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TSR Med Students' Society Part III

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Original post by Helenia
Surgical Talk told me pretty much everything I ever needed to know.


This one? http://www.amazon.co.uk/Surgical-Talk-Revision-Andrew-Goldberg/dp/1860944949/ref=sr_1_1?ie=UTF8&qid=1314136412&sr=8-1

Feel like a proper pre-fresher :tongue:
Original post by Mushi_master
Quick question - for first year clinics, is a surgical book something I should look into getting? I already have K&C, OHCM, Clinical Examination (Macleods), Medicine at a Glance and Data Interpretation for medical students as recommended by some friends, and not sure if I'll need something else to cover surgery.


I really should buy myself some of those...
Original post by Lantana
I really should buy myself some of those...


Bit of a dent in my account though! Still I like to own textbooks so I shouldn't really complain.
Original post by Helenia
Surgical Talk told me pretty much everything I ever needed to know.



I think i might have to check that out.
I own nothing surgery based.
Original post by crazylemon
I take the view that it is someone's own life let them live it how they ****ing want to. Smokers were great for the treasury too. More tax than they cost the NHS and less pension to pay. From a fiscal point of view it would be great for the chancellor if we had massive MIs on our 65th bday and croaked. Apart form him ofc.

You can't make someone be healthy. It is their choice. I don't want to live in a world with approved/non-approved foods and state sanctioned exercise for an hour a day. **** off and let people live how they want.

Forget autonomy? No thanks I will **** off elsewhere.


Autonomy is vital in medicine, but then again so is a little paternalism. How, when and how much paternalism to use depends entirely of the patient. Even today some patients really have no idea what they want, and will just take the doctors word for it.

Advertisers do not give two hoots about autonomy or informed choices, their only interest lies in how they can maximise their profits.

Therefore, while we should always strive to maintain patient autonomy, the imperative to act in our patients best interest (Beneficence) comes into conflict with this (I would say daily). This is why it is our responsibility, as the doctors to be, to provide ourselves with the best evidence based understanding of why certain lifestyle factors lead to disease and why patients should stop these.

It is only by providing an understanding to our patients that we can ever hope to make changes in their or anyone else's lifestyle.



Back to the smoking point, part of me does think that if the risks are written on the packaging, and well known in society. That if people still choose to smoke then they are accepting the risk and therefore smoking acts as a form of natural selection, which provides taxation to help to treat them when they come in with smoking related diseases, and decrease their own life expectancy which helps with pensions. Essentially this is a form of society wide eugenics.

However, that is the cynic in me. Just how many of the general public do you think actually understand the significance of the risk they are putting themselves under?

How many know how dire the statistics are for smoking?

It is all doctors responsibility via public health and via individual patient contact to inform our patients of the risk they are taking. I have seen so many doctors attempt of reinforcing patients to quit smoking, its usually something along the "you know smoking is unhealthy, are you doing anything to try to quit?" lines, which is not enough, it should be an explanation of why they should quit.

Yes the NHS is for the society and therefore we should and will always treat lifestyle related disease.
However, to even suggest that we should not try to improve our patients and our populations health just because of patient autonomy or not to try to use public health/education to prevent people from living unhealthy lives has a far greater cost than not applying autonomy all of the time (in the preference to evidence based beneficence).
Reply 5245
Avatar for buzzcat
buzzcat
Original post by crazylemon
Oh there is a point for some people where it might be better to say enough. The inevitable doesn't have to be death though. It could be reduced mobility, intense pain etc. You know being a heroin dealer doesn't make most peoples lived better.

Medicine does reduce suffering, look in primary care for any number of obvious examples of long term treatment that make peoples lives better and longer.

We may not stop people living in unhealthy ways but it isn't our place to to stop them. If they want to live a lifestyle that means they wont be collecting a pension that is up to them.


:confused:

but that's what I was getting at, when people have reached this 'inevitable' which they ultimately do, why do we continue to put them through misery? these people are living for longer, but not necessarily for better, which is my point I guess - quality of life years is the buzzword; there is quantity but we tend to neglect the quality.

my original point was that while it's great that we've boosted life expectancy by 10 years, would we not be more useful to society, have greater impact in 'quality of life years' if we practised healing in third world countries? yes it's harder to make an impact over there, but the impact is much greater and the effort is and can be reduced.

also I disagree, it is our job because we're dealing with a narrow budget to serve society rather than in private health - it is in their own, as well as society's interests, for us the prevent rather than cure. I think your belief that smokers pay more in taxes than they use is wrong, but I could be mistaken - do you have any sources?
(edited 12 years ago)
Original post by Mushi_master


Yeah, that's the one. If you're super-keen on surgery you might find it a bit basic but for anyone sane, it contains enough info to get you through finals. As with anything though, might be worth trying it from the library before buying.
Original post by Mushi_master
Quick question - for first year clinics, is a surgical book something I should look into getting? I already have K&C, OHCM, Clinical Examination (Macleods), Medicine at a Glance and Data Interpretation for medical students as recommended by some friends, and not sure if I'll need something else to cover surgery.


I used:

OCHM - best value 20 quid by a country mile.
Bates guide to history and examination - bit american, library, has pictures of the pathology and exam stuff, quite good I thought.
For pathology, Robbins and Cotran, pathologic basis of disease - far better than KC, although admittedly thinner on tx, but definately enough to get you through 3rd year.
I did dip into KC, library job, not a fan though I have to say, it just dosn't click with me. I went for Lecture notes in clinical medicine - Rubenstein, I used 6E, bit dated, but absolutly fine for basics and very well written, no fluff no *******s just what you need to know - although again, some of the stuff not for 3rd year (You'd be forgiven I think for not knowing about AIP...Incidentally, Erlichs reagent, wood's lamp and Dextrose, and if they're fitting, that's really bad)
Surgery - Surgical talk is good, I did end up buying a copy again, around 30 quid, the other one I liked was lecture notes in surgery -written by the legendary Ellis - bit more detail I thought, but actually a really easy read.
(edited 12 years ago)
Thing is, by the time patients present, a fair bit of damage has already been done, some of it reversible, others not. The point is not be treat everything, just to treat reasonably reversible causes - the 90YO in CHF with CRF and end stage COPD is probably close to the ranks of death and rigorous treatment probably wouldn't give much benefit medically - but it might buy time for family, patients often want that - by the time people are really ill, they often know they're not far from death. Patients are real people, they are not theoretical cases in a seminar where we talk about what might happen - it is happening. Sometimes I think doctors have too much power - alot of treatment is at the discretion of doctors, you only nee to sit in a clinic to see that, and when you ask why not such and such a thing, sometimes it is clear cut, and othertimes not so - it is worth thinking about when we make decisions, these decisions affect real people. A large part of medicine is, and has always been trying to make people die in the right order - roughly speaking so fathers bury sons, we cannot treat all causes, and there are not the resources to do it. If you treat patients for their sake, rather than our own, then yes, there comes a point where treatment, even through possibly medically efficacious, have become futile and unwanted for that patient.
Original post by FFCrusader
And spending it not texting me :hmpf:

:p:

I've been stalking doctors at the local A&E :awesome:


:jumphug:

I will share the love when I next see you. :sexface:

EDIT: Stalking who? Doing what? :ninja:

Original post by carcinoma
I remember you saying something about Medical Sciences at some point a while back. (the book)

What do you think of it in comparison to Tortora for physiology, as i'm considering buying it.


Tortora was decent IMO for first year. Not detailed enough for second year - alongside wiki and my lecture notes, Medical Sciences was pretty much my core book for year 2. It worked well with our lectures and pbls in that a pbl or a lecture would be summed up in a few pages in that book. Jobe done really.

Original post by Dr. Hannibal Lecter
I agree :sad:

You're doing med-ed next year right?


Yeah! Je suis tres excited! :p:

It sounds really cool though - and of course I get another year to grow up on the Whitechapel Campus before this crap gets real later! :afraid:
(edited 12 years ago)
Just a subtle warning:

You guys will get bombarded by me this time next year with book suggestions - all the stuff in my siblings rooms are probably a bit too outdated to be using for firm rotations.

:p:
Original post by Helenia
Yeah, that's the one. If you're super-keen on surgery you might find it a bit basic but for anyone sane, it contains enough info to get you through finals. As with anything though, might be worth trying it from the library before buying.


Original post by Wangers
I used:

OCHM - best value 20 quid by a country mile.
Bates guide to history and examination - bit american, library, has pictures of the pathology and exam stuff, quite good I thought.
For pathology, Robbins and Cotran, pathologic basis of disease - far better than KC, although admittedly thinner on tx, but definately enough to get you through 3rd year.
I did dip into KC, library job, not a fan though I have to say, it just dosn't click with me. I went for Lecture notes in clinical medicine - Rubenstein, I used 6E, bit dated, but absolutly fine for basics and very well written, no fluff no *******s just what you need to know - although again, some of the stuff not for 3rd year (You'd be forgiven I think for not knowing about AIP...Incidentally, Erlichs reagent, wood's lamp and Dextrose, and if they're fitting, that's really bad)
Surgery - Surgical talk is good, I did end up buying a copy again, around 30 quid, the other one I liked was lecture notes in surgery -written by the legendary Ellis - bit more detail I thought, but actually a really easy read.


Cheers for the advice guys! I really don't think I'm a born surgeon, so that book could well suffice for me. Although it is tempting to pick up Ellis' one, that guy owned the dissection room.
Books wise: OHCM, Macloed's Clinical Examinations, Kumar & Clarke and Merck manual online (www.merck.com/mmpe)

Didn't need anything else really

(For first clinical year that is!)
(edited 12 years ago)
It is so wrong that it still excites me, when I see a "Welcome Back" lecture or an Induction session. :biggrin:
Original post by carcinoma
It is so wrong that it still excites me, when I see a "Welcome Back" lecture or an Induction session. :biggrin:


the prospect of a 3 week induction period is making me want to cry tears of blood.
Original post by buzzcat


my original point was that while it's great that we've boosted life expectancy by 10 years, would we not be more useful to society, have greater impact in 'quality of life years' if we practised healing in third world countries? yes it's harder to make an impact over there, but the impact is much greater and the effort is and can be reduced.


Strong utilitarianism is strong!

Original post by crazylemon
I have no problem with prevention. It is forcing people to make choice.

That's where you and prof differ. Prof argues that we need some tough love from Whitehall to save us from ourselves - but imo a fat tax or some such is a very reductionist take on the issue.

Personally, I agree that autonomy must be respected, but that some heavier form of paternalism wouldn't go amiss (oxymoron?!)

The tobacco issue is an interesting one. I'd prefer a tobacco-free but inherently poorer society to one fuelled by tobacco tax billions (call me a romantic :tongue: ). I appreciate you could extrapolate that ad infinitum though (alcohol, anyone?)
Original post by carcinoma
It is so wrong that it still excites me, when I see a "Welcome Back" lecture or an Induction session. :biggrin:



Its my very last ever. I cannot wait till graduate whilst being a tiny big bit scared!!
I got an Induction timetable emailed to me today, from the uni I rejected for iBSc... This is after they kept badgering me about accom and transcripts and I told them I wasn't going :rofl: Might turn up and see if it's better than the iBSc I accepted.
Original post by Medicine Man
:jumphug:

I will share the love when I next see you. :sexface:

EDIT: Stalking who? Doing what? :ninja:


I'm sure you will :p: If not, you'll have to suffer the consequences

Just some random F2s that just started there :awesome: It's quite nice seeing medicine from their point of view :h: It's by far better than preclinical shizzle with little perspective of stuff in real life
I've seen my timetable for the first day and we have 3 hours rota'd in the middle of the day to take the freshers to the pub. :awesome:

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