The female of the species is more delayed than the male.

The future of medicine and women... Interesting publication that states “there is no evidence that female NHS doctors have been directly disadvantaged in their career progression, or that having children negatively affects the career progression of women who have always worked full time.”(1) show that more men (16%) than women (6%) who had worked full time were in surgery. The percentage of women who worked part time who were in surgery was at a shockingly dismal 2%. (oh dear) with the corresponding association between not doing surgery related to being female and working part-time. The median time for attaining consultancy was 11.7 years for men, 11.3 for women who had always trained full time and 12.3 years for all women.

So I suppose all these statistics tell us nothing we couldn’t already surmise: female doctors, who make up an increasing proportion of NHS doctors and make up the majority of medical students in UK medical schools, would take longer to attain consultancy (and would work about ¾ of the workload of their male colleagues, other studies quote). But if women worked the same amount as men, they tend to achieve consultancy faster.

Some more interesting stat facts:

• 12% of British medical graduates are no longer working under the NHS after 2 years of qualification.
  
• Approximately 50% of international medical graduates eventually leave the NHS. (2)
• in 2007, only 7% of accepted surgical consultants and 27% of surgical ST1's were female (3)
  

In conclusion, I would have a 50% likelihood of remaining in the UK after my 20^th year of qualification and I would have a 98% chance of not doing surgery. HMMMMMMMM……

(1)Raylor KS, Lambert TW, Goldacre MJ. Career progression and destinations, comparing men and women in the NHS: postal questionnaire surveys. BMJ 2009; 338:b1735.

(2) Michael J Goldacre, Jean M Davidson, Trevor W Lambert. Retention in the British National Health Service of medical graduates trained in Britain: cohort studies. BMJ 2009; 337:b1977

(3) Elston MA.Women and medicine: the future. London: Royal College of Physicians. 2009.

hospidelicio

"...It actually follows the familiar pattern of 21^st-century life: long periods of boredom interspersed with the occasional thrill."

hmmm...

voiceless

I have gotten my voice back, although not in the literal sense as my laryngitis-induced-voice-loss is still going strong for the 5th day running...
but anyhow, reiterate. I have my voice back. The personality-erosive effects of medical finals is slowly being reversed.

"The unreflective life is a life not worth living." Without offending any non-reflective people (or dull surfaces), I find this saying so close to the truth. And it is so often that God calls upon us to reflect, to think, to ponder, to dwell on our lives, our behaviour, ourselves, to question our actions, behaviours and thoughts and to keep them in check. If to even think evil is a sin, we have much thought-cleansing to do. How did I come to that? I don't know. My pressure of speech is starting to take rein again. Perhaps it is easier on my friends that my voice is gone at the moment..... Break them into me gently, I say...

Anyhoo, also read something very lovely which would be nice to throw into the thought-pool:

"My sole passion is thy love,
In earth beneath or heaven above,
I have no other store.
And though with fervent suite I pray
And importune thee day by day,
I ask Thee nothing more."

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _


Meanwhile, as usual, my annual / biannual pilgrimage to the motherland has brought me back with more updates from friends, family and others. It is quite comforting to know that despite the differences in location, cultures, and appearances, we are all of the same species, living out our jobs, living out our relationships, living out our religions and practising our beliefs, feeling similar sentiments, having identical needs and desires, in true Maslow-like fashion. A comforting reassurance of our existence as humans. (it never fails to provoke me that Maslow put 'sex' as a physiological need and 'sexual intimacy' as a need for belonging/love...) A reassurance... I suppose the dehumanisation and personality erosion was needing a good kick up the backside.
Anyhow, I ramble too much...

the jelly express

Royal jelly. hmmm. All female bees result from genetically identical larvae, but only those that feed on royal jelly become fertile and end up queen bees.

I wonder if humans had the equivalent elixir or 'royal jelly'. arguably, i do understand how some people might be prone to believe how some prescribed medications taken without a prescription may aid intelligence and performance. Surveys have shown that a significant fraction of students from top universities such as Oxford and Cambridge use drugs such as Ritalin and Modafinil to aid attention and concentration.
Well, i can't decide what my opinion on the matter is. Coffee / caffeine pills / red bull / paracetamol, etc etc have been manipulated and similarly partaken in order to improve study and prolong waking hours. Arguably, with newer drugs, the long term side effects are dubious. Furthermore, academic performance becomes something less meritocratic and more based on 'who's got the most money/ friends with connections'.

But then, having just emerged from the protracted blurry haze that is studying for medical finals, i have just experienced the constant upward struggle that most students nowadays have to contend with: getting connections to get hold of the most number of past papers, knowing people who know doctors who set the exam, spending money to buy the latest Littman stethoscope, paying for medical courses, etc etc... especially promoted by the fact that more than 50% of our paper were recycled questions...

Anyhow, before i further maul my foot further by this continuous stabbing, i suppose most of life is based on such an unfair selection. Nepotism in the workplace, in the selection of political leaders, etc etc... But educational institutions should not be the place where such unfair play takes place and where such behaviour should be clamped down upon. Just as there should be 'markets with morals' (ohhh-ohhh, spot the Gordon fan!!), educational institutes with mottos such as 'The way, the truth, the life' (Glasgow) and Dominus Illuminatio Mea (
"The Lord is my Light") (Oxford) should more so be institutes where such unfairness is discouraged.

work moderately, play moderately.

keeping it real, but at the same time without being heavy-handed. oh the obtrusiveness of these other-classes.... the sign of these times that we are in, despite trying to conglomerate the two, we whizzed past the shop of east meets east. but then when and where do we fall? in between the trenches? the trenches or would they be deemed as the middle-ground. the... permissive hybrids?

but who is that with the quizzical brow and the golden locks? would there be a more archetypal prototype, despite the political-correctness of the audience, we balked in a totally scottish manner and poured foolishness over our reputations. the minutes lasted for hours but all in good stead.


meanwhile, this is london :

also, cherries are the best fruits... the iniquity of english cooks has been replaced by the ingenuity of the mixing pot that is londonium. thank goodness for the French, Italians and Japanese...

you will love england.

so today was the assessment day for the end of my first medicine block...

i was told that i was definitely in the top 80th centile of medical students that my consultant has seen. This is more than twice times i've been told this by at least two different consultants... So maybe i am that good....... he said that i retain information very well, have great clinical judgement and have a fantastic memory. (except for most things non-medical, i'm sure he didn't notice..)

but he also said it would be really easy to just pass me right by and neglect me for my capabilities because i never really express them across. but it's not that i'm not confident, i'm just humble! humility is to admired too, isn't it, isn't it????? on the otherhand, if you don't blow your own trumpet, noone else will blow it for you. point taken, dr S. carol shall now be shoving her intelligence down all your throats, whether you can accept it or not.. awright, big bad medcine world, be prepared for my mind.

and then my previous consultant said i was quiet! QUIET?? me, quiet?? i'm never quiet! i dislike quiet people! i'm not shyyy!! i was just too busy to make friends! (as i usually am...)

right. so basically, i need to express my knowledge more and make a better effort to build rapport with colleagues.. i suppose my humility will not fail me now.

MEDness: am to pm...

i'm back in HOSPITALSSS! WOOOOOHOOOOOOPPEEEE DOOOOOOO my lifeee is backkk to normal again!!

aye, although 5 weeks of the GP chat and black coffee on tap was fun while it lasted, i definitely think hospitals are my true love... ohh yeahhh.. now if only they had proper caffetieres in wards as opposed to rubbish maxwell / nescafe coffee grounds. eeewwwuuuckkk...

so yes... life is gettin back on track for little ol carrol.. :)

meanwhile.. party photos....sleeveface at jim's.

optimo - still the best night in glasgow

meanwhile, carol is thinking she needs to think less and do more...

Pleural effusiveness

So after a mere 3.5 weeks of being back in Singapore and 2 weeks into my medical attachment here in the motherland, carol has learned about malignancy and seen most of its sinister toils on the human body. It has been a rather sobering experience, partially attributed to being exposed to the wishy-washy, equivocate way of medicine after 15 weeks of glorious, clean-cut, well-defined Surgery. Perhaps also attributed to the fact that the heat is penetrating my thinking and my thoughts and my efficiency in answering consultants.. ack.. if in denial, always blame the weather, i say.

On that note, i am totally missing the gloomy architecture of the Victorian British hospitals, as well as the refined assortment of consultants who work within! Of note is a certain anaesthesiologist at the Vic and a certain rheumatologist at the Royal. (nae, these not be carol-crushes or clandestine relations.. these are just inspirational physicians who have left a memory, so don't be spreading no rumours now...) but yeah.. it's something about being back in an Asian, semi-didactic teaching system enforcing learning by the whip rather than the carrot that takes the joy out of medicine for me... or maybe i'm just a bit biased against singlish. Come on, what on earth is an "AB-DOE-men"?

Anyhooo, on a plus point, auscultating my father's chest for heart sounds was rather reassuring! Ha! S1 + S2. No added sounds, no murmurs. no AR and MS murmurs detected. No basal creps. Regular, sinus rhythm.... mmm.

lyrics

so carol sat up and erected in her mind, the barricades of defense against the world that isn't crosshouse hospital, kilmarnock.

the last crosshouse scone i'll eat in a while :(

_ _ _ _ _ _ _ _ _ _ _ _

and she mourned the loss of a friend who didn't pull back her hair when she was throwing up, who didn't lament over period pains and first boyfriends, who didn't bake cakes together with her, who didn't get to meet and share in her future life, but who would have... if only time had not been robbed from us.

in a daze

we will not be trees

thisss news makes a girl like carol veryyyyy happppeeeeeeee!!!! :)))))))))

Arthritis drug gets NHS approval

well, so i leave for glasgow tonight. this whole trip back's been a bit of a madness.... there is a chinese belief that when a chinese family on a voyage eats fish, they aren't allowed to flip the fish for fear of ill luck on the voyage.... no one can choose what happens to them in life.. but it's how you deal with such circumstances that matters.

fall in the boat....

and everytime i come back, it's always another burst in the sky of fireworks, of love, of mirth, of the kinship of the friends who grew up in the same microenvironments, the same environments, the same singapore. and then we part...

and then it's the same you get everywhere - the same difference. the same souls looking for the same sense of belonging.

the mind's fruits

"There are always guys who hold on to the nostalgia of old devices that can't be bought with money." - Batou (SAC)

With the present state of things there is a certain push towards my recently-unvisited love with psychoanalysis and neurology. Memories and the effects they have with their related structures - the hippocampus : one of the oldest, also the most susceptible to ischaemic insult. Perhaps there is a reason why we are not meant to hold on to the past. Maybe its absence protects us? Maybe the past impedes our future, impedes our progress.

All of Christian life is an upward progression... Saying 'no' to the things of our old days, our old ways... for we are never born with the fruit of the Spirit. But we possess these things in increasing order.

The human brain is supplemented in areas in which are practised, pertinent and relevant to our daily living. So why dwell in and develop habits of the past when we are called forward?

_ _ _ _ _ _

We already possess the power...

of mice and men

scene : byres road, circa 5pm...
enter jonny and naomi round the corner of morton's...

jonny: "hello, carol! we just bought rats! "

me: "i just bought brown boots! *shows them my bag* this is my 5th pair of brown boots and i was like, 'when am i ever gonna stop buying brown boots? and i'm like, never!'... why'd u buy rats?"

naomi: "it's for rachel farr. "

(jonny gets a phone call.)

me: "oh yea, it's her birthday. *looks at the cage* where are the rats? "

naomi : "in the little box. i don't think it's a good idea, personally. "

me: "oh no! it's quite a craze nowadays! my friend got two rats, then beth's flat got rats and now here! "

naomi:" beth's got rats? "

me:" yeah! "

naomi: "so if rachel isn't up for the rats, we could give it to beth? "

me: "yeah! ohh, plenty of my friends would love rats! "

(jonny puts down the phone at this point.)

jonny: "mice, carol, *shoots evil look at me* not rats. "

me: "well, lots of my friends would love mice slash rats. or or OR.... if noone wants it them, u can give them to MEEE and i'll dissect out their bone marrow and get their dendritic cells.. *makes continuous crushing motion with hand* and test them of course! "

jonny shoots me a dirty glance and walks off.

laughter is the best medicine

Abstract
Introduction
Methods
Results
Discussion
References

it's good to hear our NHS spending is going into the quintessential issues of life...

Research BMJ 2006;333:1291-1293 (23 December)

Phenotypic differences between male physicians, surgeons, and film stars: comparative study

male surgeon. male physician. actor playing a doctor(control).

Objectives To test the hypothesis that, on average, male surgeons are taller and better looking than male physicians, and to compare both sets of doctors with film stars who play doctors on screen.

Design Comparative study.

Setting Typical university hospital in Spain, located in Barcelona and not in a sleepy backwater.

Participants Random sample of 12 surgeons and 12 physicians plus 4 external controls (film stars who play doctors), matched by age (50s) and sex (all male).

Interventions An independent committee (all female) evaluated the "good looking score" (range 1-7).

Results Surgeons were significantly taller than physicians (mean height 179.4 v 172.6 cm; P=0.01). Controls had significantly higher good looking scores than surgeons (mean score 5.96 v 4.39; difference between means 1.57, 95% confidence interval 0.69 to 2.45; P=0.013) and physicians (5.96 v 3.65; 2.31, 1.58 to 3.04; P=0.003). Surgeons had significantly higher good looking scores than physicians (4.39 v 3.65; 0.74; 0.25 to 1.23; P=0.010).

Conclusions Male surgeons are taller and better looking than physicians, but film stars who play doctors on screen are better looking than both these groups of doctors. Whether these phenotypic differences are genetic or environmental is unclear."


read full trial here

enter the playas.

so @#$%!@#$^@#$&#$% STRESSSEEEDDDD from doing stupid ELISAs and reading a friggin average of 10 journals a week for immunology seminars. and fecking stats exam on tuesday and bloody answer for stupid journal club to the question proposed by the cancer-module-coordinator, prof. macMURDERER : 'what other proto-oncogenes are upregulated by inflammation?' damnnnn u intercalated Bsc degree... *evil look* i curse u with a bolus of tPA to dissolve your clots and make u die in a pool of your blood coming out of your every orifice..

and hence i have sent my dear richard to fetch me a solution of diazepam from the cardiac department at the royal.. (i'm kidding, i'd never abuse medicine like that, really....i would never steal from the NHS... ... honest!)

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

oh... what i wouldn't give for a night out at the crib soon with ma boys... check em out here in class, all wrecked from a night of pimping... keep it up boyysss! ;)

Run, run, run, run... in the right way, toward the right goal.

On being a Christian medic:
There is the risk of being prideful and elitist, but there is also the milieu of being surrounded by complete idiots, incompetency, inefficiency and utter oblivious-scatter-brained-pod-scum-of-bottomdweller-scum-phytoplankton-scum people...... GRRRRRRRRrrrrrrrrr...

beware the contempt of a very organised medical student.

meanwhile, carol is in need of the banter of another very-busy-person who can understand the frustration, isolation and support that is needed by a miserable very-busy-person.

indeed, misery loves company.


on a less miserable note,
i love amalgamating with a certain eponymous character (oh, i love how this is so apt!) and a certain other southpark-ish character... meetings most oft take place at night, most oft banter-full and absolutely wonderful. :)

achilles tendon

the combined effect of Medicine and Immunity in Health and Disease has the corollary of robbing me of my conversational skills, my vocabulary and my creativity. the limits of the human mind in terms of delving into different subjects is evident of late. spreading out = lack of depth = a jack of all traits and a master of none. but hyperfocusing (the direction i seem to be headed) has left me with little to say about other aspects of Life. (which contributes to the paucity of blog entries of late)

of note was the case study of the one time i deviated from my usual west end / city centre hangouts and ventured into the wild realms of greater glasgow... that day just utterly threw me off.. i was struck, so much by the randomness of the place, the novelty of taking a public bus in the middle of the night, the thickness of the working class accent, the sight of the teenage mum pushing her child in a pram, the druggie stumbling along the path, a dwelling that was not a student flat! my goodness... i balked at my naivete! i was never so dissociated that i actually FORGOT what the rest of the world was like.. damnnit, i need a holiday.... and non-medic friends, and time to relax and see the big picture, to listen, to speak less, to refresh my eyes... i hate going round in circles..
_ _ _ _ _ _ _ _ _ _ _ _ _

anyhow, halloween and trick or treating was great fun like... cheap wine + non-medics + heavy metal music + crazy costumes = a merry, merry night.
_ _ _ _ _ _ _ _ _ _ _ _ _

a tribute:

kenneth and xiaoling-

the lovely people who delivered the doughy goodness of a krispy kreme all the way from london to me. i'm sorry, i know i was meant to take a photo of it before eating it...

ivanna-

the lovely lady who turns 21 today!

medicine men

so despite the fact that i should be blogging about more ecclesiastical things, the little devil in me still can't forget the rapture of the sweet sweet conversation i had with my medicine men last thursday evening.

alas, it is true, as pointed out by my dear flatmate, Amy, that there are only so few 'cool' people in medicine. and i am soo utterly grateful to God for dropping these lovely men in my lap... for those of you who know my comings and goings in my wee university life, u know the two men of whom i speak of...

so anyway, it was such a respite from the new people and faces i meet in my new course.. the loveliness of familiarity, of unforgiving bitchiness unrestrained by the antiquated social-norms demanded by the sense of propriety required when meeting new people. so the merry three of us were reunited in the SL (study landscape) on that merry thursday evening, our insides acheing from all the giggling and laughing and utter taking the piss... oh my life in medicine is made so much merrier with these men...

also of note was my very stress-relieving time spent last night, post-Confident Christianity weekend, ensconced in the newly created niche that is my digital-tv-equipped kitchen, watching America's Next Top Model season 6 with Amy and being totally..... blase.

_ _ _ _ _ _ _ _ _ _ _

on watching angelina jolie drop the last piece of the puzzle on a biplegic denzel washington and attempting to pick it up with a pair of tweezers in 'The Bone Collector'...

richard: do u know you can still get an erection if you have spinal injury? you just have to stroke the feet.

issaam: yeah, but doesn't that cause the urge to defaecate as well? kinda loses the mood, u know?

richard: yeah, but some people like that.

cardiovascular

'Where do you go with your broken heart in tow?
What do you do with the left over you?
And how do you know, when to let go?
Where does the good go? Where does the good go?

Look me in the eye and tell me you don't find me attractive
Look me in the heart and tell me you won't go
Look me in the eye and promise no love's like our love
Look me in the heart and un break broken, it won't happen'

It's love that leaves that breaks the seal of always thinking you would be
Real happy and healthy, strong and calm
Where does the good go? Where does the good go?

Where do you go when you're in love and the world knows?
How do you live so happily while I am sad and broken down?
What do you say it's up for grabs now that you're on your way down?
Where does the good go? Where does the good go?

- 'where does the good go' by tegan & sara

just sitting in the western infirmary library, waiting for the caffeine to kick in.. i have developed such a high tolerance to caffeine, each cup contains about 4 times the amount of caffeine as it did in my first year in glasgow. and i'm drinking at least 2 cups of the drug a day... and i'm not even in proper term time! cos when that was going on, it was a proper 6 cups. oh... the highs of substance abuse. sinus tachycardia and palpitations and hypertension, the silent killer... oh u bad boys...

non-maleficience.

"at some point, you have to make a decision. boundaries don't keep other people out, they fence you in. life is messy, that's how we're made...so you can waste your life drawing lines, or you can live your life crossing them... but there are some lines that are way too dangerous to cross... here's what i know. if you're willing to take the chance, the view from the other side.. is spectacular. " - dr. grey from 'Grey's Anatomy'

amy's birthday. mahjong night. bar brel's amazing guitar man.

epon. johhny depp is beautiful. brel man. summer flowers.

so life after exams has been amazing. it's so wonderful to be able to sleep easy again, to be able to read non-medical books and catch up with friends outwith medicine. what have i been up to? sleeping more than i should, reading, warm birthday dinners, bar-banter, gigs, steamboat dinner, late night tesco shopping with pete, 8am ward rounds at stobhill, thinking of how i should start cardiac failure coursework, etc etc...

boom monk ben+dj food+bigg taj at the glasgow school of art

so yes, started my first day at stobhill on tuesday for my cardiac failure ssm, which saw my longest day in med school... up at 6am, ward round at 8am, followed by echos, exercise tolerance tests and reading lots and lots of ecgs, was only home by 5 yesterday.. had dinner and passed out on my bed....more of the same for the next 4 weeks or so... with an essay on the multipharmacy of heart failure at the end of it. can't complain really, this is what it's alllll about! right.. off to stobhill this afternoon for more heart-hunting..

the end has just begun

sooo0000.. what do 3rd year glasgow medics do after their exams???

we.......

... pimp each other out...

try to elicit the pupil light reflex in pubs

me.gillian.douglas's hand.
get to know hot nurses...

richard.
humiliate our ourselves and our colleagues publicly...

me.rob.

jack.

me.max.
raise our LFTs...

get to sleep at 4am, shattered from the backlog of sleep from the past few weeks of the S word, wake up at 7am the following morning anyways just cause that's what we're used to, and spend the rest of the following day nursing our battered brains...