Student BMJ Review: September 2007 issue
Overall this month’s Student BMJ is a very good issue. The theme of the "ideal medic" is one that is relevant to every student out there, regardless of their background or nationality. The issue reads well and on the whole is concise enough for the typical reader to read through completely over several reads. Some interesting and controversial topics are dealt with too, such as selection criteria for entry to medical school, gaining consent for testing and informing patients regarding HIV status and paying patients for adhering to medication regimes. There is a good input from a range of different levels - from Professors to first year medical students which I feel is an essential.
The web version of the journal does however appear slightly dull in appearance and I feel could do with a greater sense of adventure and excitement, perhaps with more colour. One or two of the articles could have a slightly different focus which I have indicated below.
Cover
Simple yet effective. The simple colour scheme highlights that the question being asked is essentially a very simple one – "what is the ideal medic?" The powerful contrast in colours together with the silhouette suggest that surprisingly this is not an easy question to answer and that every medical student out there is trying to form an image of what the ideal medical student should be so that they can aspire to be like that. The contrast also brings out the idea that opinions of what the ideal medical student should be like can vary. Overall it well portrays this month’s theme.
Contents Page (on web version)
Clearly presented, though unlike previous issues, there are no graphics to grab your attention
Editor’s Choice
Extremely well put together piece drawing together this month’s issue. It reads well, makes excellent points and each theme links in very well to the next one. Every medical student can relate strongly to what is being suggested– not only are we asked to develop flexible interpersonal, workplace, and continuous learning skills we are now having to compete for jobs after graduation – this frustration is one shared by many a medic. Finishes with the warming idea that our capacity as a doctor can evolve with our experiences in medicine and that rather than our capacity being predefined by the curriculum and contractual terms, we ourselves do in fact have a choice in what type of medic we become. I feel that it is important for any editorial to set the tone of the issue and draw the reader in as it is often the first article that is read. This editorial certainly does do that.
News
"Supply and demand"
In light of the recruitment fiasco of last year in the UK this article raises a pertinent question. Does the recent increase in intake into medical schools have anything to do with the difficulty in doctors getting jobs? This is a question that certainly needs to be answered and is relevant to every single medical student in the UK and is of particular interest to medical students from other countries in the sense that this balance of supply and demand is even a problem in developed countries such as the UK.
Suggestions: Perhaps highlighting the scale of the problem in the UK. How many doctors were affected by this difficulty in matching supply and demand? At what stages were they affected (e.g. if newly qualified FY1 doctors are affected it would be immediately more relevant to the medical student) and to what extent were they affected (i.e. did this mean that doctors did not get jobs (if so how many) or did it simply mean that doctors did not get their first choice jobs). The suggestion in the article is that the increase in medical students is not associated with the increased difficulty in getting jobs. We would however also like to know whether there has been an increase in jobs made available on a similar scale to that of the increase in medical students and if not, why not. If the mismatch in supply and demand does not explain the problem seen recently then I would expect some suggestion of what does. I think that the majority of UK medical students don’t fully understand the recent changes to career structure that the MMC introduced and don’t fully understand what the MTAS problem with recruitment last year was. I would recommend that this be addressed in a future issue.
"Newsbites"
Interesting, informative and appropriate
Editorials
"To be a medical student today"
Very relevant article, well written and very logical.
"Needlestick Injuries"
Obviously relevant to medical students internationally though it is a shame that the article seems to be orientated towards a readership from a developed country. As a result, this is of primary interest to medical students who either have had a needlestick injury themselves or are planning on going to a foreign developing country for elective where there are significant rates of viral infection. I think that one will often find that the medical student unexposed to a needlestick injury (i.e. particularly the younger medical students who haven’t had much clinical experience) will not find the article too stimulating as the typical student thinks it is not going to happen to them or that they will be careful enough for it not to happen to them. Though, it does deal with an important topic that as doctors we will face a risk of on a day to day basis. The "competing interests" section raises an interesting point. Whilst there is no doubting that safer suturing and phlebotomy equipment is desirable, which countries is this equipment aimed at? For, the incidence rates of needlestick injuries indicates the relative need for the introduction of safer equipment in that country and those given in the article vary greatly from 1.5 – 39.4% of students. If, as one might suspect, the incidence rates are on the low side in developed countries (e.g. refer to Mercier C. Reducing the incidence of sharps injuries. Br J Nurs 1994; 3: 897±901, Dobie DK, Worthington T, Faroqui M, Elliott TSJ. Avoiding the point. Lancet 2002; 259: 1254.) then surely this equipment will be of greater use in developing countries. What is the real practicality of offering equipment to these developing countries where this is actually a significant problem. I would be interested to learn of the efforts to introduce this equipment to developing countries. As a general point I would also be interested in the approach taken to needlestick injuries and infection control in medical schools in developing countries where viral illness has a high prevalence and how it differs from the approach taken in developed countries like the UK.
Life
Excellent section this month.
"Head to Head"
Excellent quirky article. Payment for adherence to medication is a very interesting and controversial topic that most students would probably not have considered and on first thought seems surprising to conceive. The topic is dealt with in an excellent manner with different people presenting the argument for each side. This is a real argument with the second author seemingly addressing the former’s viewpoints not just presenting her own. This makes the article all the more convincing and I would encourage this format of article to be used more often in the Student BMJ.
"Widening access to medical school"
Knowledge of schemes at Kings College London and Southampton University to widen access to medical students from lower socioeconomic backgrounds is definitely a topical subject. Whilst we would want doctors to be able to relate to patients from all types of backgrounds, whether offering a set quota of places for students from lower socioeconomic backgrounds with lower entry grades is the way to ensure that this happens is an interesting proposition. I would recommend that the Student BMJ follow this article up with one in future years when more information is available, comparing success those students admitted on this scheme have attained to those admitted on the normal scheme. This could settle the argument in many people’s minds.
"No reservations?"
Well rounded section shows the selection issues in a developing country like India, with "reservations" for students applying to study medicine from lower castes discussed as well as mentioning "affirmative action programmes" from other developed countries like the US. This articles parallels nicely with the previous article and I feel that often the journal as a whole tends to read more nicely when similar issues in both developed and developing countries are addressed in the same issue. I feel that this approach should continue to be used in future editions.
"Islam: faith and medicine"
Discusses how religious needs for Muslims are not being met in UK medical schools and hospitals. Interesting viewpoint and one that members of other religions may not have been aware of. Though this is the case I’m sure that followers of other faiths will also argue that their religious requirements are not fully met either. The question is then raised as to what is the real practicality of meeting the religious needs of all religions in every hospital. In the future in an article like this perhaps the viewpoint of members of other religions about their religious restrictions might also be useful to assess whether this problem is more widespread or whether it is just affecting a particular religion.
"Newborn care: traditional practices in Nepal"
The developed world’s common conception of "inadequate healthcare provision" in developing countries is specifically addressed. Medical practices in Nepal in relation to child birth are broken down into specific aspects with the risks of each evaluated. Explaining exactly how these practices put the baby at increased health risk rather than just branding a developing country as having "inadequate healthcare provision" provides a refreshing change.
"That infamous interview question"
Extremely pleased to see a first year medical student’s work in the Student BMJ. It’s not often that this is the case and as a medical student in my early years it was always difficult to read journals because the majority of the articles were not wholly relevant. All first and second year medical students will probably relate to this article more so than any other article in this months edition, especially given the way that it is written. No doubt the aim of the journal is to attract younger readers too, so I highly recommend that future editions include articles in this style written by younger students.
People
Both people who were chosen to be interviewed seemed interesting enough for people to want to read about them. The questions asked were appropriate and concise. It was particularly nice to see a slightly different aspect to the work of a consultant surgeon in advising producers / researchers of a medical drama.
Careers
Mixed section; the first article is excellent, though perhaps the location of the second article in the careers section is questionable.
"Gender and choosing a speciality"
With UK medical graduates now having to decide their specialist training fields only 18 months after qualifying, this article is extremely well timed and is of extreme importance to medical students approaching their final years of medical school. It gives a good overview of factors to consider in various career paths. I feel that a particularly important point within the article is the possibility that the new EU working directive restrictions will detrimentally affect the quality of training and experience that doctors receive, thus potentially making the doctors of tomorrow inferior to those of today. If inferior training is driving UK doctors to work in other countries in order to get better training then this is a very important issue. I feel that the whole idea of when to introduce speciality training is a very important topic and should perhaps be dealt in more depth in future issues. Being forced to make early decisions has led to ST1s (several who I have spoken to myself) often making a choice that they regret after starting the job. If we need to make our career path choices earlier on then articles such as this one, giving us insight into various career paths, are essential inclusions in subsequent editions of the Student BMJ.
"Leading problem based learning"
This perhaps would seem to be an important article given the increasing use of PBL in medical school teaching. The article itself is well written. However I feel that if a course does incorporate a significant amount of PBL then the university and or tutors should be giving appropriate guidance as to how sessions should proceed and if they do not proceed appropriately, the tutor should step in. I think leading a good PBL session is a learning process that each person needs to experience this themselves by observing what doesn’t go well in a not-so-good session and what does go well in a better session. Though I may be mistaken, I don’t think that many students will therefore be motivated to read this article and I feel that even if they do, they will learn much more from experiencing a good and a bad session themselves. What I would find more interesting would perhaps be an article comparing the way that different medical schools teach with the advantages and disadvantages of each approach – e.g. Imperial College’s largely lecture based 1st year, 2nd year and 5th year pathology teaching in comparison with other universities which might use a more PBL based approach. I would like to know what the students think of each type of approach and whether or not they think it enables them to learn well.
Education
On the whole a good section this month though one or two articles were slightly wordy. Throughout, use of the blue summary boxes is excellent and ensures the reader takes the key points of the articles away with them.
Excellent article on HIV – both very through and well written. This is an important issue that all medical students should be aware of. Links in well to the newsbites section on the Bulgarian nurses and Palestinian doctor accused of infecting children in Libya with HIV.
I found the paediatric prescribing article particularly useful as I am studying paediatrics at the moment. Even for the student not studying paediatrics it is short, not overly detailed yet informative.
Picture quizzes on chest trauma and head injury are both good. The usual approach of short questions which make you think about topic rather than just passively reading information is useful.
Idea behind Polonium article is excellent, using a recent large scale media and political story which will be of interest to the reader. However the detail observed in the technicalities of some of the article seemed a bit wordy and as the topic of radiation is quite distant from the student’s normal learning experience they might find it difficult to read and might not take the effort to read about the intricacies of what is discussed.
Dignity and Medicine article – no doubt this deals with an essential topic that doctors need to get right. However the medical curriculum these days contains so much teaching on this aspect of medicine that many readers will gloss over this article as they will probably feel that they have heard it many times before.
Paper+
Level of difficulty of paper is appropriate for an individual without much experience of research papers. Explanation was logical and read well. However I would have thought that the choice of topic of the paper in this section could maybe be more relevant to one of the topics already discussed. This would perhaps add appeal to reading this article.
Frontiers
Suitable. I agree with the later placement of this section which occurs earlier in previous issues.
Reviews
Excellent articles with a large degree of truth behind each, the highlight being "Recipe for a doctor". Due to the concise and quirky nature of these articles, this section will definitely be received well by the reader.
Thank You
Veeru Kasivisvanathan, Medical student,Imperial College, London
