Guy's, King's & St.Thomas's Hospitals Medical & Dental Schools Gazette
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May 2001

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In the news this month...

Acute pain control and no side effects

An electronic device has recently been developed that controls acute pain through the external stimulation of the spinal column. The device, known as eXPain-TSE, delivers high frequency signals of 20,000 Hz through two surface electrodes placed at the top and bottom of the spinal column. After sustaining an injury, pain signals go to the spinal cord and switch on certain nerves that can produce pain for many months or years, even when the injury has healed. This causes most long-lasting pains. eXPain-TSE prevents the pain impulse passing through the spine to the brain. eXPain-TSE produces signals that are too brief for the nerves to detect and does not replace the pain sensation with a tingle, a side effect that previous devices could not avoid. TSE (Transcutaneous Spinal Electroalangesia) aims to replace the older neurosurgical technique of alleviating pain by implanting wires in the spinal column known as Dorsal Column Stimulation.

Anuj Bahl

Juniors don't want to be GPs

The proportion of junior doctors who want to become GPs has slumped to less than a third - posing a threat that the primary care crisis could worsen, according to a survey recently published. Some two thirds of the would-be GPs are women - of whom 74 per cent expect to become part-time doctors, according to the BMA survey. The survey was conducted among more than 1995 medical graduates, average age 28, in July last year. 93 per cent of doctors responded to the survey.

Dr John Chisholm, chairman of the BMA GP committee, said: "The medical profession has long realised - and the Government is at last belatedly realising - that we desperately need many more general practitioners in the workforce. "The findings of the cohort study show how difficult this will prove to be unless radical improvements to GPs' working conditions and pay are urgently made by the Government."

But the department of health insisted it was delivering radical improvements in the pay and working conditions of GPs. A spokesman said: “Every new GP joining the NHS is to get a £5,000 “golden hello”, while those working in deprived areas will get £10,000. We are also aiming to reduce violence in GP surgeries, improve primary care premises, reduce bureaucracy and give GPs greater career flexibility through a new contract. All this will help make general practice a more popular choice for medical students.”

Rag Concert Review

GKT Hospitals Music Society raised over two hundred and fifty pounds for Rag Charities on 1st April. In the splendid Guy's Chapel they performed Purcell's short opera Dido and Aeneas. This work is set around the story of Dido, the Queen of Carthage falling in love with a lowly soldier Aeneas (modern equivalent - Posh Spice falling for David Beckham). This romance all goes well until some dirty sorcerer (tabloid press) convinces Aeneas that he must go to war to defend Troy (Beckham plays football against Albania). Unfortunately Aeneas never returns and Dido dies of a broken heart. (Beckham dropped, he is forced to stack shelves for a living and Posh Spice is unable to buy Gucci anymore).

Under the watchful eye of Thomas Jackson this opera was performed in a very professional manner. Kate Holland as Aeneas displayed very good tone control and phrasing. Simon Blackburn as the sailor also sang well with much vitality. Other cast members produced some good solos so the overall standard was very high. In addition, the supporting orchestra played well in most sections.

This was a fine performance and a rare opportunity to hear this work. Congratulations to all those involved in the production for raising even more money for Rag Charities.

Bret Maddock

Red-Heads and Neanderthals

According to research at Oxford University red hair, fair skin and freckles stem from Neanderthal ancestors. Rosalind Harding, of the John Radcliffe Institute of Molecular Medicine, stated, “The gene is certainly older than 50,000 years, and could be as old as 1000,000 years. An explanation is that it comes from the Neanderthals.”

The newspaper Metro reported that scientists believe Neanderthals to have overlapped with Homo Sapiens and interbred, passing on the 'ginger gene'.

Ten percent of indigenous Scots are red-haired, while another 40 percent are supposed to carry the gene. The first Neanderthal bones were discovered in Europe and the first whole skeleton in Germany, so the explanation is faily concievable. Besides providing a politically incorrect explantion for why certain people can have ‘fiery tempers’, the research is said to hold both anthropological and medical promise.

GKT Triumph

This sporting year has brought phenomenal success for GKT clubs, making this season the most triumphant, as team after team excelled to bring back silverware.

Our Ladies tennis Club claimed both the UH and UL trophies last summer, overcoming all opposition to finish top, whilst the men’s cricket team won the UH Cup.

GKTBC have continued to dominate their events. Rowing second to none in the recent inter-hospital races, winning all eight finals, and then again repeating their success in the inter-hospital Head of the river.

Our mixed Badminton team played superbly all season to become Premier League Champions and then clinched the double by winning the mixed UL Cup against QMW.

Both GKT men and women's Football clubs have produced outstanding results. The women, victorious in the UL 4- aside tournament, (the first victory in 12 years for any medical team), additionally won the National Medics Football Tournament, beating Sheffield 1-0 in the final. The men’s 1st XI showed similar success by winning the UH Cup.

Having last won the UH Cup in 1997 as Guy's and St Thomas', and collecting the Runners Up medals since, our men's Rugby 1st XV were determined to walk away with the top prize this year, and they did not disappoint. An exciting match saw GKT emerge victorious, beating off old adversaries Imperial Medics, in a thrilling final.

For the men and women’s hockey clubs, this season has been one of resounding success. The men's 1st XI were the UH Cup winners for the second successive year and UL Cup runners up. GKT Ladies 2nd XI won Division 2 and won the UH Reserve Cup for the 3rd year running, in a gripping and close final against the GKT 3rd team. The Ladies 1st XI were UL Cup runners up for the 2nd successive year and memorably won the UH Cup, 4-0, in their 4th Cup Final appearance in as many years.

Additionally our 1st Netball team finished in fourth position in the UL Premier league, whilst our 2nd team came second in Division 2, earning promotion for next season. GKT women's basketball have gone from strength to strength finishing 7th in their league and women's rugby had a resounding victory over KCL in the UL Cup and finished 3rd in the UL league.

All of these results reflect the ever-increasing high levels of standard that GKT sports men and women compete at, and all should be congratulated for their individual and team achievements. The time, effort, hard work and enthusiasm by all participants, regardless of results, have been, as in all previous years, outstanding. Competitive sport at GKT not only offers those directly involved a chance to play as part of a team, but to be able to represent their medical, dental or biomedical school, - a very proud experience to lay claim to. It also allows non- players a chance to participate, especially by being involved in the support of a GKT club, notably at Cup Finals, where rivalry is profound and triumph or loss is heartfelt by all. The support by the medical school as a whole, by individual members of staff, many of whom are Club Presidents, and by “old boys and girls” has been extremely important in our successes, and will continue to be so.

All students, I am sure, whether originally from UMDS or KCH are pleased to be able to play for a team that retains our names and we are lucky to be able to profit from the enlarged intake of students - medics, dentists and biomedics. We must also appreciate the advantages of KCLSU, of which every club is a member. Monthly Council meetings enable Captains of Clubs (and society heads) to be involved in decision-making, regarding the running of clubs and societies. Many clubs now have access to more funding and a group within the Council has been formed to approach the College for funding regarding increased travel and tea expenses due to the new BUSA leagues. Additionally a new system of Blues and Colours has been introduced by the Sports Board and approved by the Council. As well as maintaining the standards set to be awarded Blues and Half Blues by the Blues Committee, the introduction of Colours enables the contribution of those people who play, but have not had the chance to become Club officers, or those on three-year courses, to be recognised.

Additionally, representatives of each site, including those from each Hospital, run both the Board and Council. GKT is now not only beginning to dominate hospital competitions, but also is emerging as a front-runner in London and BUSA leagues. All of the London Universities have always had separate hospital sides. This not only enables more people to be able to participate in sport, but it allows the continuation of the high standard of sport played by hospital teams participating in these leagues. Indeed without any of the hospital sides, the London Leagues especially, would be severely depleted. The importance of individual identity by retaining separate GKT Clubs is vital and I sincerely hope that GKT teams will triumph long into the future.

Sarah Merritt

Zero-tolerance for cheating

At the 2001 BMA Medical Students' conference, the motion was put before the house that, “today’s cheating medical students should not be allowed to become tomorrow's doctors.”

A heated debate ensued, in which it was pointed out that an attitude of zero tolerance does little to find the root causes of cheating. In light of the paper published in the 3rd of February's BMJ, ‘Are tomorrow's doctors honest?’ the conference was ‘delighted’ at the affirmation that most medical students are honest and conscientious. The conference re-emphasised the importance of medical schools nurturing positive ethical behaviour amongst its medical students, and called upon medical schools regarding appropriate referencing methods, and the regulations governing the exchange of information.

However, they did not support a zero-tolerance approach, which was felt to ignore underlying problems. As medical school sizes increase it will be increasingly harder to ensure students get supervision and pastoral support they need which is specific to medicine. Some effort at various medical schools has been made to provide students with introductory lectures (often poorly attended) and large quantities of guidelines and handouts (most of which are never read).

The most telling sentiment with regard to zero tolerance came from a New Testament quote, which was mentioned after the conference, “let he who is without guilt cast the first stone.” It seems more appropriate to foster an atmosphere that enables students to admit to their mistakes and inadequacies. It is the fear of reprisals that drives many to bend or break the rules and cheat in the first place.

Andrew N. Papanikitas

2001 Half-way Dinner

First Year Clinical packed Shepherd Hall at Tommies this year for the annual 3rd Year Ball. Tickets for the “Half-way Dinner” sold out to enormous demand in the space of a week, going on sale after symposia.

Starting with a champagne reception to the sound of a concert pianist along side the Statue of Victoria, the evening progressed seemingly without a hitch. The wine flowed, the food disappeared faster than the waiters could serve it, and with both a live band and DJ the tables were pushed back to open up the floor for everyone to dance late into the night.

All rose to their feet as our speaker, Prof. Gwyn Williams, toasted GKT as “the best medical School in the World!” Plus, two enormous bouquets went to key organisers, fellow 3rd Years Gabrielle Lofthouse and Clare Ross, accompanied by a hearty round of applause and more than a few cheers.

The prospect of celebrating the now very tangible sight of qualifying was clearly too much to be missed. Many commented on what fun it was for so many people from the same year to be together and how good it was to socialise with the Consultants who came to join us.

Next year’s first year clinical have a lot to live up to, and much to look forward to!

David Utting

Trouble free UH Cup Final

The GKT medics, sometimes known as the Guy's RFC, reclaimed the UH cup for the first time since 1997 on April 4th this year. The score was 15-13 in a very exciting match. This year, again, GKT played the Imperial Medics in the Hospitals’ Cup Final, at the London Welsh Ground in Richmond. Last year’s final was marred by bouts of hooliganism and drunkenness, which reflected badly on both sets of supporters and on the medical and dental professions and was commented on adversely in the national press. It was caught on camera by the BBC, which was following one of the players, a junior doctor at St Mary’s for the series, ‘Paddington Green’. Consultants and students alike were hit with raw eggs and flour, fights broke out, and some students were admitted to casualty with concussion unrelated to sporting activity. The authorities at Imperial College School of Medicine fined students who were identified on Camera by the BBC.

As a result, the authorities at the London Welsh ground introduced a system of stewarding. Stewards were given strict instructions to bar entry to any person carrying bottles or cans, and to eject trouble-makers.

Prior to the Match, Dr Hywel Thomas warned all GKT students, “On behalf of GKT I would ask you to give your team your enthusiastic support, but to conduct yourselves in a manner fitting to doctors and dentists in training, and to refrain from any disorderly or abusive behaviour. The London Welsh authorities have made it clear that any crowd problems this year will mean that the Final will no longer be held at their ground. I should also warn you that students ignoring this appeal and engaging in any unprofessional or unlawful behaviour will be subject to the College's Disciplinary Code.”

GKT was strongly supported, despite the majority of the fourth year not being able to attend because of exams. Some cynical GKT students suggested that there was a link between this and the better off pitch behaviour! Imperial Students commented that their major fear had been an encounter with the Royal United Medical School team in the final. However tradition supervened. Though they felt that their team were less prepared than in previous years, their defeat came as something of a mild surprise.

Andrew N. Papanikitas

UK Chair in Medicine and the Arts

The first Chair in Medicine and the Arts in the UK is to be established at King’s and GKT, thanks to a unique grant of £2 million from the D’Oyly Carte Charitable Trust. The creation of the D’Oyly Carte Chair in Medicine and the Arts, within the School of Humanities, will stimulate high-quality teaching and research in the creative, literary and performing arts and their relationship with medicine in its broadest sense.

Guy’s, King’s & St Thomas’ School of Medicine is the largest centre for healthcare education in Europe. The College’s School of Humanities is recognised internationally as a major centre of excellence in a range of arts subjects. The establishment of the new chair will enable medical students to learn from world leaders within one of the strongest schools of humanities in the country.

GKT already encourages applications for undergraduate medical courses from candidates who have arts or humanities subjects in addition to their science requirement and its medical curriculum extends beyond the core clinical disciplines. The role of the D’Oyly Carte Chair will be to develop this area of the College’s work by establishing courses to provide arts education for undergraduate students in the School of Medicine, expanding the programme for intercalating medical students, and undertaking postgraduate teaching and research supervision.

The D’Oyly Carte Charitable Trust, founded in 1972 by Dame Bridget D’Oyly Carte DBE, supports charitable causes, within the fields of the arts, medical welfare and the environment. The relationship between the D’Oyly Carte Charitable Trust and King’s College London builds on a shared history. Sir William Gilbert (librettist of the ‘Gilbert and Sullivan’ light operas that have been produced by the D'Oyly Carte Opera Company since the 1870s) graduated from King's in 1857. Sir William was a very active member of the student body and was responsible for attempting to replace the Engineering Society with a Shakespearean Dramatic Reading Society. Today, the Gilbert and Sullivan Society is one of the most active of the student clubs. The retiring president of the ‘G and S’ society, Carlo Prina, is in fact a GKT medical student about to finish his fourth year.

The Chairman of the Trustees of the D’Oyly Carte Charitable Trust, Mr Jeremy Leigh Pemberton, said, “The education of students of medicine and the healthcare professions and the inclusion of the literary and performing arts within that education is something to which the trustees are very committed. This will lead to a greater understanding of human problems as well as improving the ability to communicate. The D’Oyly Carte Professor will be a visionary leader in this area and we look forward to working with King's College London on this important academic initiative.”

Melanie Gardner

Kent Casualty Problems

Patients have been waiting in casualty departments for beds for more than two days in a troubled English hospital group at which GKT assistant house officers and house officers have been placed.

An NHS survey found three cases of patients waiting for longer than two days for a bed in the Kent and Canterbury Hospitals NHS Trust. One woman, aged 41, waited 54 hours to be admitted for treatment for stomach pains, according to the annual Casualty Watch survey carried out by community health councils. In Maidstone a woman aged 93 was kept in the A&E department for 30 hours while she began treatment for hypothermia. The government’s NHS reforms may mean this is the last Casualty Watch - since CHCs are to be abolished. Dr Peter Hawker, chairman of the BMA consultants’ committee, said problems in casualty were a sign of bed shortages throughout a hospital. He added that official figures failed to reflect the extent of delays that patients faced.

“Doctors and nurses feel miserable about the length of time patients have to wait and the anxiety and distress it causes…ACHCEW rightly points out that the official waiting clock only starts ticking when a decision to admit the patient has been made. However that is not the clinician's choice, it is a decision made by the Department of Health…Artificial targets imposed on an over stretched service cannot be met without resorting to ingenious massaging of the figures. It does not fool, nor does it help, patients.”

An SHO formerly in Canterbury commented, “I was a medical SHO when I resigned; largely because of the misery of being on-call there and not being able to find a space to examine patients. My experience was that clinical outcome is not affected that much. However, the experience of healthcare for patients and staff was severely damaged. It was almost impossible to deliver dignity to the patients in such an environment. I felt very despondent about the position and resigned, fully intending to quit medicine altogether. I have now worked in other places and enjoyed the job a lot more so that my decision to retire has been temporarily suspended. I was lucky to have the choice to leave the ER of the K and C - pity the poor residents of East Kent who can't!”

Andrew N. Papanikitas

Pastures new for GKT Chaplain

It's time for pastures new for our GKT Chaplain John Paton. After five years as Chaplain to GKT and Succentor to Southwark Cathedral, John has accepted the challenge of his own parish and parishioners in the not too distant Purley.

Alongside his busy timetable at the cathedral, most recently recording a new CD with the Cathedral Choir, John spends half of the week at Guys. The Chapel at Guys continues to be open all day every day until late and on top of various RAG concerts this year, candlelit mass has been celebrated weekly at 9pm every Thursday throughout the year. John’s scholarly yet pithy sermons are often challenging but always enlightening. How much we value Guys was recognised most significantly at the end of the academic year 2000, marked by a cross-campus service of thanksgiving and celebration organised by John with the whole of the KCL Chaplaincy.

John's regular Open House on the first Sunday evening of every month for pasta and wine is testament to his amiable and personalable nature. Whilst not actually doing any of the cooking himself on these occasions, which perhaps should not be overly criticised, John deserves great thanks for all his hard work and generou nature. Perhaps the most memorable event over the past was the weekend trip to Norwich. John and a troupe of faces seen around the Chaplaincy visited Norwich Cathedral under the hospitality of the Dean Rev Stephen Platten. The brave were privileged to a tour of the tower and Cathedral spire as one of the highlights of our tour of the spiritual heritage of Norwich City.

Of the Chapel, John shows us it is a place we use and love, “whatever your denomination, whatever your faith, even if you are not a believer, Guys Chapel is your Chapel. It is a place of quiet and prayer, and also a place where music is played and people celebrate the good things in life.”

Our new GKT Chaplain is due to settle in over the summer and I'm sure will be just as pleased as John to see faces drop for a quick introduction, though I'm sure we will all try hard to keep in touch.

David Utting