SOUTHAMPTON MEDICAL SOCIETY
President: Dr Alan Roberts FRCP
A meeting of the Southampton Medical Society was held on Zoom on the 12th of January 2022. The President was in the chair. A period of silence was held in memory of Dr Tom Wade West. The minutes of the previous meeting were approved - proposed by Mr Gordon Masson. The speakers for the evening were young doctors who had received Foott Memorial Bursaries for their electives - which in 2021 had to be taken in the UK. The President introduced each speaker in turn.
Our first speaker was Dr Hanad Ahmed. He spent his elective at SGH having had to cancel placements first in Cape Town, then Toronto then Papworth due to the Pandemic. He spent 12 weeks in the cardiothoracic unit at Southampton General Hospital. It was divided between Adult Thoracic surgery, adult cardiac anaesthesia and the ICU, and paediatric thoracic surgery and the PICU. He focussed his time on research and being in theatre - learning what it is like to be a cardiothoracic surgeon. He described a couple of patient cases, for one of them he became involved in the writing of a research paper, in which he is named, on the use of endobronchial valves in the management of persistent airleak in Corona virus 19 disease. It has been published in the Annals of Thoracic Surgery. He was extremely positive about his experiences and the trouble consultants and staff took to make him welcome. He experienced, he said, the highs of success and the lows of failure and how it tested the integrity of one’s character.
Dr Ellen Bodger was introduced next. She divided her time between a Moderately Secure Forensic Psychiatric unit in Leicester and Palliative care at the Countess Mountbatten Hospice in Southampton. The psychiatric unit is for offenders who cannot manage prison. The patients, both male and female, have severe personality disorders. She described how her time there was spent interviewing patients and helping with their medication. She found the terrible backgrounds of the inmates and what they had seen and suffered an eye opening experience. It was daunting to be in a unit with so much security. She also learned a lot about the law - which you do not get taught at medical school she added. She said the patients were on a journey of discovery; learning to cope with uncomfortable situations and reflecting on their dislikes as well as their likes. Patients are often on the unit for 4 years before they are able to be transferred to a lower security prison.
Ellen then spent 3 weeks in the Countess Mountbatten Hospice. She attended ward rounds and patient reviews. She found her elective helped with misconceptions about palliative care. It is not a place of death and not sad. It was an uplifting experience learning how death was managed in a positive and dignified way. The aim was to help with symptom management. About 50% of patients would go home, not necessarily to die immediately. Ellen considered she had learned skills very useful for a junior doctor.
She compared the patients in her two electives and found that both adapted to the concept of a limited time ahead in their present situation and how positively both groups learned to view this. The difference being how those dying accepted the ending of life while the prisoners could look forward to trying to start again.
Dr Katie Evans was introduced next. She is interested in infectious diseases and joined a team examining the clinical impact of a point-of-care diagnostic test for respiratory virus detection in patients presenting with acute respiratory illness comparing no antibiotic treatment to routine clinical care with antibiotics in a randomised controlled trial. The test distinguishes between viral and bacterial infections and a result is available in an hour and a half. It has been particularly helpful during the Covid epidemic as a PCR test takes at least 24 hours for a result. One thing that has been shown is that patients are more likely to get Covid whilst in hospital rather than having it on admission. It is a long project and may need 5 years more before reporting. Katie said she learned that research takes patience and persistence. POCT is a remarkable, and expensive, advance in patient care. It reduces the turn around time, reduces nosocomial infections and will have a beneficial effect on NHS expenditure. Be prepared for unexpected outcomes she said.
The last speaker was Dr Methusha Sakthipakan. Covid having cancelled a visit to St Lucia she went to the Barnet, Enfield and Haringey Mental Health Trust. She spent time in old age psychiatry, both community and inpatient care, adult ward and liaison psychiatry and in the St Ann’s eating disorder clinic. She attended daily team meetings and was encouraged to perform a daily reflection on the days activities. All outpatient consultations were on-line which she felt were unsatisfactory. It was difficult to see the patients faces clearly, the clothes they were wearing or their general demeanour. She also attended ward rounds and assisted with ward based diagnosis. She saw a number of cases of severe psychosis as a consequence of drug taking which she found quite scary. In liaison psychiatry she went to A&E departments and general hospital wards and saw the results of overmedicalisation and institutionalisation. Finally she spent time in the St Anns eating disorder unit. The treatment was based on a collaborative approach. Structure was very important. For younger patients family therapy was encouraged. Covid has resulted in a heavier workload especially from older patients.
Whilst there she performed a data audit and also wrote a handbook for medical students on electives.
All of the speakers thanked the Society for their award.
The President said he was impressed by the very high standards of the presentations and that he had found the talks very interesting.
The Treasurer was also impressed. He proposed that the usual award for best presentation should be presented to each of them. This was seconded by the Hon. Secretary.
In general discussion afterwards a member asked the speakers if they thought that an elective spent in the UK was more valuable than one spent abroad? There were differing views on this.