2015; 87:3

What even is Surgo?

80th Anniversary Special Edition


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Editorial
It has been a busy semester for the Surgo
committee.

1st

the media based on the Batman universe. Since half

years have almost completed

the medical school is on placement at the moment,

their studies and are now preparing for the upcoming

Trung has enlightened us in how to play the

3rd and 4th years made it through their

supervisor game and Tom Ainge (ft. beta-17 year

notorious clinical exams and are now starting their

club) helps us get the most out of clinical placements.

5th

Michaela confirms her distaste for the Tories in a

years are starting p4p and becoming actual, legit

shocking reveal of the creeping privatisation in the

doctors...there really is no rest for a medical student!

NHS (a must-read). Dan sticks to his strengths and

(Apart from Intercal).

gives us the abstract of Surgo's next clinical trial:

exams .

and

2nd

placement and specialities blocks. Finally the

Surgo is celebrating its

SHITS (Surgo's highly interesting toilet trial).

80 th (Oak)

But

wait, there's more! An ethical case from the Glasgow

anniversary this year and is ready to lighten-up your

University General Practice Society, Jenna's inquiry

coffee break. Due to popular demand, we start with

into if attendance should be monitored in lectures, an

the history and the formation of Surgo to ask the

abstract from Craig Johnstone, a review of the 3rd

ageless question of what even is Surgo. Following

year ball and finally a summary of recent Med-Chir

this, Jamie gives us a summary of recent medical

events. Enjoy!

news and former Surgo editor and psychiatrist Dr

Colm Hennessey gives us a portrayal of psychiatry in

Tom Baddeley, Editor of Surgo

..

ADDRESSES AND PAPERS

History of Surgo

ADDRESSES AND PAPERS

The Lectured Become the Lecturers

by Tom H. Baddeley
Medical News

by Jenna Woods
Happenings in MedChir

by Jamie Henderson
Madness at Arkham Asylum

by Tom Baddeley
We Ballsed it Up

by Dr Colm Hennessy
Playing the Supervisor Game

by Year Club Beta

Transverse Acetabular Ligament

by Trung Ton
How to Get the Most Out of Clinical Placement

by Craig R Johnstone
SHITS

by Tom Ainge
Losing Our NHS

by Daniel Taylor-Sweet
Ethics Case

by Michaela Jewson

by GUGPS

What even is Surgo?

Many a student at Glasgow Medical School
has asked themselves this eternal question:
what even is Surgo? Surgo is 80 years old
this year and so I feel we all deserve a
clarification of how Surgo came to be. Lets
start from the very beginning

hundred mark it is particularly fitting that

the society should have considered
publishing a medical journal.

Despite the University of Glasgow being

founded in 1451 it did not have a dedicated
medical faculty until the end of the 18th
century; anyone who wanted to become a
doctor had to travel to Italy or the
Netherlands for university.
The medical
profession in Glasgow during the 16th
century was: one physician, six barber
surgeons and two midwives, so not enough
to support a population of 7000. Glasgow
back then had terrible weather, no
sanitation and was rife with leprosy and
other infectious diseases, so much like it is
now! Lepers were sent to St Ninians Croft,
a hospital near present-day Gorbals. Here
they were looked after but had to wear a
long gown with hood and sleeves closed at
the fingertips and rattling clappers if they
wanted to leave the hospital, to warn
others of their presence.
After several
outbreaks of leprosy and syphilis, the
powers in charge decided that the
University and the Clergy appoint someone
to be in charge of the medical faculty in
Glasgow. They decided on Maister Peter
Lowe, who settled in Glasgow in 1598.
This high-achieving man was trained in
Paris and had 22 years of experience of
battlefield medicine whilst working with the
French and Spanish armies.
He was
employed and founded the Faculty of
Physicians and Surgeons, Glasgow on the
3rd June 1603.

1. In the first place, Surgo provides a

means of publication of papers written
by students.

The Medico-Chirurgical Society of Glasgow

was founded in 1802 but it wasnt until
1934 when the idea arose that the society
should have a medical journal. The first
steps were taken by Mr Uytman and
several other medical students who looked
into how much it would cost to run and set
up.
Mr Uytman was the Med-Chir
treasurer at the time and offered the idea
at a meeting on the 22 November 1934. Mr
Leckie was president and supported the
motion, appointing the members who
proposed Surgo as the initial committee. A
star was born.
The first issue went to print in January
1935 and here are the opening words of the
editorial:
At a time when the Medico-Chirurgical
Society of Glasgow University, by means of
its numerous progressive activities, has
definitely established itself as one of the
most important influences upon the life of
the medical students of the university this
year the membership exceeds the five

Mr Uytman then goes on to outline the

three aims (I feel we have pretty much
stuck to them):

2. Secondly, Surgo will provide an

excellent medium for the orderly,
original and articulate expression of
student opinion on all matters of
medical interest
3. Thirdly, Surgo is intended to be a
source of information. Surgo as the
instrument of the society will satisfy a
long felt want in the matter of
publishing items of news both local
and general, which are of interest to
the medical student.

As it turns out, Surgo means I arise in

Latin; this is because Surgo arose like a
phoenix from the ashes of a former
publication called The Scalpel which
allegedly had to be shut down due to it
containing gross personalities and articles
calculated to excite feelings dangerous to
the security of the college.
They were
probably proposing inflammatory ideas
such as accepting women into medical
school.
Surgo went on sale for 5 shillings a year,
so roughly 12 in our money. Surgo also
had companies pay for advertising space,
much like now. But this was before the
age of multinational healthcare companies
and old so Surgo editions featured adverts
from private companies for surgical tools,
prosthetic limbs etc. as well as household
names like Guinness and Tennents. The
advert below is advertising hernia trusses
and surgical belts.
The shop itself
occupied 249 Buchanan Street, where
Topshop is now and having tried to fit into
Topman jeans in the past I can imagine
hernia belts are not too dissimilar. During
World War 2 Glasgow medical school found
it difficult to produce doctors fast enough

by Tom Baddeley

for the war effort, there were a number of

articles published discussing whether the
course should be shortened or if extra
semesters should be brought in to 1st and
2nd years. They also discuss how Glasgow
is the only Scottish university with no
military training; this could be the liberal
anti-war spirit of Glasgow coming through
or maybe just the med school hadnt got
round to organising it yetwho knows.
During the war and the post war period,
Surgo struggled to find sponsors and the
wartime paper shortage almost ended it for
good, but plucky old Surgo powered on
through.
Whilst reading through old issues of Surgo
and old Med-Chir minutes from the last
century, I unfortunately sensed a level of
underlying sexism. An example of this is
just after when women were officially
allowed to enter the GUU in 1977, MedChir organised a field day in 1978 where
there was debating, sports at Garscube and
snooker and darts in the mens union.
The rules officially state men only as
players and spectators for the snooker and
darts, so I can guess where Med-Chir stood
on the mixed-sex union dispute. However
there was a beer drinking competition and
night out in the Savoy Centre afterwards,
all sponsored by MPS - which sounds more
like the Med-Chir we all know.
Surgo was much like it is now from the
1980s onwards with the same light-hearted
look on life as a medical student. It has
had its ups and downs but for a student
magazine to be celebrating its 80 th
anniversary, it must be something special.
As long as Glasgow has a medical school I
believe it is important that Surgo should
exist to act as an impartial judge, holding
the medical school accountable if needed
and to allow medical students to voice their
opinions. In doing this Im sure Surgo will
be celebrating its 160th anniversary in 80
years time.

MEDICAL NEWS

by Jamie Henderson

Hold the press, binge drinking is over

In a report from the Office of National Statistics (think grey suits
and lots of SPSS), they have reported that binge drinking is
waning in the UK, with more people than ever being teetotal.
Young people (<24 years old), have reduced their binge drinking by
more than a third since 2005; apparently students are becoming
sensible. We are being dubbed Generation Sensible by columnists
in the Guardian; this is a serious situation! Clearly none of them
have been to MedChir, let alone the chaos of Viper on any night of
the week. Thank the lord that in Scotland the story is a bit
different. Along with our cousins in the North East, we top the
table for binge drinking; we arent letting the stereotype disappear.
Coming first in the bingeing war is compensated by us coming
forth in the table for teetotallers, with a fifth of Scotland saying
that they havent touched a drop of alcohol (liars). While we at
Surgo are all for being responsible; when and where else is it
acceptable to drink tonic wine? Lets continue to make Glasgow
Buckfasts heartland.

BMA Contract Negotiations Stall

In October last year the BMA pulled out of contract negotiations with NHS Employers (the governments representative), as
they wanted to remove key safeguards for trainees such as protections on safe working hours at the expense of patient
safety and sustainable working patterns for doctors. This came as a surprise for the government who felt negotiations were
progressing well. However, this was not the case for the BMA, who felt that red lines had been drawn that were unsafe for
doctors and patients. The current contract is not suitable for both hospitals and doctors. The government has instructed the
Doctors and Dentists Review Body (DDRB) recommend a way to provide consultant led care 7 days a week and review junior
doctors contracts. Submissions are now being made and the review will conclude in June. Good luck to those finding a way
through this field of mud.

Scottish hospitals show improvement

in mortality
People dont go into hospital to die; at least that is the idea. But inevitably
patients do. This can be due the result of the condition of the patient on
admittance, but some deaths can be prevented by improving care and not
causing harm (beneficence and non-maleficence). It was with this aim that the
Scottish Patient Safety Programme (SPSP) was set up. It has seen a reduction in
the Hospital Standardised Mortality Ratios (HSMR) of 16.3% over the whole of
Scotland. The Southern General managed to reduce its HSMR by more than
20%: the target for the end of 2015.

Chocolates on wards at
high risk
Dont leave food, particularly chocolate, around
a ward as they will vanish quickly. A
multicentre trial, published in the BMJ, has
found that the half-life of a chocolate on a ward
is remarkably small - 1hr 39 minutes. It takes
only 12 minutes for a box of chocolates to be
opened. The main culprits in this study were
health care assistants and nursing staff,
composing 28% of consumers; doctors didnt
fair too well either, coming third overall. So
next time you grab a Quality Street on a ward
be careful, someone may well be watching you!

Attractive Men
Are Selfish
Researchers from Brunel
University have found that
attractive men are more likely to
be less generous and favour
equality less than their less
attractive counterparts; the
same could not be said of
women. Therefore there is a
lesson to all; be careful who you
go on dates with. You may end
up paying for it.

t
a
s
s
e
n
Mad

m
u
l
y
s
A
m
a
h
k
Ar

rkham Asylum looms high over Gotham.

Or sometimes it sits on an island in the

bay. Or is dwarfed by the modern buildings

around it. Or maybe it becomes part of the city,
a segment where anarchy reigns. While the
details vary, one fact always remains: its where
the bad people are. Where the murderers,
anarchists and freaks of the Batman world are
sent after being captured by the Dark Knight.
There they stay for a while, contained,
sometimes experimented on. They are never

itself comes from the Cthulhu mythos of HP

cured, never successfully helped. Sometimes

Lovecraft, whose arcane tales told of

they are discharged by misguided staff,

otherworldly insanities forever pushing in on

sometimes the staff even help them escape.

reality. And old Jeremiah Arkham himself, the

Because they always escape, and return to

architect and founder of the hospital, fell to

their life of crime, and then return to Arkham a

madness, shuffling through the halls of the

while later. No one gets better at Arkham, no

institution he built.

good is ever truly done. The patients do not

recover, and society is never safeguarded.

Gotham is indeed where the bad people are.

atman is not unique in its portrayal of

mental illness as being synonymous with

evil and danger, but it is perhaps remarkable in

n the wide pantheon of superheroes, no

its unreconstructed and profligate portrayal.

character or title has paid as much lip

The institution itself entered the Batman comic

service to the medical speciality of psychiatry

book in the early 1970s, at a time when

as Batman has. The hero himself, irrespective

psychiatry was recovering from the excesses of

of the portrayal, is always fuelled by trauma

institutionalisation and the barbarism of the

the murder of his parents, and a fear of bats.

lobotomy era. Effective medications were by

His villains are often described as mad, or

then available, and the age of de-

schizophrenic (including the great

institutionalisation was beginning. But the

misunderstanding of schizophrenia as spilt

image of psychiatry, then as now, was still one

personality, personified by Harvey Two-Face

of custody and madness. Arkham thus became

Dent). He has even faced a remarkable number

a super-villain take of One Flew Over the

of evil psychiatrists over the years: Harleen

Cuckoos Nest, where no one ever recovers and

Harley Quinn Quinzell, Jonathan Scarecrow

people are contained rather than treated.

Crane, Dr Hugo Strange, and others. Not only

are bad people held in the citys secure

psychiatric hospital, but the madness is
seemingly contagious, regularly spreading to
the abusive and incompetent staff. Even the
origins of Arkham lie in madness: the name

owhere is the Arkham Effect greater

than in the character of The Joker.

Batmans greatest villain, he serves as an

anarchistic riposte to Batmans fascistic
leanings. The Joker is unpredictable, unhinged
and extremely dangerous. He has taken the

lives of countless Gothamites, including

some way contagious, and that spending time

(during the Death in the Family storyline)

with the mad can make oneself insane.

Batmans young ward, Robin. But despite his

leanings towards anarchy, he is a methodical

criminal mastermind. There is no hint in his
portrayal that he is depressed, or bipolar.
Although unhinged, his mind maintains a
consistency of thought and action that is not in
keeping with psychosis. There have been
instances of catatonia (most notable in Frank
Millers The Dark Knight Returns). But, if any
diagnosis were to stick with The Joker, it would
be psychopathy.

hen I decided to become a psychiatrist,

there were a few comments that I grew

tired of hearing pretty quickly. Some people,

including relatives, worried about my safety;
that the dangerous patients would turn on
me. Others joked I would become mad myself.
Finally people asked why I did not want to be a
real doctor, as if I was abandoning medicine
for imprisonment and mysticism. Stigma is not
just damaging to our patients, who must
contend not just with mental illness but also

f Scotland has an institution equivalent to

with the fear and ignorance of society. Stigma

Arkham Asylum, it would be The State

is also directed towards psychiatrists

Hospital at Carstairs. I have worked there

themselves, who are frequently regarded as

myself. Rather than a gothic building of spires

bizarre, unhinged, and perhaps inferior to their

and watchtowers, it is a series of modern flat-

medical colleagues.

roofed buildings set on a remote and windy

patch of central belt countryside. As opposed to

being a chaotic and abusive place, it is a
controlled and contained environment. To be
sent to Carstairs, one must generally have a
significant mental health problem in addition
to requiring a high-secure environment. As a
rule the focus is on recovery (if possible)
enabling the patient to move to a less-secure
environment. There are medications, therapy
groups, passes to the community. The other
fact that sets Carstairs apart from Arkham is
that The Joker would never get in. Because
psychopathy, by virtue of not being a treatable
mental illness, is the domain of the Scottish
prison system.

t is hard to judge the effect of constructs

such as Arkham Asylum on stigma towards

psychiatry. Of course Arkham is one (albeit

central) part of the Batman mythology, and
Batman is only one (very well-known)
character. What Arkham Asylum is, though, is
part of a wider trend of portrayal of psychiatry
in the media. And while stigma is a wide issue,
it has its beginnings in the public perception of
mental illness. Arkham looms large in comic
books, videogames and movies. People who
grow up on Batman become aware of it, and
this terrifying and nasty environment must
surely become internalised, one of many
impressions to be called upon when they
encounter mental illness in the future. And

here is one other particularly troubling

there it will remain: gothic environments, scary

aspect of The Joker, and that is the fate of

patients, evil staff, and no recovery.

his psychiatrist Dr Harleen Quinzel. It is

something of a trope in popular culture that
psychiatrists fall in love with their patients, but
Dr Quinzels case is even more troubling: she
styles herself after him, becoming a deranged
super-villain named Harley Quinn, and begins
a life of crime and terrorism specifically to
garner the affections of The Joker. It is here
that one of the most troubling aspects of
stigma is personified: that mental illness is in

by Dr

Colm HHennessy

ST6 in Child and Adolescent Psychiatry

Former Surgo Editor

PLAYING THE

SUPERVISOR

GAME

by Trung Ton
Starting clinical placements can be a daunting
experience come third year and beyond. It is a
completely different to those PBL and VS
sessions; a sense of freedom and responsibility
rains over you as you step onto those busy
wards. However, as much as you want placement
to be your own learning experience, the ultimate
fate of whether or not you have to cancel all
summer/elective plans and resit a placement is
up to one person - your supervisor!
Supervisors come in a variety of flavours in the
world of clinical placement; each one has their
own style and attitude to supervising. It is up to
you to use your own judgement on how to get the
most out of your supervisor, and how to play the
supervisor game.
Here are some supervisor personas you might
encounter:

THE ENIGMA

THE OLD SKOOL REBEL

THE KEEN BEAN

So its nearly the end of week 3 of 5 of

your placement and youre starting
to wonder, when will I meet my
supervisor? Why haven't they replied
to my five thousand emails asking to
meet?

2 portfolio cases, mini cexs and

CBDs?! Not in my clinic!
The Rebel has their own ways of
teaching you the ways of medicine
and will not stick by the jurisdiction
of the medical school clinical years
guidebook!
There are a variety of ways in which
the rules can be bent to their will.
Some supervisors may not require
any portfolio cases, others may
demand a case a week. Some will not
give a damn about your reflection
and how the case has made you a
better person, while others will
think you are a cold hearted monster
if you didnt mention the social
aspects of a patients life.

The keen supervisor is the one who

really wants the most out of you,
and would have you by their side at
all times. Forget all teaching,
friends, lunch...your supervisor is
now your life, your heart and soul
of your 5 week placement. They
want you there at every clinic, MDT,
ward round, theatre list...all in the
name of teaching you. This could be
the best clinical exposure of your
entire medical career but
consequently the most tiring!

The enigma is clearly a busy doctor

who hardly has time for themselves
let alone a medical student!
Sometimes even their own secretary
will have no idea where they have
ran off to. Or they have a secret hate
of students constantly wanting their
signature and clogging up their
inbox.
DO NOT FEAR!.. Continue on with
your block as you would do and
make sure you have all your
necessary cases and documents
ready to present to the Enigma in the
most concise and speedy manner. Be
ready with all necessary online forms
ready to be signed before you lose
track of your supervisor for another
week.

One golden rule here is do as youre

told, or else your chances of a sign
off will be in jeopardy!

Supervisors are still human beings,

and understand you may need a
breather from time to time so do
not fear to ask if you need to get
away. However stick by them as
much as you can and you will
definitely reap the benefits of good
knowledge and that end of block
assessment form signed off!

THE SPECIALIST
Now all consultants have a special
interest. But this kind of supervisor
wants it be your special interest too
and will have nothing else you have
to offer. Even if it is something
youre not particularly interested,
there is no escaping the subject
now. Everything you do will revolve
around this topic and you just have
to accept your fate.
Best thing to do is to stick by it and
you might even learn something
that may come in handy in the
future. (regardless of the fact you
have neglected all 200 other ILOs
of the block)

THE LAID BACK ONE

The dream situation has arisen in
your block; A supervisor who
knows exactly what a medical
student needs in a clinical
placement. These supervisors will
respond with haste to your emails,
meet you at any convenient time
and give you total control of your
learning experience.
All you have to do is to keep your
work up to good standard and you
will be getting that sign off in the
easiest manner possible.

At the end of the day, it is up to you

to make the most out (or very little)
of your clinical placements and your
supervisor is just there to ensure you
are keeping up to standard with your
practice. Some top tips for the
supervisor game:
Contact your supervisor as soon as
you start to arrange a meeting
Get all your assessments done
sooner rather than later
Try to show face and attend your
supervisors clinics etc (if they permit
- this is a good way of getting things
signed off too)
Enjoy clinical placement and make it
your own personal learning
experience - (you will be getting paid
to do it before you know it!)

WANT MORE USEFUL INFORMATION LIKE THIS?

Dont forget to check out Surgos very own website at
www.surgoglasgow.com

How to get the most

out of clinical
placements
It is time

to step up to the fold and do some proper

medicine. You all must be excited and probably a bit

nervous about going on clinical placements. You should
however, remember that these years will be some of the
most exciting moments of your education. Meeting real
patients, solving real problems and doing real medicine.
This guide is about what you can do to make the most of
your time on placements. We arent talking about having
parties in the onsite accommodation; we are talking about
getting slick with clinical skills and history taking skills.
Placements are where you learn to practice, practice,
practice medicine.
In conjunction with Alna Robb we have developed this
guide to help you operate effectively and gain as much
experience in clinical skills as possible.

Before we get started

Placements will vary between hospitals, but they all will
be following the same objectives and themes. Pay
attention to their introduction they give you at your
hospital, and dont forget to read the Guide to Clinical
Years. Doing both of these will put you in good stead for
understanding what is expected of you in clinical years.

Getting the work done!

In order to be competent you need to perform each the
procedures expected of you five times, you can find a list
of these in the clinical skills logbook (If you still have it) or
online via vale or the e-portfolio. Have a list in your

notepad or Smartphone and a plan for the day of what

you would like to get done. Get all of these signed off and
logged on your e-portfolio/vale.

So what can I do?

You can do almost any clinical procedure so long as you
have been trained to do it and are supervised by a
qualified medical professional. So ask your supervisor
what you want to do, ask if you can watch them doing it
and then get them to supervise you doing it!

The Surgical block

For those who like scalpels and sutures, this will be an
invaluable experience, for the rest of us, just try not to
faint at the sight of blood. This should be a very
enlightening experience as many of you will have never
stepped into an operating theatre before.

STOP, Hand washing time!

Urinary Catheterisation

As a first initial priority, get your hand washing technique

assessed and get it mastered properly, youll be surprised
how many slip up on this basic skill. This is especially
important on the surgical block.

Most patients will be catheterised in theatre, so try and

get as much theatre time as possible. You will be shown
meticulous aseptic technique and the procedure will
generally be easier, as the patient wont be conscious
when having a tube passed up their urethra (as you can
imagine this is very uncomfortable).

Follow the patient

their operation

Injection technique
On the surgical block your subcutaneous injection
technique competency can be completed very easily as
most patients receive subcut heparin when on the wards.
These injections usually occur at about 0800 and 1800,
nursing staff usually do these, but if you have a chat with
the lead nurse (in some hospitals still called the ward
sister) you should be able to get trained to do them and
perform some yourself. In about 2-3 drug rounds you
should have completed competency
In terms of intramuscular injections, you may get the
opportunity to do these before the patient goes into
theatre but you will need to check with the nursing staff
beforehand.

through

One of the best learning opportunities to do in the surgical

block is to follow a patient though surgery. You can gain a
number of key skills and see the hospital machine in
action. Here is a step by step guide as to what to do. Dont
forget permission, training and supervision must be
adhered to at all steps:

1.

If possible, look at the theatre list for the day and ask
permission from your consultant to follow a patient
though their journey. Pick a patient who is likely to
be in theatre for a few hours.

2. Get permission to follow the patient though the

journey from the patient the day before the surgery.
3. Get your own history from the patient and enquire
with your consultant what procedure he/she is having
done.
4. Revise your anatomy/physiology regarding the
procedure the night before, as the surgeon may ask
you questions.
5. The next day be on the ward well before the patient is
due their operation. Give your phone number to the
ward sister to call you if timings change.
6. Observe the surgical checklist that is carried out
before the patient leaves for surgery and escort the
patient to theatre. Hopefully the theatre reception
and staff will have been informed you will be following
the patient through theatre.
7. Observe the handover of the patient.
8. Go change into theatre scrubs and meet your patient
before they head into the anaesthetics room. If you

have been following the patient thus far, they may

consent to you performing a cannulation under the
anaesthetists supervision.
9. You then may have the option to stay with the
anaesthetist and scrub in to theatre

The Medical block

This is where you can get the majority of your skills
polished that you already know, whilst gaining many new
ones ( These can also be applied to the surgical block too).

10. Observe, and perform a surgical scrub (handwashing

skill up!) under supervision of the theatre staff. You
will also be shown how to Gown up following aseptic
technique.
11. You may be able to catheterise the patient under
supervision, once the patient is under. If you are really
lucky you might be able to do a few surgical clips or
sutures!

Observations

12. After the operation, accompany the patient into the

recovery room and help with observations (see the
observations section). You will see how intensive
these are investigated post theatre.

Basic observations such as Pulse, BP, RR, ECG, GCS, urine

output and early warning scores are basic clinical skills,
however you should try to learn them in context of a
patients condition. When you have free time on the
wards, offer to the ward sister/nurses to do the
observations for 20 minutes or so. You may call doing
these Basic but learning to recognise patterns in a
patients condition will be an invaluable skill in clinical
practice, not to mention you will become very slick at the
basic procedures, and the examiners like that!

Nasogastric tubing
13. You will also learn in the recovery room oxygen
therapy technique (masks, observing ABGs, pulse
oximetry) and other skills such as IV drug therapy and
ECG procedure and interpretation.
14. Once the patient is ready to return to the ward,
accompany the patient back there and observe the
handover to the ward staff. You could also try having a
go at this under Supervision.

The time to look out for NG tubing in particular is on the

GI, pancreatic and surgical wards. The nursing students
usually have dibs on the first few but if you inform the
sister on the ward that you would like to do one, usually
you will get the chance to do about one per week. Even if
they say no, ask if you can watch, and still improve your
skills.

Venepuncture
Your consultant can usually give you some opportunities
to do this, but If the phlebotomist is on the ward taking
blood, ask them if you can perform a few. The
phlebotomist has a time schedule to keep and wont let
you perform too many, but get a few under your belt and
youll be well on your way to clinical competency.

ECGs

Quickfire Questions

Whilst on placement get yourself some time spent at the

cardiac clinic, patients here will have an ECG performed on
admission, you can learn how to perform, do one yourself
and practice interpreting them. You should be able to get
all five ticked off before you even leave the unit!

Can I go to A&E?
Yes, some days during your five week block, your
consultant may be on call for A&E or acute recieving. You
might be starting later in the day but be working later
when called to A&E. Whilst in A&E dont panic, play by the
rules (do exactly what the staff ask of you, you may be
helping with procedures) and remember your ABCs.

Will we be expected to be in 9-5?

It depends on your hospital, but you may be in 9-5 or even
later!

Are we expected to do weekends?

Histories
These will be the meat and gravy of your placement, do
them frequently and often. Patients will have had histories
taken from them on admission but you can perform some
yourself, be aware to ask the ward sisters before doing
this. Tell the patient why you want to take their history,
otherwise they may get annoyed about being repeatedly
interrogated. Tell them you are still learning and that you
would like some objective feedback. You could use a
feedback form from the VS com skills sessions in order to
make this easier and have a record of this. Check your
clinical skills logbook for the list of histories to take.

As a rule no, but if you wish to do so, make your

consultant aware and they should be able to help you. You
could use this time to catch up on your clinical skills youre
lacking in.

Should I bring chocolates to the nurses to make them

like me?
Please dont, the best thing you can do is to be polite,
friendly
and
respectful
(there
is
no
Nurse/Doctor/Auxiliary/Med Student hierarchy.)

Do I need to revise/study anything beforehand?

Your supervisor should be directing you in your learning,
but use your experiences to highlight areas for you to look
into. If you are following a patient through surgery, read
up on the anatomy and physiology related to the
procedure beforehand. Watch the clinical skills podcasts if
you are unsure how to do any of the core clinical skills.

These include but are not limited to: Respiratory, CVS,

Neurological, GI, Rhemo/Ortho, Endocrine, Renal/urinary.

General tips for placements

]

Make yourself visible on the wards to the ward sisters. Ask them if there are any
procedures you can do/help with (it may help to give them a short list of the things
you want to do)
Be polite to the staff, people love to teach so express you love to learn
Be on time, five minute rule!
Have a checklist of things you want to do each day/week and have a plan
If you cant do a procedure watch it and gain experience
There is always something to do on the wards, tell the nurses if you want to do things
Above all have fun on placements

So, there we go, a whistle-stop guide to clinical placements. We hope

this helps you in your endeavours. Have fun, enjoy yourselves and be
some great doctors!

A production by the 2017 Beta year club; Author: Tom Ainge

Image attributions:
https://medicalhumour.files.wordpress.com/2012/09/warning-medical-student-who-wants-to-take-your-history.jpg?w=914
http://news.bbcimg.co.uk/media/images/60028000/jpg/_60028231_m5200213-hospital_hygiene.jpg
http://www.telegraph.co.uk/news/worldnews/northamerica/usa/11197280/Operation-inventor-needs-money-for-his-own-operation.html
http://www.excellenceinjections.com/subcutaneous-injections/
http://www.theredlist.fr/media/database/films/tv-series/sitcom-and-soap/2000/scrubs/005-scrubs-theredlist.jpg
http://www.osceskills.com/e-learning/subjects/intravenous-cannulation/

Losing Our NHS

Here goes another rage
article. I challenge you to read this
article and not be shocked, sickened
and appalled. The 2010 election
campaigns of all political parties may
have differed, but all major parties
seemed to stand united in a pledge to
protect our NHS both in quality and
budget. David Cameron promised No
cuts to frontline services, real-terms
increases to the NHS budget, and no
more top-down reorganisations.
Within weeks he began to break these
promises. In the shadows; hidden
behind euphemism, carefully worded
contracts and cheery hospital visits;
the Conservatives have spent the last
4 years making the NHS ready for
sale.
Following the general election,
2011 marked the first fall in a decade
and the biggest fall in NHS approval
ratings in three decades, the ratings
fell from 70% to 58%. Government
ministers slating of the NHS in order
to justify their reforms no doubt must
have a role to play in this. The current
coalition has starved the NHS and
then taken to the headlines asking
why it isnt performing as well. It
would indeed seem a very clever plan
to create a situation in which the NHS
cannot perform to meet its targets,
criticise it for failing and then begin to
talk of ways to fix it. Ways like, I dont
know, of fering deals to private
companies? It seems our health
service has fallen victim to a smear
campaign, smeared with bad
headlines in a preparation to be
served to the bidder with the most
connections. If you want to look for
who is gaining from this then look no
further than Westminster itself. 1 in 4
Conservative Peers have recent or
present financial connections to
companies or individuals involved in
healthcare; Andrew Lansley himself
has received at least two donations
from individuals in private healthcare;
Nearly 40% of GPs on Clinical
Commissioning Groups have an
interest in selling products they are
commissioning. This is just the

by Michaela Jewson

beginning of a list of shocking

statistics linking MPs to private
healthcare companies and suggesting
ulterior motive for awarding private
companies NHS contracts.
All of this begs the question,
how are firms making profit from NHS
services that we are struggling to
provide? Many of the companies being
considered and sometimes awarded
these contracts have previously come
under fire for substandard care in
care homes and hospitals. If these
companies do decide that the services
they have chosen do not work as a
business decision, they able to pick
up and drop services as they please
with little consequence or
accountability, for example the return
of Hinchingbrooke Hospital to the
NHS after the private company
running it failed to meet standards
and came under scrutiny. There is no
such get out clause for the NHS to
cut short the contract if the private
firms fail to provide an adequate
service.
In a recent scandal, Alliance
medical has recently won a 10 year
contract to provide diagnostic services
despite their bid costing 7 million
more than a bid from NHS trusts.
When looking for an explanation for
this, I can probably give you less than
three guesses until you get it right. It
cannot be confir med but David
Cameron has not yet revealed if ex-

minister Sir Malcolm Rifkind

influenced the deal with Alliance
Medical, the Tory MP who actually sits
on the board of the private healthcare
provider has since resigned as an MP
after having been found accepting
cash for access. 70% of contracts put
out to tender are now won by private
firms. This arrangement is even more
worrying when coupled with the fact
that the most recent contracts set
performance targets and standards
after deals are signed and the contract
is won.
As shocking as the actions of
the government is the cover up. The
conservatives have recently deleted
every article, speech and press release
released before the last election from
their website. Is this as they have
said an effort to make the site easier
to read or an effort to sweep under the
rug the totality of the promises they
have broken to date? Since the
coalition has been in power we have
lost: 5,870 NHS nurses, 7,968
hospital beds, a third of ambulance
stations to name a few. The massive
top down reorganisation that has
occurred just weeks after the Tories
promised it would not has diverted
approximately 3 billion away from
patient care.
My opinion? We wont have an
NHS anymore if we have another term
of conservatives in parliament.

Do#you#have#a#very#
particular#set#of#skills?

We#will#nd#you#and#you#will#write#for#us.#
if$you$would$like$to.$$There$is$no$pressure$for$a$long$term$commitment.$We$
appreciate$all$enthusiastic$contributions$and$ideas!$
Contact:#surgo_editor@hotmail.com

e s s e n t i a l

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The Lectured Become the Lecturers

But should we be forced to endure them?

Sound familiar? Above is an article

from a 1977 edition of Surgo. How many
of us have complained about a lecture? It
seems that the use of the slide projector
(or PowerPoint) as a psychological
weapon is just as common now, in 2015,
as it was when most of our lecturers
were, themselves, being lectured.
What is proposed in the article
above, is the beginning of the whole PBL
idea - self directed learning. All of us
spend the first two years here doing PBL,
then progress to CBL to learn how to
proceed with the care of our future

patients. However, most of you will agree,

it is only with lectures to complement
this learning that we are able to become
good clinicians.
Having said this, lectures do not
suit everyone, so Surgo asks you this:
Do you think attendance should be
taken in lectures and why?
Please email your opinions to the
editor at surgo_editor@hotmail.com and
we will incorporate the best answers into
the next issue.

surgoglasgow.com

Happenings in MedChir
SCRUBBY!
A solid effort all round from the 492
attendees of Scrubby 2015! The blue tide
filled up the beer bar, Viper and pubs
across the city. Despite it being Friday
the 13th no one was injured, although a
7 year old Govan resident did take a
swing at a first year (he probably had it
coming).
A personal highlight was a
rammed Bellrock Bar singing along to
Whitney Houston.

Welcome Back Pub

Quiz
Surgos first ever legit event went
pretty much as planned and the
winning team won the enviable prize
of out-of-date Subway vouchers. Who
says we dont treat you right? First
Year Rep Shereif knocking over a table
covered in pints was pretty funny,
such a waste of Tennents though. We
also put old issues of Surgo to good
use, as shown by the big Munn
himself

MedChir Revue
Oh what a night! Talent was abundant
and came in many forms including a
particularly jovial Irish Dancing act.
Jesse Dawson, Prof Walters and Alna
Robb were the judges; euphemisms and
sexual innuendos firing left, right and
centre, though mostly in the direction of
Alna.
Med-Chir provided a satirical
clinical skills session with 5th year Anna
Yule as Alna, which thankfully went
down well. An all-round excellent night
and bring on next year!

www.surgoglasgow.com

WE

BALLSED
IT UP

Three bells, three barfs, one burn.

Here is this years

3rd

year ball

experience in a nutshell.

After months of planning and

anticipation, the halfway ball took
place from 11th to 13th of February in
MacDonald Cardrona Hotel, Peebles.
We were all sick of spending our
nights in the Study Landscape eating
food from the reduced section in M&S,
and listening to those students
claiming they know literally nothing
yet somehow always seem to get on
the honours list. With everyone
looking forward to it for so long could
it possibly live up to expectation? One
hundred and eighty medics drunk for
two daysof course it did!
With most of us having far too many
at the Beer Bar after Tuesday's MEQ
and with THREE students ringing the
bell (cheers to Michael, Cameron and
Iain), it was somewhat remarkable
that we all made it for the buses the
next day. We got off to a shaky start
Sam, Caitlin and Ross decided to
paint the buses with a cheeky bit of
vomit on the way to the hotel, however
we soon settled in to our fancy digs
and had a lovely time listening to
singer/songwriter Tony McHugh and
enjoying a hard earned pint.
A game of Ring of Fire was started
almost as soon as we arrived to the

hotel and within the hour people were

more daring. Some keen beans, who

well on their way. Joe was drunk by

obviously didnt drink enough the

3pm and with each passing sentence

night before, even went to the gym!

became more and more Welsh.

The

Here there was more grunting than a

Kings cup was overflowing with

pig orgy as Dominic Waugh was lifting

champagne, vodka and fair amounts

in front of the mirror to improve his

of pubic hair.

pectoral muscles, which allegedly can

The first night was themed

spurt whipped cream on demand.

Superheroes and Supervillains. Some

During the evening we had a drinks

people really made an effort with their

reception and a lovely three course

costumes Anna Leersen dressed as

meal. This was followed by a ceilidh in

Sauron,

but most of the other girls

which Jordan Newport looked like

dressed as Poison Ivy. Other people

Ricky Martin on coke. At one point he

dressed up as someone who cant hold

nearly dislocated Annas arms from

their drink and really true to

her sockets. There was a beautiful

character, passed out at the dinner

rendition at the end of Auld Lang

table. The night came to an end with a

Syne, Loch Lomond, and of course

DJ serenading us with classics such

Angels (again). Following that we

as Angels by Robbie Williams, the

danced the night away to hits from

anthem of our year.

Britney Spears to Kanye West. It was

Sometime during these festivities Iain

MacLeod and Lewis Walker decided
they should race down the corridor to
see who was the fastest, but we all
know both men can only last 15

great to see David swaying around to

the beat and sweating profusely. At
around 4am most peoples legs had
given up on them and we retired for
the evening.

seconds anyway. Iain was first to

Friday morning was a day of great

cross the finish line, but face-planted

regret and we all left feeling sad and

the ground in triumph and gave

hungover, or in my case still drunk;

himself carpet burn down the left side

making those who made the bus look

of his face as a reward. Maybe it is

like extras from The Walking Dead.

good that he nearly lost his left eye as

Unfortunately some poor souls didnt

Sam got locked out of his room in his

make the bus on time (Catherine,

birthday suit and the night porter had

Maria and Abi) and we are told they

to be fetched to save him from this

are still trying to hitchhike home.

compromising situation.

So that was the Ball in a nutshell. It

There was a bit of an altercation on

seems like there wasnt a great deal of

the upper floors when Dominic Waugh

scandal but unfortunately our lawyers

was left with a bit of periorbital

have advised against including those

swelling too we are not sure what

stories. Beta -2017 Year Club would

the relationship between ocular

like to thank everyone who came and

injuries and the hotel is but well keep

also those who supported our events

an eye out for more information. The

during the year. We had a ball!

second afternoon was a lot more

chilled out some people went to the
pool, others took 6 hours to play 18
holes of golf, and we had rented out
sumo suits for those who were a bit

By Year Club Beta 2017

Clinical Anatomy of the Transverse Acetabular Ligament

Craig R Johnstone
Supervised by Dr Quentin Fogg
Introduction

dissected acetabuli with an outline of the TAL and

The transverse acetabular ligament (TAL) is a poorly

attachment sites were created as for dry bones.

understood aspect of the hip with limited morphological

description in the reviewed literature. It is often used as a

Results

landmark for orientation of the acetabular component in

The TAL extended beyond the acetabular notch, around

total hip arthroplasty (THA) but its suitability is debated.

the circumference of the acetabular rim. Two attachment

The aim of the current study was to investigate the

sites were identified in each specimen in the superior half

morphology of the TAL. It was hypothesised that the

of the acetabular rim; one anterior and one posterior. In

current description in the literature is insufficient.

one specimen, an additional attachment site was identified

on the posterior horn. TAL length in each specimen as

Materials and methods

measured from 2D digital photographs were 132mm,

Seven dry bone hemi-pelves were reconstructed using a

117mm and 179mm, with attachment areas of 215mm2,

microscribe and rhinoceros 4.0 3D software. Hips (n=3;

150mm2 and 350mm2, respectively. There was marked

F=2) were dissected to expose the TAL. The TAL was

variation in ligament breadth between and within

removed and a footprint taken of its perimeter and

individual specimens, ranging from 2.6 to 5.3mm and 3.2

attachment sites for measurements. 3D models of the

to 6.3mm in the smallest and largest specimens

respectively.
Discussion
Contrary to previous literature, the TAL was found to
extend far beyond the acetabular notch, and its attachment
sites were found more superiorly on the acetabular rim
than previously described. The unexpected length may
explain disagreements surrounding its use as an
anatomical landmark. Further biomechanical research may
determine which part if any of the ligament the
acetabular component should be orientated against.

True Facts about the Hip

Acetabulum

It takes about 3000N of force to

Ligament
of femoral
head

Transverse
acetabular
ligament

fracture a hip. A car hitting you at

30mph transfers about 21000N into
you.
Gorham's Disease is a rare disease
causing osteolysis, thus rendering the
patient boneless.
In the early 1970s, DJ Kool Herc
coined the term Hip hop to describe
his epic funk block parties in the
Bronx.

S
T
I
SH
Part 1 : Diet Selection

Surgos Highly Interesting Toilet

Study
An analysis of the most
commonly occurring celebrity
diets on Google.

the five diets returning the largest number of Google search

results will be selected for study.

Daniel Taylor-Sweet1
1University

Results

of Glasgow, Glasgow, Scotland

March, 2015
Funding: No funding was received or applied for.
Conflicting Interests: None
Ethical Approval: Applied for ethical approval from
MedChir Ethics Committee, pending approval.

Background
One in five Britons will have commenced a new diet at the
start of the year, in a vain attempt to shed pounds and help
sculpt a perfect beach bod. Many of these people attempt a
celebrity diet that they have read about in the high impact
nutritional journal Cosmo. SHITS is less concerned with
the effect of the diet or the amount of weight they lose but
far more interested in how the diets affect their poop. We
aim to assess the effect of commencing a celebrity diet on
poop quality and quantity. No study has investigated this
area before. Prior to commencing investigation into the diets
effect on poop we aim to determine the most commonly
occurring celebrity diets online.

Five diets were selected for study. The most popular diets
were: Gluten free diet [61,400,000 results], Sugar free
diet [51,200,000 results], Raw food diet [32,200,000
results], 5:2 diet [20,000,000 results] and Paleo
diet [13,700,000 results].
Conclusion
The wide variety of celebrity diets listed on the Internet
shows a trend for diets to be based on removing certain food
groups from ones diet.
Another trend can be seen in the rise of diets encouraging
eating foods that are uncooked, natural or unprocessed.
It is unclear on how the selected diets will affect the
participants' poop. SHITS: Part 2 will investigate this.

Methods
SHITS will comprise of two parts; Part 1: diet selection and
Part 2: diet's effect on poop.
Part 1 will include an initial Google search will be completed
to find popular celebrity diets, which will be recorded.
A preliminary list of diets will be created for analysis. Any
diet designed to be completed with an adjunctive exercise
program will be excluded from further analysis as will any
diet involving the consumption of dangerous or illegal
substances.
Following application of exclusion criteria a subsequent
Google search will be completed on the diets identified and

Paleo?

5:2 D ie t ?
ee?

fr
Gluten

Raw food?

Free
Sugar

OX
T
DE
Go for a run

Glasgow University General Practice Society:

ETHICS CASE!

Hello! Welcome to Glasgow Medical Schools latest society. GUGPS hopes to get
more of you interested and thinking about a career in general practice. We have lots
of exciting events planned for next year, so watch this space for more information!
Ethics is a huge part of general practice, and those of you that choose a career as a
family physician will be faced with ethical dilemmas on a regular basis. So GUGPS
have decided to team up with SURGO and get you all thinking about ethics a bit
more, by giving you an ethical case to solve in every issue! Well point you in the
right direction with some questions- and in the next issue- well tell you what the best
solution would be (the solution that will let you keep your job!)

The Case: Oliver Klozoff and the Foreign Liaison

Oliver Klozoff, a 27-year-old CEO consults with you, complaining of dysuria following
a trip abroad for business. Both he and his wife Emma are patients of the practice.
Investigation reveals the presence of a Chlamydia infection. At your next
appointment you suggest that Oliver should tell Emma about this problem, because if
she is not diagnosed, treated and followed up she could suffer long term harm. Oliver
refuses, saying that their marriage is already in difficulty and this would be the 'final
straw'. He also refuses to use condoms because he feels that Emma would be
suspicious. When you challenge him about the threat to the health of Emma, he asks
you to take a swab from her on some pretext, and then treat any infection that you
discover.
Questions1) Would you go along with Mr. Klozoff's suggestion?
2) What other options do you have?
3) Would the situation be any different if Emma was not your patient?
4) Would your decision be any different if the infection was Candida instead of
Chlamydia?

CONTACT GUGPS: Facebook: Glasgow University General Practice Society/ Email: gugpsociety@gmail.com
President: Mita Dhullipala

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