Figure 1. Baby hospitalised for suspected bacterial pneumonia.

Squeezing into our rusty mutatu (bus), we handed over the fare to the conductor, who returned to us less than expected change. In response to our indignant questioning, he defiantly stated, “You are mzungu (white person) and mzungu is money.” This was lesson one in a crash course we had inadvertently stumbled into: “Life in Kenya for the naïve tourist.” More unsettling than being scammed in day to day life, however, was the rampant corruption in the hospital and university setting.

We completed our placement at Kenyatta National Hospital, the largest referral centre in Kenya, with 1,800 beds, 50 wards and 24 operating theatres. I was based within the paediatric ward and paediatric emergency department…

Empathy and the medical student – Practice makes perfect?

The observation of another person in a particular emotional state has been shown to activate a similar autonomic and somatic response in the observer without the activation of the entire pain matrix, not requiring conscious processing, but able to be controlled or inhibited nonetheless. [2] This effectively means that when we see someone in physical or emotional distress, we too experience at least some aspect of that suffering without it even needing to be in the forefront of our consciousness. As medical students we are constantly told to “practice” being empathetic to patients and family members. What we are really practicing is consciously processing this suffering we unknowingly share with these people in order to develop rapport with them (if not just to impress medical school examiners).

We are taught an almost automated response to this distress, including a myriad of body language and particular phrases, such as “I imagine this must be very difficult for you,” to indicate to a patient that we are aware of the pain they are in. Surveys amongst critical care nurses have shown that gender, position, level of education and years of nursing experience have no significant relationship with the ability of a person to show empathy. [1] Thus it could be said that empathy is less of a skill which can be practiced until perfect, and more of a mindset that makes us as human as the people we treat…

During my elective term in early 2010 at the Royal Free Hospital, London, I was presented with a fantastic opportunity: to learn how to perform a laparoscopic gastric bypass procedure. The challenge was for myself, a medical student and complete novice in laparoscopic surgery, to use the hospital’s state-of-the-art screen-based simulation technology to become proficient in a specific operation within six weeks in this rapidly advancing area of surgery.

My training was to be undertaken using the Simbionix LAP Mentor (Simbionix, Cleveland, Ohio, USA): an advanced piece of technology made up of a computer with simulation software and accompanying hardware, consisting of ports and instruments. The difference between this and a video game is the presence of haptic feedback; when you hit something or pull it, you feel the corresponding tension, making it a highly realistic representation of surgery…

Introduction

“‘Change’ is scientific, ‘progress’ is ethical; change is indubitable, whereas progress is a matter of controversy.” – Bertrand Russell

Forty years ago it was generally accepted that a baby born more than two months premature could not survive. Now neonates as young as 22 weeks can be kept alive with medical intervention. This essay will explore the medical, social and legal aspects of artificial resuscitation of extremely premature neonates and argue for a change to a palliative approach towards infants born at the threshold of viability.

Background

Extremely premature newborns face a number of medical problems, affecting almost all systems of the body. These problems include extreme skin immaturity and fluid balance instability, lung immaturity and breathing problems, malnutrition and gut damage, retinopathy of prematurity, early and late onset infections and brain damage which can lead to a spectrum of long-term neurological sequelae. [1,2]…

This photo was the winner of the 2011 Medical Students’ Aid Project photo competition. MSAP is a not-for-profit organisation run by medical students from the University of New South Wales. MSAP’s goal is to send targeted aid to developing world hospitals visited by UNSW medical students on their elective terms. This is done through collecting donations of equipment from hospitals and doctors around the state, as well as fundraising to purchase additional equipment and arrange for delivery of these supplies. To ensure that the equipment sent is appropriate and useful, the hospitals are asked to compile a “wishlist” of required supplies. In addition, MSAP also educates medical students on issues associated with global health throughout the year. To find out more, and how you can help, visit www.msap.unsw.edu.au today!

Introduction

In early 2010 the Commission on the Education of Health Professionals for the 21st Century (the Commission) convened to outline a strategy for advancing healthcare towards a system that provides “universal coverage of the high quality comprehensive services that are essential to advance opportunity for health equity within and between countries.” [1] The strategy focuses on the education of health professionals to empower their capacity as agents of social transformation. [1] This paper endeavours to encourage medical students to think critically and ethically about the consequences of different modes of health finance on the equity of the Australian healthcare system. In doing so, it contributes to this project of health professionalism in the 21st century.

Health finance may seem of little relevance to aspiring or practicing health professionals. However, it is an important determinant of how and to whom medical services are delivered and a critical aspect of Australia’s response to the increasing resource demands of the healthcare system. Rising costs are attributable to a variety of trends including innovative but expensive technology, an ageing population, and increasing prevalence of lifestyle associated disease. Policy makers continue to debate the most effective funding methods to achieve effective use of resources, quality services and equity within the healthcare system…

Sally is a pregnant nineteen year old woman at eight weeks gestation. Sally is currently serving time in gaol and has arrived at the hospital gynaecology clinic with several members of Justice Health.