Medical School Meme Review

2020-03-04 · Long video (solo, talking head or whiteboard) · Ali · recording, 14:57 · watch on YouTube

Topic: Medicine and his doctor years · mode: Playful and ironic · tags: His medical past, Aimed at students

Ali, a doctor in Cambridge, reacts to memes from the Cambridge University Medical School Facebook group and explains the medicine behind each: electives, old-fashioned pharmacology lectures, clinical skills log books, audits for publications, the university-blind decile ranking for foundation jobs, knee arthroscopy versus sham surgery and pharma reps' free sandwiches.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Cold open with meme lines and the welcome: a medical meme review

00:00:26 — Memes on electives, odd drugs, feedback, practice on each other, clinical skills log books, graduate students, MedEd and exam term

★★ Ali, a doctor working in Cambridge, reacts to fairly niche memes made at the Cambridge University Medical School, which he downloaded from its Facebook group. — 00:00:26 · University of Cambridge, Facebook
★★ Ali explains the medical elective: in the fifth year of medical school students are meant to do medical work in another country for two months, but many treat it as a beach holiday. — 00:00:26
★★ Ali says Cambridge medical school is obsessed with getting feedback from its students; he calls this objectively a good thing, though students make fun of how often they are asked. — 00:01:13 · University of Cambridge
★ Medical students learn to put in cannulas and take blood by practising on each other; Ali says he apparently has quite juicy veins. — 00:01:58
★★ Every medical student keeps a log book of clinical skills, such as putting in a catheter or a cannula, to be signed off; Ali says everyone waits until the last minute to get them signed. — 00:01:58
★★ Ali says the General Medical Council requires medical students to have their clinical skills signed off by the end, so they get around to it eventually. — 00:02:46
★★ Ali explains that graduate medical students, who took a degree before applying, are not the norm in the UK, where students go straight from school to medical school, while in the US students take an undergraduate degree first. — 00:02:46
★ Ali describes MedEd, the Cambridge medical school's online learning environment, as its online Google Drive, based on Moodle; it was famously hard to find things on, which he jokingly blames on the students. (playful) — 00:03:36 · Google Drive, University of Cambridge
★★ Ali says MODO, Mechanism of Drug Action, is the second-year pharmacology lecture course at Cambridge, which teaches many historical and old-fashioned drugs. — 00:04:04
★ Ali recalls a classic psychology case, a patient he thinks was Phineas Gage, who survived a railroad accident in which a rod went through his frontal lobe and had a profound personality change. (hedged) — 00:04:58

00:05:51 — Memes on audits for publications, the newborn hip check, CPC abbreviations, right ventricular heave and politics

★★ Ali says medical students try to get their names on academic papers, and it is common knowledge that the easiest way is to collect and write up data from a hospital audit. — 00:05:51
★★ In the fifth-year exams at Cambridge, students do a newborn baby check on a doll, examining the hips for dislocation. — 00:05:51
★★ Ali says CPCs, clinical pathological conferences, were the pathology lectures at Cambridge, and that medicine has so many abbreviations that in the first clinical year students end up googling everything. — 00:06:30
★★ Ali explains that the gesture in a TV moment of Jeremy Corbyn, his hand held up against a woman, is how a right ventricular heave is assessed: in certain heart conditions the movement of the right ventricle can be felt against the hand. — 00:07:12
★★ Ali reads a meme of Theresa May as a pathogen attacking a cell protected by the NHS, fought off by Jeremy Corbyn, as a very left-wing, pro-Labour view of UK politics. — 00:07:49 · NHS

00:08:17 — The university-blind decile ranking for foundation jobs, and why he dislikes the joke

★★★ For NHS jobs after medical school, where a UK graduate ends up depends on a score out of 100, part of which is their decile in their medical school: top 10% gets 10 points, top 20% nine, down to one point for the bottom 10%. — 00:08:38 · NHS
★★★ Ali calls the Oxbridge meme about university-blind decile rankings quite elitist and says he is not a huge fan: students at Oxford and Cambridge love to complain that the rankings ignore the university. — 00:09:04 · University of Oxford, University of Cambridge

00:09:32 — Memes on heart tests, Mobitz heart block, exam questions, resilience emails, knee arthroscopy, pharma reps and history taking

★★ Ali explains that someone having anaphylaxis, a severe allergic reaction, is injected with adrenaline to dampen down the response. — 00:09:57
★★ Ali explains Mobitz type 1, or Wenckebach, a second-degree heart block in which the heart beats a few times and then drops a beat. — 00:10:22
★★ A few years ago Cambridge set out to teach medical students resilience, which Ali calls a big part of being a doctor, but students kept getting weekly reminder emails to fill in a resilience questionnaire. — 00:10:49 · University of Cambridge
★★★ Ali says a few studies have shown that arthroscopy for knee osteoarthritis, a procedure in which orthopaedic surgeons look into the knee with a camera, is just as good as sham surgery. — 00:11:22
★★ Ali explains sham surgery: the patient is cut and anaesthetised and everything is done as for the operation except the operation itself, as a way to measure the placebo effect of surgery. — 00:11:22
★★ Drug company sales reps often provide free sandwiches at lectures and talks in hospitals and universities in return for plugging their drug for five minutes, which Ali likens to sponsored YouTube videos. — 00:12:05 · Audible
★★ Ali says drug companies buying doctors' attention with free sandwiches is not as bad as it used to be, when they flew doctors first class to holidays and then sold them the drug. — 00:13:19
★★ When a patient says a symptom has been going on "a while", Ali says the right approach is to ask whether it is minutes, hours, days or weeks, which gets the information needed. — 00:13:44

00:14:08 — Whether the memes interest outsiders, and the sign-off

★★ Ali does not know how interesting the Cambridge medical memes are to people outside the university: he thinks many are general medical-student jokes and many are inside jokes. (unsure) — 00:14:08

Humor (significant)

A meme mocks Cambridge medical school's appetite for student feedback. — 00:01:13

“Yo dog, I hear you like feedback, so I asked for feedback on the session on giving feedback.”
ACE inhibitors all end in -pril, like captopril and lisinopril. — 00:03:36

“April, not sure if it's a month or an ACE inhibitor. That's really good, okay.”
A student wakes from a coma since 1978, worried about the pharmacology exam. — 00:04:04

“All my knowledge is completely out of date. That's where you're wrong kiddo.”
A consultant asks where the falciform ligament is. — 00:04:29

“It's in the tummy somewhere.”
A picture of Jeremy Corbyn with his hand held up against a woman on TV. — 00:07:12

“I'm now going to assess for right ventricular heave.”
In Mobitz type 1 heart block the heart drops a beat. — 00:10:22

“When the beat drops, second degree heart block, Mobitz time.”
An exam-style question loaded with lidocaine doses and suture counts. — 00:10:49

“How many bananas can you eat for lunch?”
A doctor asks a patient how long a symptom has lasted. — 00:13:19

“How long has this been going on? Patient, a while, sometime.”

Mentioned

Central: FPAS score · University of Cambridge

Also: People: Jeremy Corbyn · Monkman · Phineas Gage · Theresa May

Works: University Challenge

Organizations: Brilliant · CuriosityStream · Facebook · General Medical Council · Labour Party · NHS · University of Oxford

Concepts: Clinical audit · Medical elective · Sham surgery

Products: Audible · Google Drive · MedEd · Moodle · Notion

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