Reminiscing The Past

2.5 years just passed in the blink of an eye… Looking back, my pre-clinical years in RCSI, Dublin has taught me so much about life, be it living as a medical student or as a young adult staying far away from my family in a foreign land. I guess there’s always good and bad sides to every thing that happened to us. We just need to keep ourselves positive and have a optimistic attitude. I just feel grateful and blessed now for all the opportunities I was bestowed upon and most importantly for the friendships that I have made there. Truly experience is worth much more than anything.

Being an international student, the multicultural and ethnicity environment was really eye-opening for me. I’ve learn to be more open and to accept other people’s opinion and their point of views. I’ve learnt to be a better listener instead of having prejudice and judgement deep inside towards other people of different cultural or religious background. I’ve also learnt that being different isn’t something wrong and that uniqueness is what makes this world more colourful and beautiful.

Of course the best thing about staying abroad and being an international student was that I get to travelled a lot around EU countries. There were so many interesting places that I’ve explored with my friends, so much fun and laughter and memories that we shared.

RCSI prepares me well for my clinical years in PMC. I realize RCSI students do better in terms of our knowledge and skills compare to our classmates who were from a different university. From lectures to tutorials to online self-directed learning, the resources RCSI provided us was immense. The lecturers were always so supportive and helpful. Furthermore, the clinical research opportunities there was also beyond amazing. I love RCSI and will always miss that place deep in my heart.

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Tremendous Journey of Research Summer School Experience in RCSI: A reflective writing

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Participation in the Research Summer School (RSS) has been my goal to achieve since I started my medicine course here. Well, RSS is not something  outlandish to medical students here in RCSI. As most of us know, RCSI is involved in a wide array of researches in many different areas of healthcare, be it biomedical or non-biomedical aspect. I personally have heard so much about RSS from seniors and various lecturers about the impact and benefits of this summer programme, and this has led me to be so determine in gaining a place to do research in RCSI this summer.

Research Summer School has gave me so much more than I can imagine. I get to learn from researchers and students from different backgrounds and expertise. RSS also provides a conducive environment for discussions and exchange of ideas and viewpoints. For the past 8 weeks, I have been working at RCSI Health Professions Education Center Department. At first I was a bit nervous and worried that I couldn’t adapt to the office style of working environment, but the warm welcome from the staffs and their ever-ready helping hands soon melted away my fear and worries. Students also get to know each other through the Friday Discovery Series that were organised by RSS every week, also from the Think Tank Session, IEF conference, BEME review meeting, and certainly from the HPEC department. I have met so many respectable and influential people from all walks of life. This certainly broaden up my network and help build friendships interprofessionally as there are staffs and students from pharmacy, physiotherapy and other professions taking part in RSS as well. Besides the impact of the research works done, social networking is also important in the field of medicine where team work and expertise from various professions are required.

Research Summer School opens up doors to meeting people from different background and expertise.

Research Summer School opens up doors to meeting people from different background and expertise.

Moreover, I also get to know how useful systematic review is to a research question. Basically, systematic review is a logical, explicit, and systematic method to collate all empirical data about a pre-specified eligibility criteria to answer a specific research questions. It requires high level search from various databases and libraries resources to ensure all relevant information are being captured. One can imagine how many studies that would be captured especially for a generic topic like communication skills assessment. The results of a systematic review are so immense and robust that it is actually rank the highest in the evidence hierarchy of the different types of research study. I realised too that the article abstracts are the most important part in a research paper as many reviewers do not have time to go through the full text and they only read the title and abstract to get whatever information they want. This gave me an insight on how important it is to frame the abstract so that it is like a mini-research paper and all relevant keywords are in it. However, this could also be a limitation for systematic review as it is prone to bias from the reviewers.

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Another thing that I have learnt from RSS is the wide array of projects going on. Projects range across a broad spectrum of disciplines, from biochemistry, bioinformatics, molecular biology, immunology and inflammation, microbiology, molecular oncology, neurosciences and physiology,  pharmacology, and cognitive science to clinical investigation and bioethics. There are so many fields to explore and different projects uses different tools in their research as well as teaching and learning session. I find it really fascinating and useful especially after I have attended the IEF conference and Think Tank session to explore what other people are doing in their respective research projects. Even though I may not be practically doing it myself I still can get a taste of how is it like to work in lab or a clinical setting. It has open up my mind to greater things that I have never heard or seen before.

Exploring different researches about genetic, proteins, cells,organs and even clinical research involving patients are all fascinating and interesting stuffs to learn of.

Exploring different researches about genetic, proteins, cells,organs and even clinical research involving patients are all fascinating and interesting stuffs to learn of.

Towards the end of my research project, I did a little survey among my fellow friends in RSS about what kind of experience they had in RSS and any improvement that can be made. Generally, they were quite please and happy with the projects they are doing, as well as the organisation of RSS this year. However some expressed that the Friday Discovery Series were too long and shouldn’t be made mandatory as it was hard for the lab work students to work around it. The programmes scheduled for the RSS were released quite late for some of the international students to work around their time and travel. As for the Principal Investigators (PIs), some of the PIs didn’t know that there will be students working under them until very last minute and some PIs  did not give details about the project that the students will be doing prior to interviewing them. Also, there are some students complaining that it was unfair for the students who applied early yet did not get a chance to participate in RSS but there were students who applied way passed the dateline of the RSS application date yet still were accepted into the system. However, majority of the students still think they would participate again in RSS next year and it is definitely a worth while experience.

Of course, all works and no play makes Jack a dull boy. Besides reading articles and evaluating papers, my PI also encourage me to do reflective writing and explore the usage of different presentation tools like Powtoon during our free time. I find it really beneficial to practice reflective writing about a certain topic in medical or healthcare practice as it gives me an insight of how the medical world is functioning and also who I want to be in my future career prospect. This practice gives me some personal time to really sit down and reflect on the works people have done, the impact it has made, and what other modifications that can be done. I’ve learnt how to critically appraise a paper and to think out of the box to solve a problem. Reading through the various topics and discovering that there are so much more that are unseen or  unpopular in the eyes of public, make me realized that there’s a need to stand up to what I believe in, to raise up my voice for the needy and vulnerable, and to be an advocate for the patients. Besides all the skills and knowledge that I have gained throughout this 8 weeks, I guess this is the greatest gift that I received from participation in this summer research: To look at medicine from a different perspective from now on…To love what I am doing and to live with passion everyday.

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This will not be the end of my research journey. I believe with the experience and skills I have gained, there will be more research to come in my way and this will be my stepping stone to future research endeavour. Hopefully, my works will have a little bit of impact in some people’s lives…;)

The Emperor of All Maladies: Cancer

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In 2010, about six hundred thousand Americans, and more than 7 million humans around the world, died of cancer. In the United States, one in three women and one in two men will develop cancer during their lifetime. A quarter of all American deaths, and about 15 percent of all deaths worldwide, will be attributed to cancer. In some nations, cancer will surpass heart disease to become the most common cause of death.

With this sobering statistic, physician and researcher Siddhartha Mukherjee begins his comprehensive and eloquent “biography” of one of the most virulent diseases of our time. An exhaustive account of cancer’s origins, The Emperor of All Maladies illustrates how modern treatments — multi-pronged chemotherapy, radiation, and surgery, as well as preventative care — came into existence. Thanks to a century’s worth of research, trials, and small, essential breakthroughs around the globe.

This book is composed of six parts that deal with the cenotaphic events according to the historical progress in the screening, diagnosis, treatment, and prevention of cancer. In the first part, the author mentioned the first description of leukemia as “a suppuration of blood” by Dr. John Bennett and subsequent renaming to “leukemia” by Dr. Rudolf Virchow in 1847. The author introduces Dr. Sidney Farber as the father of modern chemotherapy, who accidentally discovered aminopterin as a powerful anti-cancer chemical leading to the dramatic remission of leukemia. In addition, he describes the development of surgery and anesthesia as well as the concept of radicality in the removal of the tumor. In the following parts, this book covers several landmarks in the development of the treatment of cancer including combination chemotherapy and molecular targeted agents. Another part depicts the exploration history of cancer causes which includes the discovery of cancer-causing viruses such as Rous sarcoma virus and two-hit hypothesis, that is, activated proto-oncogenes (jammed accelerators) and inactivated tumor suppressor genes (missing brakes).  Dong Hoon Suh; Book Review

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I found this book really interesting and insightful. It is kinda a textbook as well as a thriller type of genre in the style of writing. It is written entirely for a layperson to understand but Siddhartha, the author also wanted to threat this audience with the utmost seriousness. He mentioned that this book is an attempt to answer question asked by one of his patients which had been treated with chemotherapy and had relapsed and been treated again. She said: “I’m willing to go on, but i need to know what it is i’m battling.”

As medical students, reading all these stories about real life patients struggling with cancer really struck my heart. I gained a deeper understanding not only about cancer history and revolution, but also a deeper understanding of medical humanities involved in treating this deadly diseases, to really listen to what the patients have to say. Anyone who has spent time in the oncology clinic will definitely understand that it can be a very depressing place. Thus it really enquire one to deploy everything in the battle: be it emotion, mental and physical strength.

Also, this book touched on the different research on potential treatments on various cancer from genetic regulation in cancer cells, cancer metabolism, microenvironment of cancer cells to immunological aspects. This really raise hope to the public as cancer really is a disease of old-age and as the global life expectancy continue to raise, more and more cancers will be diagnosed. Cancer, in fact is an uncontrolled growth of our own cells. This magnificent study of cancer suggests that, for all medicine’s advances, we cannot beat a disease that is a distorted version of ourselves. We will always have cancer, among us and within us. The ultimate purpose of this book is not just to understand the past of cancer but to raise a question: is it possible to eradicate this disease from our bodies and societies forever?

This book is a must read for all future doctors – fascinating and powerful!

Humanity in Geriatric Department: When Love Endures <3

“To have and to hold from this day forward, for better, for worse, for richer, for poorer, in sickness and in health, to love and to cherish, till death do us part…”

This is the marriage vow many people are familiar with, but how many people actually obey and keep the promise till death do them apart? With the divorce rate in the US approaching 50% among the married couples, what can we say about the solemn pledge on the wedding day?

Love, is the great affection for someone, something that God has beautifully made for human kinds to cherish and enjoy. And it is this unveiling of humanity in her elderly patients, is what Dr. Danielle Snyderman found as her fuel for difficult work. “Understanding my patients for who they truly are,” she said, “helps me to stay passionate about medicine and feel that I am staying above the systems challenges we, as doctors, face.”

So, in her off hours in 2013,Snyderman began formally interviewing patients at the Hill at Whitemarsh, the upscale retirement community in Lafayette Hill, where her practice is based, about their love stories.

The couples were happy to tell her how and when they had met and what had made their relationships survive. Many struggled with her kicker question: “How do you anticipate a time without each other?”

The stories have brought her closer to her patients. She believes her willingness to listen has heightened their trust in her. As she had hoped, knowing her patients better has helped her help them when medical problems worsened.

'He's our new Geriatric specialist!'

‘He’s our new Geriatric specialist to read about the love stories

I was really moved by some the stories recorded down by Dr. Snyderman. As a medical student, sometimes I tend to focus on the symptoms and signs presented by the patients, and forgot about the real concerns and expectations of them. We, as future doctors always want to relieve them from their physical illness, but often we neglect their mental, emotional and spiritual needs, especially in critically ill, paediatric or geriatric patients. These are the patients that are most vulnerable to medical exploitation as they cannot express their viewpoints in an explicit way. Thus, as healthcare professionals, we need to keep reminding ourselves, to level ourselves to the same level as the patients and to put ourselves into the same shoes that the patients are undergoing, so as to truly understand who they really are and what they really in need of. I guess, this is what most patients would appreciate us doing. In the end, patients and their family members just want to feel the sincere love and respect from healthcare workers despite their physical illness. ❤

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Medical humanities is an interdisciplinary field of medicine which includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology,cultural studies, psychology, sociology, health geography) and the arts (literature, theater, film, and visual arts) and their application to medical education and practice. Medical humanities is also defined as an interdisciplinary, and increasingly international endeavor that draws on the creative and intellectual strengths of diverse disciplines, including literature, art, creative writing, drama, film, music, philosophy, ethical decision making, anthropology, and history, in pursuit of medical educational goals.

When Google Knowledge Graph Meets Healthcare

Google has moved from being an information search engine to a knowledge hub. Since 2012, Google established the use of linked data for users to easily access related information from the search queries they have. It is indeed very useful and interesting for the public as they can get information much quicker and more conveniently. According to recent studies, Google found out that 1 in every 20 searches are about healthcare related issues. This has prompt Google to come out with the idea of bring medical knowledge to the existing knowledge graph. When type in any medical terms (laymen terms or jargon), Google will come out with three different tabs which are ‘About’, ‘Symptoms’ and ‘Treatment’. However, Google mentioned that this knowledge graph is useful for users to get more information instead of replacing doctors. But, how valid and reliable are all these information? Will patient self-diagnose themselves more and more as they lose trust in the mainstream traditional medical system?

One of the benefits for patients using this knowledge graph is that they will gain a more thorough understanding of their diseases before and after their consultation with licensed medical doctors. They can read about the definition of disease, how prevalent it is, what risks predispose them to the disease, and some demographic information about the illness. Besides that, they can also match the symptoms they have with the common symptoms provided thus giving them a more directed and informative diagnosis about the disease. Also, some common home remedies, over-the-counter medicine as well as complementary alternative medicine are also provided within the knowledge graph. Besides giving patients some reliefs and assurances it is also a way to develop health literacy and spreading of awareness about some common symptoms.

However, if patients do not use the information correctly, it can bring detrimental effects to patients as sometimes symptoms might be similar for different diseases. They might mistakenly thought that they have common flu when in fact they have a deadly influenza infection. Some people might miss the window opportunity to treat the disease because they thought the information online is reliable and is appropriate for them and that their illness is not serious. Therefore, all medical facts in the knowledge graph are actually validated by around 11 consultants in Google medical team with collaboration such as Mayo Clinic. Moreover there are also other implications for patients, healthcare provider and business field, nevertheless.

It is definitely a great move by Google to provide this information link and knowledge sharing among internet users and hopefully this can bring more benefits to the general well being of patients and generate better doctor-patient relationship as health literacy level increases and insightful communications generated.

Reflections on International Education Forum (IEF) | 22nd – 26th June 2015

The 4th RCSI International Education Forum (IEF) took place from 22nd to 26th June 2015. The theme of this year is “Leadership in International Education” which focus on contemporary developments in Health Professions Education and significant projects underway across the Faculty of Medicine and Health Sciences.

Prior to the conference, the talk I was most looking forward to was ‘Next Generation Personalized Learning: How we transform education’. Mr. Enda Kyne’s talk on transforming next generation’s education by infusing teaching in learning processes,understanding personalized learning, use of data to create personalized learning and space design was of particular interest to me. It was interesting to hear about the key issues facing higher education nowadays such as hiring and retaining qualified staffs, blended learning opportunity, personalized learning with standardized assessment etc. His talk contained much detailed advice for any other educators looking to understand and transform the current education system to another higher level. I learnt that students in this era learn differently and by incorporating technology in the learning process, students can choose how they want to learn and become more active and creative in learning as well as more collaborative with their teachers as facilitator to create an inquiry environment. Kirsten Olsen in her book, Wounded by School once said, “Our current system was designed in a time of information scarcity: libraries, books, printed materials were rare and precious…” I found the statement remarkably true because as all of us can see, most of the information that we want can usually be easily found just within a few clicks away in our smartphones. By using technology in personalized learning, students will have more flexibility and motivation to engage in their own way of active learning. This certainly is a new approach to enhance learning in higher education level.

The big surprise for me is how interesting I found the ‘Technology Enhanced Learning (TEL) Innovation at RCSI’. The TEL pilot initiative has been developed through collaboration between Health Professions Education Center (HPEC) and IT department to develop sustainable best practice models for blended learning programs in RCSI. There are 5 pilot projects focused on innovations in medical teaching and learning which are undergoing development cycle. The one that I found most fascinating one is the ‘interactive case histories for engaging student centred learning’ under Tropical Medicine curriculum. This program allows student to indulge in real-time scenario while just using a software. Students get to experience the real clinical scenario and actively learn by answering questions and writing down feedback. Besides, The other TEL projects like video simulations to support challenging consultation under Obs and Gynae and the collaborative tools to enhance engagement in a blended learning are very interesting to learn about too. There are so many novel technology software and tools that has been created to facilitate the teaching and learning experience of both educators and students. I really enjoyed listening to the different tools that are being used in different programs.

To sum up, I really feel empowered and motivated to make a change in our education system. Well, maybe not now but who knows in the near future I can bring little changes to the way learning and teaching are right now. Being a student ambassador to spread the benefits of using all these amazing tools is one way I can help to enhance better learning among students in RCSI. I hope more students and educators will have the opportunity to know all these developments and improvements in their respective fields. It was truly an enjoyable and fruitful IEF for me as a student and one of the volunteer, with opportunity for face-to-face interactions with many respectable individuals. I am definitely looking forward to the next IEF and I believe it will bring more surprises to me!

Sharing of Knowledge Through Social Media

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Have you ever wondered what Instagram will look like if healthcare professionals took it over? Figure 1, a photo-sharing application for healthcare professionals, come close.

Launched in May 2013, it has since amassed hundreds and thousands of users who have posted two million photos. This app was designed to enable doctors to share pictures of their patients, both with each other and with medical students. However, not everyone can post or commend on the photos unless their professions are being verified. Many medical students now use this app to learn from other healthcare professionals. This medical community has certainty provide a platform for knowledge sharing and learning. Doctors, nurses, interns, medical students and other healthcare professionals can now connect with colleagues to discuss compelling medical cases by discovering images by anatomy or specialty. This app can also promote interactive learning among healthcare workers while protecting patient privacy.

Privacy of patients has been the major priority and concern of this app. Patients’ faces are automatically being obscured and the apps provide in-app services to remove identifying marks like tattoos, case numbers and patients’ names manually.Also, each photo is reviewed by moderators before adding into databases. Going one step further now, this app also provides consent form that requires patients’ signature. Besides that, Figure 1 app allows any photo to be flagged for privacy concerns in order to police the site.

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As medical students in this 21st century where everyone’s hands are busy with smartphones, this photo-sharing app is definitely a great medical education tool where students can find certain images related to a certain disease relatively quicker and in a more sensitive way. Students can also learn so much from just browsing through the apps as many photos are posted by experienced healthcare professionals with an intention to educate and share knowledge with the younger generation of healthcare learners. By participating in the discussions and giving opinions of a certain conditions, students can learn better and remember the disease in different perspectives. Moreover, 50% of the brain is dedicated to visual functions, thus images are processed faster than text and can help medical students in understanding and memorizing difficult and complex signs, symptoms and diagnosis.

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Lastly, the video attached below is a review of this medical app by Dermatology Times. It is believed that this app can be a valuable tool of medical knowledge sharing and a great learning platform for all healthcare professionals. I like what the founder Josh Landy, an intensive care specialist at Scarborough Hospital in Toronto, Canada said, “It’s overdue for a tool like this,” he concludes. “I’d like to see it everywhere”.