Hello readers! Welcome to the Cambridge Widening Access to Medicine Society fortnightly newsletter
This will be our last newsletter before Christmas and the New Year – so happy holidays everybody, we’ll be back in January 😊
Food for Thought: an example interview question
A 9 year old cancer patient requires radiotherapy treatment, however her parents refuse to consent for the treatment and would prefer to use alternative therapies. The cancer type is highly responsive to radiotherapy however the outlook is poor if no treatment is given. What do you do next?
Behind the Headlines
The Federal Drug Administration (FDA) in the USA has recently approved the use of esketamine as a treatment for treatment-resistant depression. However, critics have argued that the drug has not been put through adequate drug trials for it to be approved for pharmaceutical use. Esketamine’s mode of action is that is targets glutamate - an essential neurotransmitter - rather than the typical serotonin which is more commonly targeted by current medications. Medications such as citalopram and fluoxetine, which are Selective Serotonin Re-Uptake Inhibitors (SSRIs); phenelzine and selegiline, which are MAO inhibitors affect the concentration of serotonin in the brain. Serotonin has been the de facto target for antidepressants in the last few decades and has seen relatively good success. However, the issue that is often raised is that these medications often take 2 weeks or more to work, which may be difficult for the patient to endure during this time period. However, it has been seen that esketamine improves the patient’s mood within 24 hours of inhaling the spray. However, as with other antidepressants, this medication may cause suicidal thoughts, depersonalisation and/or derealisation symptoms. Thus, patients must be monitored for at least 2 hours when taking the medication. There have been concerns raised with the number of adequate well-controlled trials and its links with substance misuse, as ketamine is used as a recreational drug.
The approval of esketamine may be a beneficial step in the improvement of psychiatry, as generally the pharmacological approaches to mental illness have targeted serotonin as the chemical of most importance. However recent studies have seen that there are decreases in the size of certain areas of the brain, such as the hippocampus, in those with depression, and when SSRIs are given, there is an increase in neurogenesis in this area of the brain. This has been a hot topic of research in psychiatry, and may be one of the reasons why there is a delay in SSRI effect, and also the mechanism of action for these antidepressants.
Link of the fortnight
Both of these websites contain paid resources for UCAT, BMAT and Interview preparation. I personally used 6med as my ‘revision guide’ for my BMAT, and found it immensely useful to know how to handle Section 1 questions, and also know what I would need to learn/revise for the Section 2 Maths and Science questions. I personally found 6med a lifesaver, and suggest you have a look at the free resources they have too! (If you have financial difficulties, you can apply for a bursary on their website! Just look for their FAQs page to find out how to apply).
During my UCAT preparation, I used the website Medify. It matches the format of the test completely, and has tons of similar UCAT questions. It’s super helpful to get used to doing UCAT questions in the computer based format, without having to use up those valuable UCAT practice exams!
(BTW, we were not sponsored to link these!)
Have a look at both websites, and possibly consider them in your preparation for these two admissions tests!
Myth-buster
Myth- you need to pay lots of money to do well in the UCAT/ BMAT
False!
You don’t need to spend any money to prepare for the tests. There are more than enough FREE resources online and they are designed so that you can’t be ‘coached’ for them by expensive courses which are often a waste of money. If you really want to use extra resources, you can try to get books (the isc book is popular) from your school/ local library or second hand on ebay. Also, if you are from a low income background don’t forget to check if you qualify for the UCAT and BMAT bursaries for a refund of the test costs.
It’s entirely possible to do well on both tests without paying for resources!
Interview question- answer
Medical ethics questions are very common and there is usually a dedicated MMI station. The key to answering these questions is to show empathy with all of the characters in a scenario (regardless of your own views), weigh up the pros and cons of each potential outcome out loud, and acknowledge the complexities. You should try to learn 4 pillars of medical ethics and drop them into your answer, and if you know any extra relevant things e.g. a similar news story (maybe Charlie Gard), any relevant law (maybe Gillick Competence and the definition of informed consent), then do include them!
In this question you are required to give a concrete answer, but in some ethics questions you can weigh up both sides well without giving a concrete decision. In this case, the patient’s safety would ultimately come first and treatment could go ahead if the proper procedures were followed BUT most of your answer will be about talking to and showing empathy with the parents, trying to persuade them to consent to the treatment.
A great resource that I used to prepare for medical ethics questions is this:
Thanks for reading – if you have any questions then as ever please just email us at access@clinsoc.co.uk!
Hope you have a great fortnight and GOOD LUCK!
Love,
CamWAMS Committee
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