Student BMJ Review: October 2007 issue

This is the first time that I have read the Student BMJ, probably because I have been in the UK for only about 21 months. I therefore read this with great interest, and found that it conveyed clear message about what the journal and the student group that manages it. In Australia I was reasonably attuned to medical student issues, and I can see a lot of similarity.

I will not comment on every article, but can make some overview and more specific comments, as follows:

Rationing and setting priorities.

I found these two papers very interesting. The authors are right – these are big issues that we all have to grapple with. Mind you, I was told that as a medical student and I have not seen much progress! I am reminded of a line from a song by Queen – ‘We want it All, and we want it NOW’ (sorry I cannot sing it for you). I would pose the following questions. Is there anything wrong with co-payments? I come from a country that has co-payments for some services. If resources are tight, why not focus them on essential services, and charge patients for services that are less essential? I know that some might think that this threatens the core values of the NHS, but what will happen in 50 years when it is predicated that the UK will have only 8 million people working and having to support the whole population? A big dilemma is that patients increasingly define their own priorities and level of urgency, so will the profession be really able to lead that debate and exercise any discretion?

Developing world healthcare.

It is refreshing to see that students are aware of the fortunate position of the medical profession and indeed the whole population in the UK in comparison with other places. There is a focus here on Africa, which is close, whereas Australian students are more focussed on the Asia-Pacific region, but the issues are similar – unstable politics, wars, natural disasters (flood, famine, earthquake, tsunamis), focusing limited resources on serious illness treatment rather than community care – and the scope for meaningful intervention from here is limited. Are there enough resources to develop the stable economies that underpin quality health care? Perhaps not, but we should maintain awareness and always be keen to help.

Debate.

I enjoyed the debate on eponyms. Both arguments are reasonable, and there may not be a ‘right’ answer. I am certain that they are gradually decreasing in use in medical education, but eponyms can be easier to remember than generic descriptors.

Clinical topics.

These were Ok, but rather static and focussed on rather rare diagnoses. The section may work better if there are specific messages (key learning points) for students, as generic clinical updates are widely available.

Careers.

This section is a good idea, but I found the talk of being a doctor in a combat zone and switching from merchant banking hard to relate to. Military medicine could be seen as the ultimate adrenaline rush (and very dangerous) but most of the time it is very routine and not a combination of World of Warcraft and Grey’s Anatomy. Perhaps there could be a focus on future career possibilities? What about student who want to use their medical training to move into other careers?

Learning through teaching.

This is a really good article and it should be read widely. The concept of learning through teaching is part of all small group interactive education processes, including PBL. Many medical schools are now offering students opportunities to be tutors, and education is a core part of Good Medical Practice. I would argue that all students should have a teaching role, both as professional development and as reinforcement of learning.

Overall, this issue is OK, but I would suggest that you try to stretch yourselves to be more challenging. That might facilitate more debate.

       

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