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3 years into Medschool…

And another year of medical school done!!! 😉

In many ways, the third year was much better than the previous years. Overall, things were finally starting to look up.

In Cambridge, the third year of the graduate course (corresponding to the 5th/penultimate year of the standard course) consists of four specialty rotations of 8 weeks length, interspersed with a week of lectures in-between placements (For more info, see here). In addition, one studies pathology “on the side” in preparation for three big final path exams.

Third year starts early in August when one still feels quite tired from the marathon that is the end of 2nd year: a double whammy of pre-clinical finals followed by clinical exams four weeks later, corresponding to the finals of clinical year 1 on the standard course. Hardly ever have I felt more tired and out of energy/morale than during this time, and the three weeks of holidays which followed did not really allow one to recover fully…

However, starting the first specialty rotation (in my case paediatrics in Ipswich) was accompanied by a new pleasant feeling: no longer did we have to juggle pre-clinical and clinical work, we could finally focus on the clinical side only. What a huge lift for morale! Even though we still had to somehow incorporate pathology into the mix of revision, it was at least possible to match its content to the specialties, as the subjects are a lot more connected.

Furthermore, having just completed the pre-clinical part of the course, it could finally serve as a starting point for tackling the clinical syllabus. All of a sudden, clinical reading and ward-experience made a lot more sense! (As opposed to previously, when one had to learn about abdominal diseases without much knowledge of the human abdomen!). For me, this represented another lift in spirits. Also, it made it a lot more obvious how difficult and even pointless the process of grasping clinical medicine had been previously lacking a proper foundation. What used to be an uphill battle now finally felt easier… what a relief.

Another pro of the third year was that the teaching of the specialties (at least those that everyone experiences in the same hospitals – Addenbrooke’s and Papworth) is relatively established and well organised. And closeby! Compared to the clinical lectures during the first two years of the course, this felt like a huge improvement. Despite some remaining flaws, the teaching was finally useful.

Finally, onto the subject of pathology. The Cambridge syllabus is absolutely enormous and at the beginning of the year, it certainly felt like a massive challenge (as described here). However, even in the early stages of third year when I was still more scared than confident about tackling this subject, I knew that for the first time, this syllabus represented some kind of organised approach to medicine. The overall content definitely covers most areas a junior doctor should know about. Furthermore, the specific details of each disease to be studied for this subject, i.e. definition, cause, pathogenesis, investigations, clinical features etc. pretty much only excluded the treatment of the disease, which is left for the final year (for more info, see here). Working through the syllabus, as painful and longwinded as it may have been at times, was definitely a good foundation to proceed to the final year of the course.

In summary, third year was a big improvement compared to previous years. Before, when it came to clinical medicine, I had felt completely lost in the huge grounds to be covered. Now, for the first time, I felt as if I had at least heard of everything once and can now build on that knowledge in the final year. Yay!

Teaching with a Vision

I mentioned in a recent post that I haven’t yet detected any great vision behind the medical teaching in Cambridge. Today, I’d like to write about a place where I have actually experienced teaching with a vision: at the university where I did my undergraduate degree. Ok, admittedly I did not go to a large state-funded university, but the small private University Fresenius in Idstein/Germany (where I did a chemistry degree), but I don’t think it’s necessarily the source of funding that makes a difference here.

In Germany, the name Fresenius (for an article on the Chemist Carl Remigius Fresenius, see here) is associated with excellence in analytical chemistry. Therefore, one strong point of the chemistry degree at Fresenius Uni is still a solid background in analytical chemistry to this day. However, being named after the great founder of analytical chemistry does not mean that the university is resting on its laurels. A quick visit to the website reveals that the chemistry course has undergone several transformations since my graduation year, proof of ongoing improvements and adaptations in times of change. Already when I was a student, the curriculum had been refined over the years by constant feedback from industry, ensuring that it was up to date, but also that the graduates would be readily recruited and employed. Furthermore, I found the content of the course very well constructed, both in terms of what was taught and what content was omitted (that’s also important!), as well as in terms of organisation. (Ok, to be completely honest, those who’ve known me since then know that I sometimes wished at the time to learn particular topics in a bit more detail, such as quantum chemistry, but that still has not changed even today as a student in Cambridge. It’s obviously more to do with my personal preferences than anything else!)

Studying at Fresenius, it seemed as if someone had sat down initially to really think about what knowledge makes a good chemist and then built up the curriculum from first principle, open to constant improvement. The key philosophy seemed to be the communication of what is the most comprehensive “working knowledge” of a chemist, and to really bring across these principles. One way in which this was achieved was the high amount of practical lab teaching, more than 50% of the time if I remember correctly. Apart from the obvious different disciplines of chemistry, the overall masterplan also included the possibility to integrate minor studies in other subjects such as economics and languages, in order to develop a well rounded set of skills relating to a career in chemistry. Another very important aspect of the degree was the possibility to study/work abroad for up to 3 semesters (of 8 in total) during the final two years of the degree (which by the way I took full advantage of, as explained here).

All this is the result of a conscious effort to not just educate excellent chemists, but “international chemists” equipped with a set of generally applicable skills indispensable in our modern world. I think all this is possible because the groundwork is laid down so conscientiously, which enables students to develop into their own direction and indulge in more detailed studies, able to fall on the fertile ground of a sound foundation of knowledge.

Germany is different to the UK in that there aren’t (m)any elite universities with longstanding traditions (although there is a discussion if this should be changed), and there is a much more common-sense attitude towards the significance of school grades. As a result, there is no restriction on the A-level average of a student wanting to study Chemistry at Fresenius or anywhere else (apart from the requirement that he/she gets an overall pass, of course). Some may say that this puts a limit on the quality of graduates that can be produced, but I am convinced that every student going through the Fresenius system, no matter how academic or not, will emerge with a sound knowledge of chemistry in the end. I think this steady output of good graduates is quite an achievement in the light of the generous admission policy and is certainly tribute to the educational philosophy. In Cambridge and Oxford on the other hand, where only the best A-level students of the country are admitted, I don’t think it’s as surprising that the graduates are excellent, because they were already excellent in the first place. (Sometimes I even think they are excellent despite the teaching they have encountered, not because of it! ;-))

To sum up, as a result of this overall vision, I think that the students graduating from Fresenius enter the professional world with a great foundation and working knowledge of Chemistry, perhaps not excessively familiar with the academic intricacies of the most advanced chemical topics, but well rounded and ready to be placed in any lab and start working. I don’t think this is the result of chance, but of a well thought through approach to produce exactly the type of graduate needed in the world of chemistry.

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I definitely think that every course on offer in an institution should be based on an overall vision or special philosophy, whatever that may be. This allows a course to stand out among the plethora of available programmes and gives the students something unique along the way. Fresenius definitely shows that this can be done, even on a smaller budget and without relying exclusively on the best students in the country.

2 Years into Medschool…

Some Aspects of Studying (Medicine) in Cambridge.

After two years of studying in Cambridge, I’ve made some observations about the learning experience here. I can’t help that it will be a rather negative post, but I am sure you can find plenty of articles praising Cambridge for its amazing education elsewhere.

In fact, I think the many purely positive reviews can set students up for disappointment once they identify an aspect of Cambridge education that isn’t ideal, and I’ve seen a few of the more critical students doubt themselves and feel isolated in an environment where criticism is not welcome (They ask themselves: If Cambridge is one of the best institutions in the country, how can it be that I am unhappy?).

Today, I will mention four issues I’ve identified. Some of them came as a bit of a revelation to me. Understanding what it was that bothered me and why I was not enjoying certain aspects of the course definitely helped me do something about it, or just accept the facts and get on with it. Perhaps it will help others as well.

 

1.     Lack of a grand vision

In terms of the overall medical course, there does not seem to be any grand vision, guiding philosophy or master plan on how to teach medicine in the best possible way. If it does exist, it is definitely not communicated well enough or not obvious in itself.

In general, there should good reasons for why and how every element of the course is taught in order to avoid inefficiency. Strategic thinking and more intense feedback from the medical profession on course structure could yield a more concise syllabus.

As a particular example for the lack of overall structure, the different pre-clinical subjects are taught alongside each other completely independently, rather than in a complementary way. There is definitely need for more cross talk between the different faculties ensuring optimal timing of subjects throughout the year and lack of redundancy.

In terms of clinical teaching, there seems to be even more of a piecemeal approach and scope for inefficiency. We are often told that “medicine is an apprenticeship”, but this statement also seems to serve as a convenient catchphrase to hide behind when criticism surfaces. I am convinced that systematic approaches to teach medicine do exist and I am sure they are employed by other leading medical schools in the world. In fact, I am determined to find out more about this and will write about this topic again in due course.

 

2.     Convolution of information

As I already mentioned in an earlier post, information is often presented in an undigested, incoherent and badly organised format. Unless one wants to pass exams by rote learning random facts, one has to reorganise all the information. This represents an enormous time investment for each cohort of students and I don’t think it is an important learning experience in itself.

If the building blocks of medicine could be presented in a more logical and concise manner, students could grasp the information much quicker and would have more time to really indulge in in-depth knowledge, leaving them with a firmer grasp of the subject and a better foundation for the future.

These issues also have practical aspects, some of which are hilarious. We all know that many components of the medical curriculum aren’t rocket science, but simple things don’t always remain simple in Cambridge. Sometimes one almost suspects intent behind the fact that access to simple information is made difficult in some way, so that the ultimate challenge is not to know the information for the exam, but to have jumped through hoops in order to get to it.

For example, content of many physiological subjects is displayed on departmental posters during restricted viewing times. These posters are older than most of the students on the course (they have been typed on a typewriter!!) and are not available electronically. Therefore tens of students crowd in front of them at any time, scribbling down the information presented. It would be very funny, if it weren’t so unpleasant for those involved.

Another example is the clinical school’s online resource, one of the least intuitive platforms I have ever come across. People joke that once you have found something on this system once, you will never find it again, and sadly this has been true on many occasions.

It is interesting that very few Cambridge learning materials are available to the public. Some people are convinced that if they were, the differences between Cambridge and other leading universities would become obvious very quickly.

 

3. Large difference in what is provided and what is expected of the students

On accepting the shortcomings of some of the teaching that is on offer, one is then struck by the great discrepancy between the leniency of the course organisers towards themselves and their teams, and the utter perfection that is expected of the students.

In my opinion, it is a major cause of demotivation, as inspiring a feeling of inadequacy among the students does not foster a desirable environment for learning.

 

4. Constant assessment leaving no room for learning

This is another point regarding the environment for learning. Learning obviously requires processing and understanding of the information to be memorised. At some point this processing has to take place because learning (at least of the more complicated topics of medicine) is not an instant event.

However, there isn’t much time for this processing to take place overtly. I often had the impression that questions associated with the process of learning weren’t generally welcome and would trigger answers that were judgmental rather than explanatory. Even though proper exams only take place at end of the academic year, students are constantly under assessment, even when they encounter facts for the first time and need some time to absorb them.

As a result, there isn’t actually much time for learning in the presence of university teaching staff, both in the departments and the colleges. While some supervisions certainly present an exception, in general they also take more of an inquisitive format.

What remains is for the student to do the actual understanding in their own time. With a full schedule, the time for this is scarce, especially on the graduate course. If nothing else, this is another unnecessary source of inefficiency.

The more I think about it, the more I realise that Cambridge often confuses teaching and learning with assessment. But assessment alone is just not enough….

In my opinion, the atmosphere would greatly improve if there were also some protected times when students can go through and enjoy the process of learning without constant external pressure.

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Anyway, these were some of my impressions over the past two years. I think Cambridge will definitely have to address some of these issues if they want to compete internationally in the long term.

Good and Bad Teaching…

For months I have been pondering about what it takes to teach (science) well, inspired by many far-from-ideal lectures I had to endure. At the beginning of this academic year, we had three great lectures within first week only (exceeding the number of great lectures of the whole last academic year), so I decided to put this blog entry on hold. Now it’s 6th week and there definitely haven’t been any great lectures since, so I am back to thinking… the writing is still in progress, but I thought I put up these two pictures in the meantime. In my opinion, they summarise the bottom line of ideal versus reality….

Number one is how I would imagine one would go about teaching. Start with the basics (the foundations, but it seemed too hard to draw a basement) and then build on them.

Number two is a summary of how I often feel in lectures. Imagine the paper shredded… It was too hard to draw that, too!! 😉

1 Year into Medschool…

one year ago, i put my scientific career on hold to start an adventure… med school in cambridge.

i took this leap in order to work more closely with people rather than proteins, to do something more applicable that may perhaps lead me to a new direction of (potentially more fundable) research in the future. even though i loved my job, the science and academic life, i wanted to do something more tangible and be able to approach science with a much broader perspective.

so i moved from oxford to cambridge in september 2010, ultra-keen and excited about what was to come. so now, after my first year in medschool, what are the conclusions i can draw?

it has definitely been a year of adjustments… it started off with my initial expectations meeting reality (see this previous post), and then getting on with things and studying for the exams. now that i’ve passed the 1st year exams and gained some more experience, i can look back and evaluate:

 

would i choose cambridge again?

* cambridge’s special focus on science

the cambridge graduate course is one of the few in the country that does NOT compress two years of pre-clinical teaching into one year, but keeps two full years of pre-clinical science on the curriculum. these two years are accompanied by an accelerated version of the first clinical year of the standard course, taught during the term “holidays”. after these initial two years, one enters straight into the 2nd clinical year of the standard course, i.e. the penultimate year of medical school, making it a 4-year course in total.

since obtaining a broad and in-depth foundation of the science involved in medicine was one of my reasons for starting medschool in the first place, i have definitely enjoyed this aspect of the course.

working through the material my own way, i definitely got a lot out of it and am full of ideas for the future. in that way i can only recommend it to anyone interested in science.

but contrasting the amount of cambridge’s scientific teaching with the required working knowledge of a physician, one can perhaps understand why other medical schools choose to define their focus differently. given that this is a graduate course and there is also a lot of medicine to learn, the two years of intense science are perhaps a bit of an indulgence. that’s why i recommend thinking about how much science you wish to encounter before choosing any particular medical course… 😉

 

* tailoring of the course to graduate students

the course organisation i described in the previous paragraph means that the graduate students work alongside the undergrads during termtime of the first two years, and have their own separate clinical teaching during the term “holidays”. after pre-clinical finals in the 2nd year, the graduates join a more advanced cohort of undergrads for full-time clinical training for another 2 years.

so apart from the few weeks of clinical teaching in the first two years, very little course content has actually been specifically designed for graduates. the grads do almost everything the undergrads do, only in less time and with much less time off.

in my opinion, the course hardly takes into consideration or even exploits the different starting points and skill sets of graduates and professionals compared to younger undergrads. while this is a pity, it would be much less of a shortcoming if it wasn’t for the relatively ineffective timetabling and execution of the course. the time constraints of the graduate course (and without wanting to sound snobbish: perhaps also the higher degree of university and life-experience of older students??) definitely highlight any lousy teaching, inefficient planning and scheduling. while it was definitely painful to sit through practicals teaching you how to hold a pipette, no matter how many times you have done it before, it was worse to suffer through full schedules of compulsory attendance, no matter how dull and superfluous the event. this left you with very little freedom to organise your time in a way that makes learning most efficient for you, something that a mature student could definitely be entrusted with.

finally, with only very few weeks off during the year (in total ~5, of which at least 2 have to be used for studying), there just isn’t much flexibility for any unforeseen events that may occur (such as parents falling ill etc… sadly more likely to happen as you get older), or to simply coordinate your life with that of your family or partner.

i wonder if other medical schools offering accelerated courses have incorporated more obvious strategies for teaching older students. at least the titles of some other courses (e.g. “graduate/professional entry” at king’s college london) suggests some awareness in that direction.

 

considering these aspects, the course has definitely been quite disappointing. but then again, there is no guarantee that it will be better anywhere else… 😉

 

* to sum up…

given that cambridge is a beautiful and convenient place to study, i’d probably still choose cambridge again. but if i could start over, i would equip myself with thick skin and various coping mechanisms right away:

– keep your expectations low and your humor high

– keep up as much of an outside life as you can

– keep some aspect of your previous career going to give you some affirmation

– never lose sight of the big picture.

Seeing the World with the Eyes of…

I don’t know about you, but when I study a particular subject in depth, my view of the world changes… literally!!! It has happened to me before, but now that I am studying medicine, it is happening again.

During my first degree in chemistry, I spent four years looking at chemical formulas learning about the molecular make-up of the world. Since then, without intending to, my brain has tried to identify chemistry everywhere, most commonly on car license plates:

During my PhD in Biochemistry, I spent day and night analysing NMR data, i.e. looking at spectra with different constellations of dots, in order to identify amino acids and their close neighbours in a protein sequence (for more detail on how this works, see here). After doing this for a while, my brain automatically tried finding protein sequences everywhere. I could no longer look at the night-sky without seeing amino acid side-chains:

This year I have been studying anatomy. My colleagues and I have spent more than 50 hours in the dissection room, cutting into cadavers to explore the human body. I have seen a lot of organs, nerves, muscles and tendons. The other day I was in a place where they did some building works, and my brain identified the cables hanging out of the wall as the flexor compartment of the forearm:

 

With this little presentation, I acknowledge these perceptual changes, but hope they won’t extend too far. Some things are better appreciated as they are… 😉

 

 

 

SCHI again, and my Behaviour of Secondary Deviance

Tomorrow is our SCHI exam (social context of health and illness, see an older post), and so I’ve spent some time reading about medical sociology. It’s really interesting to get to know the different way of thinking in this field (perhaps something to blog about another time), as well as to see how medicine and science are perceived from an external point of view.

I’ve been reading quite a bit about “deviance”, the sociological term for behaviour outside society’s norms. Deviance describes any type of criminal act, but also includes generally strange/morally flawed behaviour – anything that sets you apart from “normality”.

Once deviance has occurred, let’s say a person’s lie has been discovered, society has certain preconceptions about what the deviant person is like… in this case the “liar”. A “liar” will then be treated in a particular way, for example he/she will no longer be trusted. There are many such stereotypes, even for people with red hair (like me)… 😉

Sociologists further distinguish between two types of deviance: primary and secondary.

Primary deviance is the initial instance of deviance, i.e. lying, stealing, looking different, being ill, etc… Secondary deviance describes additional deviant acts that are a result of the first. For example, someone who lied once may eventually become a a liar, act like a liar, because he/she knows that others think of him/her as such now. Secondary deviance is to behave according to the stereotype associated with the deviant act. It’s a self-fulfilling prophecy.

Having this stuff in my head, I’ve noticed over the past few days that I display behaviour of secondary deviance, too!

Many have heard me whinge in the past few months about how I’m annoyed about how the students are treated around here (see previous post). On many occasions here in Cambridge, students are not taken seriously, not treated professionally, easily patronised or talked down to. According to the SCHI teachings, being a student is the primary deviance.

Now onto the secondary deviance: When I arrived here fresh from the real world, I treated the people I encountered in my new student life just as professionally as I was used to deal with people in my previous job. This week I noticed that this has changed…. I found myself acting like a stubborn teenager! I arrived late, refused to cooperate and was intentionally unprepared, so that I could be “as dumb as they want me to be”… really, why bother?

Then it dawned on me: this is definitely secondary deviance – I was treated like a child, so why act like an adult?

Of course, I put a stop to my secondary deviance at once. After all, I should try to keep up the standards.

But nevertheless, I acknowledge the sociologists for giving me this insight – thank you SCHI!!!

SCHI – The Social Context of Health and Illness.

I am going to write about our SCHI course today, a course about the “social context of health and illness”… and about interacting with patients. I’ve been planning to write about this for a while, but today I am also creating this entry for opportunistic reasons: I need to motivate myself to study SCHI later tonight… the exam is in two weeks!

SCHI is part of the 1st year medical course in Cambridge. It’s where students learn about sociology, anthropology and some ethics of medicine. It’s where we are reminded that we will deal with patients, which is easily forgotten during the seemingly endless science lectures and practicals. The SCHI course is really well organised and consists of tutorials (ok, supervisions!) and lectures in which we are given factual introductions to the topics, but also meet patients and learn about their experiences in coping with an illness.

Amongst our many science lectures, SCHI offered a welcome break in our schedule where we could remind ourselves of the altruistic reasons for studying medicine in the first place, and realise that science cannot (ok, in some cases, not yet, but certainly not always) explain everything or represent the sole basis for dealing with patients. Obviously, doctors don’t deal with the patients’ bodies in isolation, but with the entire human being who is real, whose life is embedded into social surroundings, a particular culture, and a society.

I was therefore quite surprised to find out that many medical scholars do not think highly of the course and question its necessity, that the course was apparently imposed onto Cambridge by the GMC (the General Medical Council), and therefore introduced rather reluctantly. What an interesting piece of gossip. But how can this be?

These opinions of SCHI reminded me of an impression I’ve had during the first term of medschool, actually starting in the very first week. During that week, the graduates spent time in the hospital and I personally spent an afternoon in the emergency department, where I saw my first open wound and lots of blood. A colleague and I were shadowing a nurse, who seemed to be very good at her job, very experienced, but also somehow roughened up after many years of hard work. We watched her stitch up a young woman with a laceration on her hand. I was surprised by her lack of empathy and harshness towards the poor lady who would not be able to work in her job for a while and would be left with an ugly scar on her hand. Obviously, this was no case of malpractice, but it left a certain impression that kept being reinforced from this point onwards: that the idealism with which one starts medical school must wear off quite quickly.

Back in Cambridge, I then noticed that the loss of idealism is not only discouraged, but sometimes even encouraged (you’ve just got to imagine that the first patient a standard course medical student meets is a dead one in the dissection room…). Perhaps it is also a result of the huge amount of science taught in the first two years of med school, which somehow makes you lose sight of the more human aspects of medicine.

I guess the subject of sociology does not fit in with this initial desensitisation of the students. Maybe the course brings up topics that doctors don’t like to be reminded of, after all it must be very hard to make it through a lifetime of medical practice without gaining some degree of cynicism. Perhaps it also has to do with the fact that a huge part of the first years of medical school is taught and organised by scientists, who can easily relate to the science behind medicine, but maybe not as easily to other “softer” aspects involving care, leaving them dismissive of the subject.

I have decided not to become roughened up yet (hopefully not ever), to keep enjoying the topic and not give up my altruistic intentions too soon.

But it’s sad to see that so many undergraduates are drawn in by this atmosphere so dismissive of anything not strictly biomedical. You can truly watch them being molded into shape, so that they will carry on the hubris of the medical profession into the next generation.

Wow, that’s getting dramatic now… Now I really have to start studying!!!!

 

 

Karl-Theodor zu Guttenberg’s resignation.

Not long ago today, Karl-Theodor zu Guttenberg resigned from his position as Minister of Defense.

In his speech he explained that he made the decision partly because of his doctoral thesis and partly because of his responsibility for the soldiers. He stressed that under the circumstances, he cannot devote full concentration to his duties and attention is being diverted away from the soldiers, who put their lives on the line every day. It should remain obvious though that the core of any of the given reasons for his resignation is his blatant plagiarism. It was yet another statement in which he merely used the word “mistake” with regards to how his thesis was produced, without explaining anything or acknowledging the severity of his actions*. I find this very disappointing.

What also remains is great disappointment with Angela Merkel. She accepted his resignation “with a heavy heart” and somewhat reluctantly. As a doctor of natural sciences, she of all people should have seen that systematic cheating in order to obtain an academic qualification cannot be compatible with a public office. She should have removed him from office in the first place, rather than now appear surprised or even sad about the resignation.

It’s shocking how many people seem to think that committing fraud in science is only a serious offense within the world of science. This is very sad given that scientific efforts make an enormous contribution to the advance of our society. These events in Germany therefore tell us scientists that we have to explain much better what we are actually doing, rather than lock ourselves up in the lab every day.

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*Ok, he does say that he will “help to answer” remaining questions regarding his thesis, but that seems bizarre given that he as the supposed writer should be able to answer any questions on the spot.

More Letters to Angela Merkel.

I just heard on the news that 20,000 people (PhDs, PhD students and “normal” individuals ;-)) have signed an open letter to Angela Merkel in which her management regarding the plagiarism of Karl-Theodor zu Guttenberg is strongly criticised. You can find this letter here and here. I just signed it, too!

I was shocked to learn additional detail about how our Minister of Defense’s doctoral thesis was generated. I hope that this open letter (rather than the downplaying remarks of the government) will help the public to fully appreciate the severity of the plagiarism committed.

 

About Karl-Theodor zu Guttenberg cheating in his doctoral thesis.

I wrote a letter to the German Chancellor Angela Merkel today, who used to be a scientist before her political career, and has a PhD in theoretical chemistry. The German Minister of Defense, Karl-Theodor zu Guttenberg, has cheated in his PhD thesis, he copied large passages of other people’s scientific writing without citing it (apparently even in the introduction!). Since the beginning of this week, he now no longer carries the doctoral title. Somehow however, his actions are merely seen as a “mistake”, and he remains in office. I find this very strange, so I wrote my first ever letter to a famous person. (Actually that’s not true, when I was six years old, I once wrote a letter to the Hoff…. ;-))

 

Sehr geehrte Frau Dr. Merkel,

Ich schreibe Ihnen, weil ich sehr besorgt bin über das Signal, welches durch die Nichtentlassung des Ministers zu Guttenberg an die Öffentlichkeit gesandt wird. Ich selbst habe im Jahr 2008 meine Promotion als Biochemikerin in Oxford abgeschlossen und erlaube mir deshalb die Meinung, die Tragweite der Situation relativ gut einschätzen zu können.

Der heutige Verteidigungsminister hat bei seiner Doktorarbeit von anderen verfasste Textpassagen übernommen und nicht als Zitate gekennzeichnet. Leider sind diese Textstellen so ausgiebig und zahlreich, dass ein einfaches Vergessen der Kennzeichnung oder Übersehen der Passagen als Erklärung keinen Sinn ergibt. Es ist leider nicht nachzuvollziehen, wie eine solch weitreichende Unterlassung ohne das Bewusstsein über eine Täuschung zustande gekommen sein kann. Meiner Meinung nach gibt es dafür nur zwei Erklärungen: entweder war sich Karl-Theodor zu Guttenberg beim Verfassen der Arbeit der versuchten Täuschung bewusst, oder die Arbeit wurde von einer anderen Person verfasst, deren wissenschaftliche Standards leider nicht den Maßstäben entsprechen, die aus guten Gründen an jegliche wissenschaftliche Veröffentlichung angelegt werden. Ich bin sehr enttäuscht, dass dieses Vorgehen des Ministers für ihn selbst, sowie auch für viele Partei- und Regierungsmitglieder ein entschuldbarer menschlicher Fehler zu sein scheint, denn dies ist leider nicht der Fall. Plagiat ist kein Kavaliersdelikt; vor allem, wenn man auch als Vorbild in der Öffentlichkeit steht. Der Doktortitel ist einer der höchsten akademischen Auszeichnungen; wenn es ohne Konsequenzen bleiben soll, diesen durch Betrug zu erlangen, was gilt dann für alle anderen schulischen und universitären Leistungen, die ein Bürger in seinem Leben zu erbringen hat?

Ich kann es leider nur sehr schwer nachvollziehen, wie Sie als promovierte Wissenschaftlerin die Schwere und die Auswirkungen der Fehlhandlungen Ihres Ministers nicht zu erkennen scheinen. Gerade als frühere Wissenschaftlerin müssen Sie die Konsequenzen ziehen, ansonsten ist auch Ihre Glaubwürdigkeit gefährdet. Ich kann sehr gut verstehen, dass es aus machtpolitischen Erwägungen heraus nicht einfach erscheint, einen bislang so beliebten Politiker aus dem Amt zu entlassen. Sie müssen jedoch handeln, ansonsten senden Sie ein Signal, das langfristig sehr negative Folgen für unser Land und das Ansehen der Politik mit sich bringen wird.

Ich hoffe, dass Sie nach gründlicher Überlegung zur selben Schlussfolgerung kommen werden.

Mit freundlichen Grüßen,

Dr. Christiane Riedinger.

 

… maybe I will get a reply! (PS. …. never did!)

5 Months into Med School…

Wow, it’s been so long since I last posted something… I had even forgotten that my last entry was about leaving science… now I am already five months into med school!

 

It’s been an intense period of many emotional states, and I thought I’d summarise them briefly. I have to admit, the first few months were hard…

Before I started, I had certain expectations / fears, some of which were met / not met / dealt with, so I can now comment on them retrospectively. Maybe it will help someone considering graduate medicine at a somewhat mature age (possibly even a scientist!) know what to expect… and not to waste any time with these things!

 

First of all, I was looking forward to learning a lot more about biology and physiology. Being a chemist by training who then became a molecular biophysicist, I had never received an introduction to these topics on a university level. One positive aspect of med school would be to receive this, which would certainly make me a better scientist (If then for any reason med school should not be for me, the outcome would still be somewhat successful).

Starting to study biology and physiology, I realised quickly: There is so much to know – I want to know everything – there is not enough time!

After eleven years in science, I got used to knowing my area of research in great detail. Suddenly I knew next to nothing about things, and it was obviously impossible to get to the same level of expertise on everything in such a short amount of time. I found myself spending a lot of time investigating details, because I was simply not used to covering things on a seemingly superficial level (also why should I have to do that? I really wanted to know!!!). Knowing how much detail there is to everything, I felt faced with an insurmountable amount of knowledge to absorb. The speed with which we were introduced to things did not help either: biochemistry students would learn about a particular topic in a whole year’s lecture series, and we would race through it in less than ten lectures and still be expected to know a lot more than the basics.

I realised that there was a gradient of satisfaction regarding the amount of information absorbed and how much education people had received before: People straight from A-level seemed happiest, but the more people had studied, i.e. undergrad, master’s, PhD, post-doc, the more they knew how much there is to know and did not know themselves, therefore the more dissatisfied they were. Given my position in that spectrum, I became pretty frustrated!

 

Another thing I was SOO looking forward to was to be taught again… to sit in a lecture theatre with some kind of expert passing his/her pearls of wisdom onto me. That would be a welcome change to sitting google-ing or pub-med-ing things on my own (which sometimes felt like re-inventing the wheel)!

How wrong I was!!! It is absolutely not the case that someone delivers any information to you on a golden plate… How sad! Even though there are lectures, they are far from ideal. Thank god I know how to google stuff! I was very surprised that there was little attempt made to bring people to the same level at the start of a lecture, how badly structured most lectures were, and how it felt over and over again like someone had just emptied a huge bucket of undigested information over your head (like so?)! In cases where I already knew the subject being taught, I was surprised how convoluted the topic was presented, how simple things were made to look much more complex than they actually were. Sometimes I knew that crucial pieces of information were missing in order to understand what was being said.

All these problems mean that the students have to spend the great majority of their time picking up the pieces of information and organising them, bringing them into some format that can be understood and then learnt for exams. Again it felt like re-inventing the wheel! With up to 30 hours of coursework every week, there just isn’t enough time to do write proper notes on everything…

This was another source of great frustration.

 

Finally, I was worried that I would find it hard to learn things by heart, something that I had not done in years. Also, I knew that most people on my course would be a lot younger than me (I was 30 when I started), and I was worried what this would be like.

At the beginning of the course, I felt like my mind was slower compared to what I remembered from my last undergrad. It seemed like my fellow 18-year-old colleagues had a much better memory initially.  Thankfully, this changed quickly, and after a lot of studying over Christmas, my mind is now much closer to the way it used to be during my undergrad. What a relief! Even though I am still waiting for my brain to reach full capacity again (I hope this is possible!), I am now more confident that I will be able to memorise enough in order to pass the exams. And I have a major advantage: I know what I want to retain for my future career, what I might need, because I have already had the experience of studying and working a job.

Regarding the age difference: I am the 4th oldest out of nearly 300 people! I am even older than most of the graduate medics, who average around 24. But since there is nothing I can do about that, I don’t worry any more! 🙂

 

A few final remarks on something I had not seen coming:

Students in Cambridge are not the most respected of all people. There is this preconceived idea that we are lazy, stupid, and have lots of free time to wait around. Even people who did a medical degree themselves seem to think that. For that reason we are sometimes not dealt with professionally. There are double standards everywhere! Also, there are a lot of fragile egos in charge of students, who would rather put you down than admitting they don’t know the answer to a question. So far, I have not found a way to successfully deal with a person like this and it can be quite demotivating.

Thankfully, many of my graduate peers find this frustrating as well. One of them put this very nicely: we have all had successful careers before, therefore the opportunity cost of us being here is very high. Hence the higher expectations. But the only way is to keep calm and carry on. Always good advice!

 

However, despite all these frustrations, I am enjoying this degree. Everything is so interesting! I have already found that I look at the literature with a much wider perspective, and I am sure this will be useful when I come back to science one day!

Leaving Science for a while…

I haven’t posted in ages… it’s been a busy year with lots of changes.

I’ve decided to put my scientific career on ice for a while and start med school. How come?

It’s not that I did not like being a post-doc… I loved it: the research, the teaching, learning new things every day (or most days), the flexible working hours and lack of dress code. I love wearing sports clothes to work! What I did not love was being in a constant state of desperation. Desperation for publications, for producing results to put into publications, for experiments to work in order to get results, for a decent project that will let you do experiments that are interesting enough to get them published. See, it’s a long chain of desperation, and after a while it is bound to get you down. Additionally, there is a lot of competition out there, and the success is not always distributed fairly. So I decided to take a detour away from science. Maybe (hopefully) I will come back to it one day, but if not, then I will be able to say that my job involves helping people on a really tangible level. If worst comes to worst, it’s better to be a failed doctor than a failed scientist!

Was wollen Sie!?! … The Experiment “Stick-in-Hand”

during my undergraduate degree, my professor of organic chemistry was quite the character. he was an expert in the synthesis of squaric acids and also convinced that his discipline was the only true chemistry (hence he called any other chemistry “pressing buttons”). he was very old school, meaning that he was not very approachable and would normally greet you with the phrase “WAS WOLLEN SIE???” or “GEHEN SIE!!!” (i.e. “what do you want?” or “go away!”). if you wrote something in an exam that he did not like (for example superfluous explanations about reaction mechanisms), he’d take a thick marker pen and write “prose” across the page or even cross out the entire answer. he was famous for drawing “chaos-snakes” too, highlighting the point at which your answer had become too complicated and he would not read on any further. admittedly, his many quirks could be quite entertaining, but if you were on the receiving end of it, then it could become quite difficult.

one of his favourite stories was to tell us about the experiment “stick in hand”, that every chemist has to perform at some point in his life. to phrase it more clearly, every lab chemist one day accidentally sticks some kind of glass item into their hand or other body parts, resulting in injury. in his eyes, this was essential chemistry.

i have to say that he certainly wasn’t one of my favourite lecturers, so i never really think about him much any more. except from today, when for the first time, i performed the experiment “stick in hand”! i was simply putting a pipette aid onto the top of a glass pipette (those 30cm long ones for NMR tubes), and somehow it ended up jammed in between two fingers of my left hand. there wasn’t much harm done, so the experiment was a full success… somewhere in chemistry-heaven where my professor is synthesising squaric acids for all eternity, someone is laughing in confidence that he is always right!!! 😉

Pogo, the Somerville College Cat.

pogo is our college principal fiona caldicott’s cat. he’s a beautiful black tomcat wearing a red collar with a little bell on it, so when it’s very quiet you hear him approaching even before you see him. pogo is well known and loved amongst all college members, especially the porters who feed him every day. pogo even has his own facebook page with 179 friends! obviously, many people would really like to pet him when they see him strolling through his territory or sleeping at his favourite spot, the radiator in the green room. unfortunately though, pogo prefers to keep to himself, and he either ignores you or walks away when you approach him. when he’s in a particularly bad mood, he’s even been known to go after people and scratch them. so it’s not surprising that you can consider yourself very lucky if pogo does allow you to play with him.

when my friend steve simon told me that pogo had once jumped onto his shoulders, i have to say i was a tiny bit jealous that he would like steve so much!!

after dinner today, i walked through the green room and saw pogo on this usual spot, the radiator. when he saw me, he jumped down and approached me. surprised about so much attention, i knelt down next to him and guess what: he jumped onto my back!

i feel so special after this event that i have to tell the world about it. i even have a picture as the ultimate proof!!!

 

😉

The New Building of the Oxford Biochemistry Department.

(picture taken from here)

in 2008, the biochemistry department of oxford got a new building: a flashy £47 million construction highly praised and recently decorated with at least one architectural award. it is supposed to attract excellent researchers from all over the world, and inspire ground-breaking research among the workers with its open-plan design…

is this really true? here is the opinion of an oxford biochemistry post-doc:

the first thing i’d like to say: of course it’s nice to work in a new building rather than an old one. old research buildings are often as ugly from the outside as they are from the inside, with labs cluttered with old equipment that’s either broken or that people have forgotten how to use, and with office-shelves filled with previous workers’ abandoned belongings collecting the dust of decades. our old building was exactly like this, absolutely not pretty to look at, with stained carpets, dirty windows and spiderwebs (sometimes even huge spiders). but i have to say, it was alright to work there. everything important was under one roof, labs and offices close together, bathrooms in close range, kettles, microwaves, sinks and water fountains in the offices and even a common room to get a bit further away from your desk. it was adequate for the work that we had to do. not beautiful, but practical.

now we work in “new biochemistry”, which is not ugly in the least. it is an L-shaped building of 6 levels, two underground and 4 above, with a huge sky-lit atrium in the centre breaking through all floors. the different levels are connected through the main staircase which crosses the atrium, with the flights of stairs arranged irregularly, a bit like the revolving staircase of hogwart’s school of witchcraft. through the atrium flies a flock of plastic birds on glass-fibre strings, semi-disturbing because some of them are siamese twins or look as if shot in mid-air, but still kind of nice to look at. around the atrium, the office spaces or “write-up areas” form little niches, filled each with six rows of a total of 24 desks and two rows of cupboards flanking them. here and there you find a PI (i.e. principal investigator’s) office or admin areas. the labs are located on the outer side of the building, with all-glass fronts so that people walking past can watch us work or so that the workers can see some daylight. the outside of the building is decorated with coloured glass panels projecting out of the window-glass front. the inner side of the L is decorated with rorschach test pictures, i.e. ink stains whose interpretation gives information about the observer’s psyche. (they could also be slices of animal brains or images of vulvas… i wonder what that says about my psyche! by the way, out of all these possibilities, the latter probably has the most to do with biochemistry….)

when i first set foot into the new building, i thought: how are we supposed to concentrate with our offices in the atrium? and how are we going to manage to work at such tiny desks?

unfortunately, these initial concerns were justified. it’s so hard to concentrate!! we hear the lab phones of every single floor ringing through the atrium, including people’s mobile phones (which also causes envy towards those who actually have reception). because we are cramped in so closely, we hear pretty much every word spoken in our write-up area. plus that of other people in the atrium! when people really need to concentrate on writing, reading or thinking, then it’s not surprising that the atmosphere can get pretty tense.

even if it was completely silent in the atrium, the small size of the desks already makes working difficult. the desks are so small that you can’t easily place your laptop and your labbook on the same desktop. i solved that problem by buying an imac, but even with the keyboard i struggle to place everything on the table. the desks are also so narrow that two people cannot easily sit next to each other in front of one computer, which is necessary when you show someone your data. the second person has to invade into the neighbour’s deskspace, which can get annoying for them. there are not enough chairs either, so the extra person either has to stand up or take someone else’s chair… you see the problem? depending on how stressed people are on any given day, people start arguing. we’ve really argued a lot more since we moved.

i once discussed the lack of space with our head of department. he simply replied: when you have to write a paper, you work form home anyway…

i’d say £47 million well spent!


finally, i just want to say that after a few months in the new building, the visual appeal of some of its features kind of grows on you. but this still does not compensate for the simple lack of practicality.

we often get groups of official visitors in new biochemistry (one time even the prime minister), who are shown around the atrium and lab areas. they admire the architecture and get an impression of how science works nowadays. sometimes the guests even take pictures of us at our desks from the staircases. working in this building every day, you start to feel like an extra in this presentation.

one major purpose of this new building must have been to project a certain image of science to the outside world. that has certainly worked.

but getting on with your research kind of ended up in the background…

 

ps: related articles about new biochemistry and similar building trends in science you can find here, here and here.

The Last Day of Relaxation.

hello there,

it is 6.13pm on my last day of roof-holiday. the time went by so quickly!

above is a picture of how i felt on several occasions during my holiday, and tomorrow i will have to open the door. that’s fine though, because i had a great time. i am in a different place now, much more relaxed than before, full of ideas for the future and some satisfaction that i did most of the things i had planned.

i can only recommend it to anyone!!!

cee.

The Stages of Relaxation.

written by a work-a-holic and recovering caffeine-a-holic

we normally spend most of our time ticking items off our to-do-lists. our days consist of work, sleep, coffee, and maybe a meal with some friends in-between. when the week-end comes (that is, if we are lucky enough to have a work-free week-end come our way), we run errands we were unable to fulfill during the week, give our flat-bottomed bodies some exercise, or try to schedule some fun. we feel we deserve this even though we have nothing to talk about but work and are so exhausted that we’d rather stay in bed. if we manage to avoid these duties, then we might spend our free time in bed, eat muesli interspersed with take-away and go through yet another dvd marathon, in order to rest our bodies, empty our brains and let our muscles atrophy even further.

(by the way, i say we because i don’t want to feel all alone.. ;-))

this has been my lifestyle for longer than i’d like to admit. so after spending months trying to reduce my working hours which caused me more stress than actually doing the work, i decided to put a stop to the situation and take some time out to wind down: three months of self-prescribed relaxation.

so what happened since then?

since my last day at work at the end of june, i have experienced several phases on the path to relaxation. here they come:

 

STAGE I

the first stage of relaxation was unexpected and brief: FEAR. having been full of enthusiasm and anticipation on my last day of work, coming home without anything to do was moving out of my comfort zone into undefined territory. was this a good idea? would i be able to entertain myself for three months at home?

 

STAGE II

thankfully these thoughts only lasted moments. since i was exhausted, the next stage of relaxation kicked straight in: the bed collapse and TV MARATHON phase, already mentioned above: you are tired, you want to rest, but you are still so hyped up on stress hormones that you can’t fall asleep. hence you need something to do in bed: watch mind-numbing television (it also helps to purge any stressful thoughts, at least for the time the movie is playing). in my case, for the first few days, a DVD set of old black and white miss marple movies served the purpose. and die hard I-4. and a few rocky movies. excellent.

 

STAGE III

after experiencing phase two for a few days, i was ready to move on to phase III: return to COMMON patterns of BEHAVIOUR. having partly recharged my batteries, i was keen to do something, but my mind was still not free to start something new. hence i used my new energy to do what? yes?

work. just a little bit, “for fun”, you might say. embarrassing.

(i have to mention that phase III also had a positive side-effect (phase IIIb). i did something i had meant to do for years and never found the time: i started my webpage. this was a great thing to do at this stage, because it resembled work and was still creative in a way. not too bad for a start!!!)

 

STAGE IV

thankfully work can be boring. however much we like to fool ourselves (using “we” helps me admit uncomfortable truths), working hard is not our natural state. when you finally come to this realisation, you are ready for the next stage: the FUN phase!!!!!

i spent this phase in venice. drinking coffee, reading the newspaper, eating ice-cream and far too much mozzarella, while looking at art in-between. splendid. i even read a book. oh yes indeed. (if you want to hear real people talking like this, take a look at the miss marple movies i mentioned above).

 

STAGE V

i returned home ready for more. and entered phase V: SELF-REALISATION. i consider this the peak of relaxation: i set up my drawing room, started with some sketches, played the piano…. i felt happy that true relaxation had finally kicked in.

that is.. until i got an e-mail from my boss. oh no! i had to climb down the ladder back onto level three, work for two days full of self-pity and go into work for a meeting. that was that.

 

but even if the path to relaxation is rocky, i don’t give up! i returned home, keen to get back to where i had left off. it wasn’t easy…

i was disappointed…. in the end i spent a few days in a state of amalgamation of the stages i had experienced before: hanging out with friends (IV), cooking my favourite meals (IIIb), watching tv (II), being afraid that i would not reach stage five again (I) and stressing about work (IIIa).

a slight boredom kicked in, which even led me to clean the house. but all that made me realise something important: boredom can be a catalyst to reach stage five again!

 

STAGE V (again)

this time around, stage five came to me in a different shape: SELF-REFLECTION. i started thinking about what i want in life, about the future, and i was able to do this much more freely than before. very nice!!!

so far at least, i can say that my holiday-relaxation-mission has been accomplished.

i’ve attached a little drawing to illustrate the stages of relaxation.

i hope you all need less practice to get where you would like to be!

 

cee.

The First Day of Relaxation.

yesterday was my last day at work. my next day at work will be the 22nd of september 2009!

i left work excited and happy, but today i woke up a little scared: what am i going to do with all of this free time?

i’ll tell you what i am going to do. in this roof-top blog.

have a nice summer.

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