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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Friday, 30 March 2012

Global Health and the Medical Student

This is only intended as a brief post, to link in with my recent post reflecting on the recent attendance of Medsin-UK at the International Federation of Medical Student Associations (IFMSA) General Assembly (GA) in Accra, Ghana.  If you're interested, you can read it here, or go to the Medsin-UK blogs.

Dr Ankomah and the apprentice, 2008
It seems apt that the brilliant team of UK medical students have just returned from the place that really confirmed my interest in medicine in the first place.  As a bright-eyed, bushy-tailed 17-year-old, I fundraised to go to Ghana for a month and worked in a hospital near Accra. I was also lucky to work in more rural areas, delivering a couple of outreach health workshops.  The experience taught me both the basics of medicine at a time when I was struggling to see beyond A-Levels, never mind university, and gave me an insight into the realities of health care in another country.  I loved it so much, I returned to West Africa after my second year at Medical School as a backpacker around Ghana, Togo and Benin.  Of course, no trip would have been complete without popping in to see Dr Ankomah, and I hope to return at some point when I'm qualified.  I have been something of a backpacking enthusiast but the more places I see in the world, the more I realise I have yet to experience.  The diversity of world is truly exciting.  But unfortunately the diversity extends to the quality of healthcare, perpetuated by the different healthcare challenges facing each corner of the world.

I'm no expert in Global Health, but my time at Newcastle University has facilitated many situations where I have learned more about it.  Early on, as a fresher, I trained with the Newcastle branch of Sexpression to deliver sexual health education to young people in Newcastle, and it was interesting to contrast these experiences with those of our outreach projects in Ghana.  It was through further work with Medsin-UK as part of the committee for the Global Health Conference here in Newcastle, and through attending the IFMSA meeting in Copenhagen last Autumn, that I really learned a lot more about the role medical students have to play in the global health message.  I think what I find most exciting is that global health often starts at home; we can challenge the health inequalities we have right here on our doorstep.  It is particularly exciting to hear about the Global Health Education Project, which promotes Global Health Education as an integral part of medical education.  Sometimes it can seem daunting and unachievable as a medical student to get involved in these various projects, but local activities are a great place to start.  

Sunday, 25 March 2012

Open Access to Research

As a medical student, research is something we 'should' know something about, and 'should' use to develop an evidence based approach to our clinical practice.  We do our best to critically appraise the literature, understand what all the statistics actually mean and, fingers crossed, we'll be able to tell you at the end of it whether the research was any good or not.  

I certainly didn't give a great deal of thought to how we are physically able to access research articles.  It wasn't until I did some lab time of my own that I realised also that a lot of research means starting from scratch, because raw data from research studies stays within that research group.  

It was around this time that I became aware of the Right to Research Coalition ( which is based across the pond, but we're working to get a base here in the UK for this important issue.  So what is Open Access and why is it important for research and clinical practice, and, indeed, global health and the international community?

When I want to read a research article, it's quite straightforward - I just log in to Pubmed either on campus or I log in from home.  Every now and again I'll hit a brick wall and be unable to access a relevant article. Has that ever happened to you?  Imagine that happened every time you tried to read any article you ever wanted to read.  Then think what research developments have happened in the last few months alone.  Aspirin to prevent cancer, laparascopic surgery for colorectal cancer, the pros and cons of new targeted therapies... Our ability to stay up to date clinically relies on our being able to read journal articles with ease; and yet some journals cost thousands of pounds for a subscription.  Great, if you are part of an organisation that does this for you, but not so great if you're not.  

Now, if you're thinking 'yes, but research is expensive and this is a way of paying for it' - well, research has kind of already been paid for, often by the government or charities.  We have a right to see this research.  A system that was never designed for profit has been made into one.  There are many more open access journals now, demonstrating that it is a sustainable business model.  

The problem isn't just clinical up-to-date-ness, it's also a question of making science accessible to all.  This blog explains the problem through the eyes of a scientist in India:  Simply, we are shutting off many countries of the world either from seeing what research is happening elsewhere, and therefore from being able to add to the knowledge base.  If we are serious about global health (and we should be), this needs to be addressed.  

Finally, it's also a question of making research more streamlined.  Just think - when you read a research article about something, you are told the aims and objective, the data is categorised and analysed and then you are told the conclusions of the study.  But what about the raw data?  That stays with the author.  Obviously this is also a question of research ethics and patient confidentiality, but what if that raw data could be accessible to other research groups rather than having to start from the beginning? 

I'd urge you to check out some of the links above if you're interested:

What do you think about Open Access?  Have you heard of it before, do you think it's a good thing?


Saturday, 24 March 2012

First Post Pressure!

So it is with slight trepidation that I enter the world of the Professional Blog.  Hello!  I hope from time to time you will pop and hopefully read something that you like, or that you share some of the things I am interested in.

To get cracking, I thought I'd start with a wee post about the BMA Council Election in which I'm currently standing as a candidate.  If you know me, I'd really appreciate your vote!  If you don't know me, and are wondering who on earth to pick on the epic-ly long ballot form, I'd like to tell you a bit more about myself and perhaps you'll consider voting for me too.

I'm a Scottish/German/English medical student - born in Glasgow, grew up in Wiltshire.  I can thank my German mother for the spelling of my first name and continuing to be better at English than I am, and my English dad for his willingness to help me with my maths queries.  The local secondary school that I attended happened to be a Performing Arts school and none of my family are medics, so medicine certainly wasn't a foregone conclusion for me!  However, I am so glad I chose this profession - I know I probably still have the rose tinted glasses of a medical student on, but I have loved my training at Newcastle University (with a detour to intercalate at Imperial in Surgery and Anaesthesia), and the extracurricular activities that have come my way have led me to become interested in medical politics.

I came very much from the grassroots level to the BMA.  At medical school, I trained with Sexpression to run sexual health workshops for young people in the North East, a role which later led me co-coordinate a National Sexpression Conference in Newcastle and train other students to lead workshops.  This led me to work with Medsin, and I was the logistics coordinator for the Global Health Conference in Newcastle.  But it was really as President of the Newcastle Medical and Dental Students Council (NMDSC) that I became really interested in medical student representation and medical politics - apart from organising various social events, it also gave me a sense of what representation can achieve on the ground.  For example, we organised peer parenting, along with a Cheese and Wine mixer to help 'parents' meet their 'children (freshers)' in a more relaxed environment, and wrote a Freshers guide for prospective Medical Students.  I remain passionate about staying in touch with what's happening at a grassroots level, and aware of what people want and need.  I should also say that the NMDSC committee was a brilliant committee to work in, with real teamwork and camaraderie, and I felt excited about working in such a motivated group and really getting things done.

I became involved with the BMA as the medical school rep (MSC rep) in my fourth year, and have never looked back.  I was struck by what the MSC could achieve and the high level on which it lobbied for medical students.

I was Chair of the Medical Students Committee (MSC) 2010-11, a role that was challenging but exciting.  Just as I took over, the Foundation Programme Oversubscription was announced, as was the Browne Review, and the start of the year was a blur of lobbying, meetings and media work to try and get our message to the politicians and organisations making the decisions.  Regarding student finance, we lobbied hard to get Medical Students to be seen as a group who required special consideration - only 1 in 7 medical students come from a lower income background, a figure that has since increased further.  Although the £9000 fees were pushed through, we did manage to secure a guarantee for NHS bursary funding for subsequent year, without which students may have been paying up front for their education right at the end of their medical degrees.  As for the Oversubscription, we cited how medical unemployment constituted a waste of taxpayers money, and eventually all graduates were offered a Foundation job.  I also attended the International Federation of Medical Student Associations (IFMSA) meeting in Copenhagen with Medsin UK, sitting on the Standing Committee for Medical Education.  There, I was fortunate to be able to discuss ideas about student representation, student feedback and political lobbying with medical students from all over the world.  There were of course many other issues that the MSC worked towards last year, which involved working with the GMC, the Medical Schools Council, UKFPO, Foundation School Directors and importantly, committees within the BMA.

As MSC Chair, I represented Medical Students as a non-voting member of BMA Council.  There aren't many voices from our end of the medical profession on Council, and I think we need to be vocal to ensure our voice is heard.  Having seen what is involved, I think I have the experience to contribute and be that voice.

This year, having returned to Newcastle, I still sit on the MSC Executive Committee and sit on the Junior Doctors Committee, and feel that this experience would help bring continuity to the role on Council.  I'm also working on developing the Right to Research agenda in the UK after meeting the RtR Director at IFMSA - I blog on behalf of Medsin-UK at....

I think I'll stop there... and round things off by saying how much I have enjoyed the experiences I have had so far, and how lucky I have been to meet the great people I have met in the MSC and the BMA as a whole.  If you ever despair of the apathy of today's young people, come along to a BMA MSC meeting and your heart will be warmed!  It has been invigorating and inspiring to work with so many brilliant people.  If I was voted onto Council, I would work my socks off!

Danke sehr, und alles gute,