the Mail trying to make? It would seem the
Mail is generating acrimony merely for the sake of it.
Since its invention in 2005, the
selection process for the Foundation
Programme has been
dogged by criticism. While
completion of the foundation years of
training is a prerequisite for full registration
by the GMC, the 2010/11 application
cycle has seen 184 more applicants
than training posts available.
The foundation programme was introduced
to provide structure and uniformity
to post graduate training, and
to contain it within a finite time frame.
Although in many ways it has been
successful in doing so, from an employment
perspective a number of applicants
could be left without a post.
Derek Gallen, co-ordinator of the
programme, has justified not increasing
the number of places to accommodate
all graduates with reference to
the problem of under-subscription in
2009. Due to an unexpectedly low number
of applicants to the programme,
many deaneries were left short staffed.
“It is estimated that
10% of graduates will
be unplaced
until as late as July”
In light of the oversubscription expected
in 2010, the UKFPO implemented
a contingency plan, where they
placed applicants in batches according
to application score;; the most highly
scoring were placed on the primary
list and allocated posts before January,
the remainder on the reserve list,
placed in batches between March and
July.. The promise that 98% of eligible
applicants will be placed is encouraging,
however the time-frame over
which this occurs could be problematic.
It is estimated that 10% of graduates
will be unplaced until as late as July.
In addition a potentially unstable
variable has not been fully addressed;;
the number of international applica-
February 2011 medicalstudent
Comment Editor: Sarah Pape
comment@medical-student.co.uk
Letters to the editor
The editor gets lonely and would dearly like
to hear from you.
If there is anything you’d like to tell us about,
either related to the paper or medical students,
please write to us.
editor@medical-student.co.uk
Unsteady foundations
Zoya Arain discusses the difficulties of securing FY1 jobs
tions, which varies significantly from
year to year. In accordance with European
employments law, all eligible
UK, EEA and non-EEA applicants
with a right to work in the UK have to
be considered equally. Therefore little
can be done to curb a potential increase
in the number of eligible international
applicants. Criticism has been
voiced over this including a comment
from a previous national facilitator
and Obstetrician, Laurence E Wood,
“The suggestion that we regard a medical
degree from anywhere in the world
in any language to the bespoke uk 6yr
preparation to core training… sacrifices
any understanding of curriculum
on the altar of political correctness;; it
is not equal opportunity to substitute
a brief snapshot selection process for
6 or 9 years of education and assessment
in the practice of UK medicine”.
Ultimately the debate raises the
question of whether all UK medical
school graduates should be guaranteed
training posts if they wish to apply.
A strong case can be made for this:
UK taxpayers contribute £60,000 for
the training of each medical graduate,
meaning unemployed graduates
are economically wasteful. Furthermore,
as medicine is a vocational degree,
the training posts will be sought
after by the vast majority of its students
and hence should be provided.
In his inquiry into the MMC in
2008, Professor Sir John Took suggested
a direct link being established
between medical schools and FY1, in
contrast to the follow on between FY1
and FY2. Furthermore, FY2, ST1,
and ST2 would be combined to form
three further years of core training.
I for one think, that after having
completed 5 or 6 years of a rigorous and
intellectually demanding degree, medical
graduates do not appreciate this Russian
Roulette style selection process. It
is time for the parties involved to reform
the system to ensure that a training post
is guaranteed to everyone who applies.

medicalstudent February 2011 11
Comment
Whatever your views,
the student protests
of 2010 were nothing
if not controversial.
Public opinion was- and is- heavily
divided over whether the cause
and the way they were carried out
was justified. Injuries caused to individuals
aside, I believe there is reason
to support the student protests
and the way they were conducted.
Firstly, protests aim to draw attention
to an issue or an injustice so the
fact that they are still being discussed
is an indicator of their success. Whilst
protests exist as a means for the populace
to voice their anger at decisions
being made by governments and other
organisations, they are also an effective
way to attract publicity. It is unpleasant
but true that controversy and
violence sells newspapers.By stimulating
debate, the protests have thus
encouraged people to consider the implications
of rising tuition fees for both
themselves and others. This is important
to prevent out politicians from creating
policies without fear of having
to answer for them. Perhaps then, the
sometimes aggressive nature of the
protests was price paid for close scrutiny
of the decisions made in Whitehall.
“Protests exist as a
means for the
populace to voice
their anger”
Secondly, whilst the protests may
have seemed heavy handed, we must
not forget why the students are so angry.
Here is a government composed
of politicians who did not have to pay
to go to university, voting for a policy
that will see further education inaccessible
for many in generations to come.
To add insult to injury, many of those
politicians signed a pledge to say they
would oppose a rise in tuition fees, a
promise they did not keep once elected.
It is all very well to say that the money
will only be repaid upon starting graduate
employment, but a debt of £27,000
(without even considering loans for
living costs) whenever and however it
is paid back is extreme. Starting your
working life already knee-deep in debt
is a heart stopping prospect. Furthermore,
the people hit hardest will not
be the lowest or highest income fam-
Head to Head
Are you a student protester?
Yes Liz Cosgrove
ilies, but rather those in the middle -
students who aren’t wealthy enough
to afford the changes comfortably;; not
quite poor enough to qualify for extra
help. I am one of these students, and I
completely sympathise with the anger
of those who were protesting. Whilst
people from different classes already
receive different standards of primary
and secondary education in this country
in many cases, it is a sad day when
this extends to the once uniformly
available opportunities at university.
Lastly, the protests and the manner
in which they were conducted demonstrated
two important characteristics
of our generation. The fact that students
came out in such numbers and
with such force to oppose the new
policy illustrates the value they attach
to the education they have received at
school and university. Here is a generation
who believes that education is
worth fighting for. Politicians heard
the students’ message loud and clear:
not in my name. Nelson Mandela once
said “education is the most powerful
tool you can use to change the world”.
Whatever the student protests were -
extreme, violent, heavy handed - they
showed that that tool would not be taken
from future generations without a fight.
As the government and the rest of the
country moves on from tuition fees, parliament
square is tidied, and scars have
begun to fade, it seems the sun has set
on the chance of the policy being overturned.
But at least we know that despite
the injustice of what was proposed and
passed, we did what we could to stop it.
Heavy handed they may have been, but
the protestors gave a voice to the voiceless.
They stood up for the innocent victims
and when this is considered, how
could the ends not justify the means?
Clare Jones
No
The year 2004 was an important
time. It marked the end
of Britney Spears’ reign as
America’s sweetheart;; the
world was introduced to Ron Burgundy
in Anchorman;; and the masterpiece
that is Dirty Dancing 2: Havana
Nights was released. However, despite
producing the aforementioned cinematic
masterpieces, 2004 had it low
points. On 1st July the Higher Education
Act was passed, which meant
that universities could charge up to
£3000 for courses beginning in 2006.
I’ll be completely honest, tuition
fees sneaked up on me. An Act that will
ultimately cost me over £12,000 completely
passed me by. It’s for this reason
that when I first heard about the demonstrations
against raising the cap on tuition
fees, I whole-heartedly supported
them. Having been apathetic and complacent
when it was my turn to protest,
I was glad that someone had the drive to
stand against the ridiculous hike in fees.
On the day of Demo-lition, the first
of the big student protests, I found
myself wandering around Parliament
Square. Was I trying to atone for my
previous lack of interest? Not exactly.
I was in fact looking for the number 12
bus stop. The atmosphere was electric,
and my disappointment that the number
12 would unsurprisingly not be coming
within a 100 miles of Parliament Square
soon disappeared. The protesters were
very vocal, but mostly peaceful and
listening to police advice. They had a
message and were getting it across.
It was only later on that I became
aware of the mayhem surrounding
Millbank and the huge amount of damage
caused. Protesting against tuition
fees that will saddle future students
with huge debts? That I agreed with.
Kicking your way into the Conservative
Party HQ, throwing rocks and
bottles at police, hurling fire extinguishers
off buildings? That I didn‘t.
It was no longer a protest but a riot.
“The demonstrations
had been high-jacked
by anarchists”
Later protests followed the same
pattern and, whilst the violence that
marred the first protest was unexpected
and impromptu, it became apparent in
later demonstrations that the violence
was premeditated. The cost of policing
the demonstrations and the cleanup
operation afterwards cost hundreds
of thousands of pounds, which did not
endear these ‘students’ to anyone. The
sight of Charlie Gilmour, son of the
millionaire Pink Floyd guitarist David
Gilmour, swinging from the Cenotaph
seemed to symbolise what the protests
had become. Gilmour later claimed he
did not know it was the Cenotaph, a perfectly
plausible excuse from boy studying
history at Cambridge University.
Such episodes deflected the spotlight
from the vast majority of students
that had protested peacefully. The NUS
leadership also came under fire, appearing
hypocritical when condemning
the violent protesters after a number of
NUS officers were spotted in the thick
of the action. It seems the demonstrations
had been high-jacked by anarchists
and other people after a fight.
Despite this, in the midst of this
mayhem there were moments of
comedy brilliance as well as well
considered opinions. One of my favourites
occurred when journalists feverishly
reported that Camilla, Duchess
of Cornwall, had been ‘poked
with a stick’. God, I thought, that’s a
bit personal to be reporting on BBC
news. Some of the placards carried by
the students were also brilliant. One
of the best was by a group of student
nurses which read, ‘We’re used to dealing
with crap, but this is ridiculous!’.
Ultimately it was great to see young
people voicing their anger over decisions
that will directly affect their
lives. I just feel it was a pity the demonstrations
descended into chaos allowing
politicians to focus upon the
anger and violence, opposed to the horrendous
debt future students will face.
Speaker’s
Corner
It’s just a soap
Neha Pathak speaks out.
New Year’s in Britain is incomplete
without a soap-opera tragedy;; the
cot-death storyline from Eastenders
certainly didn’t disappoint. Has
it overstepped the mark this time?
The record 10 500 complaints suggest
it has. I’m not sure I agree.
New mother Ronnie finds her baby
James dead from Sudden Infant Death
Syndrome (SIDS). In a fit of madness,
she swaps him for neighbour Kat Moon’s
baby Tommy, leaving the Moons grief
stricken and herself unable to mourn. It
does not make for comfortable viewing.
Critics describe it as “unrealistic”,
“hurtful” and a “cynical ploy to
make headlines by creating deliberate
controversy”, while Justine Roberts,
founder of parenting website
Mumsnet, criticised the BBC for insulting
bereaved mothers by portraying
them as “deranged and unhinged”.
Of course it’s unrealistic. That’s
sort of the point. Just because Ronnie
switched a baby in Eastenders does not
mean every bereaved mother does this
in real life. Furthermore, though she
does come awcross as “deranged and
unhinged”, it is balanced by the sensitive
examination of the Moon family’s
more typical bereavement reaction.
SIDS claims the lives of 300 babies
each year in the UK and this certainly
merits the media attention. Indeed,
the Foundation for the Study of Infant
Deaths (FSID) praised the storyline-
“We are very grateful to EastEnders
for their accurate depiction of the devastating
effect that the sudden death
of an infant can have on a family. We
hope that this story will help raise
the public’s awareness of cot death.”
I agree wholeheartedly and shook
my fist when Ann Diamond said, “the
BBC missed an opportunity to educate
a whole new generation of mothers.”
Firstly, it is not a documentary.
Secondly, before one can educate,
one needs to raise awareness. FSID
hotline traffic has already increased
five-fold. Surely, this is a success.
Sadly, the storyline is ending prematurely
and apparently, it’s going
to be a happy ending. Presumably,
Baby James is going to come back to
life, Baby Tommy will go back to Kat
and everyone will think that SIDS
doesn’t even exist. And then there’ll
be even more complaints. Great.

12
Culture
Drugs aren’t cool:
High Society
Kathryn Dickson
Guest Writer
“The jazz just isn’t the same when
I’m not stoned”. The 65 year old in the
psychiatric outpatient clinic smiles
sweetly. He gave up cannabis five years
ago thanks to its tendency to push his
bipolar disorder into depression. I feel
for him because this clinic just isn’t the
same without a black Americano. For
him, the pub isn’t the same without a
Jamesons-coke or the cold walk home
without a badly rolled Golden Virginia.
As the current ‘High Society’ exhibition
at the Wellcome Collection points
out, very few people live their life without
some kind of mood- or mind-altering
substance. Drugs have been used
throughout history and across continents.
Yet drug culture is so intolerable
to society that not only do we criminalise
it, but we turn its use into medical
syndromes. As a society, and as a medical
profession, we attempt to balance
conflicting demands of an individual’s
autonomy against the need to protect
from the harm that drugs can cause.
Drugs are used to alter our bodily
functions for a variety of purposes
- medical, recreational, religious, experimental.
Using the idea that ‘the
alteration of consciousness is a universal
human impulse’, ‘High Society’ explores
mankind’s use of drugs. Videos
of the Tukano tribe taking ritual Ayahuasca
to achieve a spiritual connection
with their ancestors play opposite
engravings of opium dens, whilst manuscripts
of Kubla Khan lie next to prohibition
propaganda. A heroin addict
describes the experience of withdrawal
in front of a case of Sativex (a cannabis
based analgesic licensed in 2010 for
MS). The wide range of materials in
the exhibition is clearly its main selling
point, although the diversity does add
to the romanticism surrounding drugs.
With only a slight nod to modern research,
it could be argued that the exhibition
focuses more on
the curious than
the current.
However,
with
the tagline ‘A free destination for the
incurably curious’, perhaps this is to
be expected. The chilling note of sobriety
is as one leaves – a giant poster
charting the cost and purity of heroin
as it travels from grower to user.
The exhibition has an emphasis on
the broadness of the term drug, which
encompasses many substances. When
we use the term we primarily think of
those which alter the mind’s functioning.
Drugs give us the power to alter
the world we perceive. One of the most
commonly used metaphors for a drug
experience is a trip, drugs literally being
able to transport us to a different
world. For some, this deepens our understanding
of what it means to be human,
but it is these drugs that are problematic.
Dangers of altered mind aside,
are we demanding fair play in our demonisation
of drugs? We are forced
to suffer the pain of the sober world,
why should others be able to opt out?
In December, the government released
their drug strategy-‘Reducing
demand, restricting supply, building
recovery’. In recent years there has
been a move towards the aim of harm
reduction instead of criminal justice.
Now the focus is on recovery, although
whether this is drug reduction or abstinence
is still unclear. The proposition
to cut benefits of drug users refusing
treatment has not been carried through,
although six pilot schemes to “explore
how payment by results can work for
drug recovery for adults” are to be set
up. In perhaps more relevance to the
future medical profession, the management
of drug and alcohol services is to
move from Local Authorities to the reformed
NHS and a new Public Health
for England body. Is this simply policy
to bring power to a more local level, or
a reflection of our attitude towards addiction
as a medical problem and a disease?
Becoming responsible for strategy
will force doctors to take a clearer
stance on the problem of drugs and alcohol,
and the associated ethical debates.
The NHS is changing, doctors are
to be held responsible for the strategies
and policies we may have previously
been able to hide behind. As ‘High Society’
neatly demonstrates, drug use is
a universal habit, one which poses complex
questions for society. If answering
these is to fall to the medical profession,
we must find our minds educated and
open. This is what ‘High Society’ does;;
it challenges all attitudes. The exhibition
offers no conclusion, these are the
things that we do, and the problems that
we are left with. The rest is up to us.
.
The exhibition ‘High Society’ is
running at the Wellcome Collection
until 27th February. For more info
visit www.wellcomecollection.org
The King’s Speech documents
the rise of Prince Albert
(Colin Firth), son of King
George V and second in line
to the throne. Though crippled by a pronounced
stammer, Albert ascends to the
head of the monarchy in an age where
for the first time ever, royal speeches
were expected to be delivered into the
home of every subject, via the cutting
edge technology of wireless radio.
The opening of the film introduces
us to not only the Prince, but also to
the severity of his disability. As Firth
attempts to give a speech to a packed
Wembley stadium, the anticipation
of all is apparent. As the Prince agonisingly
stumbles over every word,
the faces of those around him display
bemusement and disappointment,
none more so than that of his wife
Elizabeth (Helena Bonham Carter).
The film cuts to a despondent Prince
undergoing a speech-therapy session.
The upper-class three-piece suit-wearing
doctor fails to make any headway
with the Prince’s speech impediment
and is made to seem an almost laughable
figure. Frustrated by the latest failed
THE KING’S SPEECH
attempt, Albert gives up on any further
therapy. However, his long suffering
wife persists and enlists the help of Lionel
Logue (Geoffrey Rush), an Australian
speech therapist based on Harley
Street. After the death of King George
V, and the abdication of his eldest son,
Albert becomes a reluctant king. The
beginning of his reign was tainted with
the declaration of war against Germany.
It was a radio address to the entire Kingdom,
both home and abroad, that would
bring Albert his biggest test so far.
It is the relationship between Albert
and Logue that allows the Albert
to overcome his obstacles. Initially,
Albert plays the role of a difficult patient,
sceptical about anything Logue
suggests. Logue, in stark contrast to
the ‘upper class, three piece suit-wearing
doctor’, remains patient and, and
after his own stuttering start, eventually
breaks down the barriers that existed
between himself and Albert. This
opened Albert up to new ideas and
techniques for tackling his problem.
Eventually, by building rapport and
trust, Logue is able to get the Prince
to disclose personal problems, despite
February 2011 medicalstudent
Culture Editor: Robyn Jacobs
culture@medical-student.co.uk
Pranav Mahajan sees a film that sp...sp...speaks volumes for the Dr-patient relationship...
his initial insistence that he would not,
thus allowing him to explore the psychological
core of Albert’s impediment.
The film is brilliantly directed, with
a star-studded British cast. The attention
to historical detail, from the wonderfully
authentic props to the wobble
of Winston Churchill’s jowls, adds extra
dimension to a remarkable visual
experience. Firth brilliantly depicts raw
emotion, his character’s frustration and
awkward irritation at his inabilities is so
well portrayed, that those feelings are
readily shared by the viewer. It comes
as no surprise that his performance is
tipped to earn Firth his first Oscar, having
already won a Golden Globe for
best actor in his portrayal of the King.
The film will also be making a theatre
debut in the West End later this year.
The King’s Speech would appeal to
anyone, but the importance of Logue’s
relationship with Albert, makes this a
must see for medical students wanting
to explore patient communication techniques.
The importance of listening,
patience and rapport building are all on
display in a real master class in establishing
a good doctor-patient relationship .
Student
Artwork of
the Month
By Jiyu Lim
“A boy sets out on a
journey in search of
his long lost mother,
whom he is told is
a ‘mermaid’. The
boy spends all his
childhood looking
for his mother,
only to realise that
sometimes the truth
is best left unknown”
If you would like to see your
artwork, photography or
poetry featured, please email
culure@medical-student.co.uk

medicalstudent February 2011 13
Culture
AN INTERVIEW WITH...
King’s MedSoc Musical Theatre Society
Michael James talks to the team behind their latest show
For those of you who aren’t aware,
this is the section where some
grouchy misanthrope (yours truly)
goes around with pen and paper
in hand and interviews members of the
‘in’ society from ‘insert medical school
here’. Luckily, this time round it happens to
be King’s MedSoc Musical Theatre group
with their production of ‘Little Shop of
Horrors’. This particular production happens
to be a big favourite of mine, combining
science fiction, comedy and a 60’s rock/
Motown score into a great show. I’m heading
to Guy’s campus to sit in on a bit of the
rehearsals in the run up to the production.
When I get to the rehearsal venue (The
Spit in Guy’s campus) I’m let in by David
Thaxter, the shows director. He tells me
they’re currently mid-scene and sets me
down on a couch to watch until the break.
I look around and see a buzz of activity: a
group in the corner of the room practicing
a coordinated dance routine, others dotted
around with their backs against the wall,
whispering to each other, reading, doing
work, and waiting for their scene to start.
And then there’s the main rehearsal. The
scene is between the protagonist Seymour
Krelborn and his boss at the flower store
he works at, Mr. Mushnik. The musical
itself, David tells me during the break, is
about Seymour and a plant. A mutant venous
flytrap from outer space to be precise.
“The story starts in 1960’s New York on
Skid Row, in a florist shop owned by Mushnik.
Seymour works there along with shop
assistant Audrey, whom he’s deeply in love
with. But Audrey’s going out with a sadistic
dentist. Seymour one day sees a venous
flytrap in the flower market and decides
to bring it back to the florist shop. The
minute they put it in the window, it starts
attracting a lot of business for Mushnik’s
store. Because Seymour’s in love with her,
Calendar of Events
BL
Barts Got Talent
11th February
BLAS Cultural Show
1st March
RAG Fashion Show
15th March
RAG week
17th-25th March
Line learning got to the stage where only threats would work...(Photography by Francis Trapp)
he names the plant after Audrey, hence the
name Audrey II. The only trouble is, he can’t
find out what it eats, and he’s worried that
it’ll wilt and die and he’ll lose everything
the store has gained”. A bit of a pickle for
our friend Seymour, but what does the plant
eat? “Blood. Seymour tries everything that
he can, and he finds out the plant likes blood.
So he feeds it his own and it starts growing at
an alarming rate”. So fast, in fact, that after
a while blood alone cannot sustain the mutant
plant and it begs Seymour for something
a bit more “fresh”. Cue sadistic dentist. “It’s
really a sort of ‘be careful what you wish
for type thing’. After feeding the dentist to
the plant, it grows bigger, more powerful
and out of control, and everything the plant
promised to Seymour grows fainter and
fainter. So he decides to try to get rid of it.”
It’s certainly an odd story, with a mixture
of absurd scientific horror/gore and
fun music, not to mention the over the top
characters. But all of this works in the
shows favour, at once creating a real sense
of suspense and drama, while not taking
itself too seriously so you can still sit
GKT
RAG week
30th Jan –4th February
back and laugh at the idea of a massive plant
with a thick, soulful voice similar to Levi
Stubbs (he played Audrey II in the 1986 film).
“I was a massive fan of the 1986 film
version with Steve Martin”, says Mike Andrews
the Musical Director of the show,
“plus I really liked the work of Howard Ashman
and Alan Menken. It’s a really witty
and dark show and it’s been great fun to direct
such a varied score. I’d never been musical
director of a show before, and so I found
it really fun to get involved” says Mike.
Do David and Mike have any advice for people
who are directing for the first time? “Enthusiasm
comes to mind” laughs David. “If you
have the ability to go home after a rehearsal and
sit there, thinking about how it could have been
better, then that commitment is going to show.”
The show ran from the 26th-28th January,
so some of you may have missed out,
but the enthusiasm shown by both David and
Mike was infectious, and I would certainly
recommend anyone at King’s to get involved
with the society, and for anyone from further
afield to go and see the next production .
ICSM
RAG dash to Edinburgh
4th-6th February
Valentines Ball
15th February
RAG week
21st-25th February
RAG Fashion Show
15th March
Battle of the bands v
George’s
22nd February
SGUL
Comedy night
15th February
Battle of the bands v
ICSM
22nd February
A view from the bridge
24th-25th February
George’s Got Talent
1st March
Footloose
9th-11th March
The Perfect pint?
In a quest to find that perfect pint,
Odhran Keating considers the greatest
beer in the world....
Imagine clearly for a moment the greatest beer in the
world;; bring it to the forefront of your mind. It’s cool
and refreshing on a hot summer’s day but also warms
your insides on a cold winter night. It slides down your
throat easier than water and feels smoother than Weissbräu
from Munich’s famous beer gardens. When you drink it,
you feel only happiness and contentment. When you wake
in the morning, there isn’t a hangover. Hell, this stuff is
good for you;; zero calories with added iron and calcium!
Good news! It exists! Anyone who has compared the
feeling they get when they look at their cash balance at the
start and end of term will understand. Something that exists
is vastly superior to something that doesn’t. So, if this
greatest beer didn’t exist, then it would be impossible to imagine
a more perfect beer. However, we have a contradiction,
to have a beer greater than the greatest beer imaginable,
we would have to imagine an even greater beer. This greatest
beer must exist otherwise how could it be the greatest?
Confused yet? Ecstatic news I know, but there may be
a few problems. This argument was made in the eleventh
century by St Anselm as a proof of God’s existence. It is
known as the Ontological Argument and was later reworked
by René Descartes as follows 1) God can be conceived of
as a being who possesses all perfections, He is All-Perfect,
2) Existence is perfection, 3) Therefore God Exists.
But bad news for all you beer lovers, Descartes himself
countered the argument to bring anything into existence, by
stating that God alone has a special kind of ‘necessary’ or independent
existence that we can clearly perceive. This is different
to the idea of a perfect beer which is hard to objectively
imagine. For example;; how sweet is the perfect sweetness to
suit everyone? However, most feel the Ontological argument
was put paid to by Kant when he wrote that “existence is not
a predicate”. Simply put, this means that existence is not a
property that can be ascribed simply by saying “God exists”
the way “God is omnipotent” or “God is benevolent” can. To
say God exists is to say that you can have a concept of God
with all the properties attached to him. In order to confirm
that God does in fact exist, then we would need to experience
proof of his existence. Whether this is a more worthy
ideal than trying to find the most perfect beer is up to you.
Still want to find the perfect pint of beer? Visit the
Great British Beer Festival at Earls Court Exhibition
Centre, 2-6 August 2011. Tickets available from
March via www.gbbf.camra.org.uk
RUMS
RAG week
14-18th March

DOCTORS’ MESS
Poo Sniffing
Recently a group of Danish medical professionals, clearly
bored at work, decided to get together and test out the urban
myth that it is possible to get drunk by submerging the feet
in alcohol. The three aged 31- 35 years (shouldn’t they know
better by now?), kept their feet in a washing up bowl filled
with 3 bottles of off licence vodka for 3 hours. Unsurprisingly
results of the study found the feet are impenetrable to alcohol.
However, the authors claimed it is possible to get drunk if the
beverage had a higher alcohol content, absinth for example, or
if the participant could facilitate uptake of alcohol through an
ulcer.
This study inspired me to go in search of alternative methods
of intoxication used around the world. After extensive research
- here are the Top 5 weird ways to get HIGH.
3. Toad Licking
In 2007 in Kansas City, USA a man was arrested for
possession of a Colorado River Toad. He had been
extracting and drying the toad’s venom which contains
Bufotenine a potent hallucinogen. To get the venom
users must ‘milk the toad’ – stroke the toad under the
chin to produce the venom, which does not harm the
toad, then drying and smoking the venom. However,
it has been reported users may ingest the venom
through licking the toad’s underbelly to obtain the
psychedelic effects.
Side effects – poisoning and death
5. Nutmeg
Nutmeg is full of the organic compound myristicin and
according to experts eating 4-8 teaspoons of ground
nutmeg can cause mild hallucinations and increased
sensory awareness of warmth in the limbs.
However, side effects are numerous including
dizziness, nausea, paranoia, difficulty urinating and
according to one user “it feels as if God has taken a
dump on your soul”. Also nutmeg consumption takes
5-6 hours to take effect and feel the ‘high’ therefore
much forward planning is required.
2. Reindeer piss
So reindeer eats amanita muscaria mushroom,
presumably gets high, Eskimo somehow collects
reindeer piss (perhaps via catheter), then slurps back
the delicious foamy broth, Eskimo gets similarly spaced
– hopefully enough to forget he’s just drunk reindeer
piss.
The active metabolite psilocybin is not metabolised
by the reindeer and therefore is excreted in the urine
– and therefore as the Eskimo guzzles the nectar he
will get intoxicated without the nasty poisonous side
effects if he’d eaten the ‘shroom himself.
Standard illegal ‘shroom/muscarinic side effects,
nausea, blurred vision, dry mouth etc to be noted....
4. Bee stings
Wanna catch a buzz? Then why not hang around a
beehive and provoke the bees into stinging you? Bee
stings cause pain and swelling but also cause increased
production of dopamine and cortisol leading to
‘intense feelings of satisfaction’ and in some cases can
lead to hallucinations. According to experts bee sting
venom contains over 40 substances that act on nerve
receptors and blood vessels to increase blood flow. Bee
stings have been used therapeutically arthritis, nerve
pain, and parasthesia.
Side effects include pain, itching, fever, weakness,
dizziness and ear buzzing!
1. 1. 1. 1. Jenkem Jenkem Jenkem Jenkem AKA AKA AKA AKA Butt Butt Butt Butt
Hash Hash Hash
The The pinnacle pinnacle – – and and possibly possibly the the most most repulsive repulsive
practice practice ever ever described. described. Jenkem Jenkem is the the practice practice of
fermenting fermenting faecal faecal matter matter for several several days. days. Users Users place place
a balloon balloon over over the the end end of a shit shit encrusted encrusted sewage sewage pipe pipe
or bottle bottle to ‘capture ‘capture the the fumes’ fumes’ and and then then inhale inhale these these
fumes fumes in a bid bid to get get high. high.
Jenkem Jenkem is said said to cause cause unconsciousness unconsciousness followed followed by
intense intense hallucination hallucination which which can can last last up to 3 days. days. The The
practice practice is essentially essentially free free as all you you need need is your your own own
arse, arse, a balloon balloon and and a bottle bottle –no –no more more dubious dubious street street
corner corner dealers. dealers. However, However, you you need need to be disturbed disturbed
enough enough to do it it in the the first first place. place.
Three Blind Mice
Sun Rise
All for one and and one for all
Answers:

NHS Cuts
The British Medical Association
has weighed in on the new Prime
Minister David Cameron’s health
care proposals.
The Allergists voted to scratch it, but
the Dermatologists advised not
to make any rash moves..
The Gastroenterologists had a sort
of a gut feeling about it, but the
Neurologists thought the
Administration had a lot of nerve.
The Obstetricians felt they were all
labouring under a misconception.
Ophthalmologists considered the
idea short-sighted.
Pathologists yelled, “Over my dead
body!” while the Paediatricians
said, “Oh, Grow up!”
The Psychiatrists thought the whole
idea was madness, while the
Radiologists could see right through
it.
The Surgeons were fed up with the
cuts and decided to wash their
hands of the whole thing.
The ENT specialists didn’t swallow it
and just wouldn’t hear of it.
The Pharmacologists thought it was
a bitter pill to swallow and the
Plastic Surgeons said, “This puts a
whole new face on the matter....”
The Podiatrists thought it was a step
forward but the Urologists were
pissed off at the whole idea.
The Anaesthetists thought the whole
idea was a gas but the
Cardiologists didn’t have the heart
to say no.
In the end, the Proctologists won
out, leaving the entire decision up
to the twits in London ..
We all have those moments
where medicine just gets a little
out of control. Some of these
stories are funny, some are sad,
some are cringy, some are tragic,
some will leave you confused and
seeking your teddy and others
will make you pity the NHS!
But scarily, All.of.these.stories.
are.100%.true...
Steve was on a geriatrics ward
and was on a ward round when
they came to a woman with PR
bleeding. After the patient was
covered in a sheet from below
her waist, the consultant and
registrar performed a per rectum
examination on the woman.
They then offered Steve the
opportunity to perform his first
PR on the patient after getting
her consent. Being nervous,
Steve gloved and lubed up and
went straight in and had a feel
around. The consultant then
asks, ‘Can you feel the mass on
the left hand side?’ Not wanting
to appear incompetent, Steve
lied and said he did. There was
silence as Steve spent another
minute pretending he knew what
Funny Unforseen Conundrums
Unleashed on Patients
The
Alternative
Dictionary
Artery: - The study of
paintings.
Barium: - What doctors do
when patients die.
Cauterize: - Made eye
contact with her.
Dilate: - To live long.
Fester: - Quicker than
someone else.
Fibula: - A small lie.
Impotent: - Distinguished,
well known.
he was doing. The consultant
then calls Steve outside along
with the registrar and as soon
as they are out of earshot of the
patient they burst into laughter.
The consultant then asks a
confused Steve – ‘You didn’t
really feel anything did you?’
Embarrassed, Steve whimpers –
‘Sorry, it was my first time…’ to
which the consultant says – ‘It
shows, you didn’t do a PR exam
at all! That was her vagina. And I
think, technically, you just raped
that poor woman…’
Sam was hungover from
Wednesday tables and was
being briefed by the consultant
on all the patients before the
medical ward round. ‘And most
importantly, we must be very
careful with Mr Fisher. His
results are back and we must
give him a warning shot before
we tell him that he has been
diagnosed with end stage renal
cancer.’ They got started on the
ward round but Simon found
it very hard to stand and not
be nauseous. The consultant,
noticing his dismissive attention
Dingbats
S
span, decided to call him out on
it. ‘Sam, you seem very bored. Are
you familiar with this patient’s
medical notes?’ To which Sam’s
curt response was – ‘Course I am,
this is the one with cancer isn’t
it?’
Fiona found herself at a sight
impaired station in her OSCE
exam with only 1 minute of
preparation. Not knowing the
first thing about leading a sight
impaired person, she was very
nervous as she said – ‘So, how
can I help you?’ The ‘patient’
replied – ‘Well, I believe you’re
supposed to offer me you arm
and lead me down this corridor’.
Fiona then grabbed the ‘patient’
by the arm and went through
the corridor side-by-side with
the patient causing the patient
to pinball off the walls. After
embarrassingly emerging out
the other end, Fiona had to offer
some information to the patient.
‘Would you like your information
in Braille or on tape?’ The patient
asked that it be sent to him by
email. A very confused Fiona then
stutters ‘But, you’re blind...’ just
as she looks over to the examiner
sternly shaking his head. She
failed.
Man Utd 4 – 1 Liverpool
Chelsea 4 – 1 Man City
Spurs 4 – 1 Blackburn
West Ham 4 – 1 Newcastle
Birmingham 4 – 4 Tranmere Rovers
U
N
m ce
m ce
m ce

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