Sunday 26th September

Pregnant women recreating Charles Ebbet's iconic photo 'New York Construction Workers Lunching on a Crossbeam'. The aim of the photo was help highlight the high rates of mortality amongst pregnant women who die every year in developing countries.

The topic which everyone is talking about at the moment amongst the 5th year medical students is that of job applications and securing a place on the UK Foundation Programme after graduation. According to early estimates it seems as if this year there is going to be a shortfall in places for the first time. The result of telling applicants this information is that people seem to be very anxious all of a sudden about what was previously considered a given, that on graduating from medicine all doctors would have a job. There have been angry letters from concerned students, reassurances from the professional bodies such as the BMA and lots of conversations had about this years applications process.

The application form is relatively simple, students apply to a foundation school eg ‘Scotland’, and then jobs within the region to which they apply. The application forms are scored out of 100, based on a combination of academic competencies and ‘essay-based questions’. These questions make up half of the application and answering the questions well is extremely important. I’m pretty sure though that given enough time and enough thought, it should be possible to score well on these questions.

Although the prospect of having unemployed doctors at the end of their medical training seems like a total waste of talent and money, the situation is the same for many UK university graduates at the current time and relatively, medical students are still lucky in the sense that most graduates from medicine will still have jobs in 2011. Primary school teachers have to put of with competition ratios in the region of 17 applicants per job and people are having to leave the UK to find work. It will be interesting come November this year to find out the exact number of applicants and whether or not there will be a shortfall in job numbers, but until then all I can do is take as much time and care as possible to fill in the application form and score highly on the essay based questions.

A Taste of Socialism in Cuba

I don't think I quite knew what I was getting myself in for by travelling to Cuba. I had an idea in my mind about what to expect. A spanish speaking country steeped in fascinating history and culture, distinctly different from the many of the countries around it. In truth, visiting Cuba is like going back in time about 50 years. It is quite refreshing that there is such a lack of Western culture and influence in the country. The streets are still crawling with classic US cars, many of the buildings have a distinct resemblance to how I would imagine the former soviet union to have looked like and the country is filled with tributes to the men who have helped develop Cuba into the country that it is today. In fact, the likes of Fidel Castro and Che Guevara are seemingly worshipped as Gods.

Cuba is still listed by the UK Foreign Office as a country of 'concern'. There are remain hundreds of political prisoners in Cuba and it is still possible to be thrown behind bars for opposing the communist regime. International human rights organisations such as Amnesty International are not permitted access to Cuba. And yet it seems such a contradiction that Cuba has one of the best medical health care systems in the world. Statistically there are more doctors in Cuba than there are in the whole of Africa. Cuban actually exports doctors in exchange for food and economic benefits from neighbouring countries such as Venezuela, the oil rich country with which is Cuba's largest trading partner.

I was surprised when I visited Cuba by the level to which the country is shut off from the western world. I witnessed thousands of students arrange at the University of Havana to hear Fidel Castro make his first public speech in 4 years, the majority of content of which was a lecture on the 'evil' powers America and the fact that the Amercians are putting the world on the brink of a nuclear war. My experiences in Cuba have given me an insight into just how fortunate we are in the UK to have access to information and freedom of speech. The personal impact of having my bag stolen from my hotel room on my first day of arriving of course left a bad taste for the rest of the trip, but in a way it further opened my eyes to what it's like to have things taken away from you, much like the population of Cuba have had things denied from them from most of their lives.

Spice Mas Carnival 2K10

It's the Wednesday after Carnival today so things are getting back to normal after the 48 hour street-party. Thought I'd share a couple of photos from the event. 2 are from the Soca Monarch Finals at the national cricket stadium on the Friday night last week and one is of some of the parade, passing the judges (on the balcony) on the Tuesday afternoon. I didn't have my camera for much of the event but Gordon B's got alot more photos to come.... I'm pretty sure that nearly everyone in Grenada turned out in St Georges over the past couple of days and we were there for pretty much the whole event (not much time for sleeping!). The main road routes through the capital are closed off for the whole event and the streets just become rammed with people following trucks blasting soca music as loud as you can imagine for 2 days straight, it's kinda hard to describe. Monday and Tuesday were both public holidays so no time for the hospital! I was expecting the wards to be swamped today after Carnival but actually things were relatively calm! The highlight of the carnival had to be getting up at 4AM and heading into St. Georges for J'Ouvert (the official start of Carnival on the Monday monring) with just some cash and old clothes, then getting covered in red paint and drinking rum till mid-day! Gordon B and I are now down to our last week in Grenada (can't believe it's gone so fast) so we're hoping to make the most of the last week on d'island!

Carriacou and Mid-Way Point

As far as the elective goes, this is the start of my 4th week so I'm half way through and it's flying by. Monday was a public holiday so had the day off. To make the most of it, a group of us went to Carriacou (Granada's little known sister island) in the Grenadines. It happened to be the weekend of the annual sailing regatta on the island so there was lots going on and a real buzz around the small island. We stayed in a great guest house called the green roof inn. The 1st photo is of sandy island where we spent a full afternoon on the saturday and the picture of us getting on the boat is actually the 'water-taxi' which took us from the mainland beach to Sandy Island. We only spent one night in Carriacou because Gordon and I were keen to get back to Grenada for more wreck diving on the Monday. We dove on the ship 'Bianca C', also known as 'The Titanic of the Caribbean' because she sunk on her maiden voyage. Whilst anchored in St. Georges, the capital of Grenada in 1961, an explosion in the boiler room caused her to catch fire. Everyone managed to get off safely and she was towed out to where she's currently resting in about 50 meters of water.

Back to the elective I've reached the mid-way point so starting to feel pretty familiar with the daily routines here and the way things work on the female and medical wards. I've got some company too now, a couple of elective students from Southampton have arrived (Jamie and Anthony) who are on the wards as well. I've started collecting data for an audit project I'm going to do on antibiotic prescribing and am looking for a couple of interesting cases to write up for my elective report. I want to write about sickle cell anaemia for one case because the disease is so prevalent here and the history that the first ever documented case of the condition was recorded here on this island. Also there's a large number of cases of Dengue Fever, otherwise known as 'Break-Bone' Fever on the wards at the moment which could be worth writing about.

If you're reading this I hope you're well and enjoying the summer. Please feel free to leave any comments below good or bad ones!!

Welcome to Grenada

This is the start of my 3rd week in Grenada and the fact that I am only now getting a chance to write something is probably good testament to how busy I've been! The first 2 weeks were obviously alot of fun and luxurious, staying in the Coyaba Hotel right on Grand Anse Beach. It was sad seeing Amy and her Mum and Dad leave last Thursday but sort of marked the beginning of the next part of the elective. Once they had left, I moved into the apartment in Mont Tout, about 10 minutes walk up the hill, away from the beach. The photos here are the view from my apartment, and me outside Grenada General Hospital on the first day of the placement.

The hospital itself is a fascinating place. The staff and patients have all been very friendly although it is very evident that the healthcare set up here is way behind what we have at home in the NHS. I'm still finding it hard to get used to the idea that for many test, scans and procedures, patient's have to pay or leave the island to travel to Barbados, Trinidad or even the US. The basics are availiable free to the non paying patient but they really are basic tests eg. chest X-rays, simple blood tests. The lack of availiability of these things means that there is a much heavier reliance on clinical skills in diagnosing patients so it's been a good test of those skills. I've been based on the male and female general medical wards since I've arrived which are probably the 2 busiest wards in the hospital (there are approx 10 wards in total). In particular the junior doctors or 'interns' as they're called here have been very welcoming although it seems that in general the expectations of us as elective students are quite low. This is good in a way because they seem impressed any time you help out with small things such as taking blood samples, putting in intra-venous lines, reviewing patients, writing in the notes and running blood samples up the laboratory.

A typical day involves starting around about 8AM reviewing patients (how they have been overnight, any new symptoms etc) before the consulant round which starts at about 9, half 9ish and lasts 1-3 hours where all patients under the consultant's care are discussed, test results reported and managment plans drawn up. It's useful because Dr Noel (my supervisor) keeps the students on their toes by asking us questions eg. 'So Gordon, what do you think is wrong with this patient....' Err.... After the ward round there are normally lots of jobs to do on the ward and I keep busy with them and we normally finish up around time for a late lunch.

In general I'd say the first two weeks have been great, probably better than I expected. Gordon B seems to be enjoying it too which I'm pleased about. Part of what's made it so good is also the other elective students we've met, at any one time there are about 6 or us and so far we've had folk from Newcastle, Leeds, Glasgow and Southampton as well as us from Dundee. Hope everyone reading this is well and I'll try and put up some more posts from my elective here in due course...

Taking a Break...

<--- The beach in Barbados. (elective countdown - 5 weeks to go!)





Going to take a break from the blog for a month or so to concentrate on revision for finals, thanks for reading though!