The musings of a final year medical student

Monday, 24 March 2014

Uni Application

So far:

UCL interviewed me and subsequently gave me an offer (I'm just as shocked as you)

Liverpool haven't replied yet but have said we will hear back at the end of March, so any day now

Cardiff & Leeds rejected me prior to interview

Newcastle have given me an offer (AAB) to study Biomedical Sciences

Once I have firmed my choices I will write a thorough blogpost!


Friday, 21 March 2014

Why Agnosticism IS valid

Today I stumbled across a YouTube video titled "Agnostics ARE Atheists" By the Youtuber Jaclyn Glenn.

In her video she explains the following:

- the word agnostic, literally means "without knowledge"
- Hence, both atheists and theists alike are agnostics, too, because neither of them have black and white evidence to back up their beliefs
- you cannot call yourself an agnostic because you either believe in god or not and technically we are all "without knowledge"

I do agree with many items that Jaclyn discusses, but I do not agree with the conclusion she draws from them.

First of all, yes the word 'agnostic', when you derive it's literal meaning, does mean "without knowledge". She is also correct that of course neither an atheist or a theist can prove their beliefs are factually correct.

However, what Jaclyn gets wrong here is that she assumes that everyone has already decided what their religious opinion is. She assumes that everyone either thinks God exists or doesn't. However, there are some people who genuinely don't have an opinion that veers either way. Take myself for example, I do not swing more closely to either end of theism or atheism. I don't have an overall opinion of whether I think God actually exists. Therefore, it would still be incorrect to call myself an atheist because I still don't believe whole-heartedly or suspect with  that God doesn't exist. I admit that is highly unlikely from what I have been educated, but I don't feel certain in any regard that God does not exist. Therefore, by definition, I am an agnostic still.

The video: Agnostics ARE Atheists, by Jaclyn Glenn

Friday, 7 March 2014

Should we adopt the minimum unit pricing for alcohol?

After the flop that tried to introduce minimum unit priced alcohol in 2010, alcohol is back up for discussion. 

Globally, 4.6% of ill-health and mortality is due to alcohol and 3.8% of deaths. In 2009, 6584 deaths were  directly related to alcohol abuse, mostly caused by alcoholic liver disease.

But wider than the diseases that an alcohol consumer can inflict on themselves, they also have an effect on society through drink-driving, crime, instability in families as well as in the workplace. The children's commissioner, Dr Maggie Atkinson, has stated that alcohol is a key factor in child protection issues and social work cases involving children and families.

What shocked me was to discover that in 47% of violent crimes in England and Wales alcohol has been consumed. One could argue that the introduction of a minimum unit pricing for alcohol would help to combat this percentage. 

In addition, the UK stands alone with Malta within Europe by retaining to the drink driving limit to 80mg per 100ml, compared to our neighbours adopting 50mg/100ml - a potentially life saving difference.

Is today's culture to blame? Most of us accept the stereotypes that the Scots and the uni students (particularly medical students, ironically) to be heavy drinkers;  it is not something to be questioned or critiqued but simply the way it is. Listen to any music in the UK music charts and you'll hear rappers and the likes of Miley Cyrus talking about all their 'bottles and ice'. Alcohol is just as seductive as smoking to some teenagers. And as the Student BMJ mentioned in their recent publication, alcoholic products are allowed to be advertised at films for unaccompanied 12 year olds.  

Excessive alcoholism needs to be taken seriously. As the Student BMJ pointed out, according to the ICD-10 (international classification of disease, 10th revision), there are over 200 diseases that can be caused, both directly and indirectly, by alcohol, including:
Cirrhosis of the liver
Cancers of: the liver, mouth, oropharynx, oesophagus, colon, rectum, breast
Hypertensive and ischaemic heart disease
Low birth weight and disorders arising in the perinatal period
Road traffic incidents
Falls, poisonings and other unintentional injury
Alcohol use disorders and unipolar depression

I wonder how many young people are made aware of all these risks. Without this knowledge, I don't see how we can look down at alcohol-abusing youths if they are not at liberty to make educated decisions. The alcohol industry and public figures only portray one side of alcohol consumption. No one speaks publicly about the disastrous effects of alcohol, and I don't know why that is. 

It does beg the question as to why alcohol is even legal. I wouldn't be surprised that, if alcohol was a new drug being introduced in British culture, analysis of it from the government would most likely deem the drug too harmful to be legalised. Like smoking, the longstanding prevalence of alcohol in today's society inhibits it's banning because if such a thing was to happen there would be nationwide uproar and the synthesis of an unregulated black market. But at least with smoking we're actually raising its more unglamorous, life-threatening profile. Youtube and UK television is littered with anti-passive smoking advertisements, we have the ban on smoking in public places, smoking companies are not permitted to advertise their products on UK television at any point, plus all smoking products must be clearly labelled that they can potentially kill its users. The disparity here is, quite frankly, ridiculous. 

So, getting back to the question, should we adopt the minimum unit pricing for alcohol?
In British Columbia they have found that a 10% increase in alcohol pricing has reduced the number of alcohol-related hospital admissions by nearly 9%. Alcohol attributable deaths also decreased by 32% after the introduction of a minimum unit price. This indicates that if we, too were to introduce such a scheme the effects could be very beneficial to UK health, especially as 45% of all alcohol consumed in the UK is bought by the heaviest 10% of drinkers. The number of alcohol-related admissions to hospital seem to be on the rise, so some action ought to be put in place. 

Scotland has already passed a bill requiring a minimum unit price of 50p per 8g unit of alcohol in 2012, however the bill has yet to take effect. 

Of course, most people in the UK do not drink alcohol to excess, therefore some feel that the minimum unit pricing would unfairly penalise those who already drink moderately. However, this argument falls short when if you were to model the estimates of 50p per unit then moderate users would be less than £10 worse off annually, compared to to heavy drinkers that would be almost £200 worse off if they continued to drink the same amount. 

It goes without saying that those on tighter budgets are going to suffer more from this ban than bigger earners. People on low incomes are believed to be most at risk of alcohol related harms, reinforcing the necessity for the minimum unit pricing for alcohol. 

If we want to increase national health, less alcohol needs to be consumed, and regular drinkers need to consistently consume in moderate quantities. Simple as. If the minimum unit pricing for alcohol is going to encourage that, then I'm all for it. 

Monday, 3 March 2014

I have an interview at UCL medical school!

I've got over a week to prepare…

Wish me luck!

Living in care

For the past year I have worked on a voluntary basis at a residential home. Here, we have residents with varying different mental and physical diseases. As we are a 'residential' home than a 'care' home, we do have a very select few (2) number of residents that are deemed safe enough to leave the complex unattended as they choose. We have the complex set up to facilitate this without causing too much frustration from the other residents that are not allowed this privilege. However, I've always wondered how it feels to live 24/7 at such a place.

I'm proud to say that where I work we uphold a very positive reputation in the community, and when I speak to the residents I look after they have nothing but nice things to say about our carers and healthcare assistants. But one thing I didn't appreciate until began working there was just how busy carers and HCAs are. It's non-stop work. Consequently, the residents may be well fed, dressed and comfortable, but once these needs are met there's always another resident that needs tending to. Some residents have good established friendships, but not all of them. Some are either too ill to leave their bed, or if they wanted to move they would need someone to help that they oxygen tank came with them as well. That's why I am so happy to be a volunteer, because most of my job revolves around simply talking to the residents. I work with one particular resident who is disabled; I take her to church and back each week, make her a cup of tea and have a nice chat with her. Because of her disability she can't just pop into the lounge whenever she wants and have a chat, and she doesn't eat her meals in the dining room with the rest of them. Yes, she has her books, her letters, her flute recordings, and she has a circle of friends of family that visit her on a weekly basis. But that doesn't mean she isn't lonely sometimes.

I suppose loneliness is an issue that depends on the resident. Some residents with very poor memory would never wallow in being forever alone all day because they simply don't remember it. They live right in that moment.

I never appreciated how much the few hours I spend with her on a Sunday would make such a difference. I also feel like I'm helping out the carers because before I joined the team they always had to alter the Sunday timetable and bring in extra carers so that one was spare to take residents to church, which leaves fewer at the home to look after all the other residents. Now I take the residents to church by myself, so the carers have a good capacity of staff to look after them.

I can see the disappointment on the lady's face when I can't stay longer for a chat. She sends me letters and always asks me about my A levels and my family, and my dreams of becoming a doctor. Likewise, I know all about her long-lost brother that died aged 17 to the war, her wonderful husband, when she lived in India, her life in Dorset, her yoga teacher daughter, her grandson and her 2 great grandchildren.

Whenever my parents talk about when they 'get old', my dad insists "Just chuck me in a home, I don't want to burden you and stop you from living your life. Don't make me live in with you, it'll be too stressful for you and you'll resent me for it".
He says this probably from experiences that he's had to deal with his patients as a GP. But I think should that scenario ever come to play, I will certainly make sure I can visit him several times a week, because one hour or one lunch every now and then can never replace the longer loneliness.

Sending a loved one to a home is often a very necessary step, but to be quite honest I still don't know how I feel about inflicting that lifestyle onto a loved one.


Sunday, 2 March 2014

The future

At the moment it seems that I am really questioning the rest of my life.

It all started when I was talking to a close friend who is currently applying to read psychology as well as applying to ballet school. So far she has an offer at a prestigious London university as well as an offer at a highly competitive contemporary dance school, also in London. She was telling me all about how excited she was to live there, and I am absolutely ecstatic for her. All her hard work has paid off. However, it reminded me how much I adore London, too. I've always yearned to study there, and each visit I make there consolidates this desire in me. However, I have only applied to one London university, UCL, to which they haven't yet replied to me. Given that interviews started in December there I am 99% certain a rejection is looming.

So far, London isn't on the cards. I wondered how the others around me would react if I purposefully took a gap year just so I could apply to London universities. They'd probably think I was mad and a little selfish. But then I thought, "Well why would I care what they thought! This is my life, my journey."
My mum was fairly apprehensive; she thought that surely if I wanted to go to medical school that much I wouldn't care where I got in. Every medical applicant has the opportunity to choose the place where they want to study, not just based on the medical education but also the lifestyle attached to the geography of the institution. Medicine at UCL/Imperial is a 6 year course, including a compulsory intercalated Bsc. Six years is a long time for a person to live in one place, and with the probability to continue studying the Foundation years there, too, plus specialist training afterwards. I know I love London. We have friends and family living in different areas that we meet up with all the time, to the point where London already feels homely to me.

There's also an aspect of what the London medical schools may offer that the others cannot. Studying in London gives the opportunity to work in the most famous UK hospitals, not to mention some of the best specialists and surgeons. I still don't know what kind of doctor I would like to be, however I would like to have the opportunity to really sink my teeth into testing out the specialities on offer. London gives me the opportunity to do that in the best places, to see the most up to date and revolutionary of modern medicine.

It doesn't mean I don't want to be a doctor that much that I am prepared to waste a year I could have been at medical school. It's all I've been thinking about since I was 15 and I cannot be more certain that this is the profession for me. I will stop at nothing to one day be a doctor. It's just medicine isn't the only dream I have, but nevertheless the biggest.

Now I'm trying to think of ways I can enhance my medical application. I've been volunteering at a residential home for over a year now as well as working at a GP surgery for over a year, too. I will continue these placements into next year, should I choose to reapply. So far I could only get w/e at a community hospital, so I am currently in the process of attaining some more in some of the larger hospitals in Gloucestershire. I'm looking out for a GP shadowing placement as well. This year I am planning on running a half marathon.  Most universities seek evidence of teamwork/leadership/communication skills, so I am trying to brainstorm as many ways I can broaden this area, however I already feel I have developed this section well.
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