UNIQ Summer School Experience (Summary)

This was a truly unique (UNIQ Haha!) experience! Not only that I got to study oncology for a week, which is a very interesting field in medicine yet not offered as an undergraduate degree, but also because I had the opportunity to meet some aspiring medics just like myself. Spending an entire week with these lovely and intelligent people was simply amazing. We have had a lot of interesting conversations about our work experience, personal statements, AS subjects, university choices and other interests outside school and academics.

The fact that we all share a common goal meant that our most of our conversations were about or somehow linked to medicine. Personally, this was really valuable because no one in my family or close friends have the same interests as I have. This enabled me to communicate and my thoughts about science and certain medical issues, ethics for instance, which I could not normally do due to the fact that these topics never really interests my peers. Therefore, I took advantage of this fantastic opportunity by ensuring that I participate well in our group discussions and give my own opinion, explain them fully, provide specific examples and challenge other people’s opinions. These are some of the skills I have certainly improved and became more comfortable with by the end of the week.

The lectures we had for the oncology course were really interesting and mentally stimulating. We started looking at the history of cancer. All the information from this lecture was based on the book ‘The Emperor of All Maladies’ by S. Mukherjee. We were also introduced to the idea of the 10 hallmarks of cancer. This concept was relatively new to me as I simply thought that cancer was just the uncontrollable cell proliferation and division yet I realised that my initial understanding was very basic and somehow outdated. We also did a practical in the laboratory which was about amplifying copies of a piece of DNA using a technique called PCR.

The following day we had a lecture about biomarkers and how they could be potentially useful for predicting, diagnosing and curing cancers. These are specific substances that can be detected from biofluids (e.g. blood and urine) that are indicative of cancer. These can help oncologists to determine the most suitable treatments for the patients and it could also increase the success rate of chemotherapy by allowing the doctors to personalise medications for them based on the type on cancer they have. Moreover, biomarkers would be beneficial in reducing costs by identifying the patients that would be the most responsive to the treatments. Yet this is still fairly a new technology and a lot of research is currently being done to identify some potential biomarkers.

We also learned about some of the imaging techniques such as PET, MRI and CT scans. This is the ‘physics bit’ about the course hence I somehow found it a bit confusing and not as interesting as the previous lectures.

Another ‘physics’ related lecture was about radiotherapy. This is one of the main and most common cancer treatments along with surgery and chemotherapy. In contrast to the previous ‘physics’ related topics, I found this lecture quite interesting. I have in fact asked quite a few questions to the lecturer who was a medical physicist. My questions were purely based on my curiosity about this technique. For instance, I asked about how radiotherapists deal with prostate cancer because obviously as the bladder gets filled the position of the prostate becomes altered and therefore the electron beams would not be aimed directly to the prostate. Also, for lung cancer a similar problem would be encountered. As we breathe in, our lungs expand and the opposite happens when we exhale, hence the position of the malignant cells would change. The lecturer said there are different ways to address this problem; the most common solution is having multiple beams directed to the tumour. In this way even if the position of the cells is altered, different portions of the tumour will be receiving some radiation at a given time.

After all our lectures we had our first tutorial. We were split into small groups (three/four people per group) and we had to go to specific rooms to meet some of the experts in this field. At first I was really nervous. I did not know what to expect and what our tutor would ask us. But I realised that this was the perfect opportunity for us to ask questions and discuss some of the topics we did not quite understand. The tutorial started with our tutor, Martin Christlieb, asking us about our thoughts about the previous lectures we’ve had over the week. Since we are such a small group (three people) everyone had to share something. I talked about how I found the idea of the 10 Hallmarks of Cancer interesting. I have encountered these ‘hallmarks’ before when I shadowed an oncologist back in the Philippines, yet they were not called ‘The Hallmarks of Cancer’ and back then I did not really understand these concepts. The idea that malignant cells are able to evade apoptosis is the most fascinating among all of the hallmarks. This is because cell death is the end of a cell’s life and being able to avoid that makes a cell immortal. This immortality gives them a greater chance to proliferate and metastasise, which are the other two hallmarks, and therefore cause more damage to the body. After the tutorial I learned that cancer cells can simply be described as very successful cells as they have certain mutations that gave rise to these hallmarks. I have also gained a better understanding of the complexity of this disease and the fact that this can be explained via the concept of natural selection.

During the final day we met a cancer survivor named Jackie. Jackie was diagnosed with oesophageal cancer about 6 years ago. She shared her experiences in the hospital and how she managed to cope with the physical and emotional stress brought about by her condition. During her talk she mentioned that she has undergone oesophagectomy.  This is a surgical procedure where her oesophagus was removed and reconstructed by stretching her stomach to her throat. This meant that she could not consume large portions of food as her stomach has significantly reduced in size. Jackie mentioned that this was a big change for her yet she is doing really well due to the support she receives from her dear friends and family. This highlighted the importance of having a good support group, which she recognised as being really helpful and accelerated her recovery, hence she started an organisation that offers help to those who are suffering from cancers of the digestive system and their families. Their main aim is to share experiences and help the patients and their relatives to  live with cancer.

This is just an overview of the academic side of my summer school experience. During our free time, my news oncology buddies and myself explored the city of Oxford. I’m so excited to write about this soon!

Excretion! :) (NEPHROLOGY?)

This is the first topic we have covered in A2 Biology! Before starting on learning what the liver and the kidneys do, I initially thought that excretion was basically about ‘pooing.’ HAHA! I was wrong.. so wrong!

So excretion.. I definitely learned quite a lot of new concepts and terminologies from this topic. For instance, the process of ultrafiltration that happens in the Bowman’s capsule is particularly my favourite. This is due to the fact that the process is so clever and some clever-sounding words were involved such as the glomerulus, podocytes, glomerular fitrate, afferent and efferent arteriole.

Ultrafiltration is basically filtration at a molecular level where blood coming into the glomerulus (which is simply a network of capilaries surrounded by the Bowman’s capsule) via the afferent arteriole is filtered. Thus large molecules such as blood cells (erythrocytes/red blood cells and white blood cells) as well as plasma proteins are left in the blood and only the smaller molecules pass into the lumen of the Bowman’s capsule. But what is really fascinating is how this actually happens! Cleverly enough, the efferent arteriole (the small artery that carries blood away from the glomerulus) has a smaller diameter than the afferent arteriole (whoa!). This means that the blood inside the glomerulus is under high pressure hence the fluid is forced out into the Bowman’s capsule! Not just that.. The Bowman capsule itself is well adapted to this filtration process. It has three layers – the endothelium, basement membrane and the specialised epithelial cells called the podocytes. The endothelium is very thin and has gaps between the cells that allow blood plasma to pass through. The basement membrane does all the filtering. It is basically a fine mesh of collagen fibres that acts as a filter. Therefore, only small molecules such as glucose, amino acids, inoragnic ions/salts, urea and water are filtered out (from the blood) into the filtrate. This filtrate goes through the final layer, the podocytes. These are the little specialised cells that contain many finger-like projections, ensuring that there are gaps for the filtrate to pass through into the lumen of the Bowman’s capsule. How clever?! 🙂

Yet this is only the start of the whole ‘urine production’ process. As the filtrate goes through the nephron, other processes happen such as selective reabsorption, osmosis and active transport of salts until it reaches the collecting duct and finally become URINE!

This is a very detailed process and the whole topic is jam-packed full of interesting concepts and terminologies. Hence why I really loved it. Moreover, this gave me some insight to the importance of our liver and kidneys. Performing over 40,000 different functions, the liver is simply brilliant! It helps control our blood glucose levels, breakdown of hormones and old red blood cells, synthesis and storage of some essential vitamins and of course the detoxification of alcohol (and drugs). The liver is just an incredible organ and learning about some of its functions made me appreciate its importance to our biological system. THANK YOU LIVER!

Another superstar organ is the kidney (well most of us have two so the KIDNEYS)! Osmoregulation or basically the control of water and salt levels in our body is their most important function. I never really realised how important they are to us until we started learning about kidney/renal failure. I never thought that it is a serious medical condition that can ultimately lead to death.. in quite a short period of time (without any treatments involved). This also gave me some insight into the two current medical treatments that are used – dialysis and kidney transplant. Both treatments have their pros and cons and the patients have to work with their nephrologists (physicians that specialise in kidney care) to plan the best possible treatment(s) to improve the quality of their lives.

Taking everything that I have learned so far in this topic, I personally think that Nephrology sounds like a very exciting field in medicine. For this reason, I have decided to send an e-mail to my mother’s friend who is a nephrologist in one of the biggest hospitals in the Philippines (Philippine General Hospital).  I asked her if she could answer some of my questions about her chosen specialty via e-mail. She responded swiftly and even suggested to have an informal chat via Skype (PERFECT!). I took advantage of this opportunity and asked her about what nephrology is, what being a nephrologist meant to her, what her typical day in the hospital was like, what were some of the most recent and or/most interesting medical cases/patients she has encountered in her field, and a lot more!

“..but perhaps even more satisfying is experiencing the profound change a patient’s life goes through after transplantation. When someone tells you with a look of amazement how it feels to wake up expecting to go through the agony of dialysis – only to realize that they now have a functioning transplant, or when they still cannot believe that after 30 years of diabetes they no longer have to check their blood sugar or watch their diet – those are the moments when I know for sure, that nephrology was the right career choice for me.”  This was her personal reason why she chose to specialise in nephrology. Talking to her was truly inspirational and everything she mentioned to me was not just full of valuable information for my exam but also full of her personal experiences and thoughts about her chosen career.

Excretion and nephrology.. absolutely interesting!! ❤

Kidney Dissection

Three regions: Cortex (outermost), Medulla (middle), Pelvis (centre)

The Immortal Life of Henrietta Lacks

This is the second book that the UNIQ team has sent me to have a little read and think about my course for the upcoming summer school. Every word in this book is worth reading and these are my thoughts about this brilliant book..

Rebecca Skloot is the author of this book that certainly sounds like it could be science fiction, but in truth it is incredible science. However, it’s not only about the science, but more importantly about who is behind it all. She has put a very real face to one of the most important medical research discoveries of our lifetime and given an appropriate name to the HeLa cells used in that research all over the world – Henrietta Lacks.

This book recounts the life of Henrietta, the death of Henrietta and the immortal cells she left behind that became the basis of many life saving discoveries in the medical field. HeLa cells are those which were taken from Henrietta’s cancerous tumor many decades ago. They were easily replicated and viable for testing therefore they became an important staple in laboratories doing medical research right up to the present. Many have her cells to thank for their treatment and cures of deadly diseases.

Sounds like a generous donation to the medical community but Henrietta and her family had no idea that any of this had taken place. They didn’t know that her doctor had taken the cells, and upon realizing how unique they were, shared and traded them with other researchers. They especially were unaware that these were eventually being sold for a profit among labs and medical companies. Personally, I believe that this is a case of exploitation rather than making medical progress and discoveries.

The author finds the surviving family of Mrs. Lacks and realises there is far more to the story than it would first appear. She touches on each of the sensitive topics that present themselves as the family approaches her with so many questions left unanswered. The more I read, the more fascinated I became with the complexities.

The Lacks family are uneducated and living in poverty, struggling to understand how their loved one could have saved so many lives while her own could not be saved. They find it hard to believe their mother has done so much for the medical community, and made some companies millions of dollars, yet they cannot even afford good medical care. They wonder how cells were named after her yet there was no true recognition of her by her full, real name. The children hope that Ms. Skloot will not be another journalist to take advantage of them, but that she will give their mother the place she deserves as a real person, not just a “cell donor”. Ms. Skloot does exactly that and I believe they would be very happy with the care she has given to the subject.

In my opinion everyone who wants to study and are currently studying medicine or oncology should read this book to gain insight to the genuine lives of the patients. The understanding that there is much more to a person than their cells, their lab results, their disease, etc., is such an important lesson to be learned. I would also highly recommend this book to anyone interested in the ethical and legal aspects of the medical and scientific communities. There is also a significant component relating to the Johns Hopkins, the black community and black history. Every aspect was fascinating and eye-opening.

If you are wondering how this could have happened, be warned that it could just as easily happen to any of us tomorrow, as there are still no laws in place preventing any doctor or hospital from keeping and using our tissue, or our children’s umbilical blood, or our parents tumors for research once collected. Perhaps it is better that we all contribute to furthering scientific discoveries. But, you might rethink “immortality” after hearing this story. Just one more good reason to read this book.

AS exams officially over! What I’ve learned!

AS Exams are over! Finally! I now have to wait until I get my grades on Thursday, the 14th of August. I am quite confident that I did well in most of them, however, I would not be confident enough to say I actually did until I see the results in a few weeks time.
The next challenge for myself is to get an A*AA in my A2 Exams next summer! Speaking about A2, I have now started doing my A2 subjects. These are my top 3 favourite subjects – Chemistry, Biology and Psychology. I have chosen them, not just because I really enjoy these subjects. but also because they would be really useful when I get into a medical school.

Since my AS subjects are now over here is nice summary of the skills I have learned and developed from them as well the topics I enjoyed the most.. 🙂

PSYCHOLOGY

Psychology increased my confidence in criticising and evaluating theories as well as research studies. Considering different approach and being able to offer more than one explanation for a particular behaviour are some of the other skills I have developed through this subject.

The most interesting topic that we have covered was the whole module about stress. This was particularly interesting for me as it enabled me to understand the biological explanations of stress. Stress is undoubtedly complex. It can influence both our physical and mental or emotional health. This is what makes it really interesting.

Another fascinating module was about abnormality. What is considered as ‘normal’ and ‘abnormal’? Though question.. Abnormality is a concept that is difficult to define. However, it can be described as one of the following: (1) deviation from social norms, (2) failure to function adequately and (3) deviation from ideal mental health. I’d say that this was the most tricky module as there were quite a lot of content to learn, however, the fact that it’s actually the most interesting one allowed me to spend more time revising it and making sure that I have a thorough understanding of the different explanations for ‘abnormal’ behaviours.

BIOLOGY

The anatomy and physiology of the human heart, liver and lungs as well as lessons about specific organ systems such as the endocrine and the nervous system were the topics I found really interesting in Biology. This was because I was fascinated about the complexity of these organs and often times I would extend my knowledge and do independent research about the different diseases and potential problems that an individual might encounter if these organs fail to fulfil their function.

CHEMISTRY

Chemistry greatly improved my practical and analytical skills which are essential for laboratory work in medicine. Most of my chemistry lessons involved some experiments. This gave me the opportunity to familiarise myself with the laboratory setting, technical equipment and laboratory safety which really increased my confidence in doing some practical work. I was not really a big fan of working in a lab and doing some experiments before I started with the course, yet through AS Chemistry I learned the value of being able to apply my knowledge to actual chemical and be able to interpret or provide explanations (most of the times what I think is the explanation) as to why chemicals behaved that way.

Oxford Open Day

Exactly a week ago, my parents and I went to the Open Day in the University of Oxford to look around the city and the individual colleges in the university. Both of my parents are very keen to get involved and  know more about the collegiate system in Oxford hence I decided to take them with me during the open day. Bookings were not required in some of the colleges which is perfect because this means that we can simply go and visit the colleges without having to worry about registering and booking in advance. My initial plans were to visit my top 5 colleges. I have printed a map and noted them down, identified their location within the city just to make it easier for us to find the colleges. These colleges were Balliol, Oriel, Brasenose, St. Edmund Hall and Christ Church College. However, since our train came really late (which is a hassle) I had to change my plans and decided to just look around all the colleges near the very heart of the city. We ended up going to more than five colleges which is a good thing as I have helped my parents understand the collegiate system. At the end of the the day I came to realise that the colleges have more similarities than differences between each other. Hence, I believe that stressing out about choosing a college is not really necessary. I also gained a lot of information about the nature of the course whilst talking to the current medical students in Oxford. In fact I spent most of my time asking them a lot of questions instead of simply looking around the colleges (and taking photos of the amazing architecture). I have heart loads of interesting things about what they have previously done and what they are most excited about in their course. They also gave me some valuable tips as to how I can make myself stand out in my application and interview (if I am lucky enough to get short-listed!). Selling myself is not one of the things I am particularly confident at, however, they made me feel like it’s totally different from being arrogant and self absorbed but more of being true to myself and highlighting the my best qualities. Overall, this has been such a brilliant and productive day. Going to open days are really beneficial to get a good feel about the university atmosphere and most importantly talking to the current students have given me a lot of vital information that are not available elsewhere.

The Emperor of All Maladies

Dr Siddhartha Mukherjee, a medical oncologist, is the author of this brilliant book which is a definitive history of cancer. It is one of the best medical non-fiction books I have read. Complex but simple in terms of understanding. The book serves as a timeline of the disease and those who waged the wars agianst it. In 1600 BC the first case of probable breast cancer was documented. In the thousands of years since, the Greek word, ‘onkos’, meaning mass or burden, has become the disease of our time – Cancer. The title of the book, is “a quote from a 19Th century physician” Dr Mukherjee had found inscribed in a library book that “cancer is the emperor of all maladies, the king of our terrors”.

Dr Mukherjee started his immersion in cancer medicine at the Dana Farber Cancer Institute in Boston. He relates the beginning of the study of ALL, Acute Lymphocytic Leukemia, by Dr Sidney Farber in 1947. Dr Farber, a pathologist at the time decided to change his focus and start caring for patients. He was given a medication to trial for ALL, and though most of his patients died, some survived to remission. This opened his world and with the help of Mary Lasker, and Charles E Dana, philanthropists, they opened one of the first clinics that specialized in cancer care and research, The Dana Farber Cancer Center. Dr Mukherjee gives us the timeline of ALL and lymphomas and the medications that turned into chemotherapy. The development of specific care for blood cancers and the emergence of AIDS and patient activism. He discusses the surgery for breast cancer. It was thought that the more radical the surgery the better the outcomes. We now know that lumpectomies have an excellent outcome. But, women before me had a radical removal of breast, chest tissue, lymph nodes and sometimes ribs. The lesson learned is that breast cancer is very curable now and all those men and women, the patients who suffered, gave us the answers and cancer care has moved on.

The onslaught of chemotherapies changed the face of cancer, and the 1970’s served us well. In 1986 the first outcomes of cancer care were measured. Tobacco emerged as an addiction and soon lung cancer was a leading cause of death. Presidential Commissions ensued, politics entered the world of cancer, the war against cancer and the war against smoking. The Pap smear was developed, and prevention came to the fore. The two sides of cancer, the researchers and the physicians at the bedside, who often thought never the twain shall meet, recognized the importance of research to bedside.

The story of the boy ‘Jimmy’ from New Sweden, Maine, became the face of childhood cancer. The Jimmy Fund, a Boston Red Sox charity in Boston, is still going strong today. ‘Jimmy’ opened the door to the public for the need for money and research, and care for those with cancer. We follow Dr Mukherjee with one of his first patients, Carla, from her diagnosis through her treatment. He has given a face to cancer. We all know someone with cancer, those who survived and those who did not. Cancer prevention is now the wave of the future.

“Cancer is and may always be part of the burden we carry with us,” says Dr Mukherjee. He has now written a “biography of cancer” for us, those without special medical knowledge. However, he does go astray in some discussions such as genetics. He also mentioned that the patients are the real heroes. They withstand the horrors of cancer, and the horrific, sometimes deadly treatments. The stories of his patients made me weep, and the complex decision making about their care made him the most caring of physicians.

The ‘quest for the cure’ is the basis of all science and research, and Dr Mukherjee has written a superb tome in language that we can all attempt to understand. The biography of Cancer.

Excellent read!

Oncology Prereading

I have received a letter today from the UNIQ team about some of the materials I can read before I go to the summer school. They also have sent me two books accompanying this letter, both looking interesting, based on the title page and reviews on back covers.

This made me even more excited for the summer school and also made me think about my course – Oncology. I honestly do not think I know a huge amount of information about cancer. Hence why these books are just perfect! I am sure they would give me some important details about the nature of the disease.

I am going to start reading the book entitled ‘The Emperor of All Maladies’ by Siddharta Mukherjee. According to the letter, this is a ‘story of cancer from 3600 BC to 2007’. I have decided to begin with this one as I think it is basically the history of the disease which is exactly what I need to give me a bit of background and just to stimulate my thinking about what cancer really is and how it impacts our lives today.

‘The second book is called ‘Immortal Life of Henrietta Lacks’ by Rebecca Skloot. I believe that this is a story about a woman named Henrietta Lacks who died from cervical cancer. The letter mentions that her cells had huge implications for modern day oncology and my exciting task is to find out why! I cannot wait to read this one! I feel like a detective now.. 🙂

The letter sent by a member of the UNIQ team

The books they have sent me

UNIQ Oxford University Summer School

Words cannot express how grateful and fortunate I am to acquire a place in this year’s UNIQ Summer School! I was so thrilled upon receiving an e-mail saying I successfully got a place for the Oncology course. The summer school is going to take pace in one of the most, if not, the most prestigious and well-known university, not just in the UK but in the entire globe.. THE UNIVERSITY OF OXFORD!

There are a lot of things I am genuinely excited about the summer school. First of all, the fact that this is going to be another fantastic opportunity to meet some people with the same interests as me. I cannot wait to meet other students who are just as passionate and enthusiastic as I am about medicine.

Another thing I am excited about is the nature of the course. I could not wait to experience the life of being a medical student (oncology student). Although this is just for a week, I will ensure that I will make the most out of it and really get a sense of how medical students cope with the demands of medical school as well as have fun. This will then give me an insight as to how I could manage and balance my time for my course and social life when I finally get into a medical school!

Meeting other people who also got a place and doing other courses is as equally important as meeting other potential medics. This would expose me to a variety of people who I can interact with and socialise, giving me the opportunity to improve my communication and interpersonal skills; both of which are essential skills especially in medicine.

Finally, this will be a good preparation when I leave my house to go to uni. Since I will be away for a week, my independence and ability to ‘stand on my own two feet’ will be put to test. Personally, I do not think this will be a big issue and I am rather excited to get be away and gain independence for a couple of days.

Oxford Summer School! This is going to be fun!

Work Experience – CCU

I had the opportunity to shadow some cardiologists at the Coronary Care Unit in Pembury Hospital.
This was a really valuable experience as I was exposed to the daily routines of the doctors starting with rounds early in the morning with the whole healthcare team. This gave me an insight to the dynamics of hospital wards and the importance of teamwork, communication and the diplomacy required, with colleagues, patients and their relatives.

I was also exposed to some of the machines used in cardiology such as the ECG machine.

Electrodes attached to a patient’s chest during an electrocardiography (ECG) test. They are connected to an ECG machine, which monitors the electrical activity of the patient’s heart. The test is used to diagnose heart complaints such as arrhythmia and coronary artery disease, and is commonly used to monitor the heart following surgery or a heart attack.

Hi guys! This is just a quick note to say A MASSIVE THANKS to Medlink and the entire Medlink Community!

Going to Medlink was one of the best decisions I have ever done in my life. The whole experience gave me a better insight not just about how I can make my dream a reality (get into a medical school!) but as well as the real role of doctors in our society.

In addition, this gave me an opportunity to finally free myself from all my doubts of pursuing this career as well as enabled me to meet some new friends who are also aspiring to be future medics. Sharing our own experiences with each other inspired me a lot! I have also gained a lot of confidence due to the fact that I am now aware that I am not alone in this journey.  Although the Medlink Conference is now over, I believe that I would not lose contact with them as we all have a common goal and share the same interests. These amazing people will be another source of support and encouragement for me and I sincerely hope I could be the same for them.

Above all, I had a chance to personally talk to one of the most inspirational people I’ve ever met, Mr James Ridgeway. I can confidently say that he has completely changed my perception about medicine. I am now about to start reading his book, Surf, which is definitely going to be another source of motivation. A big thanks to him and everyone who made it a meaningful experience. I will never forget the important lessons I have learned from this. THANK YOU SO MUCH!

I genuinely cannot wait for the future Medlink conferences and other activities! ❤

Lecture in the Sports Hall

Outside my room

A view from my window

Ophthalmoscope

Otoscope

Using a stethoscope lecture

Natia and Me

Cath and I

Having fun

Lecture Room

Common Room (Hugh Stewart)

Me and Denissa

Break during the lecture

Salaj 🙂

Christmas Jokes

Me and Gom

Amazing note-taking skills