September 18th 2013; 86; 1

SURGO 2013
The Freshers Edition
SURGO

Issue 83.18/09/2013

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SURGO

Surgo Freshers edition 2013

Contents
2 3 4 6 7 8 Editors note Presidential addresses Medical news Talking the talk: deciphering med school jargon Meet the Wolfsons: whos who of the med school The long road to doctor-hood

10 A Tale of Two cities: a freshers guide to Glasgow 12 Clubs and societies 14 Pre-hospital care on the battlefield: the changing face of military medicine 16 Cornwall to Cape town 18 Book reviews 20 Med-Chir sports 22 Crossword Competition

The Surgo Team

(during their own freshers weeks)

Ella Bennett Editor

James Tadjkarimi Assistant Editor

Tom Baddeley Finance Editor

Josh Nielson Production Editor

David Boyle Arts Editor

Lucy Waite Expert advisor

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Editors note

Editorial
Welcome to your first week at med school and Glasgow Universitys best(and only) med school magazine! Surgo, the highly esteemed but as yet unrecognised journal of Glasgows Medicochirulogical society, has been running for nearly 80 years. Run by students and funded mainly by the medical unions, Surgo is completely independent from the faculty itself with total journalistic freedom; this generally results in an array of mildly offensive, occasionally funny articles with varying relevance to daily life. This edition however, is unusually useful; it is intended to soften the blow of independence (postgrads notwithstanding) and minimise the damage, as you dip your distal phalanx into the icy waters of med school life. We start by handing you over to Kieran McGivern and Dr Russell Drummond, our new med -chir presidents, for a welcome address intended to leave you brimming with hope, enthusiasm and pride(things us miserable third, fourth and fifth years are not so good at). Tom Baddeley continues the hopeful theme by bringing you a selection of this summers medical news featuring highlights such as the infamous Liverpudlian Lisa, who dislocated her jaw eating a burger. Assistant editor James Tadjkarimi, kicks off all things first year by deciphering the med schools penchant for unfathomable acronyms while production editor Josh Nielson introduces you to the med schools most important individuals. Hoping youre suitably primed, Josh braves a run down the long road to doctor-hood to give you an idea of what each year entails (in the hope that you dont stumble as blindly into it as your poor heroic forefathers.) Once youre feeling a bit more at home in the med school, Arts editor David Boyle ventures outside to give you a tour of Glasgows best places to eat, drink and cure a hangover. Lucy Waite and this years med-chir sports reps, Josh Barnett and Rebecca Orr, move on to arguably the best aspects of med school life, introducing you to a small sample of the societies and sports teams on offer. Katie Lunn rounds off the practical stuff with a somewhat condensed version of the med schools infamous reading list with reviews of many a useful book. Make sure you enter our crossword competition on the back cover to win your very own copy of the best book youll come across at med school. Once youre done with all that, weve got a gentle reminder of life beyond Glasgow with James exploring recent developments in military medicine before two intrepid doctors tell us all about their journey from Cornwall to Cape Town. So thats it for now; join us again at Halloween for another fun filled issue but until then, enjoy this edition and have a fantastic Freshers week. Ella Bennett Editor in chief

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Presidents Address

Kieran McGivern
Med-chir president
Hello! I am this years President of the Glasgows MedicoChirurgical Society. To those of you returning after a Summer of developing your CV, electives in far off lands and brushing up on everything learned so far i.e. watching Jeremy Kyle while wrapped in a slanket trying to remember your arse from your elbow - welcome back. To those of you just joining us after successfully navigating your way through months of exams, interviews and keeping up to date with recent studies in the Lancet and BMJ (yeah right) congratulations and welcome to Glasgow School of Medicine. MedChir is Glasgows oldest and largest medical student society and as one of the founders of GUU, has been making your Thursday nights fun and your Friday mornings fuzzy since 1802. Our committee are dedicated to ensuring that students are well catered for be that academically, with revision nights and mock OSCEs, or socially with legendary nights as Beer Olympics, the Scrubby and the Revue. We also have our fantastic in house magazine Surgo, our Schools Outreach Programme, Medic Families and so much more. We cant wait to make this another exciting year for you all so make sure you join up and join us at our freshers event on the 16th of September! So all thats left to say is enjoy your year and we look forward to seeing to you around the Medical School (or more likely The Beer Bar.)

Dr Russell Drummond
Honorary Med-chir president
Congratulations upon embarking upon your medical career, beginning with your undergraduate studies at Glasgow University Medical School. Having overcome school exams, buffing your personal statement and passing through admissions you can now look forward to medical school. This is a period of time in your life which, while at times challenging, offers multiple opportunities which to be honest I am jealous of. Settling into your class, routine and for some of you a new city is coupled with a huge array of social, athletic, intellectual and even romantic possibilities! Your colleagues at medical school become life long associates and many close friends perhaps even more! The Glasgow University MedChir Society has existed since 1802 and is one of Glasgows, and indeed Medicines longest standing establishment. The secret of its success lies in its drive to continually provide a relevant and vibrant platform for a wide array of activities. These include not only formal balls and informal nights in Viper, but also academic evenings, sporting events and the infamous annual revue. Furthermore the society is held in high regards by your postgraduate colleagues who are delighted to be asked to be involved. It's a massive honour for me to have been invited to be the 2013 Honorary President and not only do I plan on pulling pints behind the bar, hopefully entertaining at the ball and the revue but am available via email to help where I can!

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News

Medical News
A collection of the summers finest and funniest medical headlines from finance editor Tom Baddeley

12 babies a day born with heart defects

Statistics from the BHF has found that 12 babies every day are born with a heart defect, making it more common than any other birth defect. On the up side death rates for congenital heart defects, like Patent Ductus Arteriosus or Atrial Septal Defect have fallen by 83% in the last three decades due to earlier diagnosis and better surgical techniques. Despite the chilling title, there is still good news for the 70,000 children living with heart defects because the BHF have launched a new campaign Fight For Every Heartbeat to raise awareness of this little-known issue.

Malaria vaccine success

A vaccine made from live-attenuated malaria parasites has worked well in phase 1 clinical trials. The parasites are extracted from the salivary glands of mosquitos and when injected at high doses, prevented 12 out of 15 people contracting the disease. There are currently over 20 malaria vaccine candidates in clinical trails with the most advanced being used in a phase -3 trial on over 15,000 children in Africa as we speak.

Immune system reset for Multiple Sclerosis sufferers

A joint operation between US and German researchers has completed a phase 1 trial to reset the immune systems of nine MS patients with great success! The result of more than 30 years of preclinical research, their therapy proved safe and reduced patients immune system reactivity to myelin by 50 to 75%. In MS the immune system attacks the insulating myelin sheath that covers nerve cells, resulting in a loss of conduction. In this trial, patients were given a single infusion of their own T-cells coupled with billions of myelin antigens. These T-cells were processed in the spleen and forced the immune system to tolerate the myelin antigens. The treatment stopped autoimmune responses whilst leaving the immune system intact.

Woman dislocates jaw eating burger

Ms Peate, 25, had to have her jaw reset after eating a triple decker burger at a restaurant in Liverpool. She says she will be more conscious of food size in the future.

New app to audit your own sex life

US developers have created a new app, Spreadsheets which records data on its owners sex life. It measures everything from duration and frequency to thrusts per minute, even providing users with a decibel count for each encounter. Its designers encourage users to share data with your friends to let the facts speak for themselves.. So on that note, heres mine*

Copper linked to Alzheimer's

US scientists say that a lifetime of too much copper in our diets could trigger Alzheimers disease. High levels of copper disrupts the protein LRP1, which removes beta -amyloid protein from the brain, before it forms the plaques that are the hallmark of Alzheimers disease. Copper was also found to encourage the clumping of beta amyloid inside the neural tissue.

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Events

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Freshers Guide

Assistant editor James Tadjkarimi translates all the med school jargon and acronyms thatll youll need to survive first year PBL - Problem Based Learning
For the next two years of your medical career youll be building on your knowledge with Problem Based Learning, aka PBL. As a group of eight or nine with the addition of a staff facilitator, youll spend four hours each week talking and drawing about different body systems and various pathologies. Hopefully youll have known a bit about PBL before you got here as its a subject that tends to divide many some of you will dig it, others not so much. To the systems credit, its great way of getting to know your fellow students by frantically churning out everything you learnt the night before; but like most things in life, you get out what you put in.

Coursework (Ok, pretty self-explanatory, but youll still

be talking about it) No getting away from this one Im afraid. Theres a pretty ample amount of coursework in your first two years. All of it quite varied and arse-numbingly dull. But it does all count towards your end of year grade so unfortunately holds some importance. You do tend to get quite long deadlines to complete most pieces, but that wont stop many of you from starting the day before; just get used to pulling all-nighters with a truckload of pro plus for company.

FRS - Fixed Resource Session VS - Vocational Studies

Vocational studies is Glasgows way of teaching you all the bits and bobs needed to be a doctor that dont fall under the Science umbrella. That includes bedside manner, communication skills, and examinations. VS also includes visits to hospitals and GP practices so you can adequately talk to patients without sounding like a socially awkward robot. Your tutor will guide you through the ups and downs of difficult patients, moral and ethical dilemmas as well as teaching you how to take a decent history. Many an hour of first year was squandered on these little gems. FRS can unfortunately be quite variable and how interesting they are is heavily dependent on subject matter. Some will involve simply reading from posters and jotting down answers, whereas others will be a bit more eccentric like dunking your arms in iced buckets of water to check pain threshold (definitely one of the more fun ones). Despite their inconsistence in interest, a high proportion of exam questions are based on their content, so you would be foolish to miss em.

Thankfully you start honing your skills by talking to simulated patients a fancy way of saying actors employed by SSC - Student Selected Component the medical school to fake a gammy knee, which takes some of This is basically your chance to pick an area of medicine that the pressure off. youre really interested in to find out more about. The med school gives you a pretty varied list of things to choose from like paediatric anaesthetics or global health. Choose wisely The MILE padawans, some of these SSCs will result in a bit of a holiday The MILE is the medical schools way of adding a tortuous for a five week period with only a 4 hour week. Others may edge to problem based learning. It is a 24 hour exam that tests total 40, on top of massive essays. your ability to do PBL scenarios. It may be seem like a hellish, Bare in mind that there are some things that you might not get unnecessary task but it does have its highlights; nothing to focus on in future clinical years so your SSC could very brings people together like a bitch of an exam. Eat together, well influence your career path. Another bonus is that you can sleep together and write your objectives together and youll be propose your own SSCs, so if theres something youre really fine. Dont write it up together though because not only will interested in and you can find someone to supervise you, ask. you be in the SL til 4am, but youll also get done for The med school may just let you do it. plagiarism..

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Freshers Guide

Meet the Wolfsons

Josh Nielson introduces you to your new mummies, daddies and the odd creepy uncle... Professor Alan Dont Call Me Alan Jardine VS Tutors Head of the Undergraduate Medical These are usually GPs taking time out of their busy schedule School to teach you why you shouldnt kill patients and how to avoid
The highest of the high, Alan Jardine rules Glasgow Medical School with an iron fist. In first year youll rarely see him apart from a couple of introductory lectures (which I think I missed in first year, so until clinicals in third year I had no idea who this Jardine fellow was), unless you get called in for a little chat about your progress or lack thereof (in which case, really, dont call him Alan, he hates that). a GMC tribunal. Your VS tutor will give you both a thorough grounding in ethics and communication skills and a few of your sessions will be spent visiting them in their practices. This will also afford you some of your first encounters with patients, and while these can be cringingly embarrassing as your struggle to remember all those things youre meant to ask, everyone has to go through it.

PBL Facilitators
An amazing assortment of people responsible for ensuring your smooth sailing through the stormy educational seas of each PBL session. Facilitators will keep each session on track so you cover all your learning objectives with as little interference as possible. They vary in their style, some being more laissez faire and others taking a more active role, but youll mostly experience this as how much spine -cringing silence they can endure before stepping in.

Mr. Iain Black Swan Deputy Head of the Undergraduate Medical School
This erudite ENT surgeon earned his nickname from his hauntingly beautiful pirouettes, frequently performed as he lays the smack-down on a lazy student. Dr. Swan is another of those people youll probably only encounter in a progress meeting, which is something youll want to avoid after experiencing such a session, youll be amazed there hasnt been a hurricane named after him yet.

The FRS Leaders

These brave souls are tasked with making three hundred bored medical students interested in hard science, and for the most part they do a pretty great job of it (though I cant say I ever really took to the histology sessions I swear they make the stools uncomfortable on purpose to stop you falling asleep at the microscope). Theres a different block leader for each discipline (anatomy, physiology etc.), and as leaders, you must address them as Course Captain . Its just good manners.

The Year Secretaries

Tireless administrative machines, without the year secretaries the medical school would shudder to a halt. They ensure the massive amounts of organisation involved in getting you good and doctored up getorganized. Youll come to know them primarily as the number one source of new mail in your inbox.

The Labbies

A strange race of people known to inhabit the Boyd Orr and various other laboratory settings around the Glasgow campus. They seem to tolerate the presence of idiotic medical students ineptly attempting science in their labs, and are generally friendly and helpful when approached, but dont push your luck; Your Adviser of Studies the Boyd Orr has many This lucky man or woman will be your constant companion dark hiding places, and through the next few years, a close confidante and wise mentor no one would miss to guide and nurture till you master the art of medicine. Thats another medical student the theory anyway. In practice, you will meet this person once, who knocked over a have an awkward discussion about how youre settling in, test tube rack. and never see them again, unless you fail an exam, in which case you get to have another awkward meet-up.

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Freshers Guide

The Long Road

Production editor Josh Nielson takes you through the 5 -6 years of your medical degree Year 1 The Honeymoon
First year is a euphoric and joyous time, a time to socialize and make as many friends as possible, even if only for the duration of a night. Enjoy it to the full for never again, at least in your medical career, will you be so free of real responsibility. The subjects studied in first year are designed to give you an introduction to the fundamentals of medicine; youll cover most of the topics in more depth in later years (the infamous Spiral of Learning). You will have the odd assessment, such as the MILE, which attempts to give PBL scenarios a thrilling edge by requiring you to complete one in 24 hours, but these are all pretty straight forward, and as long as you remember sometime in April that exams are on the horizon, youll do just fine.

Year 2 Oh, So You Like Science Do You?

Time to get real. Youre doing medicine dammit, its not supposed to be easy, and boy will you come to know it. In second year you can no longer cruise by on a quick flick through Tortora and Fac Notes the morning before. Forget all those nice friends you made in first year in-depth biochemistry, histology and physiology will be your new and unceasingly dull companions. On top of that, as well as written exams, 2nd year will also be your first encounter with a real OSCE. Just make sure you turn up to the right hospital for it, people have been known to make mistakes with this in the past.

Years 3 and 4Welcome to Clinicals

3rd year is split in to two halves initially, youll have 15 weeks of teaching on a different specialty each week,. This is a grueling, pathology ridden slog, with exams hitting in February, just close enough to Christmas to ruin it. The second half of the year marks the beginning of the last phase of your medical educationplacements. These are 5 week clinical attachments in different specialties all over the West of Scotland, intended to give you proper teaching and experience in the ways of practical medicine. Placements are often quite far from the cosy West End which means staying in hospital accommodation unless you want a 2 hour commute each morning. On the bright side a lot of the more remote hospitals give excellent teaching, which is

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Freshers Guide

to Doctor-hood
something youll definitely be in need of with the new fourth year exam looming. This year will be the first year that Glasgow split finals between fourth year and fifth year so only time will tell how good/bad/ugly this proves to be... For most people, placements are a welcome relief from the abstract knowledge of second year as you get the chance to apply your knowledge and skills in a real setting. This also, hopefully, makes the OSCE at the end of the year seem a little more doable and a lot more relevant. Of course, with greater power/fun comes greater responsibility, and expectations will start to run higher youll be quizzed on a dayto-day basis and a thick skin is a must when your consultant favours the teaching by ritual humiliation method. Placements continue on into 4th year, unless you opt to take a

Intercal Make Mine A Double

Between 3rd and 4th year you have the option of applying to do an intercalated degree, thus netting yourself a handy extra BSc for your time at medical school. Intercal is an opportunity for you to study something that interests you, be it a clinical field such as psychology or sports medicine, or a more academic one such as anatomy or microbiology. Though this may sound fun, the decision to undertake an intercal should not be made lightly not only is it another year of uni to pay for, but the assessment schedule can be a new level of academic intensity altogether.

Year 5 The End Is Nigh

Yep, Finals. Finally. Youll have a couple more attachments, then a short revision period before the apocalyptic exams later in the year. If theres one reason not to burn your PBL notes on a triumphant victory fire come results day, its this as you can be examined on almost anything from the previous 5 years of study. After the main exams are over, youll have a further 10-week shadowing period called preparation for practice, and then hey presto, youre a doctor. That wasnt so bad now, was it?

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Freshers Guide to Glasgow

A Tale of Two Cities

Arts Editor David Boyle, takes us on a tour of his favourite parts of Scotlands biggest and best city. The fun starts around midday and ends long into the night.
So youve spent months, maybe years, trying to get here and Carry on your culture fest with A Play, a Pie and a Pint at Oran finally youve made it to Glasgow University and the sacred Mor. If sport is your cup of tea then Glasgow is a haven for you. land of Medical School. However, there are many of you who will not have fully considered the fact that Glasgow is going to be your home for at least the next 5 years. Moving to Scotlands biggest city may be a daunting prospect but fear not, Surgo is here to smooth the process and help you settle in. There are boundless activities and ways to spend your invaluable time when you arent up to your eyes in coursework or PBL (see Fac Notes*).

Glasgow by day
Believe it or not its not always snowing or raining in Glasgow (we get hurricanes too, see bawbag 2k12) No seriously, its not. We have some fantastic areas to lounge about in the tepid warmth of the Glasgow sun; Kelvingrove Park on a sunny day is idyllic and has free tennis courts where Andy Murray is often spotted playing with his balls. If shopping is your vice then head down to Buchanan Street, Sauchiehall Street and Argyle Street. While youre in town be sure to head through to George Square and grab a pint at Glasgows nicest spoons, the counting house. Of course there are Rangers and Celtic but Glasgow Warriors play at Scotstoun stadium on Fridays and offer discounted tickets for students! Catching Warriors vs. Ulster is always a treat and a chance to get one over a significant proportion of the medical school. For some organised fun head down to the Clyde. Here youll find Glasgow Science centre and the new transport museum; both are well worth a wander even if just to admire the impressive architecture and the jewel-encrusted hippie van. The Science centre is home to Scotlands biggest Imax a well as a planetarium and a really tall tower (that never seems to be open).

Cant be bothered leaving the West End ? A trip round the corner from GUU will take you to the Kelvingrove Art Gallery and Museum which is free and a surprisingly good hangover cure.
*ask your medic parents

Finally, youve explored Glasgow. Youve discovered everything and more. Youve had enough of Uni and youre feeling claustrophobic in your grimey Murano flat. Well luckily for you we designed Loch Lomond just for this possibility. Created by Surgo for your enjoyment. A truly gorgeous environment and easily and cheaply accessible by train. A perfect escape for the day.

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Freshers Guide to Glasgow

Glasgow by night
By night Glasgow shakes off the charm and becomes a bustling, vibrant and truly mind-blowing hub of activity. Whatever your music taste, fashion sense or drink of choice, there will be somewhere to suit you.

Comedy
Glaswegian comedy is second to none. Kevin Bridges and Frankie Boyle are two prime examples of the style of comedy that makes this city (in)famous. The Stand Comedy Club is 2 on Monday and Tuesday nights and has up and coming local comedians, as well as the odd appearance from Kevin and Frankie. But make sure you get there early to graba seat in the cramped club!

Clubs
Everywhere. Clubs everywhere. Mondays are best spent at Viper, theres a premium on space but if you want to be with your pals and the rest of Glasgow Uni in one room then its ideal! Tuesday is either Kushion (think Geordie Shore) or Buff Club - think funky beats, funkier hairstyles and 1 drinks. Wednesdays give you two options; indulge the hipster within and head to SubClub for face-melting bass and neck-snapping headroom, or head to Polo Lounge (Glasgows best gay club) for free entry and super-cheap cheese. Thursday is spent at Glasgow University Union at MedChir events when theyre on with free pints-a-plenty! Post-medchir head to our sponsors Viper, the messiest club the in West End. You may briefly glance at this Rightly so perhaps, but in a moment of hang- Friday is the time to head to Cheesy Pop at QMU and let it all go over-induced despair you might fancy a to some terribly addictive tunes a night not to overlook (despite quieter night at the theatre. Big shows what some will tell you). Fridays are always coming Glasgow as well other option is Propaganda at 02 some more local stuff at the Mitchell ABC, look out for free entry cards theatre and Tramway. Even if you being given out on campus dont go yourself, always a handy place to take your parents should they ever visit you! Saturday and Sunday is when the money comes out so be frugal but time split between Corinthian Club & Casino on a Saturday and Bamboo on a Sunday will round off a whistle-stop clubbing tour of Glasgow.

Music
Glasgow is well-known for its ability to attract some of the best artists and bands with a wide variety of music on show throughout the year. The O2 Academy, O2 ABC and SECC always have big acts. For a cheeky Glaswegian twist be sure to check some bands out at Barrowlands or King Tuts Wah Wah Tent both incredible venues. The Arches is another cracking hotspot for big DJs and another interesting setting ,a derelict railway station!

Theatre

Food

Im getting to clubs, dont worry. Glasgow is a gastronomic delight with food to indulge the most sophisticated palettes and pub grub to put you into a pleasant coma. TriBeCa on Dumbarton Road provides a hearty breakfast to soak up that hangover postPBL. Great lunches for a fiver can be had at Hillhead Bookclub and Naked Soup. For dinner, Ketchup and the Grosvenor both do 2 for 1s but for something different head to Rumours for Malaysian or Viva Brazil for a mind-blowing meat-feast.

So, by day and night you are mildly prepared to take your first steps around Glasgows streets. Glasgow is a wonderful city to study in and we hope with this mini-guide you can experience it in all its glory! Just remember: stay safe and always say you support Partick Thistle if ever asked, followed by mon the Jags!

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Freshers Guide

Clubs and Societies

Lucy Waite takes you through the highs and (a few) lows of whats on offer
You were all probably highly and irritatingly involved with extracurricular activities at school and beyond (or at least thats what the med school were led to believe by your personal statement) so why stop now?! Below is the tip of the iceberg when it comes to university societies, for every interest, hobby, sport or obsession there is a table at the freshers fair dying to include you in their annual intake. interest in or merely get an idea of. This can take the form of anything from an introductory lecture to getting some hands on experience. A list of some of the current specialist interest societies follows but if you feel theres something missing, why not pioneer and set up your own society. Glasgow Undergraduate Neuro Interest Group (Glasgow Neuro) Glasgow Oncology Society GU Surgical Society (GUSS) GU Psychiatry Interest Group (GUPIG) GU Cardiovascular Society GU Paediatrics Society GU GP Society (GUGPS) Glasgow Orthopaedics and Rheumatology Society (GORS) GU Renal society GU Radiology Interest Group (GURIG) GU Anaesthetics Society DermSoc Glasgow Medical and Surgical Emergency Society GU Mountain Medicine Society Chivalric Dreams (?!) Roller Derby Supporters Club of Glasgow University Boob-team Society Sitting Down and Being Friendly

Want to get AND give?

If your interest in giving back extends further than padding out med school application forms (we kind of hope so), then there are lots of fantastic medically relevant charities to get involved in at Glasgow. There is a lot to be gained from becoming involved and a great variety of issues addressed, you could end up teaching sex ed in schools or travelling to Africa. From teddy bears to knife crime giving out condoms in between, there are plenty of causes that could do with your help. Glasgow Marrow Glasgow Medics Against Violence Student Society(MAV) Students for Kids International Projects (SKIP) Sexpression Glasgow Glasgow Straight Talk Teddy Bear Hospital Glasgow Society Red Cross Medsin

Glasgow Medico-Chirurgical Society

Your very own MedChir! We are one of Glasgow Universitys oldest running societies and one of the founding members of the Glasgow University Union. Since 1802 MedChir have been providing ridiculously good value Thursday nights and less than fresh Friday mornings for all. Our nights vary greatly from the traditional welcome ceilidh and (comparatively) sophisticated ball through to the renowned beer Olympics and genuinely useful revision lectures. MedChir also brings together the medic sports teams for events like sports day, and takes things to new cities, and levels of silliness, on our field trips. All in all it is an essential way of getting to know the people you will be spending the next 5 years surviving with.

The Freshers Fair

The freshers fair and sports fair are easy ways to see a whole lot of societies in one place and take your pick. These are found during Freshers week at the main university building, the Stevenson building (sport) and the med school. There really is something for everyone, whether war hammer never got old or cheese tasting is what you live for. Here are some current favourite alternative societies to prove that youre never, ever alone... Students of a Jane Austen Persuasion

Specialist Interest Societies

Maybe you already know that orthopaedics is the career path for you, or maybe youre not sure what it is, either way there are a host of medical speciality and interest societies for you to further an

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Beyond Glasgow

Assistant editor James Tadjkarimi looks at the most recent and influential developments in medicine used by the military
Over the past decade the UK has sent many thousands of troops to the Middle East with the total number of casualties from operations in Afghanistan and Iraq equating to 623. On top of that, thousands more have been evacuated to UK preferred weapon of choice. These devices range from rudimentary homemade bombs to sophisticated weapon systems packed with high-grade explosives that even kevlar body armour cant really protect against. These roadside bombs are pretty nasty: shattered bones, exploded muscle and missing limbs are just some of the injuries they frequently cause. On top of that, shrapnel caked with all kinds of nasty bugs can lead to secondary infections, which when combined with explosives, make for lifethreatening injuries requiring immediate pre-hospital treatment. enhancer (some pre-PBL facts for you 1st years.)

Anaesthetics have been developed in many forms: lollipops included

hospitals in order to receive treatment for a spectrum of life changing injuries. These injuries come in many different forms; some return with PTSD (posttraumatic stress disorder) and other psychological illnesses, others with serious physical trauma such as burns and amputations. It seems apt to investigate the changing face of medical services on the battlefield to see how weve adapted to dealing with a new class of injury synonymous with the conflict in the Middle East. Compared with previous conflicts, there has been a shift in nature and in the type of injuries encountered. One major change is the use of improvised Explosive devices (IEDs for short) as the

Pre-hospital care

Field medics in combat have coined the term the platinum ten minutes to replace the golden hour of trauma as in these situations, time really makes all the difference. One of the most crucial pieces of kit available to soldier and medic alike is a simple tourniquet. Theyve seen an aggressive reintroduction since the Vietnam War. At that time they were used sporadically by troops, with no clear consensus on how effective they were in reducing mortality. Evidence has now painted a clear picture that a pre-hospital tourniquet applied effectively and quickly ensures much better survival. In truth, it seems remarkable that stemming blood loss immediately wasnt always a numSpecially trained Anaesthetists have also ber one priority. been assessing whether a nerve block (a direct anaesthetic injection that blocks pain signals to the brain whilst keeping On top of tourniquets, we now have smartly engineered bandages impregnat- the patient awake and alert) can be at all effective on the battlefield. ed with either Celox (a substance made up of ground up shellfish that forms artificial plugs in wounds) or Kaolin, a coagulation cascade and platelet aggregation

Pain management is also seeing a few changes in the pre-hospital setting. The theory being that tighter, more rapid control of symptoms can help speed up recovery and reduce PTSD occurrence and phantom limb pain. Traditionally, intramuscular morphine injections had been used to dampen down pain. The problem with this is that it has a delayed onset of pain relief thats often suboptimal and difficult to titrate. Intravenous morphine can be more effective, but a far less dangerous alternative is oral transmucosal fentanyl citrate (OFTC.) OFTC is a rapid and non-invasive synthetic opioid substitute, and best of all? It comes in lollipop form.

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Beyond Glasgow

Flying fortress

These Chinook helicopters are staffed by two paramedics, a senior physician and nurse with critical care or experience and dont discriminate between casualties; regularly receiving coalition forces, Afghan National Security Forces, civilians or Taliban fighters. On board equipment is highly sophisti-

limbs make venous access impossible. Instead the team often resort to using an Intra-osseous device: a drill that injects directly into medullary bone marrow allowing for immediate fluid or blood transfusion. Once access has been achieved on board in one way or another, the doctors can start to give blood in preparation for the war woundeds arrival at the closest field hospital. Of course we will never be able to fully prevent anyone dying on the battlefield, but with better instantaneous care more fully available to those injured by war, we are seeing the number of casualties in combat drop substantially. And that can never be a bad thing.

Medics can call in the big guns,

a flying resus room cated, and capable of managing life threatening injuries including cataWith a serious enough injury, field strophic bleeding, thoracic trauma and medics can call in the big guns with what airway obstruction. In many casualties theyve dubbed the MERT- a Medical its near impossible to restore adequate Emergency Response Team thats basi- circulation by conventional means as cally a flying resus room bringing the ER massive blood loss and missing to the wounded.

Do you have an interest in journalism or writing in general? Are you curious about the influence of the wider world on medicine, and vice versa? Do you have an opinion or perspective you think should be heard?

Join the writing team at Surgo!

Breath-taking (- Stephen Fry), Visionary ( - William Shatner) The scalpel-sharp edge of modern medical journalism ( - Alan Jardine)

If youre interested or want to know more, email Ella at surgo_editor@hotmail.com

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back.

Justin Timberlake

NO. I will not answer any questions on the rumoured relationship between myself and the editor of Surgo. Iron Man blah blah blah Robert

Carlsberg guy

Downey Jr

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Beyond Glasgow

Cornwall to Cape Town

My own junior elective took me as far away from Glasgow as I could physically get without actually leaving the country/spending much money. And so three of us found ourselves in sunny Cornwall for a month, attempting to surf, drinking too much cider and spending (some) time in A&E. Whilst there I had the pleasure of meeting three junior doctors, Baz, Rich and Dan, who had a better than average plan for the next year of their lives. The following is a brief insight into what they are up to but for a closer look, and some stories you really couldnt make up, it is well worth having a read of their blog at www.cornwalltocapetown.com
The Cornwall to Cape Town expedition have developed into a tight-knit team, bonded by a succession of mechanical is an ongoing project by three British doctors and a 1992 Land Rover Defend- challenges, wilderness, urban er named Tess. The primary objective is to drive from Cornwall, our home and place of work, to Cape Town. Along the way the team is raising money for Medicins Sans Frontiers and Gondar, Ethiopia Eye Surgery (GEES), a charity we will also be visiting. The expedition has and will Warning continue to visit a number of health organizations on route, exploring the varying health systems, burdens and beliefs of each country. This includes a one-month general medical placement in Iganga Hospital, Uganda and participation in Malawi with the C.R.A.D.L.E. project, an Africa-wide screening and referral project for preeclampsia (a potentially fatal, maternal disease of uncontrolled high blood pressure). The team is into our 23rd country and 14,995th mile, having traversed Europe, landed in Egypt by boat from Turkey, tracked up the Nile through the Sudan into Ethiopia, then Somaliland and Kenya. We are now near the source of the white Nile in Uganda. Along the way, Sebastian Wallace, Richard Wain-Hobson and Daniel Nuth chaos, break-ins, crashes, illnesses, and problems of our own making.

this route may have

We have almost lost the car to a sinking Turkish salt lake; found ourselves in the thick of the political upheaval in Greece and Egypt; repaired 16 punctures and a high speed blow-out on the mountain roads of Ethiopia; talked ourselves into (and then out of) televised semi-captivity, met the Somaliland PrimeMinister, and retreated from North -Kenyan bandits as the car in delays front was strafed by machine gun fire. In between these challenges however, we have found sincere hospitality, easy-going curiosity, genuine friendships and an endless continent of changing beauty.

What follows is an extract from their most recent blog entry by Dan. The following unfolded after slipping through a previous checkpoint in Somaliland.

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Beyond Glasgow

A Ridiculously Good Adventure

...We found ourselves at the tiny airport west of Berbera still looking for the coastal road. I exited the Landie to ask directions. Despite my walking 50 yards from the car in plain sight, the airport security guard was a little startled by my arrival in front of him. I had, it seemed, interrupted his vacant gazing out to the desert. As he pondered my question, a soldier raised the barrier behind him. Underneath slipped a sleek white saloon car with dark windows and beige furry mat visible on the dash. It stopped and a man stepped out in uniform.

It was time to abort this conversation before we found ourselves arrested.

He had glinting medals on his breast, mirrored sunglasses and a proud paunch resting on his belt buckle. The officer stepped towards me and waited to be informed of what was going on. The soldier operating the barrier approached.

Rich, Baz and Dan, with their long-suffering Land Rover Tess
degree of familiarity. He explained that we had been found moving illegally in Somaliland and that we were to accompany them back to Berbera. I was ushered into the saloon and a soldier climbed into my seat in the Landie. Bas and Rich who were out of earshot of my conversation looked at me through the windscreen for an explanation. I offered nothing.

definitely over reacting, it is time to remain calm and make some friends. I offered the man behind the mirrors a Marlboro Red. He took one without expression and began to smoke leaving the windows firmly shut. I chanced a little pigeon English conversation. I am from Where you go? said the soldier. UK Britain? England? It is very hot today, it is very cold in England. I barked I decided against exposing our plans for an anxious laugh, too loudly for the still illegal camping and said we were on our air in the car. He remained silent and way from Hargeisa to Berbera and had As we sped towards Berbera I frantically smoked. Perhaps he doesnt speak Engbecome lost. I flapped our most official evaluated the situation. We were in trou- lish. I smoked as well. looking documents around while I spoke. ble. It couldnt be big trouble, surely. We have just broken a small bureaucratic The officer barked in Somali, the soldier rule. In Berbera there would be a small translated, where are you soldier, you bribe, more stamps and forms and we The detailed exploits are need soldier! It was looking like we should be on our way. Somalia is a bit of recounted in writing and were busted. It was time to abort this an unknown quantity though, maybe we photography at conversation before we found ourselves were trespassing, maybe we were suspiwww.cornwalltocapetown.com. arrested. Delivering some excuses about cious! I didnt want to spend even one being late for Wheel of Fortune and hav- night in a Somali prison, thank you. All All donations go 100% to our ing left the iron on, I made to leave. As I of a sudden those words I had disregardselected charities. turned, a third man in desert fatigues ed on the FCO website came back to me barred my way. His hand rested on the with a shiver there is no embassy presstock of his AK47 with an unsettling ence in Somaliland at this time. I am

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Useful Stuff

Book Reviews
One of the first things on your mind when you start med school is likely to be what textbooks to buy. Actually its probably the last thing on your mind but still, Katie Lunn brings you some info about textbooks that will come in handy over the next 5-6 years...

First Year
Principles of Anatomy and physiology- Tortora
A fantastic book for first year as it introduces you nicely to the very basics of anatomy and physiology. Organised by system rather than region, this allows you to relate the anatomy to the function as you learn.

Fundamentals of Anatomy & Physiology - Martini

A very user friendly book providing the basics of anatomy and physiology, some copies come with an interactive CD and Atlas of the Human Body as well as the textbook. People often switch between this and Tortora for first year, so check out both to find your personal preference.

Clinical Atlas of Human Anatomy McMinn's

Really useful anatomy book for using to prepare for/ alongside your cadaver dissections. It contains large pictures of cadaver dissections in excellent detail as well as great surface anatomy to help you to orientate yourself around the body.

Clinical Medicine - Davidsons

If you only want to buy one book, this is a good one to go with! It is basically the bible of pre-clinical medicine. Every disease imaginable is included and laid out in a very comprehensive DASPITE (youll soon know what this stands for!) format. Again includes an online resource which is much easier to search and includes downloadable pictures and diagrams.

TURN TO THE BACK COVER FOR A CHANCE TO WIN YOUR VERY OWN BRAND-SPANKING NEW AUTOGRAPHED COPY OF DAVIDSONS
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Useful Stuff

Second Year And Beyond...

Oxford Handbook of Medical Sciences
Concentrates on the basic medical sciences starting with the general principles of cells and metabolism, followed by chapters for each of the body systems. Each chapter is laid out in a really comprehensive way following anatomy then function and finally clinical application. Very good for revision also and it is small enough to fit easily in your bag!

Oxford Handbook of Clinical Medicine

Once you have reached clinical years this is an amazing little book to carry with you on placement. It contains all the clinically relevant information you need to know about most common presentations. Very useful for reference on placement- also free copies are often given to students by MPS, MDDU etc. It is also great for diagnosing yourself with everything from lupus to lymphoma whenever youre slightly under the weather.

Macleods Clinical Examination

Excellent book for clinical examinations, but written by Edinburgh University staff so aimed at their students. Some discrepancies with the way we are taught things in Glasgow so its good for learning general examination skills in the first few years but can confuse you for 3rd and final year OSCEs which expect you to perform the Glasgow way.

Medical Embryology - Langmans

A great little embryology book, definitely worth a look during the dreaded child development block of 2nd year! Includes an online resource with very good illustrations to help you understand developmental stages, plus sections on abnormalities and genetics.

Core Clinical Cases: Self Assessment for Medical Students

This excellent revision aid has dozens of practice cases which follow a patient from presentation to discharge asking questions along the way. Theres a great mix of question types and crucially theyre followed by well written explanations, as well as answers. Heres the best bit! While there are hundreds of revision books out there, this one was actually written by two Glasgow lecturers who will be involved in writing your exam!

Good ol Dr Wikipedia
I have to admit that if I had to recommend the best textbook of all, though somewhat controversial, it would have to be... Wikipedia! Whether you agree with using good old Dr Wikipedia or not its a good starting place when researching new topics.

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Fun Stuff

Study medicine? Like sport? If the answer to both of these taxing questions is yes, then Med-Chir sport is definitely for you. Now that you have begun your journey through big bad medical school, you may find that you have a lot less time to yourself than what you used to. Sadly, the medical school doesnt always allow students the time off that other faculties get for university sport. Couple this with the long hours in class and late night PBL sessions and it becomes extra difficult to represent the university in your desired discipline. This is where Med-Chir sport steps in; our teams train and play at times which wont conflict with your hectic schedule and it is never the end of the world if you miss a training session, weve all been there before so we understand! was of a surprisingly high quality on the Saturday. Spirits were We have Mens Rugby, Mixed Hockey, Mens & Womens also high, as Im sure were spirit levels in the majority of the Football, Mixed Basketball, Womens Netball and Mixed Ultiparticipants circulating blood. After the sport a night of fancy mate Frisbee. dress (and cross-dressing) in the theme of Fairytales and nursery rhymes ensued. Unsurprisingly, Aberdeen managed to find an excuse to dress as sheep, and the rugby boys found an excuse to wear obscenely tight clothing more commonly found in the female changing rooms of primary schools across the country. The sporting theme of the weekend continued late into the night, with boat racing, rhythmic dance floor gymnastics and even some improvised equestrianism into the early hours for a lucky few. Naturally Glasgow emerged as the overall victors and we now have the task of defending our title at SNIMS 2013 in Aberdeen. If you want to be a part of the biggest and best Medics sports The teams compete against teams from other faculties team in Scotland, keep throughout the year- such as the Dentists (wannabe doctors), your eyes peeled and the Lawyers (not smart enough to be doctors), the Engineers your ears open for in(glorified mechanics) and the Vets (sheep lovers). But the formation about joining main event on the Med-Chir Sports calendar is undoubtedly up. Captains from each SNIMS, which Glasgow had the enjoyable task of hosting last team will be making year. Almost 800 students from the finest medical schools of announcements during Northern Ireland and Scotland (plus a mob from Dundee) some of your lectures descended on Glasgow for a weekend dedicated to sport and a over the opening few few other extracurricular activities that probably wont get weeks, so even if you mentioned on the CV (see attached pictures). Most teams are drying from a hangarrived on the Friday night, except Edinburgh who couldnt over make sure you get make it until Saturday morning- something to do with daddys to class so you dont chauffeur having prior engagements. After some team bondmiss out! ing, intervarsity networking and general gettin yaldae on the Friday night at one of Glasgows cultural hubs, the sport

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COMPETITION
The letters in green to spell out a greeting. Send it to us in a facebook message for a chance to win a copy of Davidsons RRP 100,000,000 (45)
Across
1. The rave Bar not for the faint hearted 3.1344m 7. Only queen on campus 8. One of Glasgows Underground music venues 10. Join a medic sports team purely for this 14. Tympanic membrane 15. Seismic vibrations 16. The problem is basically learning 21. Kennedy and Mackintosh 23. Glasgows answer to Hogwarts -clot rises(anag) 27. Home of uni sports 29. Our canine benefactor 30. Glasgows style mile

Down
1. Hub of the West End 2. Mackintoshs middle name 3. Bonfire night for a poet 4. Home of 13 down 5. Egg white protein 6. Wear it like a true Scot 7. & 24. Scottish drink 9. A Frank comedian 11. The view from the Royal, cemetery 12. Messiest night of the medic year 13. Weegie rugby team 17. Medicinal dispensary 18. Med soc 19. Hepatic organ 20. Your local infirmary 22. A wild Scottish animal 24. see 7 down. 25. A hot river 26. GUUs cocktail 28. Beauty is this deep

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