Friday, March 30, 2007

MMC Big Daddy Resigns

Professor Crockard, National Director of MMC, marches out of the MMC bunker for good

I was online at FrontPoint Systems (yes, so I was procrastinating again. What's it to you? YOU AIN'T THE BOSS O' ME!* --Editor) when he broke the news that Professor Alan Crockard, the National Director of Moderning Medical Careers (MMC) has resigned. Read his full story here, and the full letter of resignation at Dr Rant here. (Link not safe for kids. Don't bother with noisy grown-ups arguing, li'l tykes, go play a Teletubbies game or something. --Ed)

Let's take a break from revision together, folks, and take a look at ol' Crocky's letter. In it he simultaneously plays both hero AND villain (a feat previously only managed by President Bush --Ed). He says "The principles of MMC are laudable and I stand by them. More patients should be treated by trained doctors, rather than doctors in training."

Forgive me, for I am but a humble overworked medic, not blessed by the abundance of brain cells required for a position of such great responsibility, but I fail to see how exactly we are supposed to GET trained doctors unless we LET doctors-in-training treat patients.

However towards the end he nicely states "But the overriding message coming back from the profession is that it has lost confidence in the current recruitment system." There we go. At least he's acknowledged that doctors don't bloody like MMC, without resorting to the whole ignore-doctors-won't-apologise-lalala-I-can't-hear-you stance of the Department of Health. If he stepped down in genuine protest at how the system is treating doctors in such a haphazard manner, and if he is not a traitor like the complaint lodged against him suggests, then he is truly worthy of applause.

So c'mon, folks, join me in celebrating by putting this on repeat on your playlist, courtesy of the brilliant DogHorse. Turn the volume up real loud - it's great for accompanying revision!

* unless you're my Director of Studies/Senior Tutor/supervisor, in which case, sorry, sir. I'm heading back to the library now, sir. Honest.

Thursday, March 29, 2007

I Am A Lazy Bum

(To all you wise-guys out there who yelled "Tell us something new!" - I heard you. --Editor)


4 days into lockdown, and what great worldview-revolutionising truths have I learnt?

I have forgotten how to revise.

Lord give me strength to stay in this library without going back to my room to nap every 2 hours...

(And if any of you med students out there have any revision tactics to drop off, now would be a good time too. Especially if you want my eternal gratitude for any reason.)

(To all you pervs wanting to know who the newscaster chick is: she's the French news icon Melissa Theuriau. --Ed)

Sunday, March 25, 2007

Thinking Bloggers: Not Just Neurologists


Cambridge Lockdown Update: Ugh. I haven't slept in 24 hours due to having to jostle for table space at my 24-hour-open library. (Even though we have a 5-week vacation, many students have elected not to go home in favour of staying at the library to revise, despite living 2 hours away in London. Only in Cambridge, folks, only in Cambridge. --Editor) My eyes feel like they're about to pop out of my head, and I am strangely gripped by the suspicion that this may be because my brain has melted and is about to start pouring out of my eye sockets.

But I finally crawl out of my prison cell at the library, come home, and am just about to read my favourite blogs with a nice steaming cup of hot chocolate when I stumble on this. And this. And then Dr Crippen 'BritMeds' me saying this:
The Angry Medic is not overworked, it seems.
"Term ended at Cambridge last week and the holidays have already started..."
It’s all right for some!
Oh hohohoho. Eet's a conspeeracee, I tell you! They're all trying to get me to go back to work. I know whose fault this is. My Director of Studies must have put them up to this. But no matter. I'm still going to get some sleep.

Then, as I lift the cup of hot chocolate to my lips, I glance at my watch, and the kicker hits.

Thanks to British Summer Time, I have just been robbed of an hour.

ONE HOUR! Do you know what an hour MEANS? I could have memorised FOUR different signalling mechanisms in that hour! HEARTLESS CHILD-MURDERING THIRD-WORLD-COUNTRY- ENSLAVING BASTARDS *shakes fist at whoever dreamt up British Summer Time*

So it is only natural, then, that I put down my cup of hot chocolate, clear everything from my hard, spartan wooden table, and begin rhythmically slamming my head against the tabletop, praying for unconsciousness before any more bad news hits me.

But just before unconsciousness swallows me, I check my mail, and hallelujah! My first piece of good news for the day. My favourite nurse Mother Jones has tagged me with the Thinking Blogger Award, an award which I've been following across the web but which I never thought I'd be worthy of, what with my inane ramblings here.

It's called the Thinking Blogger meme, and I'm honoured to pass it on to the 5 blogs that make me think (in no particular order):

1. If you get tagged, write a post with links to 5 blogs that make you think,
2. Link to this post so that people can easily find the exact origin of the meme,
3. Optional: Proudly display the 'Thinking Blogger Award' with a link to the post that you wrote (here is an alternative silver version if gold doesn't fit your blog).

1. Michelle vs The Med Student
2. Nurse William
3. The Rumours Were True
4. HospitalPhoenix
5. A Jolly Company

These are blogs whose subject matter, being far more substantial than mine, make me think. Tag, you're it! You can of course choose not to participate in the meme, but I give you the award nevertheless.

Now excuse me whilst I go get my regular six five hours of sleep. (Dangit. --Ed)

Thursday, March 22, 2007

Lockdown

Our Director of Studies encouraging us to revise.
Rifle included purely for effect-enhancing purposes.

Term ended last Thursday here at Cambridge, and so begins the five-week-long Easter vacation. This means most Cambridge students (even those lazy dossers doing Land Economy and SPS who spend all year rowing and prancing about on stage stealing good parts from poor hardworking medics who obviously deserve them better [not that I'm bitter or anything] --Editor) start to realise how close they are to exams (67 days, but hey, who's counting? --Ed), get all penitent about not doing enough work, start to work, freak out after realising how much work they ACTUALLY have to do, go home and fall at their parents' feet apologising for shaming the family and bringing dishonour into their homes (and if you're Japanese, possibly try harakiri --Ed) and then go into lockdown mode for the rest of the vacation to prepare for exams.

College libraries stay open around the clock. Porters patrol the libraries at night. And at St John's College, the famed Suicide Watch will soon start patrolling St John's Tower to deter any poor sod who realises he's in the wrong university and decides he wants to go scream "WHY ME?!" at God in person.

As for me, I'm starting to get my act together and will soon instruct the porters to forward my mail to 'Room With Plastic Skeleton, The Library, Jesus College'. Unfortunately, I'm not the only medic determined to move into the library. I'm anticipating a blogworthy battle coming up. Wish me luck. In the meantime, go check out what happened when I became a disability patient* on Medscape. No smartarse cane jokes please--you quickly find out how useful they are for bashing people on the head...

*Tell me you love the post title. I spent HOURS dreaming up the title. You MUST love the title! Love the title or die by cane bashing!

Tuesday, March 20, 2007

The Empire Is Struck Back Against, Part II

Aboard the MTAS Death Star, Emperor Blair and Darth Hewitt try to get themselves out of hot soup

After last Saturday's widely-publicised march in London by junior doctors protesting against MTAS, Patricia Hewitt has gone into hiding and left behind her henchman Lord Hunt, the Health Minister, to face the music and gibber incoherently. Dr Crippen wonders where she's gone; I suspect she's hiding on the MTAS Death Star.

And since my last post on the MTAS debacle (which was picked up in last week's BritMeds due to my use of the word 'wankpile' to categorise it; I don't think that's weird at all, do you? --Editor) Opposition Leader David Cameron has finally got it through his thick head that hey, thousands of doctors protesting could actually be a good time to campaign for votes:

David Cameron gets a clue

But you have to admit, his speech was stirring. It made doctors feel something they haven't felt in a long time -- like they were valued. You can watch it here.


Comments
under the original post here please.

Saturday, March 17, 2007

The Angry Medic: Comic Relief Edition


I happen to think I am funny. I persist in this belief, despite the fact that the comments box on my previous post (which I happen to think was quite funny) has not exploded with praise and adulation, and despite the fact that when I go on stage in a comedy play I usually get off stage either by being yanked off by a horrified show manager or accompanied by a torrent of rotten vegetables thrown from the audience. But as a funny medic, it should come as no surprise that my favourite charity is Comic Relief.

Therefore in support of Comic Relief, I urge you to spend a few pounds to give children in need a better future by buying 'Shaggy Blog Stories', a collection of 100 short humorous pieces from the UK blogosphere, put together by prominent blogger Troubled Diva in just 7 days. All profits from the sale of this book will be donated to the Comic Relief charity.

For the next week, my blog banner will link directly to the Shaggy Blog Stories website. The full list of bloggers featured can be found here. More information about Comic Relief and its signature event, Red Nose Day, can be found by clicking on the picture of the beautiful ladies above (mind where you click, you perverts. --Editor).

Comments under my previous post here please. Have a great weekend!

Friday, March 16, 2007

This Post Is Brought To You By The Letter 'B'


B. What does B stand for, children? Let us count together.

Firstly, it stands for bitching. Which is what this post is going to be about. So if you can't stand a pissed-off medic ranting about his extremely sad but ironically humourous medicky excuse for a life, then for heaven's sake, press the back button now and go back to whichever porn site you came from. Or go here and dance with the fluffy bunnies.

Secondly, B stands for Type B. As in Type B medical students. As explained by Michelle of Michelle vs The Med Student.

Normally it's tough being a Type B in a med school. You aren't as driven as some of the people in your classroom, fine. You don't take as many notes, fine. You don't score 99% on every test, fine. You still graduate, get unleashed on the poor sods who are going to be your patients, and get to do doctorly stuff like jab people and stuff your fingers up their bums. And as long as you don't kill anyone, you'll be okay. (If you DO kill someone, then you're either 1) very unlucky, or 2) an idiot. Don't point at me and tell the judge at your malpractice trial "But some Cambridge medic said it was okay if I killed a few people along the way!" --Editor)

But to be a Type B medical student in Cambridge? Cambridge, Seat of Academic Power, Home of Zombie Lecturers Who Stay In Their Labs All Day, Birthplace of Research So Impressively Named It Makes Your Granny's False Teeth Fall Out Just Pronouncing It?

Burn in hell, SINNER!

A Cambridge Biochemistry lecturer

Oh heck no. If you don't sit in the library for at least 8 hours a day and whack some fat textbook against your forehead until you can recite everything in it including the author's grandmother's favourite dog's name, then you're not fit to be in Cambridge. You're a Type B. Throw off those fake glasses, you bastard, and pack your bags. Here's a ticket to Hull. Try your luck there, and if they don't take you in, we've already told the British Institute of Learning Disabilities you're coming. Retard.

What else can we find for the letter B? Oh yes, here's one: burnout. As written about magnificently by the inimitable Sid Schwab of Surgeonsblog. I had a supervision today where my supervisor was a real doctor (you know, one of those sad blokes who slaves away in hospital, not some aging hippie who has a PhD and sits in a lab for 5 months obsessing over some obscure molecule which about 3 people in the world genuinely care about. --Ed). As some of you know, I'm interested in doing surgery as a career. I tell my supervisor this. And he tells me he's never doing surgery because it's a horrible, horrible specialty, where all the extremely competitive anal-retentive medics just backbite and bitch about each other in a mad scramble to the top. In fact, he goes so far as to say "It's just like an episode of The Apprentice".

The true nature of surgery

Why the hell am I doing medicine again? Remind me, someone. Please. Answers on the back of a postcard to Jesus College, Cambridge. Either that, or send me a 9mm handgun so I can put myself out of my misery. (But not before taking out a few of my course organisers first. Hey, if I'm going to hell, I want company on the way down. --Ed)

And if you've managed to keep reading this far without passing out cold on your laptop or taking me up on my earlier offer of clicking over to Fluffy Bunny Land, then congrats! I'm not all moan moan bitch bitch, you know. There's some meaning to this B nonsense I've been spouting all this while, and it's that I've finally made the blogging B-list, according to this little Bloglebrity gadget. I've been wanting to make it out of the C-list for a while, and now I'm finally on the B-List. Give it a click and see what list you're on. (Disclaimer: The results are UTTERLY MEANINGLESS and don't mean a thing about blogging ability or popularity, in fact. It's just another one of my lame ways to pass the time whilst waiting to fail my degree. --Ed)

Now excuse me whilst I go do a little lame dance now to celebrate the fact that whilst I am totally and utterly screwed in my career and my life, I at least am nerdy enough to be able to maintain a blog. Though I may have to change its name soon. The Angry Lawyer, anyone? The Angry MBA-Holder? The Angry Construction Worker? Catchy, no?

Wednesday, March 14, 2007

The Empire Is Struck Back Against

Aboard the MTAS Death Star, Emperor Blair and Darth Hewitt find that the Force is no longer with them

The doctors have begun to strike back against the injustice that is MTAS.

Earlier last week they turned to David Cameron, Opposition Leader. They looked to him as a saviour, someone who would use the huge political stick that is the MTAS fiasco to beat Tony Blair on the head and secure several thousand votes. So great was the call that MTAS became the top question on Cameron's Open Blog, where the Conservative leader responds to the top 5 posts every week.

Sadly he has let them down. His response, viewable here, saw him sidestepping the issue like a Labour politician. This idiotic political move is already costing him votes, as an be seen from the responses on his blog.

Doctors wait in vain for David Cameron to save them

But the doctors aren't done in yet! What do good, honest UK citizens do when civil rights are threatened and evil greedy government types screw them over? Why, march, of course. This Saturday's 'March in March' is hoped to raise more media pressure on the government to fix the situation.

The deaneries themselves have spoken out. Some have resigned in disgust. The Royal Colleges have condemned it. In fact, several of the UK's leading doctors have spoken out against it, including, I am proud to add, several of my lecturers here at Cambridge.


But all this is above my humble medical student head. All I know is that the future suddenly looks a lot bleaker, and unless all these angry people in white coats can convince this woman to change her mind, I'd better start looking for jobs in Australia.

So what can I do? Several things. Firstly, I've done my part to educate the international community on what is happening here in the UK by writing a post on it for Medscape. Do check it out and leave a comment or two, if only to confirm what's happening, as the editor left out the BBC news links I gave her (either that or she thinks I'm a loon, which isn't too far from the truth. --Editor).

I also blogged here about the tragic passing of Laura Case, a former medical student at Cambridge who was killed whilst delivering medical aid in Uganda. Her father has written to me with a heartfelt letter that he has sent to The Times, saying how Laura disagreed with the current system of training junior doctors:

My daughter, Laura Case, was a medical student who was killed in Uganda while working there in a hospital as part of her final year training. (Times 20 February).

Like most medical students, she was committed, but not particularly idealistic. Nor was she political. She was, though, angry about the failings in the training and selection of junior doctors. Admittedly her experience was only her own hospital area, but she thought the central organisation and supervision of her training poor, and when on six weekly rotations round various hospitals and GP practices found, with some notable exceptions, that students’ training was often chaotically organised, and students tolerated rather than involved. The view of senior doctors seemed to be that it was better now than when they were young, so ‘get used to it’

She found the failure of government to plan effectively for the requirement for doctors dispiriting, as it lurched from creating new medical colleges, and then in the face of ‘overcapacity’ ditching non EU doctors that had been encouraged to train here, and now admitting an oversupply of newly trained doctors due to ‘changes in the system’. The actual selection process, which has been marginally improved from last year when humans were more or less replaced by computers in selecting junior doctors for posts, is still so useless that a group of consultants recently refused to conduct job interviews on the grounds that the process was unfair. (Times 6 March).

The Department of Health and Downing Street both defend the position with weasel words, but junior doctors, not usually a militant bunch, are so incensed that they will stage a march on March 17th to protest at the position. (www.remedyuk.org). My daughter was well aware of the cost of her training both in terms of taxpayer money and her six years of study; let’s hope many more join the thousands of young doctors planning to march to highlight this cavalier handling of investment and talent, and the government’s inadequate response to the problem.

The medical profession has spoken. We will not stand for dictatorial high-handedness with a policy that looks like it was dreamt up by a bunch of baboons in a doughnut shop with John Prescott. Like this comment says from a friend of Laura's:
Compassion is fine but Laura would have wanted you to fight. Stick a card in front of the complacent - 'Laura Case died because she cared enough to be a doctor.'

Friday, March 09, 2007

The First Duty

"With great power comes great responsibility"

What is the first duty of a doctor? Of a nurse? A paramedic? A first-aider?

What is the first duty of the medical profession itself?
There comes a moment in every medical student’s life, when he realises that all he’s learning is not just for exams, that one day he will be out there on his own, with real live patients and no medical professor leaning over his shoulder to guide him.

I knew it would happen.

And this week it did.

Something happened to me last week that reminded me why I'm doing what I do. And that I'm far, far away from becoming a doctor, despite the fact that I technically become one in 4 years.


And so I wrote a post on it for Medscape. Since it was posted, I have received over 50 comments, as well as numerous emails from fellow medics here at Cambridge who saw it happen. I am not proud of what I did that day. I have questioned myself countless times over the past few weeks, on my ideals, my motivation, and what it really means to be a doctor.


Read the full post on Medscape.

Wednesday, March 07, 2007

Giant Penguins Invade Cambridge!


"Hey Kate."

"What?"

"There's a guy walking behind us."

"So? This is King's Parade, Tom. The centre of Cambridge. There are TONS of people walking around us."

"No, no, I think this guy's a bit...weird."

"Why?"

"For some reason, he's carrying a giant penguin."

Sigh. The things I do for art...

Medics Revue promotional penguin

Monday, March 05, 2007

"No, Osama...I Am Your Father!"

Darth Osama bin Vader

Well, okay. So maybe that statement's got a LITTLE inaccuracy in it.

Actually, I'm Osama's MOTHER.

Or at least I will be, when the Medics Revue opens this Wednesday at the ADC Theatre in Cambridge. Titled 'Happy Fetus', it's a fast-paced series of sketches that's sure to induce side-splitting laughter (don't worry, we've got NHS Direct on speed-dial. --Editor) without a penguin in sight.


It runs from Wednesday to Saturday at 11pm, and has always sold out in the past, so book your tickets (which are priced to suit the average student's constricted wallet) today here at the ADC Theatre website or by calling the box office at 01223 300085.

Our past shows (with the ever-so-catchy title 'The Chronicles of Hernia: The Lion, The Stitch and The Ward-Round' --Ed) went to Edinburgh Fringe festival last year and performed to sell-out audiences. This year's production promises to be no less entertaining, especially with a crazed medic completely fed up of lecture theatres in it.

So do me a favour and when you see Osama's mom come on stage, clap loudly. Either that or laugh uproariously when Barney the Dinosaur comes on stage. I wrote that sketch, and if after 573 times rehearsing it, it turns out not to be funny, I'll be eaten alive by my fellow cast members, who despite all being medics, won't be bothered about catching E. coli infections at the time.

Ah well. At least then I won't have to worry about MTAS anymore.

Friday, March 02, 2007

The Angry Medic Finally Gets MMC & MTAS

Wheel of Fortune: Doctors' Edition

Remember Wheel of Fortune? That game show where, given a hint, you had to spin a large wheel and win money by correctly guessing letters illuminated on a giant board by an inexplicably lovely assistant who was the subject of wet dreams and midnight fantasies everywhere?

Well the UK Government, capitalising on the gameshow's popularity and deciding that doctors' lives are too bloody bland and boring, has decided to introduce its own version for doctors in an attempt to spice up their lives a little (and get their lazy arses off those plush taxpayer-funded chairs --Editor). And they've called it MMC.

Go ahead. Look at the picture above. See if you can fill in the last letter for the win.

Before today, I had no concept of the horror of MMC and MTAS. Oh, I read about it all right. Any half-brained drooling numbskull looking at the blogs out there could tell it was horrible. HospitalPhoenix, a good competent surgeon who genuinely cares about his profession, lost sleep over it. SHP, the very sort of doctor keeping the NHS afloat, has lost hope. Even her partner has not been to work for fear of her breaking down. Dr Rant, being his usual self, has been mouthing off about it.

But I, being a mere medical student cosied up in his snug ivory tower, buried under piles of drug name sheets and obscure biochemistry named-after-car-license-plate molecules to remember, didn't understand. All I could do was pat them on the shoulder, drop a nice comment on their blogs, and hope that things would be better.

Until now.

Dr Crippen has finally put it in language I can understand. Here he posts sample questions with sample answers from an unsuccessful candidate who now has to emigrate to find work. And here are more example questions with sample answers from a more fortunate candidate.

I read the questions. I read the answers. And then it hit me. Because I had seen some of the questions before. Also on an arbitrarily marked, wishy-washy-waffle-requiring exam known as Preparing For Patients (PfP).

I have blogged about PfP before. The questions asked are rather arbitrary, marked not by doctors but by "communication skills experts". No one knows if they will pass or fail; I know gifted medics who spent hours slaving over their PfP reports, only to be told that they couldn't progress to the next year because they had failed this minor subject (because they didn't dot an I or misspelt a few words. No, seriously --Ed). Conversely, everyone knows someone who spent two hours on the last day typing up some crap, handing it in 15 minutes before the deadline and passing. (Not that I'd know anything about that. Ahem. --Ed)

In many ways, it is a lottery. Compare the questions from MTAS and from PfP:

MTAS: Describe a recent example from your surgical experience of a time when you found it difficult to make an effective judgement in a challenging situation. How did you overcome this difficulty, and how has this experience informed your subsequent practice?

PfP: Give examples from an interview you conducted with a patient to illustrate what you did that helped and hindered making the interview successful
a) From the viewpoint of the patient
b) From your viewpoint in terms of gathering information about the symptoms
c) From your viewpoint in terms of gathering information about the illness (the patient's perspective)

See the similarity? Both questions require wishy-washy bullcrap (or require you to become John friggin' Steinbeck). In fact, the PfP question stops just short of requiring you to bloody read the patient's mind. There are no correct answers; whether you pass or fail depends on whether the course organiser thinks you maintained enough eye contact or said "hmm" and "uh-huh" enough times in your patient interview. I have known students who, having run out of ideas, put down "I smiled at the patient" and "I patted his arm".

But PfP serves a purpose. I'm not complaining, because it gave me the opportunity to finally go to hospital and see real patients. And if you fail it, you can always resit it, and almost always pass the second time (unless you do something really stupid, like turn your patient's respirator off for kicks --Ed).

Look at the final paragraph of the successful MTAS candidate's answer to the above question:
On reflection, I realised the value of my clinical judgement, prioritisation, teamwork and communication. The experience increased my confidence in adopting leadership roles.
I know exactly what that is. Any medical student who has done PfP, indeed any student who has ever filled in a UCAS personal statement to apply to university, will also recognise that for EXACTLY what it is.

Pure and utter bullcrap.

Don't get me wrong; the candidate was very smart to write that. And indeed, it's simply because I'm so good at crapping that I got into university in the first place (that and the sexy eyelashes. --Ed) But it's still waffle. It's the waffle we come up with to pad our CVs/personal statements. It's the waffle we type into our PfP reports when we need to fill two A4 pages. It's waffle that hardworking, competent, caring doctors with families to feed and lives to save should not have to think up after shovelling through decades and decades of this:

Actual Cambridge University lecture material

Entire careers. All dependent on one lottery. I cannot imagine how it must feel like filling out that form. Knowing that everything you stand for, everything you've worked your entire life for, is dependent on what you put down. If you're a doctor who has recently gone through this, I offer you my admiration. I simply cannot imagine the hell you must be going through.

Some of my friends have advised me to switch to law and run whilst I can. I'm seriously thinking of listening to them.