Sharp Scratch

At medical school, we learn about the importance of healthy health behaviours and promote them to patients at consultations. But do you always do what you preach? In this episode, we chatted about the importance of self-care, admitting to the inability to be infallible, and whether your health habits would affect the way you counsel your patients. Expert guest: Professor Erica Frank (erica.frank@ubc.ca) is a Professor at the Faculty of Medicine at the University of British Columbia; she is also the Founder of NextGenU.org. Articles mentioned in the episode: • Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study - https://www.bmj.com/content/337/bmj.a2155 • Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey - https://www.bmj.com/content/333/7570/682 Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

“Do no harm” is a mantra that is drummed into medical students from day 1 of medical school. Most of us have gone into medicine as we believe medicine to be a force of good. However, too much medicine is capable of causing harm to patients and generating unnecessary waste. In this episode, we spoke about overdiagnosis, communicating risks and benefits with patients, and why you shouldn't take that free lunch sponsored by drug companies. Recommended reading: •Preventing overdiagnosis: how to stop harming the healthy. Link: https://www.bmj.com/content/344/bmj.e3502 •Who pays for the pizza? Redefining the relationships between doctors and drug companies. 1: Entanglement. Link: https://www.bmj.com/content/326/7400/1189 Expert guest: Dr Martin Brunet (@docmartin68 on Twitter) is a GP and a GP trainer at Guildford. He is also the author of The GP Consultation Reimagined: A Tale of Two Houses. Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

Along with the general public, medical students are feeling the cost-of-living crunch. How are medical students faring with the increasing cost of living? In this episode, medical students from outside of the studio send in their perspectives on how they are making ends meet, balancing medical school and part-time work and navigating the student funding system. Thank you to Michaela Vernon, Elle Gordon, Alex Twist, Trisha Suji, Ruth Carter and Eilidh Garrett who contributed to this episode. Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

If you see something that doesn’t look right when going on placement, do you feel comfortable raising a concern? In this episode, we discuss the topic of raising concerns and the considerations that med students and junior doctors may have when it comes to speaking up. Expert guest: Dr Natasha Malik (@1natasha_malik on Twitter) is a portfolio GP who works with Health Education England, UCL medical school and Imperial medical school. Top tip: “In moments of uncertainty, the first thing to do is to find those pillars of support and talk to people about it, because that increases confidence. It also allows you to find out information about where to go next.” Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

As medical students progress through medical school, some students are becoming dissatisfied by the lack of attention to socially relevant healthcare issues in the conventional curriculum, and begin to understand that some of the frustrations we encounter at work arise from political decisions. These issues have prompted medical students to voice their concerns and advocate for change. In this episode, we will be talking about activism, how to get involved and what you can do to push for change. Topics: • What makes an activist? • There is a role for everyone in activism • Things to bear in mind when considering civil disobedience Expert guest: Dr Rita Issa (@DrRitaIssa on Twitter) is a GP, public health academic, and activist. The groups that she’s helped (co)founded or worked with include Doctors for Extinction Rebellion, Docs Not Cops and Medact. Shout out to the following student-activists: Mikaela Loach (@mikaelaloach on Twitter) Rhiannon Osborne (@rhiannon_osborn on Twitter) Amit Singh (@amit_ankhi on Twitter) Marina Politis (@marinadpol on Twitter) Interested in getting involved? Here are some organisations that you can check out: Health for Green New Deal - https://www.medact.org/project/health-for-a-green-new-deal/ Student for Global Health - https://studentsforglobalhealth.org/ Doctors for Extinction Rebellion - https://www.doctorsforxr.com/ Docs not Cops http://www.docsnotcops.co.uk/ Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

As healthcare professionals, we meet people from all walks of life and collect stories along the way — stories of illness and convalescence. When we hear interesting stories, there can be an urge to share them. When something bad happens, you may want to talk and offload it onto your friends and family. As we know, patient confidentiality is a core value in medicine. So what is permissible to share? Is there a way to share these stories while respecting the ethical boundaries? In this episode, the Sharp Scratch team explores the ethical considerations involved in talking and writing about patients, and discusses the popular literature genre of medical memoirs. Expert guest: Dr Matt Phillips is a sexual health consultant and a honorary clinical professor in genitourinary medicine and ethics at the University of Central Lancashire. Recommended reading: The ethics of medical memoirs. Link: https://www.bmj.com/content/367/bmj.l6270 Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

Medical students are taught about and examined a lot on clinical guidelines. What is best for patients overall, as recommended in guidelines, may not be appropriate for individuals. Blanket recommendations, rather than a menu of options or recommendations for shared decision making, ignore patients' preferences. So what do guidelines mean in practice? When do we deviate from them when your clinical acumen is telling you that guidelines may not be the best fit? Expert guest: Dr Liam Loftus is a GP trainee and a National Medical Director’s Clinical Fellow who has worked with the Personalised Care Institute. Recommended reading: How can tomorrow’s doctors be more caring? A phenomenological investigation. Link: onlinelibrary.wiley.com/doi/10.1111/medu.13684 Potential benefits, limitations, and harms of clinical guidelines. Link: www.bmj.com/content/318/7182/527 Check us out on social media: Twitter: twitter.com/BMJStudent Instagram: www.instagram.com/bmj_student/ Facebook: www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

There is often a debate about whether medicine is an art or a science. Our medical curriculum tends to favour the science bit, with pathophysiology of diseases and treatment algorithms dominating our learning agenda. Social determinants of health also have equal importance in influencing one’s health, but are we taught enough to address this? Timestamps: 0:00 - 3:15 Intro 3:16 - 7:19 How much do you get taught about social determinants of health at medical school 7:20 - 12:00 Do we apply what we learn in medical training about social determinants on health in actual clinical practice? 12:01 - 14:29 There is no easy one-size-fits-all managing social determinants of health 14:30 - 18:53 How do you adapt management plans according to the patient’s circumstances? 18:54 - 21:15 A medical student who has experienced homelessness before shares her insight 21:16 - 24:26 Importance of diversifying the demographic of medical students 24:27 - 28:10 The importance of empathy, compassion and being non-judgemental 29:20 - 34:20 Doctors make up the system that patients have to go through, and we can make the experience pleasant for patients 34:21 - 35:18 Vote for Lily as the next prime minister! 35:19 - 36:44 What medical students can do to address social determinants of health outside of medical capacity 36:45- 39:47 What you can do to learn more about social determinants of health in and outside of medical school 39:48 - 43:38 Final remarks Expert guest: Dr Andrew Moscrop (@andrewmoscrop on Twitter) is a GP working in a health centre for people who are homeless in Oxford and a researcher in social determinants of health. Thank you to Maz Sadler who contributed to this episode. Recommended reading: If social determinants of health are so important, shouldn’t we ask patients about them? https://www.bmj.com/content/371/bmj.m4150 *We’re looking for new panel members!* Are you a: ✅ Medical student ✅ Listener of Sharp Scratch ✅ Keen on representing the voice of medical students? In the past, the panel only consisted of medical students studying in the UK. However, remote recording meant that we can extend this opportunity to medical students in other countries. If you’re interested, please apply via the link below. We look forward to hearing from you! Apply here: https://forms.gle/QocryfkG137cWTb88 Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

Empathy is one of the essential qualities of a good doctor. One way this is assessed at medical school is the use of objective structured clinical examination (OSCE) stations. The use of OSCEs in medical schools is controversial - it can be used to simulate clinical examination and test students’ ability to express empathy while some perceive OSCEs as an artificial and narrow understanding of clinical medicine. Topics: • How do medical students’ experiences of empathy change during their medical education? • What factors do medical students describe as influencing their empathy during medical school? • Should and can empathy be assessed? • Importance of empathy in the patient-doctor relationship Expert guest: Dr David Jeffrey is a retired palliative doctor and former academic mentor at Dundee medical school involved in student support. He also did a PhD exploring empathy in medical students. Recommended reading: • I never asked to be ICE’d - https://www.bmj.com/content/354/bmj.i3729 • Communication skills and the problem with fake patients - https://www.bmj.com/content/357/sbmj.j974?sso= *We’re looking for new panel members!* Are you a: ✅ Medical student ✅ Listener of Sharp Scratch ✅ Keen on representing the voice of medical students? In the past, the panel only consisted of medical students studying in the UK. However, remote recording meant that we can extend this opportunity to medical students in other countries. If you’re interested, please apply via the link below. We look forward to hearing from you! Apply here: https://forms.gle/QocryfkG137cWTb88 Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.

When going on placement, you are probably more interested in gaining experience in the clinical environment and less interested in how frequently doctors can take breaks. Doctors’ working conditions may seem irrelevant as a medical student but they are closely associated with work satisfaction and wellbeing. In this episode, the Sharp Scratch panel discussed doctors’ working conditions and how it impacts our day-to-day work. Expert guest: Dr Kevin Teoh (@kevinteohrh on Twitter) is a Chartered Psychologist and the Executive Officer for the European Academy of Occupational Health Psychology. Thank you to Dr Saliha Mahmood Ahmed (@salihacooks on Twitter) and Neely Mozawala (@NeelyMozawala on Twitter) who contributed to this episode. *We’re looking for new panel members!* Are you a: ✅ Medical student ✅ Listener of Sharp Scratch ✅ Keen on representing the voice of medical students? In the past, the panel only consisted of medical students studying in the UK. However, remote recording means that we can extend this opportunity to medical students in other countries. If you’re interested, please apply via the link below. We look forward to hearing from you! Apply here: https://forms.gle/QocryfkG137cWTb88 Check us out on social media: Twitter: https://twitter.com/BMJStudent Instagram: https://www.instagram.com/bmj_student/ Facebook: https://www.facebook.com/BMJStudent/ This podcast is produced and edited by Dom Byrne and Duncan Jarvies.