What even is Surgo? 80th Anniversary Special Edition

2015; 87:3

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ADDRESSES AND PAPERS

History of Surgo

by Tom H. Baddeley

Medical News

by Jamie Henderson

Madness at Arkham Asylum

by Dr Colm Hennessy

Playing the Supervisor Game

by Trung Ton

How to Get the Most Out of Clinical Placement

by Tom Ainge

Losing Our NHS

by Michaela Jewson

ADDRESSES AND PAPERS

The Lectured Become the Lecturers

by Jenna Woods

Happenings in MedChir

by Tom Baddeley

We Ballsed it Up

by Year Club Beta

Transverse Acetabular Ligament

by Craig R Johnstone

SHITS

by Daniel Taylor-Sweet

Ethics Case

by GUGPS

It has been a busy semester for the Surgo

committee. 1st and 2nd years have almost completed

their studies and are now preparing for the upcoming

exams . 3rd and 4th years made it through their

notorious clinical exams and are now starting their

placement and specialities blocks. Finally the 5th

years are starting p4p and becoming actual, legit

doctors...there really is no rest for a medical student!

(Apart from Intercal).

Surgo is celebrating its 80th (Oak)

anniversary this year and is ready to lighten-up your

coffee break. Due to popular demand, we start with

the history and the formation of Surgo to ask the

ageless question of what even is Surgo. Following

this, Jamie gives us a summary of recent medical

news and former Surgo editor and psychiatrist Dr

Colm Hennessey gives us a portrayal of psychiatry in

the media based on the Batman universe. Since half

the medical school is on placement at the moment,

Trung has enlightened us in how to play the

supervisor game and Tom Ainge (ft. beta-17 year

club) helps us get the most out of clinical placements.

Michaela confirms her distaste for the Tories in a

shocking reveal of the creeping privatisation in the

NHS (a must-read). Dan sticks to his strengths and

gives us the abstract of Surgo's next clinical trial:

SHITS (Surgo's highly interesting toilet trial). But

wait, there's more! An ethical case from the Glasgow

University General Practice Society, Jenna's inquiry

into if attendance should be monitored in lectures, an

abstract from Craig Johnstone, a review of the 3rd

year ball and finally a summary of recent Med-Chir

events. Enjoy!

Tom Baddeley, Editor of Surgo

Editorial

Many a student at Glasgow Medical School

has asked themselves this eternal question:

what even is Surgo? Surgo is 80 years old

this year and so I feel we all deserve a

clarification of how Surgo came to be. Lets

start from the very beginning

Despite the University of Glasgow being

founded in 1451 it did not have a dedicated

medical faculty until the end of the 18th

century; anyone who wanted to become a

doctor had to travel to Italy or the

Netherlands for university. The medical

profession in Glasgow during the 16th

century was: one physician, six barber

surgeons and two midwives, so not enough

to support a population of 7000. Glasgow

back then had terrible weather, no

sanitation and was rife with leprosy and

other infectious diseases, so much like it is

now! Lepers were sent to St Ninians Croft,

a hospital near present-day Gorbals. Here

they were looked after but had to wear a

long gown with hood and sleeves closed at

the fingertips and rattling clappers if they

wanted to leave the hospital, to warn

others of their presence. After several

outbreaks of leprosy and syphilis, the

powers in charge decided that the

University and the Clergy appoint someone

to be in charge of the medical faculty in

Glasgow. They decided on Maister Peter

Lowe, who settled in Glasgow in 1598.

This high-achieving man was trained in

Paris and had 22 years of experience of

battlefield medicine whilst working with the

French and Spanish armies. He was

employed and founded the Faculty of

Physicians and Surgeons, Glasgow on the

3rd June 1603.

The Medico-Chirurgical Society of Glasgow

was founded in 1802 but it wasnt until

1934 when the idea arose that the society

should have a medical journal. The first

steps were taken by Mr Uytman and

several other medical students who looked

into how much it would cost to run and set

up. Mr Uytman was the Med-Chir

treasurer at the time and offered the idea

at a meeting on the 22 November 1934. Mr

Leckie was president and supported the

motion, appointing the members who

proposed Surgo as the initial committee. A

star was born.

The first issue went to print in January

1935 and here are the opening words of the

editorial:

At a time when the Medico-Chirurgical

Society of Glasgow University, by means of

its numerous progressive activities, has

definitely established itself as one of the

most important influences upon the life of

the medical students of the university this

year the membership exceeds the five

hundred mark it is particularly fitting that

the society should have considered

publishing a medical journal.

Mr Uytman then goes on to outline the

three aims (I feel we have pretty much

stuck to them):

1. In the first place, Surgo provides a

means of publication of papers written

by students.

2. Secondly, Surgo will provide an

excellent medium for the orderly,

original and articulate expression of

student opinion on all matters of

medical interest

3. Thirdly, Surgo is intended to be a

source of information. Surgo as the

instrument of the society will satisfy a

long felt want in the matter of

publishing items of news both local

and general, which are of interest to

the medical student.

As it turns out, Surgo means I arise in

Latin; this is because Surgo arose like a

phoenix from the ashes of a former

publication called The Scalpel which

allegedly had to be shut down due to it

containing gross personalities and articles

calculated to excite feelings dangerous to

the security of the college. They were

probably proposing inflammatory ideas

such as accepting women into medical

school.

Surgo went on sale for 5 shillings a year,

so roughly 12 in our money. Surgo also

had companies pay for advertising space,

much like now. But this was before the

age of multinational healthcare companies

and old so Surgo editions featured adverts

from private companies for surgical tools,

prosthetic limbs etc. as well as household

names like Guinness and Tennents. The

advert below is advertising hernia trusses

and surgical belts. The shop itself

occupied 249 Buchanan Street, where

Topshop is now and having tried to fit into

Topman jeans in the past I can imagine

hernia belts are not too dissimilar. During

World War 2 Glasgow medical school found

it difficult to produce doctors fast enough

for the war effort, there were a number of

articles published discussing whether the

course should be shortened or if extra

semesters should be brought in to 1st and

2nd years. They also discuss how Glasgow

is the only Scottish university with no

military training; this could be the liberal

anti-war spirit of Glasgow coming through

or maybe just the med school hadnt got

round to organising it yetwho knows.

During the war and the post war period,

Surgo struggled to find sponsors and the

wartime paper shortage almost ended it for

good, but plucky old Surgo powered on

through.

Whilst reading through old issues of Surgo

and old Med-Chir minutes from the last

century, I unfortunately sensed a level of

underlying sexism. An example of this is

just after when women were officially

allowed to enter the GUU in 1977, Med-

Chir organised a field day in 1978 where

there was debating, sports at Garscube and

snooker and darts in the mens union.

The rules officially state men only as

players and spectators for the snooker and

darts, so I can guess where Med-Chir stood

on the mixed-sex union dispute. However

there was a beer drinking competition and

night out in the Savoy Centre afterwards,

all sponsored by MPS - which sounds more

like the Med-Chir we all know.

Surgo was much like it is now from the

1980s onwards with the same light-hearted

look on life as a medical student. It has

had its ups and downs but for a student

magazine to be celebrating its 80th

anniversary, it must be something special.

As long as Glasgow has a medical school I

believe it is important that Surgo should

exist to act as an impartial judge, holding

the medical school accountable if needed

and to allow medical students to voice their

opinions. In doing this Im sure Surgo will

be celebrating its 160th anniversary in 80

years time.

What even is Surgo? by Tom Baddeley

MEDICAL NEWS

Scottish hospitals show improvement in mortality People dont go into hospital to die; at least that is the idea. But inevitably

patients do. This can be due the result of the condition of the patient on

admittance, but some deaths can be prevented by improving care and not

causing harm (beneficence and non-maleficence). It was with this aim that the

Scottish Patient Safety Programme (SPSP) was set up. It has seen a reduction in

the Hospital Standardised Mortality Ratios (HSMR) of 16.3% over the whole of

Scotland. The Southern General managed to reduce its HSMR by more than

20%: the target for the end of 2015.

Attractive Men Are Selfish Resear che rs f r om Brune l

University have found that

attractive men are more likely to

be less generous and favour

equality less than their less

attractive counterparts; the

same could not be said of

women. Therefore there is a

lesson to all; be careful who you

go on dates with. You may end

up paying for it.

Chocolates on wards at high risk Dont leave food, particularly chocolate, around

a ward as they will vanish quickly. A

multicentre trial, published in the BMJ, has

found that the half-life of a chocolate on a ward

is remarkably small - 1hr 39 minutes. It takes

only 12 minutes for a box of chocolates to be

opened. The main culprits in this study were

health care assistants and nursing staff,

composing 28% of consumers; doctors didnt

fair too well either, coming third overall. So

next time you grab a Quality Street on a ward

be careful, someone may well be watching you!

Hold the press, binge drinking is over In a report from the Office of National Statistics (think grey suits and lots of SPSS), they have reported that binge drinking is waning in the UK, with more people than ever being teetotal. Young people (

Madness at

Arkham Asylum

rkham Asylum looms high over Gotham.

Or sometimes it sits on an island in the

bay. Or is dwarfed by the modern buildings

around it. Or maybe it becomes part of the city,

a segment where anarchy reigns. While the

details vary, one fact always remains: its where

the bad people are. Where the murderers,

anarchists and freaks of the Batman world are

sent after being captured by the Dark Knight.

There they stay for a while, contained,

sometimes experimented on. They are never

cured, never successfully helped. Sometimes

they are discharged by misguided staff,

sometimes the staff even help them escape.

Because they always escape, and return to

their life of crime, and then return to Arkham a

while later. No one gets better at Arkham, no

good is ever truly done. The patients do not

recover, and society is never safeguarded.

Gotham is indeed where the bad people are.

n the wide pantheon of superheroes, no

character or title has paid as much lip

service to the medical speciality of psychiatry

as Batman has. The hero himself, irrespective

of the portrayal, is always fuelled by trauma

the murder of his parents, and a fear of bats.

His villains are often described as mad, or

s c h i z o p h r e n i c ( i n c l u d i n g t h e g r e a t

misunderstanding of schizophrenia as spilt

personality, personified by Harvey Two-Face

Dent). He has even faced a remarkable number

of evil psychiatrists over the years: Harleen

Harley Quinn Quinzell, Jonathan Scarecrow

Crane, Dr Hugo Strange, and others. Not only

are bad people held in the citys secure

psychiatric hospital, but the madness is

seemingly contagious, regularly spreading to

the abusive and incompetent staff. Even the

origins of Arkham lie in madness: the name

itself comes from the Cthulhu mythos of HP

Lovecraft , whose arcane tales told of

otherworldly insanities forever pushing in on

reality. And old Jeremiah Arkham himself, the

architect and founder of the hospital, fell to

madness, shuffling through the halls of the

institution he built.

atman is not unique in its portrayal of

mental illness as being synonymous with

evil and danger, but it is perhaps remarkable in

its unreconstructed and profligate portrayal.

The institution itself entered the Batman comic

book in the early 1970s, at a time when

psychiatry was recovering from the excesses of

institutionalisation and the barbarism of the

lobotomy era. Effective medications were by

t h e n a v a i l a b l e , a n d t h e a g e o f d e -

institutionalisation was beginning. But the

image of psychiatry, then as now, was still one

of custody and madness. Arkham thus became

a super-villain take of One Flew Over the

Cuckoos Nest, where no one ever recovers and

people are contained rather than treated.

owhere is the Arkham Effect greater

than in the character of The Joker.

Batmans greatest villain, he serves as an

anarchistic riposte to Batmans fascistic

leanings. The Joker is unpredictable, unhinged

and extremely dangerous. He has taken the

A

I

B

N

lives of countless Gothamites, including

(during the Death in the Family storyline)

Batmans young ward, Robin. But despite his

leanings towards anarchy, he is a methodical

criminal mastermind. There is no hint in his

portrayal that he is depressed, or bipolar.

Although unhinged, his mind maintains a

consistency of thought and action that is not in

keeping with psychosis. There have been

instances of catatonia (most notable in Frank

Millers The Dark Knight Returns). But, if any

diagnosis were to stick with The Joker, it would

be psychopathy.

f Scotland has an institution equivalent to

Arkham Asylum, it would be The State

Hospital at Carstairs. I have worked there

myself. Rather than a gothic building of spires

and watchtowers, it is a series of modern flat-

roofed buildings set on a remote and windy

patch of central belt countryside. As opposed to

being a chaotic and abusive place, it is a

controlled and contained environment. To be

sent to Carstairs, one must generally have a

significant mental health problem in addition

to requiring a high-secure environment. As a

rule the focus is on recovery (if possible)

enabling the patient to move to a less-secure

environment. There are medications, therapy

groups, passes to the community. The other

fact that sets Carstairs apart from Arkham is

that The Joker would never get in. Because

psychopathy, by virtue of not being a treatable

mental illness, is the domain of the Scottish

prison system.

here is one other particularly troubling

aspect of The Joker, and that is the fate of

his psychiatrist Dr Harleen Quinzel. It is

something of a trope in popular culture that

psychiatrists fall in love with their patients, but

Dr Quinzels case is even more troubling: she

styles herself after him, becoming a deranged

super-villain named Harley Quinn, and begins

a life of crime and terrorism specifically to

garner the affections of The Joker. It is here

that one of the most troubling aspects of

stigma is personified: that mental illness is in

some way contagious, and that spending time

with the mad can make oneself insane.

hen I decided to become a psychiatrist,

there were a few comments that I grew

tired of hearing pretty quickly. Some people,

including relatives, worried about my safety;

that the dangerous patients would turn on

me. Others joked I would become mad myself.

Finally people asked why I did not want to be a

real doctor, as if I was abandoning medicine

for imprisonment and mysticism. Stigma is not

just damaging to our patients, who must

contend not just with mental illness but also

with the fear and ignorance of society. Stigma

is also directed towards psychiatrists

themselves, who are frequently regarded as

bizarre, unhinged, and perhaps inferior to their

medical colleagues.

t is hard to judge the effect of constructs

such as Arkham Asylum on stigma towards

psychiatry. Of course Arkham is one (albeit

central) part of the Batman mythology, and

Batman is only one (very well-known)

character. What Arkham Asylum is, though, is

part of a wider trend of portrayal of psychiatry

in the media. And while stigma is a wide issue,

it has its beginnings in the public perception of

mental illness. Arkham looms large in comic

books, videogames and movies. People who

grow up on Batman become aware of it, and

this terrifying and nasty environment must

surely become internalised, one of many

impressions to be called upon when they

encounter mental illness in the future. And

there it will remain: gothic environments, scary

patients, evil staff, and no recovery.

I

T

W

I

Cby Dr olm Hennessy ST6 in Child and Adolescent Psychiatry

Former Surgo Editor

H

PLAYING THE SUPERVISOR

THE ENIGMA

So its nearly the end of week 3 of 5 of your placement and youre starting to wonder, when will I meet my supervisor? Why haven't they replied to my five thousand emails asking to meet?

The enigma is clearly a busy doctor who hardly has time for themselves l e t a lone a med ica l s tudent ! Sometimes even their own secretary will have no idea where they have ran off to. Or they have a secret hate of students constantly wanting their signature and clogging up their inbox.

DO NOT FEAR!.. Continue on with your block as you would do and make sure you have al l your necessary cases and documents ready to present to the Enigma in the most concise and speedy manner. Be ready with all necessary online forms ready to be signed before you lose track of your supervisor for another week.

THE KEEN BEAN

The keen supervisor is the one who really wants the most out of you, and would have you by their side at all times. Forget all teaching, friends, lunch...your supervisor is now your life, your heart and soul of your 5 week placement. They want you there at every clinic, MDT, ward round, theatre list...all in the name of teaching you. This could be the best clinical exposure of your e n t i r e m e d i c a l c a r e e r b u t consequently the most tiring!

Supervisors are still human beings, and understand you may need a breather from time to time so do not fear to ask if you need to get away. However stick by them as much as you can and you will definitely reap the benefits of good knowledge and that end of block assessment form signed off!

Starting clinical placements can be a daunting experience come third year and beyond. It is a completely different to those PBL and VS sessions; a sense of freedom and responsibility rains over you as you step onto those busy wards. However, as much as you want placement to be your own learning experience, the ultimate fate of whether or not you have to cancel all summer/elective plans and resit a placement is up to one person - your supervisor!

Supervisors come in a variety of flavours in the world of clinical placement; each one has their own style and attitude to supervising. It is up to you to use your own judgement on how to get the most out of your supervisor, and how to play the supervisor game.

Here are some supervisor personas you might encounter:

THE OLD SKOOL REBEL

2 portfolio cases, mini cexs and CBDs?! Not in my clinic! The Rebel has their own ways of teaching you the ways of medicine and will not stick by the jurisdiction of the medical school clinical years guidebook! There are a variety of ways in which the rules can be bent to their will. Some supervisors may not require any portfolio cases, others may demand a case a week. Some will not give a damn about your reflection and how the case has made you a better person, while others will think you are a cold hearted monster if you didnt mention the social aspects of a patients life.

One golden rule here is do as youre told, or else your chances of a sign off will be in jeopardy!

GAME

by Trung Ton

THE SPECIALIST

Now all consultants have a special interest. But this kind of supervisor wants it be your special interest too and will have nothing else you have to offer. Even if it is something youre not particularly interested, there is no escaping the subject now. Everything you do will revolve around this topic and you just have to accept your fate.

Best thing to do is to stick by it and you might even learn something that may come in handy in the future. (regardless of the fact you have neglected all 200 other ILOs of the block)

THE LAID BACK ONE

The dream situation has arisen in your block; A supervisor who knows exactly what a medical student needs in a clinical placement. These supervisors will respond with haste to your emails, meet you at any convenient time and give you total control of your learning experience.

All you have to do is to keep your work up to good standard and you will be getting that sign off in the easiest manner possible.

At the end of the day, it is up to you to make the most out (or very little) of your clinical placements and your supervisor is just there to ensure you are keeping up to standard with your practice. Some top tips for the supervisor game: Contact your supervisor as soon as you start to arrange a meeting Get all your assessments done sooner rather than later Try to show face and attend your supervisors clinics etc (if they permit - this is a good way of getting things signed off too) Enjoy clinical placement and make it your own personal learning experience - (you will be getting paid to do it before you know it!)

WANT MORE USEFUL INFORMATION LIKE THIS? Dont forget to check out Surgos very own website at

www.surgoglasgow.com

How to get the most

out of clinical

placements

It is time to step up to the fold and do some proper medicine. You all must be excited and probably a bit nervous about going on clinical placements. You should however, remember that these years will be some of the most exciting moments of your education. Meeting real patients, solving real problems and doing real medicine.

This guide is about what you can do to make the most of your time on placements. We arent talking about having parties in the onsite accommodation; we are talking about getting slick with clinical skills and history taking skills. Placements are where you learn to practice, practice, practice medicine.

In conjunction with Alna Robb we have developed this guide to help you operate effectively and gain as much experience in clinical skills as possible.

Before we get started

Placements will vary between hospitals, but they all will be following the same objectives and themes. Pay attention to their introduction they give you at your hospital, and dont forget to read the Guide to Clinical Years. Doing both of these will put you in good stead for understanding what is expected of you in clinical years.

Getting the work done!

In order to be competent you need to perform each the procedures expected of you five times, you can find a list of these in the clinical skills logbook (If you still have it) or online via vale or the e-portfolio. Have a list in your

notepad or Smartphone and a plan for the day of what you would like to get done. Get all of these signed off and logged on your e-portfolio/vale.

So what can I do?

You can do almost any clinical procedure so long as you have been trained to do it and are supervised by a qualified medical professional. So ask your supervisor what you want to do, ask if you can watch them doing it and then get them to supervise you doing it!

The Surgical block For those who like scalpels and sutures, this will be an invaluable experience, for the rest of us, just try not to faint at the sight of blood. This should be a very enlightening experience as many of you will have never stepped into an operating theatre before.

STOP, Hand washing time!

As a first initial priority, get your hand washing technique assessed and get it mastered properly, youll be surprised how many slip up on this basic skill. This is especially important on the surgical block.

Injection technique

On the surgical block your subcutaneous injection technique competency can be completed very easily as most patients receive subcut heparin when on the wards. These injections usually occur at about 0800 and 1800, nursing staff usually do these, but if you have a chat with the lead nurse (in some hospitals still called the ward sister) you should be able to get trained to do them and perform some yourself. In about 2-3 drug rounds you should have completed competency

In terms of intramuscular injections, you may get the opportunity to do these before the patient goes into theatre but you will need to check with the nursing staff beforehand.

Urinary Catheterisation

Most patients will be catheterised in theatre, so try and get as much theatre time as possible. You will be shown meticulous aseptic technique and the procedure will generally be easier, as the patient wont be conscious when having a tube passed up their urethra (as you can imagine this is very uncomfortable).

Follow the patient through

their operation

One of the best learning opportunities to do in the surgical block is to follow a patient though surgery. You can gain a number of key skills and see the hospital machine in action. Here is a step by step guide as to what to do. Dont forget permission, training and supervision must be adhered to at all steps:

1. If possible, look at the theatre list for the day and ask permission from your consultant to follow a patient though their journey. Pick a patient who is likely to be in theatre for a few hours.

2. Get permission to follow the patient though the journey from the patient the day before the surgery.

3. Get your own history from the patient and enquire

with your consultant what procedure he/she is having done.

4. Revise your anatomy/physiology regarding the

procedure the night before, as the surgeon may ask you questions.

5. The next day be on the ward well before the patient is due their operation. Give your phone number to the ward sister to call you if timings change.

6. Observe the surgical checklist that is carried out

before the patient leaves for surgery and escort the patient to theatre. Hopefully the theatre reception and staff will have been informed you will be following the patient through theatre.

7. Observe the handover of the patient.

8. Go change into theatre scrubs and meet your patient before they head into the anaesthetics room. If you

have been following the patient thus far, they may consent to you performing a cannulation under the anaesthetists supervision.

9. You then may have the option to stay with the anaesthetist and scrub in to theatre

10. Observe, and perform a surgical scrub (handwashing

skill up!) under supervision of the theatre staff. You will also be shown how to Gown up following aseptic technique.

11. You may be able to catheterise the patient under supervision, once the patient is under. If you are really lucky you might be able to do a few surgical clips or sutures!

12. After the operation, accompany the patient into the

recovery room and help with observations (see the observations section). You will see how intensive these are investigated post theatre.

13. You will also learn in the recovery room oxygen therapy technique (masks, observing ABGs, pulse oximetry) and other skills such as IV drug therapy and ECG procedure and interpretation.

14. Once the patient is ready to return to the ward,

accompany the patient back there and observe the handover to the ward staff. You could also try having a go at this under Supervision.

The Medical block This is where you can get the majority of your skills polished that you already know, whilst gaining many new ones ( These can also be applied to the surgical block too).

Observations

Basic observations such as Pulse, BP, RR, ECG, GCS, urine output and early warning scores are basic clinical skills, however you should try to learn them in context of a patients condition. When you have free time on the wards, offer to the ward sister/nurses to do the observations for 20 minutes or so. You may call doing these Basic but learning to recognise patterns in a patients condition will be an invaluable skill in clinical practice, not to mention you will become very slick at the basic procedures, and the examiners like that!

Nasogastric tubing

The time to look out for NG tubing in particular is on the GI, pancreatic and surgical wards. The nursing students usually have dibs on the first few but if you inform the sister on the ward that you would like to do one, usually you will get the chance to do about one per week. Even if they say no, ask if you can watch, and still improve your skills.

Venepuncture

Your consultant can usually give you some opportunities to do this, but If the phlebotomist is on the ward taking blood, ask them if you can perform a few. The phlebotomist has a time schedule to keep and wont let you perform too many, but get a few under your belt and youll be well on your way to clinical competency.

ECGs

Whilst on placement get yourself some time spent at the cardiac clinic, patients here will have an ECG performed on admission, you can learn how to perform, do one yourself and practice interpreting them. You should be able to get all five ticked off before you even leave the unit!

Histories

These will be the meat and gravy of your placement, do them frequently and often. Patients will have had histories taken from them on admission but you can perform some yourself, be aware to ask the ward sisters before doing this. Tell the patient why you want to take their history, otherwise they may get annoyed about being repeatedly interrogated. Tell them you are still learning and that you would like some objective feedback. You could use a feedback form from the VS com skills sessions in order to make this easier and have a record of this. Check your clinical skills logbook for the list of histories to take.

These include but are not limited to: Respiratory, CVS, Neurological, GI, Rhemo/Ortho, Endocrine, Renal/urinary.

Quickfire Questions

Can I go to A&E?

Yes, some days during your five week block, your consultant may be on call for A&E or acute recieving. You might be starting later in the day but be working later when called to A&E. Whilst in A&E dont panic, play by the rules (do exactly what the staff ask of you, you may be helping with procedures) and remember your ABCs.

Will we be expected to be in 9-5?

It depends on your hospital, but you may be in 9-5 or even later!

Are we expected to do weekends?

As a rule no, but if you wish to do so, make your consultant aware and they should be able to help you. You could use this time to catch up on your clinical skills youre lacking in.

Should I bring chocolates to the nurses to make them like me?

Please dont, the best thing you can do is to be polite, friendly and respectful (there is no Nurse/Doctor/Auxiliary/Med Student hierarchy.)

Do I need to revise/study anything beforehand?

Your supervisor should be directing you in your learning, but use your experiences to highlight areas for you to look into. If you are following a patient through surgery, read up on the anatomy and physiology related to the procedure beforehand. Watch the clinical skills podcasts if you are unsure how to do any of the core clinical skills.

]

So, there we go, a whistle-stop guide to clinical placements. We hope this helps you in your endeavours. Have fun, enjoy yourselves and be some great doctors!

A production by the 2017 Beta year club; Author: Tom Ainge

Image attributions:

https://medicalhumour.files.wordpress.com/2012/09/warning-medical-student-who-wants-to-take-your-history.jpg?w=914

http://news.bbcimg.co.uk/media/images/60028000/jpg/_60028231_m5200213-hospital_hygiene.jpg

http://www.telegraph.co.uk/news/worldnews/northamerica/usa/11197280/Operation-inventor-needs-money-for-his-own-operation.html

http://www.excellenceinjections.com/subcutaneous-injections/

http://www.theredlist.fr/media/database/films/tv-series/sitcom-and-soap/2000/scrubs/005-scrubs-theredlist.jpg

http://www.osceskills.com/e-learning/subjects/intravenous-cannulation/

General tips for placements

x Make yourself visible on the wards to the ward sisters. Ask them if there are any procedures you can do/help with (it may help to give them a short list of the things you want to do)

x Be polite to the staff, people love to teach so express you love to learn x Be on time, five minute rule! x Have a checklist of things you want to do each day/week and have a plan x If you cant do a procedure watch it and gain experience x There is always something to do on the wards, tell the nurses if you want to do things x Above all have fun on placements

Losing Our NHS Here goes another rage article. I challenge you to read this article and not be shocked, sickened and appalled. The 2010 election campaigns of all political parties may have differed, but all major parties seemed to stand united in a pledge to protect our NHS both in quality and budget. David Cameron promised No cuts to frontline services, real-terms increases to the NHS budget, and no more top-down reorganisations. Within weeks he began to break these promises. In the shadows; hidden behind euphemism, carefully worded contracts and cheery hospital visits; the Conservatives have spent the last 4 years making the NHS ready for sale.

Following the general election, 2011 marked the first fall in a decade and the biggest fall in NHS approval ratings in three decades, the ratings fell from 70% to 58%. Government ministers slating of the NHS in order to justify their reforms no doubt must have a role to play in this. The current coalition has starved the NHS and then taken to the headlines asking why it isnt performing as well. It would indeed seem a very clever plan to create a situation in which the NHS cannot perform to meet its targets, criticise it for failing and then begin to talk of ways to fix it. Ways like, I dont know, of fering deals to private companies? It seems our health service has fallen victim to a smear c a m p a i g n , s m e a r e d w i t h b a d headlines in a preparation to be served to the bidder with the most connections. If you want to look for who is gaining from this then look no further than Westminster itself. 1 in 4 Conservative Peers have recent or present financial connections to companies or individuals involved in healthcare; Andrew Lansley himself has received at least two donations from individuals in private healthcare; Nearly 40% of GPs on Clinical Commissioning Groups have an interest in selling products they are commissioning. This is just the

beginning of a list of shocking statistics linking MPs to private healthcare companies and suggesting ulterior motive for awarding private companies NHS contracts.

All of this begs the question, how are firms making profit from NHS services that we are struggling to provide? Many of the companies being considered and sometimes awarded these contracts have previously come under fire for substandard care in care homes and hospitals. If these companies do decide that the services they have chosen do not work as a business decision, they able to pick up and drop services as they please w i t h l i t t l e c o n s e q u e n c e o r accountability, for example the return of Hinchingbrooke Hospital to the NHS after the private company running it failed to meet standards and came under scrutiny. There is no such get out clause for the NHS to cut short the contract if the private firms fail to provide an adequate service.

In a recent scandal, Alliance medical has recently won a 10 year contract to provide diagnostic services despite their bid costing 7 million more than a bid from NHS trusts. When looking for an explanation for this, I can probably give you less than three guesses until you get it right. It cannot be confirmed but David Cameron has not yet revealed if ex-

m in i s t e r S i r Ma l co lm R i fk ind influenced the deal with Alliance Medical, the Tory MP who actually sits on the board of the private healthcare provider has since resigned as an MP after having been found accepting cash for access. 70% of contracts put out to tender are now won by private firms. This arrangement is even more worrying when coupled with the fact that the most recent contracts set performance targets and standards after deals are signed and the contract is won.

As shocking as the actions of the government is the cover up. The conservatives have recently deleted every article, speech and press release released before the last election from their website. Is this as they have said an effort to make the site easier to read or an effort to sweep under the rug the totality of the promises they have broken to date? Since the coalition has been in power we have lost: 5,870 NHS nurses, 7,968 hospital beds, a third of ambulance stations to name a few. The massive top down reorganisation that has occurred just weeks after the Tories promised it would not has diverted approximately 3 billion away from patient care.

My opinion? We wont have an NHS anymore if we have another term of conservatives in parliament.

by Michaela Jewson

Do#you#have#a#very#particular#set#of#skills?

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appreciate$all$enthusiastic$contributions$and$ideas!$Contact:#surgo_editor@hotmail.com

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The Lectured Become the Lecturers But should we be forced to endure them?

Sound familiar? Above is an article from a 1977 edition of Surgo. How many of us have complained about a lecture? It seems that the use of the slide projector (or PowerPoint) as a psychological weapon is just as common now, in 2015, as it was when most of our lecturers were, themselves, being lectured.

What is proposed in the article above, is the beginning of the whole PBL idea - self directed learning. All of us spend the first two years here doing PBL, then progress to CBL to learn how to proceed with the care of our future

patients. However, most of you will agree, it is only with lectures to complement this learning that we are able to become good clinicians.

Having said this, lectures do not suit everyone, so Surgo asks you this:

Do you think attendance should be taken in lectures and why?

Please email your opinions to the editor at surgo_editor@hotmail.com and we will incorporate the best answers into the next issue.

Happenings in MedChir

SCRUBBY! A solid effort all round from the 492

attendees of Scrubby 2015! The blue tide

filled up the beer bar, Viper and pubs

across the city. Despite it being Friday

the 13th no one was injured, although a

7 year old Govan resident did take a

swing at a first year (he probably had it

coming). A personal highlight was a

rammed Bellrock Bar singing along to

Whitney Houston.

MedChir Revue Oh what a night! Talent was abundant and came in many forms including a particularly jovial Irish Dancing act. Jesse Dawson, Prof Walters and Alna Robb were the judges; euphemisms and sexual innuendos firing left, right and centre, though mostly in the direction of Alna. Med-Chir provided a satirical clinical skills session with 5th year Anna Yule as Alna, which thankfully went down well. An all-round excellent night and bring on next year!

Welcome Back Pub Quiz

Surgos first ever legit event went

pretty much as planned and the

winning team won the enviable prize

of out-of-date Subway vouchers. Who

says we dont treat you right? First

Year Rep Shereif knocking over a table

covered in pints was pretty funny,

such a waste of Tennents though. We

also put old issues of Surgo to good

use, as shown by the big Munn

himself

www.surgoglasgow.com

Three bells, three barfs, one burn.

Here is this years 3rd year ball

experience in a nutshell.

After months of p lanning and

anticipation, the halfway ball took

place from 11th to 13th of February in

MacDonald Cardrona Hotel, Peebles.

We were all sick of spending our

nights in the Study Landscape eating

food from the reduced section in M&S,

and listening to those students

claiming they know literally nothing

yet somehow always seem to get on

the honours list. With everyone

looking forward to it for so long could

it possibly live up to expectation? One

hundred and eighty medics drunk for

two daysof course it did!

With most of us having far too many

at the Beer Bar after Tuesday's MEQ

and with THREE students ringing the

bell (cheers to Michael, Cameron and

Iain), it was somewhat remarkable

that we all made it for the buses the

next day. We got off to a shaky start

Sam, Caitlin and Ross decided to

paint the buses with a cheeky bit of

vomit on the way to the hotel, however

we soon settled in to our fancy digs

and had a lovely time listening to

singer/songwriter Tony McHugh and

enjoying a hard earned pint.

A game of Ring of Fire was started

almost as soon as we arrived to the

hotel and within the hour people were

well on their way. Joe was drunk by

3pm and with each passing sentence

became more and more Welsh. The

Kings cup was overflowing with

champagne, vodka and fair amounts

of pubic hair.

T h e f i r s t n i g h t w a s t h e m e d

Superheroes and Supervillains. Some

people really made an effort with their

costumes Anna Leersen dressed as

Sauron, but most of the other girls

dressed as Poison Ivy. Other people

dressed up as someone who cant hold

their drink and real ly true to

character, passed out at the dinner

table. The night came to an end with a

DJ serenading us with classics such

as Angels by Robbie Williams, the

anthem of our year.

Sometime during these festivities Iain

MacLeod and Lewis Walker decided

they should race down the corridor to

see who was the fastest, but we all

know both men can only last 15

seconds anyway. Iain was first to

cross the finish line, but face-planted

the ground in triumph and gave

himself carpet burn down the left side

of his face as a reward. Maybe it is

good that he nearly lost his left eye as

Sam got locked out of his room in his

birthday suit and the night porter had

to be fetched to save him from this

compromising situation.

There was a bit of an altercation on

the upper floors when Dominic Waugh

was left with a bit of periorbital

swelling too we are not sure what

the relationship between ocular

injuries and the hotel is but well keep

an eye out for more information. The

second afternoon was a lot more

chilled out some people went to the

pool, others took 6 hours to play 18

holes of golf, and we had rented out

sumo suits for those who were a bit

more daring. Some keen beans, who

obviously didnt drink enough the

night before, even went to the gym!

Here there was more grunting than a

pig orgy as Dominic Waugh was lifting

in front of the mirror to improve his

pectoral muscles, which allegedly can

spurt whipped cream on demand.

During the evening we had a drinks

reception and a lovely three course

meal. This was followed by a ceilidh in

which Jordan Newport looked like

Ricky Martin on coke. At one point he

nearly dislocated Annas arms from

her sockets. There was a beautiful

rendition at the end of Auld Lang

Syne, Loch Lomond, and of course

Angels (again). Following that we

danced the night away to hits from

Britney Spears to Kanye West. It was

great to see David swaying around to

the beat and sweating profusely. At

around 4am most peoples legs had

given up on them and we retired for

the evening.

Friday morning was a day of great

regret and we all left feeling sad and

hungover, or in my case still drunk;

making those who made the bus look

like extras from The Walking Dead.

Unfortunately some poor souls didnt

make the bus on time (Catherine,

Maria and Abi) and we are told they

are still trying to hitchhike home.

So that was the Ball in a nutshell. It

seems like there wasnt a great deal of

scandal but unfortunately our lawyers

have advised against including those

stories. Beta -2017 Year Club would

like to thank everyone who came and

also those who supported our events

during the year. We had a ball!

By Year Club Beta 2017

WE

BALLSED IT UP

Introduction The transverse acetabular ligament (TAL) is a poorly understood aspect of the hip with limited morphological description in the reviewed literature. It is often used as a landmark for orientation of the acetabular component in total hip arthroplasty (THA) but its suitability is debated. The aim of the current study was to investigate the morphology of the TAL. It was hypothesised that the current description in the literature is insufficient.

Materials and methods Seven dry bone hemi-pelves were reconstructed using a microscribe and rhinoceros 4.0 3D software. Hips (n=3; F=2) were dissected to expose the TAL. The TAL was removed and a footprint taken of its perimeter and attachment sites for measurements. 3D models of the

dissected acetabuli with an outline of the TAL and attachment sites were created as for dry bones.

Results The TAL extended beyond the acetabular notch, around the circumference of the acetabular rim. Two attachment sites were identified in each specimen in the superior half of the acetabular rim; one anterior and one posterior. In one specimen, an additional attachment site was identified on the posterior horn. TAL length in each specimen as measured from 2D digital photographs were 132mm, 117mm and 179mm, with attachment areas of 215mm2, 150mm2 and 350mm2, respectively. There was marked variation in ligament breadth between and within individual specimens, ranging from 2.6 to 5.3mm and 3.2 to 6.3mm in the smallest and largest specimens respectively. Discussion Contrary to previous literature, the TAL was found to extend far beyond the acetabular notch, and its attachment sites were found more superiorly on the acetabular rim than previously described. The unexpected length may explain disagreements surrounding its use as an anatomical landmark. Further biomechanical research may determine which part if any of the ligament the acetabular component should be orientated against.

True Facts about the Hip

It takes about 3000N of force to fracture a hip. A car hitting you at 30mph transfers about 21000N into you.

Gorham's Disease is a rare disease causing osteolysis, thus rendering the patient boneless.

In the early 1970s, DJ Kool Herc coined the term Hip hop to describe his epic funk block parties in the Bronx.

Clinical Anatomy of the Transverse Acetabular Ligament

Craig R JohnstoneSupervised by Dr Quentin Fogg

Transverse acetabular ligament

Acetabulum

Ligament of femoral head

Background

One in five Britons will have commenced a new diet at the

start of the year, in a vain attempt to shed pounds and help

sculpt a perfect beach bod. Many of these people attempt a

celebrity diet that they have read about in the high impact

nutritional journal Cosmo. SHITS is less concerned with

the effect of the diet or the amount of weight they lose but

far more interested in how the diets affect their poop. We

aim to assess the effect of commencing a celebrity diet on

poop quality and quantity. No study has investigated this

area before. Prior to commencing investigation into the diets

effect on poop we aim to determine the most commonly

occurring celebrity diets online.

Methods

SHITS will comprise of two parts; Part 1: diet selection and

Part 2: diet's effect on poop.

Part 1 will include an initial Google search will be completed

to find popular celebrity diets, which will be recorded.

A preliminary list of diets will be created for analysis. Any

diet designed to be completed with an adjunctive exercise

program will be excluded from further analysis as will any

diet involving the consumption of dangerous or illegal

substances.

Following application of exclusion criteria a subsequent

Google search will be completed on the diets identified and

the five diets returning the largest number of Google search

results will be selected for study.

Results

Five diets were selected for study. The most popular diets

were: Gluten free diet [61,400,000 results], Sugar free

diet [51,200,000 results], Raw food diet [32,200,000

results], 5:2 diet [20,000,000 results] and Paleo

diet [13,700,000 results].

Conclusion

The wide variety of celebrity diets listed on the Internet

shows a trend for diets to be based on removing certain food

groups from ones diet.

Another trend can be seen in the rise of diets encouraging

eating foods that are uncooked, natural or unprocessed.

It is unclear on how the selected diets will affect the

participants' poop. SHITS: Part 2 will investigate this.

Paleo?5:2 Diet?

Gluten free?

Raw food?

DETO

X

Sugar FreeGo for a run?

Part 1 : Diet Selection

Daniel Taylor-Sweet1

1University of Glasgow, Glasgow, Scotland

March, 2015

Funding: No funding was received or applied for. Conflicting Interests: None Ethical Approval: Applied for ethical approval from MedChir Ethics Committee, pending approval.

SHITSSurgos Highly Interesting Toilet

Study

An analysis of the most commonly occurring celebrity diets on Google.

CONTACT GUGPS: Facebook: Glasgow University General Practice Society/ Email: gugpsociety@gmail.com President: Mita Dhullipala

Glasgow University General Practice Society: ETHICS CASE!

Hello! Welcome to Glasgow Medical Schools latest society. GUGPS hopes to get

more of you interested and thinking about a career in general practice. We have lots of exciting events planned for next year, so watch this space for more information!

Ethics is a huge part of general practice, and those of you that choose a career as a family physician will be faced with ethical dilemmas on a regular basis. So GUGPS

have decided to team up with SURGO and get you all thinking about ethics a bit more, by giving you an ethical case to solve in every issue! Well point you in the

right direction with some questions- and in the next issue- well tell you what the best solution would be (the solution that will let you keep your job!)

The Case: Oliver Klozoff and the Foreign Liaison

Oliver Klozoff, a 27-year-old CEO consults with you, complaining of dysuria following a trip abroad for business. Both he and his wife Emma are patients of the practice.

Investigation reveals the presence of a Chlamydia infection. At your next appointment you suggest that Oliver should tell Emma about this problem, because if she is not diagnosed, treated and followed up she could suffer long term harm. Oliver refuses, saying that their marriage is already in difficulty and this would be the 'final

straw'. He also refuses to use condoms because he feels that Emma would be suspicious. When you challenge him about the threat to the health of Emma, he asks

you to take a swab from her on some pretext, and then treat any infection that you discover.

Questions-

1) Would you go along with Mr. Klozoff's suggestion?

2) What other options do you have? 3) Would the situation be any different if Emma was not your patient?

4) Would your decision be any different if the infection was Candida instead of Chlamydia?

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