tag:blogger.com,1999:blog-24411918088781278152024-03-13T21:35:45.326-07:00Medical Education @ WMSAnonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-2441191808878127815.post-27766024695672712362016-07-05T03:01:00.000-07:002016-07-05T03:02:12.237-07:00Medical Schools Council Student ConferenceBy Claire Keith and Tom Walker<br />
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You may be wondering what on earth the <b>Medical Schools Council</b> is. Tom and I didn't know either when we were asked to attend this event.<br />
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It turns out it's a group of all the deans from medical schools around the country, who are working together to promote excellence in education. This year, they held a student conference to find out what we thought about the key issues that are going to affect us.<br />
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Our first discussion centred around careers; how to promote <b>general practice</b> as a more popular option to medical students, the <b>'shape of training review'</b> and the <b>NHS five-year</b> plan to move more and more services into the community. It was a very vocal and engaged group of med students, and what became immediately apparent was the vast difference in experiences at each med school.<br />
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It turns out that, comparatively, we have a relatively large exposure to <b>general practice</b> as a specialty, whereas our colleagues at Imperial are being actively put off it as a career by their faculty, with no time built into the curriculum for it.<br />
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Some people felt uncomfortable admitting they were considering a career in general practice to their peers as it was felt to have a stigma attached to it - that it was the easy way out, or a career for students who lacked ambition. This was an interesting perspective to see when so many of my cohort seem particularly attracted to it for the work-life balance aspects - just one of the many differences between undergrad and postgrad medicine it seems.<br />
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With regards to the promotion of <b>more generalisation in hospital medicine</b>, there was a largely positive feeling among the students who, after all the hard work they've put in, didn't have any desire to lose the skills they'd built up. It was suggested that an occasional on call rota for all specialties could be a potential way to do this. The move towards <b>medicine in the community</b> didn't bring up any particularly strong opinions as people tended to think that was something they'd deal with when they actually had jobs.<br />
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We had a very enlightening presentation from the <b>GMC</b>. Apparently they also have a role in supporting us in our education - who knew there was more to them than FTP? It was suggested that they need to increase engagement with students and have a more noticeable presence at the medical schools to make us more aware of this fact. Currently their visits are <b>every five years</b>, which for us would miss out an entire cohort from ever getting to voice their opinion on our educational system.<br />
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The GMC is responsible for ensuring high standards in education in all UK medical schools, so the option of <b>standardising medical courses</b> was discussed. However, general opinion was that med schools are successful because of their diversity and offer the opportunity for applicants to choose a university based on their preferred learning styles and career goals.<br />
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The discussion moved to the <b>introduction of the medical licensing assessment</b>. This would be a standardised MCQ and OSCE exam for all UK medical schools and applicants from other countries, that could potentially be used for foundation programme ranking. At this point, it wouldn't be an exaggeration to say that the crowd was infuriated.<br />
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With the GMC's role being to ensure that all UK medical schools are of a qualified standard to produce safe doctors, it was felt that they were trying to skip this duty and take an easy route out of working for quality in education. As our medical schools are approved by the GMC, that should inherently mean that they are trusted to examine us to a suitable standard.<br />
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Additional examinations are not good for student wellbeing nor a suitable way to rank applicants on a one-off performance. It was unanimously thought that this should not become a reality. There will be a <b>consultation period</b> on this in the <b>autumn</b>, and although we will not be directly affected as the exam wouldn't come into play until 2022, it's important for future medical students that we have our say.<br />
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The <b>removal of the pre-registration year</b> was also discussed in relation to this, which is particularly relevant to graduate entry courses as that year counts towards our total number of educational hours. Personally, in my admittedly biased opinion, I think all medical courses should be postgraduate as the extra life experience is great preparation for the highs and lows of medicine. The argument for getting rid of the pre-reg year however is that there is now much better continuing training and so it isn't as necessary to have that 'trial period'.<br />
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The afternoon commenced with a talk from <b>Danny Mortimer</b>, Chief Executive of NHS Employers with regards to the new contract. He successfully deflected most questions and didn't really tell us anything new in regards to how they are going to deal with the gaps in rotas or how they're going to rebuild their relationship with the profession.<br />
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Key points that were raised however were that there is <b>no increase in pay between ST3 and ST8</b>, apart from an allowance made for higher grades involved in decision-making. In theory, pay has been equalised across the period to protect those who may be taking time out, in particular women. It does however, seem a long time to go without a pay rise. Measures are also being put in place to make it easier to <b>switch between careers</b> with your prior experience being taken into account and facilitating your move into a later stage of training.<br />
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A student-led session on the <b>Anti-bash campaign</b> highlighted the impact that consultants' light-hearted comments about other specialties may be having on students desire to do said specialties. This was particularly with regards to psychiatry. More information can be found on the<a href="http://www.rcpsych.ac.uk/discoverpsychiatry/anti-bash.aspx" target="_blank"> Anti-Bash website</a>.<br />
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<b>Achieving good medical practice</b> was the final talk, informing us about a new GMC document specifically designed for students to enable us to understand what is expected of us. Copies will be delivered to med schools early next year.<br />
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Lastly, a <b>Q and A session</b> revealed some more worries of med students around the country:<br />
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<ul>
<li><b>Will private med schools steal all our placements?</b> Apparently not. Interestingly, the NHS pays more for our placements than they would be able to afford.</li>
<li><b>How are we promoting a diverse population of medical students?</b> The MSC is working with both primary and secondary schools to get med students and health professions in to promote healthcare as an option for everybody.</li>
<li><b>Is there a plan for in case we leave the European Union?</b> No, please don't leave... Although I guess we'll know the results by the time you read this.</li>
</ul>
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All in all, it was a very interesting and enlightening day, which made me realise just how many things are going to potentially affect all of our futures. The MSC has made a start by engaging with medical students at this conference, but it was obviously a very small representation of the student body. The issues raised could have such a huge impact on our lives, it is vital that we remain involved and voice our opinions whenever possible.</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-68383823967974633612016-02-03T03:11:00.000-08:002016-08-19T07:55:13.502-07:00Part 4. The four seasons of a clinical academic without borders<h4>
<i style="font-weight: normal;">Franco Cappuccio, Professor of Cardiovascular Medicine & Epidemiology, concludes his journey through the ‘four seasons’ of his career to date as a clinical academic which we hope will inspire and delight you and hopefully encourage some of you to follow suit in this challenging but fulfilling medical career path.</i></h4>
<h4>
Part 4. The Harvest Season (2005-2015)</h4>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3XehaqvBJ3WSARgP-wT4XgyuIVcCGTIrlYi-wHEMEDTFbUdBg2PTBXdnwA3Lodz18zLrXnLw5av7345oiXX7CEOkRYfj5fvNTTWI5Q1L0nNp82Se3avGlEhQF3WmeFmycj1BhyphenhyphenvlBwZk/s1600/Cappuccio.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3XehaqvBJ3WSARgP-wT4XgyuIVcCGTIrlYi-wHEMEDTFbUdBg2PTBXdnwA3Lodz18zLrXnLw5av7345oiXX7CEOkRYfj5fvNTTWI5Q1L0nNp82Se3avGlEhQF3WmeFmycj1BhyphenhyphenvlBwZk/s200/Cappuccio.jpg" width="200" /></a></div>
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Thank you for enduring reading this blog. We have come to the good harvest of formidable seeding seasons. I decided to accept new challenges by moving to Warwick in 2005 to take an Endowed Chair in Cardiovascular Medicine & Epidemiology (Inaugural Lecture). The mandate was clear: to improve the research profile of the new Medical School in my areas of research and, at the same time, to establish a teaching and research programme in sleep medicine. This section shows how, from an initial narrow research interest, I became involved in a variety of fields and made global impacts.</div>
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Sleep, Health & Society Programme</h5>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">OUP Book 2010</span></td></tr>
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Over the last ten years our group, with the tireless support of my closest collaborator, <b>Michelle Miller</b>, established a reputable research <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/sleep">programme</a> and a new teaching module in sleep medicine.<br />
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The work has led to many <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/sleep/sleeppublications">publications</a> of high impact, a <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/sleep/SSM">teaching module</a> attended by just under 100 MB ChB students, many directly engaging in sleep research, and the publication of a <a href="https://global.oup.com/academic/product/sleep-health-and-society-9780199566594?cc=gb&lang=en&">textbook</a>. We became an immediate target of interest for media outlets which allowed us to expand our dissemination and impact activities towards lay audiences.</div>
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World Health Organization Collaborating Centre</h5>
My interest in salt and cardiovascular disease developed into the need to engage with policy makers to make sure that we could influence them (governments too!) to develop comprehensive action plans for a population reduction in salt consumption to prevent cardiovascular disease.<br />
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I acted as a Technical Advisor to the World Health Organization to develop global recommendations and we continued the production of research evidence. In 2008, I became the Head of the University of Warwick’s first <a href="http://www2.warwick.ac.uk/fac/med/staff/cappuccio/who/">Collaborating Centre</a>, which has since been at the forefront of the development and implementation of global <a href="http://www.bmj.com/content/343/bmj.d4995">policies</a> across several continents.<br />
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At the same time, our Centre contributed to the development of national guidelines through the National Institute for Health and Care Excellence (<a href="https://www.nice.org.uk/guidance/ph25">NICE</a>). Furthermore, our group has been the first in the world to demonstrate the presence of <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/salt_inequalities/">social inequalities in salt consumption</a> both in Britain and in other countries in Europe, calling for the modifications of health policies aiming at narrowing the social gap.</div>
<h5>
European Society of Hypertension Centre of Excellence</h5>
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Notwithstanding the significant shift of interest and activities towards epidemiology, public health and policy, I always kept a firm grip with patients, people and clinical activities, Hypertension and Cardiovascular Medicine being my focus.<br />
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In 2008, the European Society of Hypertension awarded our group at University Hospitals Coventry & Warwickshire NHS Trust the status of <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/eshcoe/">Centre of Excellence</a>, an important international recognition for a newly established specialist service. As I hinted in Part 2, the level of expertise I accumulated during the Season of Growth has also allowed me to serve for many years in the Executive Committee of the British Hypertension Society as Treasurer, Executive member, <a href="http://www.bhsoc.org/about-us/executive-committee/">Vice-President</a> (and … in due course ... President), training doctors and allied professionals in hypertension.<br />
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These rewards, alongside the daily manifestations of satisfaction, respect and gratitude of my patients, have reinforced in me the belief that I have served them well over the years and have fulfilled the Hippocratic Oath.</div>
<h5>
Additional benefits of a clinical academic career</h5>
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<span style="font-family: "verdana" , sans-serif; font-size: xx-small;">Prof D Singer (Deputy-Director) and<br />
Prof G McInnes (BHS President)<br />
at the ESH CoE launch in 2008</span></div>
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I want to finish by honestly acknowledging the additional opportunities this job as given me over the years, that is, meeting very interesting people, visiting the world and being known. Beyond meeting Her Majesty The Queen, I attend regular meetings at the House of Commons and the House of Lords to act as an advocate for policy changes in nutrition. I have dined in the presence of Royals (memorable a banquet in the presence of King Juan Carlos I of Spain and a similar experience with the Sultan of Brunei) and I have met politicians and ministerial representatives from several countries.<br />
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I touched <a href="http://www2.warwick.ac.uk/fac/med/staff/cappuccio/places_in_the_world_1.pdf">all continents</a> in my travels, including the unforgettable experience of co-ordinating a five-year population-based programme of salt reduction in rural <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/kumasi/">Ghana</a>. All these visits have not only given me the opportunity to interact with colleagues from all over the world in enriching and stimulating scientific discussions, but they have been a constant open window on different cultures, the necessary yeast of progress and innovation.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhy85Pe2hJ1MIrxgcpyauB7wYZcKCRwEiMaClxEtPukYOVVuzXwioYr-lA9UY-1KIyarzp2oU6u_rdD_Hz1iDYIeSKSzriSRe2ZY0J7h2esp3MWxa2Ft7dkXHL-WrLKaXCw2gPrcWZBXTc/s1600/4.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="130" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhy85Pe2hJ1MIrxgcpyauB7wYZcKCRwEiMaClxEtPukYOVVuzXwioYr-lA9UY-1KIyarzp2oU6u_rdD_Hz1iDYIeSKSzriSRe2ZY0J7h2esp3MWxa2Ft7dkXHL-WrLKaXCw2gPrcWZBXTc/s200/4.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: xx-small;"><a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/a_pinch_too_far_.mp4" target="_blank">"A pinch too far"</a></span></td></tr>
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One of the important aspect of medicine and research is to pass on the information about your research to audiences other than your peers. To communicate and disseminate knowledge to wider audiences are essential skills not taught at medical schools. As part of my clinical academic work I was fortunate to receive professional media training that proved extremely useful. Over the years I was able to create media interest in what I was doing and managed to convey concisely and effectively the implications of our results (<a href="http://www2.warwick.ac.uk/fac/med/staff/cappuccio/press">press releases</a> and <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/podcasts/">videos/podcasts</a>). One recent memorable event is the <a href="http://www2.warwick.ac.uk/about/warwick50/events/imagination/talks/salt/">Cookery Session</a> at the Festival of Imagination at the University of Warwick last October</div>
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Choosing a clinical academic route is tough and courageous, and the path is not free from uncertainties, hurdles and traps. However, I hope my journey shall be an inspiration for some of you to follow this path with enthusiasm and belief. Have a great career and enjoy every moment of it.</div>
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<div id="yoursay">
<h3>
Career learning points:</h3>
<ul>
<li>Good seeding leads to good harvest.</li>
<li>It takes time to make a difference.</li>
<li>Science and research have rules, but innovation does not always follow a straight line.</li>
<li>There are no valuable personal achievements without good work.</li>
<li>The life of a clinical academic is <i>always</i> fulfilling in the end.</li>
</ul>
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<div id="yoursay">
<h3>
What did my research show about salt?</h3>
<ul>
<li>Population evidence in salt consumption is cheap, feasible, achievable, effective and equitable - it is a <i>preventive imperative</i>.</li>
<li>Population reduction in salt consumption is the best buy for a public health system (second only to tobacco control) - is it an <i>economic imperative</i>.</li>
<li>Effective policy options always involve political choices - it is a <i>political imperative</i>.</li>
<li>Every country in the world is going to take action to reduce dietary salt consumption to prevent CVD and to reduce its global burden.</li>
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Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-91811274756633853342016-01-26T01:35:00.000-08:002016-01-26T01:35:15.184-08:00Part 3: The ‘four seasons’ of a clinical academic without borders<div class="MsoNormal">
<i style="font-weight: normal;"><span style="font-family: "verdana" , sans-serif;"><span style="background-color: white; font-size: 11pt;">Franco Cappuccio, Professor of </span><span style="background-color: white; font-size: 11pt;">Cardiovascular Medicine & Epidemiology</span><span style="background-color: white; font-size: 14px;">, continues his</span><span style="background-color: white; font-size: 11pt;"> journey through the ‘four seasons’ of his career to date as a clinical academic which we hope will inspire and delight you and hopefully encourage some of you to follow suit in this challenging but fulfilling medical career path.</span></span></i></div>
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<h4>
<span style="font-family: "verdana" , sans-serif;">Part 3. The Season of Ripening (2000-2005)</span></h4>
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<span style="font-family: "verdana" , sans-serif;">The opportunity to apply for a suitable Chair came at
St George’s in 2000 where I became Professor of Clinical Epidemiology, and my confidence
in being able to pursue independent ideas strengthened. I secured funding for
two large epidemiological studies, <b>IMMIDIET</b> and the <b>Kumasi Study</b>, and established a research group around these
two studies, whilst continuing exploiting the results of the WHSS.</span><span style="font-size: x-small;"><o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif;">The <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/immidiet"><i>IMMIDIET</i></a><b> </b>study was a European-funded consortium whose aim was
to look at gene-environment interactions of risk factors for coronary heart
disease to explain the geographic gradient in heart disease across Europe. We
studied three population samples in Surrey (England), the Flanders (Belgium)
and Abruzzi (Italy), all with the same standardised protocol. </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipAeWsEUFKCk5XHGezGQD2TxulwlA9XRAiv5tMdsSbKIG5G50_9zcITu6mOOue2kzJn2ve275Rv2mlc4Gl8f9nSliQCucJp4C03mqVovL0RZsK2niAMRnQSHFxD2RFPEcnXMMniQufgAA/s1600/image+2.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipAeWsEUFKCk5XHGezGQD2TxulwlA9XRAiv5tMdsSbKIG5G50_9zcITu6mOOue2kzJn2ve275Rv2mlc4Gl8f9nSliQCucJp4C03mqVovL0RZsK2niAMRnQSHFxD2RFPEcnXMMniQufgAA/s200/image+2.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">IMMIDIET in Surrey</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;">The Consortium
was a mix of clinical researchers, epidemiologists, statisticians, biochemists,
geneticists, IT experts, nutritionists and health promotion and communication
specialists. The memories of those three intense years offset the feeling of
hard work and tight deadlines. We met regularly rotating each participating
Partners as host. We enjoyed hand-made pasta in Abruzzi, the pre-Christmas
atmosphere of a traditional pub in Surrey (see picture), ate fondue (cheese as
well as chocolate) on the hills of Lyon and drank good Belgian beer in Leuven. The
study had a successful completion and created a repository that is still producing
data <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/immidiet/immidietpublications">now</a>.<span style="font-size: x-small;"><o:p></o:p></span></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjf-tlAJk4SNA2_dMf6qozjA2xmK-I89DHSnphjU4fpKkQVrDPeTxg68zbxF-M7_cVtozWfQRf3ymeaXgu_N2dcHv-V0YCR0k-99882RZGD3AKklYw7sX6EPFzp44APLeAtDuPJWdOYH5A/s1600/image+3.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjf-tlAJk4SNA2_dMf6qozjA2xmK-I89DHSnphjU4fpKkQVrDPeTxg68zbxF-M7_cVtozWfQRf3ymeaXgu_N2dcHv-V0YCR0k-99882RZGD3AKklYw7sX6EPFzp44APLeAtDuPJWdOYH5A/s200/image+3.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">MMIDIET</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;">High blood pressure is very common in sub-Saharan
Africa alongside stroke and kidney failure. Due to the scarce resources to
detect and treat these problems in rural areas I developed the idea of applying
the knowledge accumulated in studying hypertension and salt in my patients to
the people leaving in Africa. The underlying hypothesis was that they were at a
greater risk of salt-dependent rise in blood pressure and stroke and kidney
failure, and that a reduction in salt intake would be cheap, feasible and
beneficial in those settings. It took me a few years to convince the Wellcome
Trust that it was a good idea to set a population study in sub-Saharan Africa
and to carry out a randomised clinical trial of salt reduction. </span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEit-vDXZciIjNDHa-mTMWt0umnhJWwlHn2KsItw-a5umG9x-Y9eEVULXZ0_6VDV67v_VvT0zkO0GNfRiSILsVpcxd8MWCkrmqzVeBylHOcJIDkU-kUCux6hpFhXXjDKFSP0MBPXHXkex7w/s1600/image+4.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="107" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEit-vDXZciIjNDHa-mTMWt0umnhJWwlHn2KsItw-a5umG9x-Y9eEVULXZ0_6VDV67v_VvT0zkO0GNfRiSILsVpcxd8MWCkrmqzVeBylHOcJIDkU-kUCux6hpFhXXjDKFSP0MBPXHXkex7w/s200/image+4.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">The Kumasi Study Team</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;">No one had ever
managed to complete one, and most reviewers deemed it impossible to do. It took
resilience, beliefs, determination and teamwork to produce pilot data that
would eventually convince the funding body to grant us the money to go ahead
with it. The <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/kumasi/"><i>Kumasi Study</i></a><span style="color: #5b9bd5;"> </span>became the first ever population based study of
hypertension and salt that performed a longer-term (six months) controlled
intervention trial (key publications <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)73821-6/abstract" target="_blank">1 </a><a href="http://qjmed.oxfordjournals.org/content/95/7/445" target="_blank">2</a> <a href="http://hyper.ahajournals.org/content/43/5/1017.full?sid=f3710228-d22f-479c-bf2c-13446c91ee57">3</a> <a href="http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-6-13">4</a> <a href="http://ndt.oxfordjournals.org/content/25/7/2178.full?sid=3bee9b2c-4e8f-4841-9e62-950610b3fb0a" target="_blank">5</a>). The
results are still highly quoted. They have also influenced more recent global
recommendations on population salt reduction (more on this in Part 4 next week). <o:p></o:p></span><br />
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<span style="font-family: "verdana" , sans-serif;">I reached a
personal milestone when <b>Her Majesty The
Queen</b> visited the modern St George’s premises in Tooting in December 2002 to
unveil a sculpture donated by Sir Joseph Hotung to celebrate the 250<sup>th</sup>
Anniversary of St George’s Hospital (established at Hyde Park Corner in 1752). </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtpZOVfWMddUZPOMuqcrnhQctX29Mv4r3vd8SG0bhMy9tpLYRd3rI5yHU9rXFahfuO-GdEWTMaJtGvfr1wz-mZwBbvdHykUL6qDi7HtBt87mHgpvnRTInng_M1UQELORfIJAw0prsFIIY/s1600/queen.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtpZOVfWMddUZPOMuqcrnhQctX29Mv4r3vd8SG0bhMy9tpLYRd3rI5yHU9rXFahfuO-GdEWTMaJtGvfr1wz-mZwBbvdHykUL6qDi7HtBt87mHgpvnRTInng_M1UQELORfIJAw0prsFIIY/s200/queen.jpg" width="147" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">Her Majesty at the Queen at <br />St George's</span></td></tr>
</tbody></table>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">During Her visit, Her Majesty met selected
groups and key areas of research were highlighted to Her in a mini-symposium
with short eight-minute presentations.
The Kumasi Study was one of them. Never in my professional life did I
experience such level of adrenaline flowing during a presentation. If asked ten
years earlier, I wouldn’t have predicted such a level of exposure of my work!<span style="font-size: x-small;"><o:p></o:p></span></span><br />
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<span style="font-family: "verdana" , sans-serif;">Whilst on the home front my work was recognised and showcased,
internationally it received unexpected accolade. In 2003, I received the <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/kumasi/"><b>International Society of Hypertension in Blacks
(I.S.H.I.B.) Distinguished Researcher Award</b></a><b>. </b>The motivation was <i>“…in
recognition of significant research contributions in the control of
hypertension and cardiovascular risk factors in ethnic minority populations
around the world.”</i> The award was undoubtedly flattering but, more
importantly, indicated to me the importance and outreach of my research
findings. <o:p></o:p></span></div>
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<span style="font-family: "verdana" , sans-serif;"><br /></span></div>
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<span style="font-family: "verdana" , sans-serif;">Next time: The Harvest Season
(2005-2015). If you have any questions or comments for Professor Cappuccio please post below. </span></div>
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<div id="yoursay">
<h3>
<span style="font-family: "verdana" , sans-serif;">Career learning points:</span></h3>
<ul>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Achievements are hard to get, but possible...</span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Be resilient in your work.</span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Believe in yourself but do not underestimate the value of working with others.</span></li>
</ul>
</div>
<br />
<div id="yoursay">
<h3>
<span style="font-family: "verdana" , sans-serif;">What did my research show about salt?</span></h3>
<ul>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Reductions in salt intake can be achieved in difficult low-resource settings to help control high blood pressure and its complications. </span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Population salt reduction should be a global strategy to tackle the epidemic of cardiovascular disease. </span></li>
</ul>
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Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-67377238756277817262016-01-20T03:58:00.001-08:002016-01-21T03:26:09.859-08:00Part 2: The ‘four seasons’ of a clinical academic without borders<h4>
<i style="font-weight: normal;"><span style="font-family: "verdana" , sans-serif;"><span style="background-color: white; font-size: 11pt;">Franco Cappuccio, Professor of </span><span style="background-color: white; font-size: 11pt;">Cardiovascular Medicine & Epidemiology</span><span style="background-color: white; font-size: 14px;">, continues his</span><span style="background-color: white; font-size: 11pt;"> journey through the ‘four seasons’ of his career to date as a clinical academic which we hope will inspire and delight you and hopefully encourage some of you to follow suit in this challenging but fulfilling medical career path.</span></span></i></h4>
<h4>
<span style="font-weight: normal; text-align: justify;"><span style="font-family: "verdana" , sans-serif;">Part 2. The
Season of Growth (1989-1999)</span></span></h4>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig2sXEmdJ13c2d6rOcBKnURNy66yycem8AX8JdON_GSReqaY6uO-4ITa-fIJqCJV5Cb77Af74kw3R8IJlP4mtN1-trCKdLCjZj8BGpKupSbCMpJPlBj_WDsVIE2T9iQwltVFP27HOEmeU/s1600/Cappuccio.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig2sXEmdJ13c2d6rOcBKnURNy66yycem8AX8JdON_GSReqaY6uO-4ITa-fIJqCJV5Cb77Af74kw3R8IJlP4mtN1-trCKdLCjZj8BGpKupSbCMpJPlBj_WDsVIE2T9iQwltVFP27HOEmeU/s200/Cappuccio.jpg" width="144" /></a></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8bRtdy1qWRjqPlWV2ruTdEOyFnejXbLrmMK-tAidHklkc4MfW2Sq_j_2cFqGfnt3gET1_V4ZsgNoD0LtmwJ2jfTg-7WsGGcVK-VVimnEEajCArVHKsuAJ3_5hHZpPVEklFDGKE8a7-IY/s1600/group+of+3.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img alt="" border="0" height="148" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8bRtdy1qWRjqPlWV2ruTdEOyFnejXbLrmMK-tAidHklkc4MfW2Sq_j_2cFqGfnt3gET1_V4ZsgNoD0LtmwJ2jfTg-7WsGGcVK-VVimnEEajCArVHKsuAJ3_5hHZpPVEklFDGKE8a7-IY/s200/group+of+3.jpg" title="" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">With Donald Singer and Graham MacGregor </span><br />
<div style="text-align: left;">
<span style="font-family: "verdana" , sans-serif; font-size: xx-small;">at St. George's </span></div>
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<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;">After
a short spell of work back in Italy, in 1989 I accepted a five-year fixed term
contract as a Clinical Lecturer in Medicine at <b>St George’s Hospital Medical School</b> in South London, where <b>Graham MacGregor</b> had moved as a
Professor. I returned to my previous research group. I completed the training in General Internal Medicine (MRCP then FRCP),
resumed clinical research, secured grant income, consolidated my publication
record, and pursued my previous interests in epidemiology.</span></span><br />
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"> </span></span><br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGzQyYPMPfcZLX3c1yCtbVzArF0-EddGgZ-uGarkaUkuCBsSMBNrAkVA0TjRNH0zydsoA1aabdSdNtCgpLNTNHE4ZxTkFRlz32Y-uXuClkDhsjZf1rFgNAHhLT2doqQVQ-gJRsixz2oQU/s1600/St+George%2527s+Hospital.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGzQyYPMPfcZLX3c1yCtbVzArF0-EddGgZ-uGarkaUkuCBsSMBNrAkVA0TjRNH0zydsoA1aabdSdNtCgpLNTNHE4ZxTkFRlz32Y-uXuClkDhsjZf1rFgNAHhLT2doqQVQ-gJRsixz2oQU/s200/St+George%2527s+Hospital.jpg" width="200" /></a></span></span></div>
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<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"><br /></span></span>
During the first
part of this period, I published relentlessly and got myself involved in
numerous clinical trials studying the mechanisms by which different drugs lower
blood pressure in people with hypertension. I was rapidly absorbing a level of
expertise in hypertension that later in </span><span style="font-size: 10pt;">my
career would constitute an asset.</span></span><br />
<span style="font-size: 10pt;"><span style="font-family: "verdana" , sans-serif;"><br /></span></span>
<b><span style="font-size: 10pt;"><span style="font-family: "verdana" , sans-serif;">The passage to
epidemiology and public health</span></span></b><br />
<b style="font-family: Verdana, sans-serif; text-align: justify;"><span style="font-size: 10.0pt;"><br /></span></b>
<span style="font-family: "verdana" , sans-serif;"><b style="text-align: justify;"><span style="font-size: 10pt;">Geoffrey
Rose’s</span></b><span style="font-size: 10pt; text-align: justify;"> work on the principles of
prevention has inspired generations of epidemiologists and clinicians
worldwide, including me. His clear paradigm of </span><a href="http://ije.oxfordjournals.org/content/30/3/427.full" style="text-align: justify;"><i><span style="font-size: 10.0pt; mso-bidi-font-weight: bold;">Sick
individuals and sick populations</span></i></a><b style="text-align: justify;"><span style="color: #5b9bd5; font-size: 10.0pt;"> </span></b><span style="font-size: 10pt; text-align: justify;">opened the vision of a physician like me (who had great
expectations to make a difference) not to neglect the bigger picture of prevention:
to amalgamate the dichotomy between ‘high-risk’ and ‘population’ strategies.</span></span><br />
<div>
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<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"></span></span></div>
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<div>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"><span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"></span></span></span></span></div>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;">
</span></span><span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;">If we wish to find the causes of common diseases, we ought
to study the determinants of the ‘normal’ levels of the risk factors as <i>“the population mean predicts the number of
deviant individuals.</i> <i>If we wish to
find the causes of hypertension, obesity, alcoholism … then we need to study
the determinants of average blood pressure, weight and alcohol intake …” <span style="color: #4472c4; mso-themecolor: accent5;">(</span></i></span><a href="http://www.bmj.com/content/301/6759/1031.full.pdf+html"><i><span style="font-size: 10.0pt; mso-bidi-font-weight: bold;">Br Med J 1990</span></i></a><i><span style="color: #4472c4; font-size: 10.0pt;">)</span></i><span style="font-size: 10pt;">. When referring to the
strategy of secondary prevention of cardiovascular disease, <b>Jeremiah Stamler</b>, another great
cardiovascular epidemiologist of our time I had the pleasure to meet
recurrently, used to say: <i>“The strategy
[of secondary prevention] is late, defensive, reactive, time consuming,
associated with side effects, costly, only partially successful, and endless”</i>.
These thoughts represented the most
powerful encouragement of chronic disease prevention, through actions directed
at avoiding the occurrence of the disease in the first place rather than
focusing exclusively on the clinical approach of disease management.</span></span><br />
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 13.3333px;"><br /></span></span><span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1S0js8B2VnDKqSItvbYNta-yH5a3NUga8tYcuAGhjUwsJAI9-BnWqg02FgCJXymqsNpTa488W2U4tnLT4PfJL7Isg0nmnAKkyM7G_DTe7VEk0sSVp7vVVphE9LXob3R5VCHGMByLvjTE/s1600/working+outside+lshtm.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="249" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1S0js8B2VnDKqSItvbYNta-yH5a3NUga8tYcuAGhjUwsJAI9-BnWqg02FgCJXymqsNpTa488W2U4tnLT4PfJL7Isg0nmnAKkyM7G_DTe7VEk0sSVp7vVVphE9LXob3R5VCHGMByLvjTE/s320/working+outside+lshtm.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: xx-small;">Working at the LSHTM</span></td></tr>
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</span></span><br />
<div style="text-align: left;">
</div>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"></span></span><span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"> I set off
to pursue epidemiology by enrolling into a Master programme in Epidemiology and
Public Health at the <b>London School of
Hygiene & Tropical Medicine</b> where I completed an MSc and worked for a further
three years. My training peaked with the MFPH (then FFPH) and the participation
at the Advanced Ten-Day Seminar in Cardiovascular Epidemiology held in
Singapore in 1993.</span></span><br />
<br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfgIyi78kkH22lPbseA1_TN3ym0Wf3_2Ax4fRmqXFYOJj5JKX3DjD3ZWN8u35_fDSoMBvfV25CSdQds9jWjgtC5yyz_YSpS95Ezo2-8rKlXPgBofmRB_fROSWmvsFzcSRzY5QeEegBZVc/s1600/the+winning+team.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="206" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfgIyi78kkH22lPbseA1_TN3ym0Wf3_2Ax4fRmqXFYOJj5JKX3DjD3ZWN8u35_fDSoMBvfV25CSdQds9jWjgtC5yyz_YSpS95Ezo2-8rKlXPgBofmRB_fROSWmvsFzcSRzY5QeEegBZVc/s320/the+winning+team.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "verdana" , sans-serif; font-size: xx-small;">The winning team with the officers of the RCGP</span></td></tr>
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<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;"><br /></span></span>
<span style="font-family: "verdana" , sans-serif;"><span style="font-size: 10pt;">I </span><span style="font-size: 10pt;">established
a personal line of research by succeeding in fully funding a research programme
known as </span><span style="font-size: 12pt;"><a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/whss"><i><span style="font-size: 10.0pt;">The
Wandsworth Heart & Stroke Study (WHSS).</span></i></a></span><span style="font-size: 10pt;"> I returned to practice cardiovascular medicine at
St George’s as a Senior Lecturer (then Reader), in a highly ethnically mixed
area of South London. I began to question whether and why some risk factors
appeared more often in some groups than others. </span></span><span style="font-family: "verdana" , sans-serif; font-size: 10pt; text-align: center;">I established a population-based survey of three ethnic groups in South London, and studied them in all possible aspects, including the establishment of a biological and genetic databank for future exploitation. The study was
published widely and in high impact journals, its results influenced future
directions in the diagnosis and management of CVD risk factors in ethnic
minority groups and led to the </span><a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/whss" style="font-family: Verdana, sans-serif; text-align: center;"><i><span style="font-size: 10.0pt; mso-bidi-font-weight: bold;">2002 RCGP and Boots The Chemists Research Paper of the Year Award (Royal
College of General Practitioners).</span></i></a><b style="font-family: Verdana, sans-serif; text-align: center;"><span style="color: #5b9bd5; font-size: 10.0pt;"> </span></b><span style="font-family: "verdana" , sans-serif; font-size: 10pt; text-align: center;">The Research Paper of the</span><span style="font-family: "verdana" , sans-serif; font-size: 10pt; text-align: center;"> </span><span style="font-family: "verdana" , sans-serif; font-size: 10pt; text-align: center;">Year Award had been running since 1996. Its purpose
was to raise the profile of research in general practice and to give
recognition to an individual, or group of researchers, who had undertaken and
published an exceptional piece of research relating to general practice. The
paper demonstrated the difficulties of applying the Framingham risk assessment
for ten-year coronary risk across different ethnic populations and indicated
the need for further inclusions of estimates of risk based on ethnic background
(precursor of the QRISK-2 Score).</span></div>
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<span style="font-family: "verdana" , sans-serif;">Next time: The Season of Ripening. If you have any questions or comments for Professor Cappuccio please post below. </span></div>
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<span style="font-family: "verdana" , sans-serif;">Career learning points:</span></h3>
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<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Pursue your ideas, if you believe in them. </span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Work hard and value other people, colleagues, your team. </span></li>
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<span style="font-family: "verdana" , sans-serif;">What did my research show about salt?</span></h3>
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<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Salt intake is a determinant of the rise in blood pressure with age. </span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Reducing salt intake reduces blood pressure in a dose-dependent manner in everyone. </span></li>
<li><span style="font-family: "calibri" , sans-serif; font-size: 14.66px;">Salt intake is too high in populations, and a reduction across the entire population would reduce high blood pressure and cardiovascular events. </span></li>
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Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-46276309366466544462016-01-12T04:07:00.001-08:002016-01-12T04:07:14.829-08:00The ‘four seasons’ of a clinical academic without borders<h2>
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<i style="font-weight: normal;"><span style="font-family: Verdana, sans-serif;"><span style="background-color: white; font-size: 11pt;">Welcome to the first medical education blog of 2016. This month we are pleased that we have a series of four weekly blogs from Warwick Medical School’s own Franco Cappuccio, Professor of </span><span style="background-color: white; font-size: 11pt;">Cardiovascular Medicine & Epidemiology</span><span style="background-color: white; font-size: 10.5pt;"> </span><span style="background-color: white; font-size: 11pt;">who will take us on a journey through the ‘four seasons’ of his career to date as a clinical academic which we hope will inspire and delight you and hopefully encourage some of you to follow suit in this challenging but fulfilling medical career path.</span></span></i></h4>
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<span style="font-family: Verdana, sans-serif;">Part 1. The Foundation Season (1975-1988) by Professor Franco Cappuccio</span></h4>
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<span style="font-family: Verdana, sans-serif;">No human story is alike. We’re all different. Different in ambitions, abilities, preferences, resilience, fears, beliefs, motivations, strengths, weaknesses. Furthermore, serendipity is often around the corner to change our lives. Yet, patterns exist that may repeat themselves over years and generations, so that we can all learn from someone else’s experiences. I have been asked to write a blog about my profession for those of you who have started on the path to become a physician. I am not sure how many of you will find my reflections relevant to your own circumstances. The very fact that I am writing and that you are reading, however, fulfils the primary objective: sharing experiences.</span><br />
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<tr><td class="tr-caption" style="text-align: center;">Pietro Fabris ~1760 (Compton Verney, Warwickshire) </td></tr>
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<span style="font-family: Verdana, sans-serif;">A basic biography is necessary to grasp the nuances of my tale. I was born in a city that has inspired many over the centuries, struck by its beauty and its startling contrasts of wealth and poverty, affluence and despair. The typical scene of Neapolitan peasant life, painted by Pietro Fabris, includes musicians, card players and a wine seller, as seen through the mouth of a cave by the Bay of Naples with the Castel dell’Ovo and Vesuvius in the distance. </span><br />
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<span style="font-family: Verdana, sans-serif;">On the left is Naples as it looked almost two centuries ago, with the beautiful sea front promenade and the Vesuvius in the background, and below, as it is now. A familiar view to those who have been there!</span><br />
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<span style="font-family: Verdana, sans-serif;"> The reason for this long-winded preface is that the most common question I have had to answer in the past thirty years is <i>‘why on earth did you come to Britain?’ </i></span><br />
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<span style="font-family: Verdana, sans-serif;">I started medical school in 1975 in Naples. The curriculum was made of three pre-clinical years followed by three clinical ones. At the beginning of year 4, I had the option to choose what type of dissertation to prepare for the finals. In those days, the dissertation was not a formality but contributed significantly to the final mark. I could have opted for a ‘descriptive’ piece on a chosen subject or for a more challenging ‘research’ piece. The latter would require practical work for the following two years, in parallel to completing the busy curriculum of subjects and exams. Whilst I had shown some early interest in orthopaedic surgery, after 6 months of frequenting orthopaedic theatres and ward rounds, I decided that I would never become a surgeon!</span></div>
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<span style="font-family: Verdana, sans-serif;"> Instead I became fascinated with general medicine. The first act of serendipity was to apply for a research placement in the Academic Department of Medicine when they granted me a ‘research’ dissertation in the broad subject of hypertension. It was 1978! That episode steered most of my future career. I studied the effects of alpha-beta adrenergic blockade on the peripheral vasculature of patients with hypertension using strain-gauge plethysmography of the lower limbs. I completed the study on time, wrote up the dissertation and got the highest marks at finals. </span></div>
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<tr><td class="tr-caption" style="text-align: center;">Federico II University of Naples Medical School </td></tr>
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<span style="font-family: Verdana, sans-serif;">Whilst enrolled in a Specialty MD I became involved in the <a href="http://www2.warwick.ac.uk/fac/med/research/mhwellbeing/cvme/olivetti/" target="_blank">Olivetti Heart Study</a>, an epidemiological study of cardiovascular risk factors and hypertension in the male workforce of a local factory near Naples. The major objective of my project was to explore a possible association between blood pressure and 24h urinary sodium excretion, a biomarker of salt consumption. This project too saw a successful completion with my <a href="http://eurheartj.oxfordjournals.org/content/4/9/608" target="_blank">first international publication</a>. </span></div>
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<tr><td class="tr-caption" style="text-align: center;">Charing Cross Hospital in Fulham </td></tr>
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<span style="font-family: Verdana, sans-serif;">During this time, I became fascinated with the ‘salt story’ as a possible cause of high blood pressure. The opportunity to spend some time abroad with a fellowship provided by my supervisor gave me the chance of my life (so to speak!) and I joined the <b>Charing Cross Hospital</b> in Fulham where <b>Hugh de Wardener </b>and <b>Graham MacGregor</b> had developed a hypothesis that would dominate the next 15 years of research in the field. </span><br />
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<span style="font-family: Verdana, sans-serif;">Six months into my first research job, a rare opportunity came from the Italian Ministry of Health for a research fellowship to be spent at a foreign institution. I went for it without realising that it was a national contest with over 1,200 candidates competing for only 49 awards! My colleagues considered this an utterly unrealistic and foolish attempt. However, in order to succeed - I guess - we have to have some dose of self-belief and be determined. To cut the story short, I endured a stepwise selection with two written tests and a viva and, to everyone’s disbelief, I was awarded a fellowship. This gave me enough funds to stay three years at Charing Cross and to get married as well. These were three fantastic foundation years. I learnt a great deal about what clinical research is, how it is done, how to produce good research papers, and I began travelling the world presenting research results and developing a true passion for the subject. During this time I produced my </span><a href="http://www2.warwick.ac.uk/fac/med/staff/cappuccio/olderpublications/j_hypert_1985_saralasin.pdf" style="font-family: Verdana, sans-serif;" target="_blank">first author paper</a><span style="font-family: Verdana, sans-serif;">,</span><a href="http://www.bmj.com/content/291/6490/235" style="font-family: Verdana, sans-serif;" target="_blank"> first BMJ paper</a><span style="font-family: Verdana, sans-serif;">, </span><a href="http://www2.warwick.ac.uk/fac/med/staff/cappuccio/olderpublications/lancet_1989_na_dose-response.pdf" style="font-family: Verdana, sans-serif;" target="_blank">first Lancet paper</a><span style="font-family: Verdana, sans-serif;">, and first international oral presentation. </span><br />
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<span style="font-family: Verdana, sans-serif;">Next time: The Growth Season. If you have any questions or comments for Professor Cappuccio please post below. </span></div>
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<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">Follow your interest and passion.</span></li>
<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">Keep an open mind.</span></li>
<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">Be positive, things will happen.</span></li>
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<span style="font-family: Verdana, sans-serif;">What did my research show about salt?</span></h3>
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<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">There is a significant and graded relationship between the level of salt intake and the level of blood pressure. </span></li>
<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">The kidneys are central on how sodium is handled by the body.</span></li>
<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">The renin-angiotensin-aldosterone system is pivotal in regulating the blood pressure response to changes in salt intake. </span></li>
<li><span style="font-family: Calibri, sans-serif; font-size: 14.66px;">First randomized controlled evidence that reducing salt intake reduces blood pressure</span></li>
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<br />Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-44256840260940873522015-11-25T02:11:00.000-08:002015-11-25T02:11:01.493-08:00On the other side of the fence!<h3>
By Dr James Gill</h3>
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WMS Alumnus and Academic Clinical Fellow</h4>
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Being at WMS is a bit like having a virus… where you spend four years fighting as the medical curriculum infects and finally takes over your life. You are constantly buying tissues to try and stem the flow of knowledge that seems to pass into your ears before seemingly running, unhindered, straight out of your nose.</div>
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Simultaneously you are trying to get your exhausted body to jump through the hoops and requirements for progressively more difficult clinical examinations. The ordeal, the hardest four years you could imagine, finishes, when you finally rally and break the fever that is Medical Finals. With your graduation, and your immunity to the medical school complete, you move out onto the wards as an FY1.</div>
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The problem is that, a bit like having recovered from chicken-pox, you seem to have cleared the infection, but there may still be a few viral remnants lurking in a dormant ganglion! Viral remnants that begin to awaken as you battle the stresses and strains of being a junior doctor.<br />
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Out in the Real World, on the wards, you realise how <b>good</b> life was at WMS, and recall the fun you had there. Not only the fun, but also the direct access to passionate lecturers, who actually enjoy explaining about the latest, sexy, cutting edge treatments they are working with, or the inspired management plans they putting into practice on the wards</div>
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It’s the gleam in the eye of the lecturer, like <strong>Dr Ramesh Arasaradnam,</strong> when as he finishes a lecture, he starts to explain about the Electronic eNose he has built with The Warwick School of Engineering, allowing him to “smell” diabetic urinary markers, in a new way of identifying patients.</div>
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Or the passion with which <strong>Dr Vinod Patel</strong> and the Diabetes team discuss the latest anti-diabetic medications such as dapagliflozin and novel approaches to trying to manage diabetes, one of the greatest disease burdens of our time.</div>
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Seriously, if I had the time, or the money, I’d pay to come back and sit in some of the lectures that the students get here at WMS, both for the entertainment, but also in order to get an update on some of the latest clinical developments!</div>
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Out on the wards, as you start to interact with students and assuming a teaching role as a junior doctor, you begin to develop an itch. An itch like that which heralds the re-activation of VZV from an old chicken-pox infection… Suddenly after having fought tooth and nail to graduate and leave WMS, you start to think about applying for a job back at there!</div>
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As a GP Registrar, the opportunity arose for me to come back to WMS as an academic clinical fellow (aCF). After successfully passing through the hurdles and hoop jumps of the selection process (everything about medical school is a hoop jump, I think that the original doctors must have been failed PE teachers - anyway) I was back at WMS! - That itch had developed into full blown shingles!</div>
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Returning to WMS, you realise that some things are the same for both the staff and students. <strong>There are simply not enough hours in the day!</strong> Working as an aCF, whilst also undertaking GP training, is a little like doing two 75% jobs, rather than two 50% jobs. But as with undergrad medicine, the experience is worth it!</div>
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Working on the faculty side of the fence, you get all the joy of unfettered medicine, the pure biology, without the attached patient in preparing sessions. Yet at the other end of the spectrum, you also get to play the human aspect, working with students, to "question-smith" their histories. They're developing communication skills, and working on phrases to get the most out of patients during history taking, whilst looking for nuanced body language that might suggest a patient hidden agenda.</div>
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Working with students is challenging. But it’s also an amazing buzz! In many ways, having a role at the sharp end of teaching at WMS requires mix multiple personalities, a little Jeremy Paxman, a little Robin Williams, a little Barry Marshall and a little Tess Daily (although I’m still working on that kind and caring bit!), somehow Jamie Roebuck seems to encompass them all!</div>
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The buzz comes from the challenges the students bring, and their still un-medicalised approach the questions. Everything from the simple building block questions of medicine, “How does <em>that</em> work?” to the “Question-smithing”, the question honing, done to illicit the most information out the patients, with the least repetition. Sometimes I even steal phrases the students come up with to use in day-to-day general practice! I’m sure I get as much out of working as WMS as I put into it!</div>
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Building on the concept of getting things out of WMS - medics, GPs, (I’ve even heard some surgeons) are life-long learners. A major benefit of working at WMS is you are continually thrown curve balls by the students, meaning there is always something to look up, clarify, or read around for the next sessions to answer a question.<br />
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As an aCF you get to deliver sessions on a wide variety of topics, but at a depth of detail I haven’t needed since I was on the wrong side of my Finals Exams! The preparation for these sessions is time consuming, but its always rewarding, and certainly keeps my knowledge fresh!</div>
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Probably the most surprisingly enjoyable part of working at WMS is the iterative culture here. Constant improvement is welcomed. The “we can do better” mind set, really is a pervasive attitude. Yes, there is an element of red tape, as there is everywhere, but if you have an idea that you can demonstrate will support the students and improve their learning, and you have to passion for its development, you’ll normally get support for it, or at least the opportunity, to pursue it.</div>
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<tr><td class="tr-caption" style="text-align: center;">Some of the volunteers taking part in Biking4Breasts</td></tr>
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One clear example of this has been the <a href="https://www.justgiving.com/Biking4Breasts/"><b>Biking4Breasts campaign</b></a>, where the Medical School supported a campaign to purchase the latest in clinical breast examination models from <a href="http://www.limbsandthings.com/uk/products/advanced-breast-examination-trainer"><b>LimbsAndThings</b></a>, for use not only by students, but as an education tool for the wider community.<br />
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Students, staff, even the VC’s wife Lady Thrift came down to join the fun in the main plaza where we collectively clocked up 2,000.1km, cycling around a virtual track with our riders efforts displayed on the Big Screen in front of Rootes.</div>
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<tr><td class="tr-caption" style="text-align: center;">Volunteers taking the evening shift at Biking4Breasts</td></tr>
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Just to go a little bit Marks & Spencer on you, “These are not just <em>any</em> Breast examination models…” the fidelity on these models is absolutely jaw dropping. Using these models, we can choose where to put the cancer models, which makes both teaching and examination setting, higher quality experiences. Again, all of this is directed towards bettering the student experience, and build better doctors. A simple GP factory, WMS isn't!</div>
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Working at WMS is frequently a challenge. Meetings about exam standards setting and question writing can become quite passionate, as there is always to drive to push a bit harder, just that little bit better for everyone. In any other environment, I don't think this constant culture of self-improvement and change would have been supported in the way it has been at WMS. But here, everything is <strong>always</strong> funnelled towards doing things for the benefit, and advancement of the students, which I think gives people the drive to keep pushing.</div>
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I've seen WMS change a lot since I graduated in 2010. It's changed further still since I've been here, and I hope I'll be able to contribute, and be part of, the next cycle of improvements and growth. One thing is for sure, whilst I'm at the medical school, the shingles has seemed to have gone into remission. Maybe I've found my place?</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-90068931444666545842015-10-19T08:36:00.001-07:002015-10-19T08:39:11.864-07:00Pro Dean Education... What does that mean?<div class="separator" style="clear: both; text-align: center;">
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<h4>
Lesley Roberts, Pro Dean Education</h4>
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Hopefully everyone is settled into the new year and our new students have been fully welcomed.<br />
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Last year we trialled use of a blog style approach to inform you a little more about the School and some of the behind the scenes workings. We saw an interesting student-authored blog about the experience of being one of the panel members for the quality assurance monitoring visit to UHCW and you learnt a lot about Professor Mark Pallen, including the fact that he is a previous winner of University Challenge!<br />
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This year I am really keen to use the blog to better inform you of the various research ongoing within the school and the special interests of some of our academics. So in forthcoming editions I hope we can get some insights from recent media stars (well local media stars at least) about work they are doing.<br />
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<strong>Dr James Gill</strong> was recently featured in the Leamington Courier in relation to his efforts to raise money for newer devices to improve GP training in the diagnosis of breast cancer, <strong>Professor Swaran Singh</strong> was featured on BBC radio (C&W) discussing a new play called ‘Cracked’ based on his research into mental health and <strong>Professor Francesco Cappuccio</strong> also had a radio slot discussing his research into salt so the first few blogs should be interesting and diverse.<br />
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But to start off the ball I thought I would share what I have been up to over the last year. I have been asked by a couple of students ‘<b>What exactly is the role of the Pro Dean Education?</b>’ and having been here a year now I thought I would try to explain this role.<br />
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I am a member of the senior executive team within the School with responsibility for all matters of education. We have a growing <b>postgraduate research portfolio</b> which engages in work which really does go from bench to bedside and significantly beyond with students undertaking work research around the globe. We also have a suite of <b>postgraduate programmes</b> which are also diverse in their coverage – from advanced clinical practice, to orthodontics, diabetes, reproductive technology, medical education and much more. And of course we have our <b>MBChB</b>!<br />
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All of these programmes have course directors and my role is therefore not one of detailed engagement within programmes but one of developing School strategy, monitoring delivery and quality metrics and supporting programme development. I also chair both the Graduate and Undergraduate Studies Committees for the Faculty which form part of the University approvals process for new courses, changes to courses and determination or application of regulation around education and student life. I also sit on University level Education Boards as Faculty representative and engage with some of the general activities of the wider university in relation to student progression and life.<br />
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Outside the University, I attend a variety of meetings engaging with NHS Trusts, Local Education Training Boards, Health Education West Midlands and other regional Universities. Much of my time at my desk is spent working through a rather uncontrollable email backlog.<br />
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So in essence I do a lot of sitting... Which is not conducive to a healthy lifestyle! I have also been trying very hard to remain research active (although this ‘activity’ also involves a lot of sitting at my desk) and am at the moment working on three papers which relate to medical education, thyroid dysfunction and the experiences of transition from paediatric to adult services… so somewhat eclectic in my focus. <br />
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One thing I don’t get enough time to do in this role is have as much face-to-face contact with students as I would like and I am aware so many of you are engaged in great work both within the School and through extra-curricular activity. You are publishing your own research, raising money for charity, developing your own peer learning approaches and generally impacting on the world in positive ways… So if you find yourself standing next to me in the queue for coffee please do introduce yourself and tell me something about what you are doing.<br />
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Good luck for the challenges ahead this year.</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-2285302444398881042015-06-23T06:11:00.000-07:002015-06-25T06:20:52.358-07:00Great Expectations <h3 style="clear: both; text-align: left;">
Joint Monitoring visit to UHCW</h3>
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By Alan Kan, MB ChB student</h4>
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We live in a time of digital media and high speed connectivity. The ideas of an individual can quickly become the knowledge of the masses, and the voice of the quiet minority can be amplified through all levels of society. It is through such a medium whereby the intricacies of complicated processes can be better understood, hopefully through a transparent lens.<br />
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The new curriculum is now ending its second year, and within the melting pot of student emotions are those of the 1st years, currently sitting their summative examinations. Ahead of them is the prospect to mingle, learn, and work within the frontline of the NHS, alongside the professionals who are dedicated to patient care.<br />
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Whilst the students receive some guidance on what to learn, how can there be reassurance that consultants and others are following the curriculum and offering high quality teaching, whilst also supporting Joe/Jane Blogg’s growth in confidence and competency as an aspiring doctor?<br />
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One of the ways in which this happens is through a regular process of monitoring and review of education delivered in the Trusts. In the past, this was done by a visiting Panel from the Medical School. This year, at Warwick, the process changed to amalgamate the quality monitoring visits done by the medical school and the team from Health Education West Midlands, who routinely look at education for foundation year doctors – known as the Joint Monitoring Visit Panel.<br />
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What is the Joint Monitoring Visit (JMV) process?</h3>
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<li>Key aspects of the hospital were analysed in relation to these areas of education, such as: patient safety; finance distribution; future goals of the hospital as a leading teaching hospital; foundation doctor education, and critically for me – medical student education.</li>
<li>Q&A sessions were held with a various groups of people at the hospital: consultants; students; foundation doctors; managing staff and clinicians.</li>
<li>Aims to improve the services and provisions offered at the hospital, working with them to achieve and exceed the status quo.</li>
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So, what was my role?</h3>
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<li>Student representative on the Panel which visited UHCW</li>
<li>Involved in open discussion forums, alongside other committee members, with the various groups to discover what was working and what improvements could be implemented in the future – particularly constructive and positive adjustments to improve the student experience.</li>
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There was great turnout from some groups we invited to participate in JMC discussions; from senior management (CEO, medical director, clinical director, managers and co-ordinators); Undergraduate and postgraduate academic/education teams; foundation year 1 & 2 trainees; and teaching fellows, specialist nurses and trust consultants involved in clinical education supervision. All were enthusiastic to give their views on the trust, aspirations and improvements that could be implemented in the future.<br />
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It was, however, disheartening to see that there were not so many current medical students involved on the day. The reasons for this could not have been more concerning: 3rd year students were on electives, and 4th years studying for their finals – perhaps the arrangements of such an important meeting should have been considered for those mentioned? It was, however, fantastic that medical school had arranged to meet 2nd year students before the JMV, to gain feedback on what was going well and what needed changing to enhance the student experience at UHCW.<br />
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I entered the process with the belief that education at any teaching hospital will always have room for improvement, regardless of how fantastic they may be. To push the boundaries further with intentions to benefit all who visit, in whatever capacity, can rarely be considered a negative thing, right?!</div>
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It is, therefore, a reassuring sign that Warwick Medical School (and its partners of Health Education West Midlands) are committed to ensuring students are obtaining the most from teaching hospitals, such as University Hospital Coventry and Warwickshire, by involving students in the JMV process.<br />
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Student involvement and contribution in such important procedures indicates to the rest of the student body that the veil which hides so many intricacies in managerial decisions in the medical school (and teaching hospital) is slowly being lifted; in the process building the tentative steps towards greater transparency which will undoubtedly better the growth and development of these students.</div>
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We can only wait and see if the recommended improvements can bring a lasting benefit to those using the facilities for education. In the meantime, greater effort must be made in ensuring administrative processes at the medical school (and teaching hospital) are more transparent; so those who are affected by sweeping changes can have a greater say in these organisations’ remodelling and redevelopment.</div>
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A message from Lesley<div class="separator" style="clear: both; text-align: center;">
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This edition of the Medical Education blog is written by fellow MB ChB student Alan Kan who participated in the recent monitoring visit to UHCW. Alan provides some interesting observations about being involved as a panel member at such an event and explains the purpose and methods of such visits which are an important element of education quality assurance.<br />
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Joint visits from medical schools and the West Midlands Deanery have only recently been introduced and this was the first such joint visit for Warwick Medical School. Similar visits to other hospitals will be occurring next year and I hope Alan’s blog inspires others to get involved.<br />
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I note Alan’s concerns around the lack of representation from year 3 and 4 students which was unfortunate and unavoidable given the timing of this visit which coincided with electives and final year examinations (which are fully understandably your priorities!). Hopefully such clashes can be avoided going forward so that we maximise your opportunity to input.<br />
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For those of you shortly moving to pastures new I wish you the very best for the future and for those of you staying with us I hope the weather warms up soon and you have a chance for some summertime fun.<br />
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Best wishes<br />
Lesley</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com2tag:blogger.com,1999:blog-2441191808878127815.post-30099795758325690092015-02-24T08:32:00.000-08:002015-02-24T08:55:57.359-08:00Behind enemy lines: a medic goes native among the scientists (Part Three)<div class="separator" style="clear: both; text-align: center;">
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<h2>
Professor Mark Pallen</h2>
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In my <a href="http://wms-mbchb.blogspot.co.uk/2015/02/behind-enemy-lines-medic-goes-native_17.html" target="_blank">previous</a> post, I talked about how I entered the world of laboratory medicine, first as a clinical academic gaining my MD at Barts, and then doing my PhD at Imperial College.<br />
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In this, my final piece, I'll talk about my focus on basic research, the challenges faced by clinical academics and how advances in technology eventually led me back to translational research.<br />
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Making a living from basic research</h2>
In late 1998, my fellowship finished and I returned to my old job at Barts. The first year back was very exciting, as I got stuck into analysing bacterial genome sequences that were being sequenced at the UK’s new genome sequencing centre, the Sanger Centre.<br />
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Through my interactions with the BMJ, I had gotten to know a bright tech-savvy 18-year old, <a href="https://twitter.com/pathogenomenick">Nick Loman</a>, who was doing a gap year while attempting to get into medical school. I recruited him to work for me for most of that year and together we both gained our exciting first taste of bioinformatics in the genomics era. This culminated in co-authorship of a <i>Nature</i> paper for me and entry on to the MBChB programme at Barts-London for Nick.<br />
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Learning point:</h3>
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<li><a href="https://www.youtube.com/watch?v=G2e_M06YDyY" target="_blank">Seize the day</a>: career opportunities are made not merely taken.</li>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKk9gK-zh18ycDftOrCkDMzEuwZrNKKq3Fb7RNNJHNOywKp5ixKv9h5tVXSEpzr6Dp1NHwTGdVOaefHEv1Ks5AfoH0s8dXDtwGco1LB7iskdsMZ3F0ZjXe8qBJsOa5ied7_CRUZK2gOmE/s1600/microbe350.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKk9gK-zh18ycDftOrCkDMzEuwZrNKKq3Fb7RNNJHNOywKp5ixKv9h5tVXSEpzr6Dp1NHwTGdVOaefHEv1Ks5AfoH0s8dXDtwGco1LB7iskdsMZ3F0ZjXe8qBJsOa5ied7_CRUZK2gOmE/s1600/microbe350.jpg" height="240" width="320" /></a></div>
The following year my mentor Soad Tabaqchali was forced to retire and my friend Brendan Wren left Barts for a chair at the London School of Hygiene, so I began to feel restless. I said to my wife that I would start looking for a chair in medical microbiology and that we might have to move to any one of the UK’s two dozen or so medical schools. We both agreed that Aberdeen and Belfast might be just a bit too far to go…<br />
<br />
The first chair in medical microbiology to be advertised was, of course, in Belfast and complete with another one of those offers one cannot refuse, I took up a chair at Queen’s University Belfast in late 1999. Having achieved the lofty status of “prof”, I moved back to England a couple of years later, to take up a chair in microbial genomics at the University of Birmingham. <br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>You will probably have to move jobs to get promoted. If you want to move fast up the ladder, you may have to move far away. But once you made it up to the next rung, you can move back closer to home.</li>
</ul>
</div>
<br />
In the decade that followed, I largely stayed true to my commitment to do basic rather than translational research, developing a grant-funded research programme that spanned genomics, bioinformatics and lab-based research, with a focus on <i>E. coli</i> and a specific bacterial protein secretion system known as type III secretion. <br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Even if you like to work on lots of things, it is good to have one or two in which you are recognised as an expert.</li>
</ul>
</div>
<br />
Alongside the academic career, for well over a decade after I had achieved consultant status, I managed to keep first a foothold and then a toehold in clinical practice, just enough to maintain my status as a clinical academic.<br />
<br />
However, on both sides of the job there was a creeping tendency to formalise the employer’s expectations of the clinical academic. Clinical governance, the new consultant contract with its formal job plans and revalidation took hold in the NHS, while academic life was governed more and more by the need to get grant money in and high-impact papers out for the Research Assessment Exercise and to improve the student experience for the NSS.<br />
<br />
When the new consultant contract finally caught up with me, I was told I was no longer doing enough clinical work to merit clinical academic status under the new scheme, so I would either have to do more clinical work, or I could become a non-clinical academic. I chose the latter option, in the hope of maintaining my competitive research credentials. <br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>The powers that be need to put more effort into making it possible for clinical academics to survive in the modern workplace. Universities should recognise their unique contribution and the challenges they face</li>
</ul>
</div>
<br />
<h2>
Back to my roots?</h2>
<div>
<br /></div>
Ironically, just as I was abandoning my clinical academic status, a new development that would lead me back into translational research was setting the world of genomics alight — the arrival of high-throughput sequencing, that is sequencing technologies that made it possible for research groups outside of major sequencing centres to sequence bacterial genomes. I was a keen early-adopter of the new high-throughput sequencing technology for microbial applications, but in the process tracked a path back to my roots in translational research.<br />
<br />
In parallel with several others in the field, I showed that bacterial genome sequencing could be used to investigate the epidemiology and evolution of bacterial pathogens, particularly within outbreaks. We focused our efforts on hospital outbreaks caused by antibiotic-resistant Gram-negative pathogens, such as <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Pallen+MJ%5BAuthor%5D+AND+(Acinetobacter+OR+Pseudomonas)"><i>Pseudomonas aeruginosa</i> and <i>Acinetobacter baumannii</i>.</a> <br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Can you become an ex-medic? Or is this a badge you carry for life?</li>
</ul>
</div>
<br />
I managed to recruit Nick Loman back into working for me and together we explored the potential of social media in academic life. This led to our involvement in a pioneering crowd-sourced analysis of the genome of an <i>E. coli</i> strain causing a devastating outbreak in Germany, which resulted in a <a href="http://www.nejm.org/doi/pdf/10.1056/NEJMoa1107643">paper in the high-profile <i>New England Journal of Medicine</i>.</a><br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnGVSLb-RaPkVfMd48Lpz8buKuHma1eXLPwFWbm-l7FWcFZ8ORLlPgA6_P7rsfsNJ1IAph6zpVOU7hhON5OaAP8syjN-nKR_LShj70iBJn9CBqKi2xRf4sBO1ss61tF5fx1o-pZzKSiaU/s1600/team350.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnGVSLb-RaPkVfMd48Lpz8buKuHma1eXLPwFWbm-l7FWcFZ8ORLlPgA6_P7rsfsNJ1IAph6zpVOU7hhON5OaAP8syjN-nKR_LShj70iBJn9CBqKi2xRf4sBO1ss61tF5fx1o-pZzKSiaU/s1600/team350.jpg" height="320" width="264" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The team at Warwick Medical School</td></tr>
</tbody></table>
We were also early adopters of the new smaller, faster benchtop sequencing platforms—a pioneering comparison of three new benchtop platforms led to a <a href="http://www.nejm.org/doi/pdf/10.1056/NEJMoa1107643">highly cited paper in <i>Nature Biotechnology</i></a>. And then a second collaboration with a group in Germany allowed us to reconstruct the genome of the <i>E. coli</i> outbreak strain just by sequencing and analysing faecal samples from the outbreak, without having to culture the strain.<br />
<br />
I moved to Warwick in April 2013 and shortly afterwards this <a href="http://www.ncbi.nlm.nih.gov/pubmed/23571589">work appeared in the high-impact journal JAMA</a>. And since I have been here, I have sponsored research projects for two academic clinical fellows.<br />
<br />
So here I am in Warwick Medical School, in the Division of Translational and Systems Medicine. But have I moved entirely back to translational clinical work? No, not all!<br />
<br />
One of the most promising directions in my recent research concerns the study of ancient DNA. This has involved <a href="http://pubmed.gov/25028426,23863071">recovering pathogen genomes from hundreds of years ago</a>, from which one can spin a translational narrative — it really is shedding light on the epidemiology and diagnosis of <a href="http://www.ncbi.nlm.nih.gov/pubmed/25279265">contemporary infection</a>. However, with Robin Allaby in the School of Life Sciences, we have also been sequencing ancient DNA from 8000-year-old submerged sediment cores to investigate the spread of domesticated plants to the British Isles and it is impossible to call that translational medical research. <br />
<div id="yoursay">
<h3>
Learning points:</h3>
<ul>
<li>Am I pleased that I stayed a medical student and a medic in my early career. Yes! </li>
<li>Would I recommend a career as a clinical academic? Yes!</li>
<li>Is it possible for medics to become scientists too? Yes! </li>
<li>And do you make your own luck in this life? Yes!</li>
</ul>
</div>
<br />
<i>If you want to know more about my academic journey, take a look at my inaugural lecture on the <a href="http://www2.warwick.ac.uk/fac/med/news/events/inaugural/archive/">WMS website</a> or on <a href="https://storify.com/mjpallen/palleninaugural">Storify</a>.</i>Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-11945872071979413542015-02-17T07:40:00.000-08:002015-02-17T07:50:14.828-08:00Behind enemy lines: a medic goes native among the scientists (Part Two)<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjimjNzAnKY8OlSNZZK84MHNxHHZHn1IPRrBLsGGSNQ6aFwqUSKBsKYcF_zV8DJsUCYWf-TJi4c4013KOLaquVhgyfX0TSOr9EpLhHpcwBzKawdQlWxVpXo_EoDWpdcVx_f_1FN6cBzTVI/s1600/mpallan_150.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjimjNzAnKY8OlSNZZK84MHNxHHZHn1IPRrBLsGGSNQ6aFwqUSKBsKYcF_zV8DJsUCYWf-TJi4c4013KOLaquVhgyfX0TSOr9EpLhHpcwBzKawdQlWxVpXo_EoDWpdcVx_f_1FN6cBzTVI/s1600/mpallan_150.jpg" /></a></div>
<h2>
Professor Mark Pallen</h2>
<div>
In <a href="http://wms-mbchb.blogspot.co.uk/2015/02/behind-enemy-lines-medic-goes-native.html" target="_blank"><b>my first post</b></a>, I talked about my experiences as a medical student and a junior doctor, my growing interest in clinical research and how I decided I wasn't suited to front-line medicine or surgery.</div>
<div>
<br /></div>
<div>
This week, I'll be talking how how I progressed from being a house officer to life in laboratory medicine.<br />
<br /></div>
<h2>
Specialist training in Medical Microbiology</h2>
I decided to look at laboratory medicine as a career choice—an option often termed “Pathology” within the UK system. When I asked for advice from the local microbiology professor, J. D. Williams, I was surprised to be offered a job as a temporary lecturer in Medical Microbiology at the London. And so, without much forward planning and a heavy dose of serendipity, I embarked on a career in microbiology.<br />
<br />
<a name='more'></a><br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Use your own initiative to make contact with people who can help shape your career. You make your own luck.</li>
</ul>
</div>
<br />
I started on a research project on serodiagnosis of tuberculosis, but soon realised that I would be better off combining clinical and research training. I learnt the basics of medical microbiology and discovered how easy it was to slip between academic and clinical work within a laboratory-based discipline.<br />
<br />
I was surprised to learn that the clinical laboratory was still using animals in routine diagnosis: all tissue samples were being inoculated into guinea pigs as part of the diagnostic work-up for tuberculosis. When I asked the laboratory staff how this could be justified, they said that it probably couldn't, but would provide something that could be cut the next time the professor was asked to save something from his budget!<br />
<br />
In a fit of righteous indignation, I then did my own audit of the use of guinea pigs for TB diagnosis and established that they made at best only a marginal contribution to patient management and their use could not be justified on grounds of cost, safety, and animal welfare. This became <a href="http://www.sciencedirect.com/science/article/pii/0041387987900079" target="_blank"><b>my first original research publication</b></a>.<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>If something doesn’t seem right, marshal the evidence and then fight bad practice with the facts</li>
<li>Get your first research publication out as soon as you can, however modest it may be</li>
</ul>
</div>
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjP35uw5vNN_C43IqwUJ6ZslixXY7iI7hNurk1OfKWZyMBlCcaQpq8HyQG_J2TprT3FzoTCvo485qYpub8y0Yd3PUxB0mOM4FwwqF42760vFLNmaOGopy4-YAqglU0IPW32aVGjOu5uVSk/s1600/mpallen2_250.png" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjP35uw5vNN_C43IqwUJ6ZslixXY7iI7hNurk1OfKWZyMBlCcaQpq8HyQG_J2TprT3FzoTCvo485qYpub8y0Yd3PUxB0mOM4FwwqF42760vFLNmaOGopy4-YAqglU0IPW32aVGjOu5uVSk/s1600/mpallen2_250.png" height="320" width="192" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Me as a trainee microbiologist at the Royal Free</td></tr>
</tbody></table>
Frustrated by the fact that I was being employed on a short-term contract at the London, in 1986 I set off for a new job at the Royal Free, first as Senior House Officer then as Registrar. I soon passed my MRCPath Part 1 examination and by early 1988 was ready to apply for the next rung up the ladder: a Senior Registrar position.<br />
<br />
However, by then I had decided that I wanted to follow a clinical academic career path, which meant finding a post in which I could pursue an MD (a research degree, similar to a PhD in being awarded after thesis and viva, but aimed at medics interweaving research with clinical work). This meant getting a Clinical Lectureship with honorary senior registrar status.<br />
<br />
I was looking to move out of London, so when I saw an advert for a job at Barts (the UK’s oldest hospital on its original site: founded 1123), my only thought was I might as well apply for interview practice, particularly as there was a strong internal candidate. Surprisingly, I was offered the job and continued my academic career in Professor Soad Tabaqchali’s department.<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Don’t be put off by competition from internal candidates—they have most to lose and so will often be nervous, whereas the outsider can impress with a relaxed indifference.</li>
</ul>
</div>
<br />
The Medical Microbiology department at Barts at that time was a remarkable place, with a thriving academic research lab joined to a busy diagnostic lab. There was a wide variety of pioneering projects underway, harnessing the new power of molecular biology and recombinant DNA technology to the study of bacterial pathogens. In addition, there was a very relaxed and flexible approach to clinical duties, which left plenty of time for research.<br />
<br />
I enthusiastically imbibed the research culture, which included regular trips to the Barley Mow pub. I worked alongside several remarkable non-clinical scientists early in their careers, including Brendan Wren, Chris Clayton, Pete Mullany and Harry Kleanthous. I became a devotee of the Apple Mac computer, which I used to produce attractive student handouts. I also learnt how to analyse protein sequences and run searches against protein databases and gained a reputation as the lab’s computer geek.<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Seek out smart and interesting people as colleagues. Work somewhere with an exciting research vibe. As Jim Watson says: avoid boring people.</li>
</ul>
</div>
<br />
I learnt the value of computers in biology when Chris Clayton asked me to analyse some sequence he had generated from what he thought might, or might not, be the gene for urease from the recently discovered gastric pathogen Helicobacter pylori. I compared his sequences with the only other known urease sequence (which came from the jack bean plant) and was amazed to discover a remarkable degree of sequence conservation across such a vast evolutionary distance. This culminated in <a href="http://nar.oxfordjournals.org/content/18/2/362.extract" target="_blank"><b>a brief but highly cited publication</b></a>.<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Find your own niche, where you can make a difference.</li>
</ul>
</div>
<br />
While at Barts, I developed my own MD project out of a clinical problem — how to diagnose diphtheria (and also how to avoid unnecessary scary false-positives). I developed the first polymerase chain reaction aimed at detecting the diphtheria toxin gene. I also continued my specialist training and so by 1992, I had passed the final part of my MRCPath examination and been awarded an MD. I was then promoted to Senior Lecturer and given an Honorary Consultant position (the first from my year at the London to get a consultant position).<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>If you want to climb the ladder quickly, work in one of the less competitive disciplines.</li>
</ul>
</div>
<br />
<h2>
Parachuted behind enemy lines</h2>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijzQdGFPQ8KPVqztzamKPfFVO-yG0rFznX89LIPQspsUJ4GyIr-PnGvFqTILl5ZvfcJ22SvE4TZcnrmhtI9RGMEtJ5do0QOWqE1Ea9GiGBgPvLshGkU2fLrdhgsFZFU8Cw-TXG5dxokXU/s1600/mpallen3_250.png" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijzQdGFPQ8KPVqztzamKPfFVO-yG0rFznX89LIPQspsUJ4GyIr-PnGvFqTILl5ZvfcJ22SvE4TZcnrmhtI9RGMEtJ5do0QOWqE1Ea9GiGBgPvLshGkU2fLrdhgsFZFU8Cw-TXG5dxokXU/s1600/mpallen3_250.png" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Me as lab idiot at Imperial</td></tr>
</tbody></table>
Once I had got my MD and become a Senior Lecturer, I soon learned that the goal posts have shifted. To be taken seriously as a clinical academic it was becoming clear that you had to have a PhD, i.e. the very same qualification that scientists who were non-medics had.<br />
<br />
Through Brendan Wren I had gotten to know Gordon Dougan, who had recently become a professor at Imperial College and was highly influential with the Wellcome Trust. Dougan had taken a look at the state of medical microbiology in the UK and was not impressed. He persuaded the Wellcome Trust to invest in a scheme that allowed medically qualified microbiologists to spend three years at the bench gaining a PhD and before I knew it I was being encouraged to apply to the scheme.<br />
<br />
While it clearly represented an opportunity I could not refuse, I have to admit to being very uneasy about taking up a fulltime research fellowship in my mid-thirties. Once I arrived in the lab at Imperial, I went from being a (self-) important medic to being the lab idiot. It was harsh medicine, but it worked.<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Sometimes you have to seize opportunities that might you uncomfortable in the short term, but pay off in the long term.</li>
</ul>
</div>
<br />
During the course of those three years, thanks to interactions not just with Dougan, but with others in his lab, including <a href="http://www.imperial.ac.uk/people/g.frankel" target="_blank"><b>Gadi Frankel</b></a>, Paul Everest, Jeannette Adu-Bobie and Gill Douce, I absorbed the mind-set of the professional and competitive scientist.<br />
<br />
Ironically, just as I was deciding that I was now interested in exciting basic curiosity-driven research (my thesis was on how <i>Salmonella</i> responds to starvation stress) rather than dull old applied translational research, my supervisor Gordon Dougan was complaining about the artificiality of studying <i>Salmonella</i> infections in mice and stressing the need to study typhoid in humans!<br />
<br />
Aside from doing enough research to gain a PhD, I did three more things while at Imperial:<br />
<ol>
<li>I wrote a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2544383/" target="_blank"><b>series of articles</b></a> for the <i>BMJ</i> introducing the medical profession to the newly emerging phenomenon of the Internet.</li>
<li>My wife and I started a family.</li>
<li>I led the Imperial College team to victory in University Challenge.</li>
</ol>
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Research fellowships with no on-call commitment are a good time to start a family—only one source of sleepless nights, not two!</li>
</ul>
</div>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiy08qvlV8j90xaghmePVM53YPyLOHujZcqQcBUu-PFFrMQhVUMUjIFEoC0ZkLGQZXceTHc9dvcByJhAlQ2Zx1y0A9N0t5Mb74VbGvCgO_7ymZ4S80QAlQtMrqyBL77WMWodN3X2GBDMG0/s1600/mpallen_uc_500.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiy08qvlV8j90xaghmePVM53YPyLOHujZcqQcBUu-PFFrMQhVUMUjIFEoC0ZkLGQZXceTHc9dvcByJhAlQ2Zx1y0A9N0t5Mb74VbGvCgO_7ymZ4S80QAlQtMrqyBL77WMWodN3X2GBDMG0/s1600/mpallen_uc_500.png" height="193" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Appearing on University Challenge</td></tr>
</tbody></table>
<br />
By a twist of fate, items 2 and 3 clashed, in that the final rounds of the contest were scheduled to appear a week before our first child was due to be born. I sought advice from my old friend Brendan Wren, who advised me that I would have many chances to have children, but only one to win University Challenge and that I must broker a deal so that I could participate in the contest and still act as a companion to my wife in labour. And so the compromise was struck that my wife and I would stay with her parents in Newcastle-under-Lyme while the shows were being filmed in Manchester, so that if she did go into labour, I would be close by.<br />
<br />
As it happened, we won our way through the quarter-final, semi-final and then the final itself (<a href="https://www.youtube.com/watch?v=DDNzUNdbOss" target="_blank"><b>view on YouTube</b></a>) and Emma Louise (born November 5 1995) didn't come until a week later!<br />
<br />
<div id="yoursay">
<h3>
Learning point:</h3>
<ul>
<li>Learn the art of creative compromise</li>
<li>Add a few quirky things to your CV to stand out from the crowd</li>
</ul>
</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-72037491434012634242015-02-10T07:46:00.000-08:002015-02-12T08:08:13.979-08:00Behind enemy lines: a medic goes native among the scientists (Part One)<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibEv32PR9aHX5THGmIkR4qwat82uoSZuzq-q9jwBgEHGPBwEJF3ZtcNUCjNf_A7tCCk9_7-OD5jWARf4t7a3SF2N9j-eFmbliNsqmYL14DsY0vnKwVU_E-rPZ7mGh_SfppgJcmXZB3lPY/s1600/mpallan_150.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibEv32PR9aHX5THGmIkR4qwat82uoSZuzq-q9jwBgEHGPBwEJF3ZtcNUCjNf_A7tCCk9_7-OD5jWARf4t7a3SF2N9j-eFmbliNsqmYL14DsY0vnKwVU_E-rPZ7mGh_SfppgJcmXZB3lPY/s1600/mpallan_150.jpg" /></a></div><h4>Professor Mark Pallen</h4>Allow me to introduce myself. I am Professor of Microbial Genomics at Warwick Medical School and I have been here since April 2013.<br />
<br />
Although I was once, like you, a medical student and then a medic, I am now a full-time non-clinical academic. I thought I might share my academic journey, highlighting some of the pivotal points in my career, illustrating how I made a living behind enemy lines, as medic going native among the scientists, while also showing how I had some fun along the way.<br />
<br />
Learning points (some of them tongue in cheek) are highlighted in the boxes below.<br />
<br />
<a name='more'></a><br />
<br />
<h3>Student years: becoming a medic</h3><div><br />
</div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1MuslZVMHGA4hjyJpKgeufKp_bMzlLw46dzSjeBnZ1wOBi8MD9TxC1tGVOikhnFdh02hv9ADj4utdC3lZid6sZIFxRzmcQd-RNxSp6irX63RicR95sKFpg-0qhgDLOs9xqmhI13kY7V4/s1600/mpallen_HO300.png" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1MuslZVMHGA4hjyJpKgeufKp_bMzlLw46dzSjeBnZ1wOBi8MD9TxC1tGVOikhnFdh02hv9ADj4utdC3lZid6sZIFxRzmcQd-RNxSp6irX63RicR95sKFpg-0qhgDLOs9xqmhI13kY7V4/s1600/mpallen_HO300.png" height="320" width="221" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Me as a medical house officer</td></tr>
</tbody></table>My ambivalence about whether I was really a medic or a scientist started early on. Like most sixth-formers who are good at science, especially biology, I was encouraged to apply to do medicine. I got into <a href="http://www.fitz.cam.ac.uk/">Fitzwilliam College Cambridge</a> to study medical sciences. I have to admit that I was always more interested in facts than in people and nowadays would probably fail to get on to a medical degree because of a lack of “caring experience” or a “people-person” mind-set. But back then academic credentials were all that mattered.<br />
<br />
As soon as I arrived, I started to wonder whether I should transfer across to the Natural Sciences course. But, as everyone pointed out how lucky I was to have gotten on to the medical course, I stuck with it! One of the great features of the Cambridge experience was that medics and scientists often shared teaching and I also rubbed shoulders with science students within the college environment. As a result, I picked up on the excitement of developments in gene cloning and molecular biology. <br />
<br />
Unfortunately, during my second term and again in my second year at Cambridge, I was hospitalised with <a href="http://en.wikipedia.org/wiki/Pericarditis" target="_blank">pericarditis,</a> which knocked the wind out of my sails academically speaking. The upshot was, as Charles Darwin (a hero of mine) put it, “<a href="http://darwin-online.org.uk/content/frameset?pageseq=60&itemID=F1497&viewtype=side" target="_blank">during the three years which I spent at Cambridge my time was wasted, as far as the academical studies were concerned</a>”— I graduated with a 2.2 <span style="font-family: Wingdings; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Wingdings;">L</span><br />
<br />
However, all was not lost. A final-year dissertation on the transmission of leprosy piqued my interest and forced me to adopt the rigours of tightly argued scholarly discourse. I even managed to get it published in an academic journal (although that happened several years later: <a href="http://www.ncbi.nlm.nih.gov/pubmed/3540493" target="_blanK">'How might Mycobacterium leprae enter the body?'</a> [on PubMed]). <br />
<br />
<div id="yoursay"><h5>Learning points:</h5><ul><li>A student is not a vessel to be filled but a torch to be set alight!</li>
<li>It is possible to redeem a career after a poor start, although it is better to get things right first time.</li>
</ul></div><br />
Back then, most Cambridge medical students went elsewhere to complete the clinical phase of their course. I went to the London Hospital Medical College, right in the heart of London’s East End. The contrast with the cloistered world of Cambridge could not have been greater—I enjoyed the pubs, parties and curries!<br />
<br />
Disappointed with my performance at Cambridge, I set about re-building my academic credentials by winning several essay prizes. One of these, awarded through a national competition run by the leprosy charity <a href="http://www.lepra.org.uk/">LEPRA</a>, became my first scholarly publication, which appeared the month I graduated as a medic in 1984 (<a href="http://ila.ilsl.br/pdfs/v52n2a14.pdf" target="_blank">The Immunological and Epidemiological Significance of Environmental Mycobacteria on Leprosy and Tuberculosis</a>). <br />
<br />
<div id="yoursay"><h5>Learning point:</h5><ul><li>Start building your CV as a student. Every little helps, particularly early in our career.</li>
</ul></div><br />
It soon became clear to me during my clinical years as a student and during my year as a house officer that I was not temperamentally suited to front-line medicine or surgery, particularly as I hated doing without sleep. Nonetheless, during that time, I came face-to-face with a range of clinical challenges — I delivered two babies, made a blue-light trip in an ambulance to see a woman miscarrying on a sofa, performed an appendectomy, assisted at an all-night aortic aneurysm repair and participated in a harrowing unsuccessful attempt to resuscitate a young child dying of asthma.<br />
<br />
<h3>Coming in Part Two:</h3><br />
<ul><li><b>Specialist training in Medical Microbiology</b> - my transition into becoming a microbiologist and early steps as a clinical academic</li>
<li><b>Parachuted behind enemy lines</b> - working with non-medic scientists (including appearing on University Challenge)</li>
</ul><br />
<br />
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-86286785810412342092014-12-10T03:12:00.003-08:002014-12-12T07:47:30.638-08:00Looking back over the last term<h4>
Colin Melville, Head of Medical Education<div class="separator" style="clear: both; text-align: center;">
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</h4>
Christmas is almost upon us. 2013 and 2014 cohorts have already started their break and others will follow shortly. I'm sorry I haven’t been able to meet everyone, but on behalf of all the MB ChB team I do want to wish you all a happy Christmas break.<br />
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We've been quite busy during the last term, with the refreshed curriculum now well into its second year, and changes too for those still on the pre-2013 curriculum. The Dean has hosted a number of student breakfasts throughout this term in the Trusts (thank you to our NHS partners for organising these), and we've had a positive and productive SSLC meeting.<br />
<a name='more'></a><br />
We also had a huge amount of useful feedback from our own ‘NSS’ survey at the end of the last academic year. As a direct result of these we are continuing to make and/or influence changes for the benefit of students.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEmp4HdXDiyxcBGCCSzR_rZBuq_6AG5wZ7lPBQeXTe-ux82asBHxey8FDcAs7ak2D4Sy__m-QtjIA0JzIVPuAndJWTImzgcC6r33SWOKLdO19kiTsLg-_QxX75aVeh9qcmZ3hn3AwtcC8/s1600/baubles250.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEmp4HdXDiyxcBGCCSzR_rZBuq_6AG5wZ7lPBQeXTe-ux82asBHxey8FDcAs7ak2D4Sy__m-QtjIA0JzIVPuAndJWTImzgcC6r33SWOKLdO19kiTsLg-_QxX75aVeh9qcmZ3hn3AwtcC8/s1600/baubles250.jpg" /></a></div>
Here’s a few examples:<br />
<br />
<ul class="content-list2">
<li>We continue to roll out a peer observation for our teaching faculty, accompanied by lecture feedback from students, which the 2014 cohort have already contributed to. Expect to see more of this: we are trying to be careful to balance the need to evaluate the quality of teaching, whilst not over-surveying students</li>
<li>We continue to update the ‘data-reveal’ following summative assessments to improve the information contained in this feedback</li>
<li>We’ve negotiated wifi access for students based at UHCW to have (details on the MB ChB course home page)</li>
</ul>
<ul>
<li>We will provide a mock IPE and FPE MCQ paper for 2012 and 2011 cohorts respectively.</li>
<li>We have enhanced the revision block for our finalists, developed in partnership with the NHS, including a plan to offer regular mock OSLER clinical assessments in preparation for the clinical FPE</li>
<li>UHCW has made some changes to the undergraduate admin team which should improve communication between the UHCW office and students</li>
<li>UHCW has been conducting focus groups to explore what further changes are needed to enhance the student experience</li>
</ul>
It was also a great pleasure for me to be able to host our annual student awards evening recently in which a number of students were recognised for their achievements on the course so far. Our Dean, Professor Winstanley did the honours in presenting the awards. Further awards will be presented to our finalists at graduation day in the summer.<br />
<br />
Well, whatever you do during the Christmas break, I hope you have a peaceful and relaxing time, and look forward to seeing you again in the New Year.<br />
<br />
If you have any thoughts on the last term that you'd like to share, please use the comments section below.Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0tag:blogger.com,1999:blog-2441191808878127815.post-35725138303810557872014-11-11T08:42:00.003-08:002014-11-19T01:54:16.688-08:00"You said, we did..."<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifXn0ybYaJIgV4VPkk_Wdulmj_Iy2tE3GAoHY6hNjbWX8H0TgW79YD1-1esSqOAvKud4BXo88EkxKnbj82_lKpSraGm6507B2hFMuSHEV2cWi6e-uzsGUjNZJNJyL-5lyWfhR9rFHzVZg/s1600/gknotts.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifXn0ybYaJIgV4VPkk_Wdulmj_Iy2tE3GAoHY6hNjbWX8H0TgW79YD1-1esSqOAvKud4BXo88EkxKnbj82_lKpSraGm6507B2hFMuSHEV2cWi6e-uzsGUjNZJNJyL-5lyWfhR9rFHzVZg/s1600/gknotts.jpg" style="margin-bottom: 5px;" /></a></div>
<h4>
Gareth Knott, Student Chair, SSLC</h4>
<br />
The simple phrase "you said, we did..." encapsulates what the aim of the SSLC is; to get the <b>views of students</b> out there and to ensure that they are <b>listened to</b>, <b>acted upon</b> and that these actions are <b>fed back</b> to students. <br />
<br />
Life at medical school is tough, really tough, and it is absolutely right for students to demand excellent experiences, education, facilities and support. All too often for some students it feels like 'excellent' is too generous a word.<br />
<br />
Worse than that, students can feel like things can’t change or won't change. They simply complain to each other over a coffee, then buy a cookie, and merrily get on with their lives. But change has happened.<br />
<a name='more'></a><br />
<div class="separator" style="clear: both; text-align: center;">
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The SSLC has worked with the faculty to:<br />
<ul class="content-list">
<li>Ensure a four week deadline for all feedback</li>
<li>Hugely increase the number of face-to-face feedback opportunities</li>
<li>Ensure students receive more teaching from consultants (e.g. OSLERS)</li>
<li>Clarify what is and is not going to be in upcoming examinations</li>
<li>Re-organise finals revision</li>
<li>Give students access to the Postgraduate Hub</li>
<li>Improve the experience within placements, which in some situations has not been good enough for students. Progress has been slow but we continue to work for improvements</li>
</ul>
Change needs to continue to happen and we need to continue to set the bar higher. I implore all students to maintain high expectations and when these standards are not met to act on it. Email your head of Phase and <b>expect</b> a response. Email your SSLC rep and let's work together.<br />
<br />
Staff need to do better in showing that they are listening to students and showing students what actions they are taking. Also some staff need to ensure they are replying to emails - nothing annoys students more than feeling they are being completely ignored. Students - if this is happening to you please let the SSLC know.<br />
<br />
At the SSLC we too need to do better in receiving more views from students in order to better represent your views. We need to better communicate with you to show exactly what we are doing to make the changes you want.<br />
<br />
If you would like to share your thoughts and experiences, we'd love to hear from you in the comments section below. If there's anything you don't feel comfortable sharing here but would like to raise, please contact your <a href="http://www2.warwick.ac.uk/fac/med/study/ugr/mbchb/societies/sslc/contacts">SSLC reps</a>.<br />
<br />
<div id="message1">
<h5>
A message from Lesley<div class="separator" style="clear: both; text-align: center;">
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</h5>
"Gareth is obviously committed to the work of the SSLC and makes a very good point that it is all too easy to have a moan over coffee and then get back to work – life is full of minor irritants and moaning actually does have a therapeutic benefit but Gareth gives some convincing examples of how the SSLC has brought about real change and if irritants are more than minor I would certainly support his plea that you inform the SSLC and allow them to lead on improving things for you and those who follow you.<br />
<br />
"I will point out that Gareth and the SSLC also do tell us when we have got things right and when changes bring about significant improvements in the student experience… like you we also need a little positive feedback to counter the negative… But are committed to getting it right. Please do make sure you continue to raise issues (good and bad) with your reps."</div>
<div id="yoursay">
<h5>
Have your say</h5>
<br />
Is there a current irritant you would like to tell us about here rather than wasting your precious coffee time later today? Tell us in the comment section below:</div>
Anonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com2tag:blogger.com,1999:blog-2441191808878127815.post-25068533656504376742014-10-13T07:01:00.000-07:002014-10-17T02:30:27.509-07:00Welcome to the Medical Education Blog<h4>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9KFwL3KqQ3KWV9d124jpGeMvOppKyv17yKrZjmbImChf25CREbVuGtzpGJV9sdHmMgs3oz6AkOtnKln2hHUYZXdx4WgMaTf311WP9ZcudAxqai_L8wapkxoMtTgmYiAHOmvVTEnUQjJ0/s1600/lesley150.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9KFwL3KqQ3KWV9d124jpGeMvOppKyv17yKrZjmbImChf25CREbVuGtzpGJV9sdHmMgs3oz6AkOtnKln2hHUYZXdx4WgMaTf311WP9ZcudAxqai_L8wapkxoMtTgmYiAHOmvVTEnUQjJ0/s1600/lesley150.jpg" /></a>Professor Lesley Roberts, Pro Dean Education</h4>
This is the first of what I hope will be many blogs created by faculty and students (with maybe a smattering of guest bloggers) within the School. I hope this will act as a forum for you to learn a little more about the staff you work with and for us to do the same about your experiences as a Warwick medical student.<br />
<br />
I perhaps need to start with an introduction. I joined WMS in July, taking over the role of Pro Dean Education from Professor Neil Johnson. This was a big move for me, having spent almost the last 20 years working in the Medical School at Birmingham.<br />
<br />
The schools are very different in size, age and of course in terms of school leaver versus graduate entry. My new role expands far beyond the MB ChB and I have responsibility for our educational delivery, development and strategy including our postgraduate programmes and other professional training.<br />
<a name='more'></a><br />
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Being new has given me the opportunity to really reflect on the experience our new first years are going through. Despite having previously uprooted and engaged in University education the transfer to a significantly different programme of study in a new place, with new people is undoubtedly stressful – and this year just for added fun we have the complexities of trying to move around the obstacle course that road works have made of campus! I am sure the same applies albeit to a lesser extent as you move into each new phase of the course and rotate around different hospitals and other sites and experience new specialties.<br />
<br />
What has struck me, however, is the way in which others have gone out of their way to make me feel at home. I know the same occurs every year in medical schools everywhere as those in later years share knowledge and survival info with the new starters. For me this process is ongoing, as my absolute lack of any sense of direction still sees me wandering aimlessly around the building looking for rooms and, indeed on more than one occasion, wandering around campus in search of my car. So if you do see a rather frazzled looking woman and know the whereabouts of a black VW beetle do point me in the right direction!<br />
<br />
The other opportunity new starts provide us with is the chance to reflect on our strengths and weaknesses and I encourage you all at this point in the year to stop and take check for a minute to identify whether there are any changes you can make to facilitate your learning and daily work.<br />
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One of the biggest challenges we face is that the world is now in such a period of rapid progression and we therefore need to repeatedly force ourselves to stop and reflect in this way.<br />
<br />
As doctors of the future it is difficult to envisage what the state of medicine will be towards the end of your careers – when I started working most memos were still delivered to my office on paper and tracking down a reference involved hours of laborious work in the library. Now if I don’t know something Google usually helps me out and if I need something one of my Facebook friends inevitably is in possession of it. But such resources place increasing pressure on our time and open up new challenges to medicine as patients no only self-diagnose but also turn to the internet for medication, screening kits and self-help.<br />
<br />
Last year I undertook some research into the impact of self-harm websites – many facilitated recovery and helped create the sense of community that many individuals who were harming felt was absent from their lives – but obviously the impact of the internet on health can be negative as well as positive. Your role as doctors is therefore vast – skills in diagnosis and treatment need to be underpinned by a sense of society, culture and what it really means to be human. Those of you starting to plan electives will have the opportunities to explore a whole raft of other impacts on health and the innovation required to deliver care in poorly resourced settings.<br />
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The key to success is reflecting, sharing and remaining solution-focused and this is what I hope to do in my new role. We are a community who have vast experience and have experienced education in a host of settings and disciplines. I hope together we can continue our own evolution (which sounds so much better than mutation!) to create a school in which we all thrive.<br />
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So I end this ramble with an invitation for your thoughts. If you are a new entrant let’s hear about your first few weeks, if you are in later years what are the things that you wished someone had told you. What lessons or experiences have you previously had that might help us continue to evolve and improve?<br />
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I hope to meet many of you in the forthcoming months and years (The Dean’s breakfasts are going to continue this year and provide a forum for some of you to chat with us and I will be trying to meet many of the final year students to learn what I can from you). I have always felt that every year I learnt more from students than I could ever have taught them and I sincerely hope this continues at Warwick.<br />
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Best wishes, good luck and good health.<br />
<br />
LesleyAnonymoushttp://www.blogger.com/profile/18202996683281009523noreply@blogger.com0