Hurdles in Medicine

Jade Scott-Blagrove, Year 2/3 Medical Student, intercalating in Neuroscience, Manchester Medical School

‘Hello, my name is Jade Scott-Blagrove and I am a second year medical student from the University of Manchester…’ Every time I say this as part of my introduction to a patient I feel privileged. Facing four rejections at my first attempt was hard, as I received the rejection letters one by one and I became more disheartened. After my fourth rejection, without any interviews, I decided to look for jobs in my local hospitals and fortunately I had two interviews and received two offers.

During my gap year, I worked as a health care assistant in neurosurgery theatres where I watched a variety of operations. I was amazed to see how resilient the brain is to instruments used by the surgeons and multiple medications from the anaesthetist. I was able to follow the patients’ stories starting from the symptoms they experienced, their scans and I was able to view their operations. Deep brain stimulation appeared to be one of the more complicated and time consuming procedures which was mainly used to reduce movement symptoms in patients with Parkinson’s. The location of the electrodes required careful planning and a robot would be used for precision. Many children with cerebral palsy had an operation, known as a selective dorsal rhizotomy, where nerves in the spinal cord are cut to reduce spasticity in hope to increase mobility.

On my first day working in theatres I was greeted by the smell of the diathermy on human tissue, the sound of the drill going through the skull and the sight of a lot of blood (which appeared worse due to all the saline used). After a few weeks this became relatively normal as I would see several craniotomies and burr holes every day. However every time the brain was revealed after the dura mater was peeled back I would realise how amazing surgery actually is.

Working in theatres really changed the way I viewed life since each day would have an emotional aspect attached to it. Not only did I witness a patient die from an AAA, I also washed and prepared a patient who had just passed away so their family could see their body. I was surprised to see so many children requiring operations, mainly shunts, and young adults who had life-threatening car accidents. Another patient had a cardiac arrest in theatre and I performed chest compressions as the anaesthetist continued their work, I was so relieved when their heart regained its rhythm. Every specialty has pros and cons but my experience in theatre never deterred me from surgery.

After four rejections I started to think that I was not good enough to be a doctor but my gap year made me realise that medicine was all I wanted to do so I decided to apply again. I organised lots of work experience and I saw many operations including a carotid endarterectomy in Brussels. My second application to medicine resulted in four interviews and four offers.

Only 15% of medical students accepted come from one of the four lower socio-economic classes which include me. I believe that there are many factors which prevent students accessing medicine. Many people believe that medicine is for people who can afford it, others lack support and encouragement. Access to medicine and university has become more equal over time and this can be seen by the increased diversity within universities compared to the past generations. However, I feel this can still be improved.

One question frequently asked is ‘What would you like to specialise in?’ I reply with psychiatry (they look very surprised at my choice) and neurosurgery (they appear shocked). Psychiatry is a specialty which seems to have a stigma attached to it and neurosurgery is an extremely competitive specialty. When I worked as a HCA I realised that only one registrar out of the whole team was female and none of the neurosurgeons were black British. I felt as if my goal seemed somewhat delusional to others, especially when one GP laughed at my choices. Perhaps I’ll change my mind about neurosurgery in the future but this won’t be based on statistics. My decision will be based on my clinical and foundation years and what I want out of my career. Increased diversity in neurosurgery may even add value to the specialty.

I am currently intercalating in neuroscience. Not only will this allow me to explore an area of science that I am really interested in, it will also help me build toward my goal as a neurosurgeon. The brain is a fascinating organ; it is so complex with and has a variety of functions. Defects in the brain can have a huge impact on people’s lives and it amazes me that operations I have seen can lead to very positive outcomes. I would like to finish with a quote: ‘All the most acute, most powerful, and most deadly diseases, and those which are most difficult to be understood by the inexperienced, fall upon the brain’ – Hippocrates.