Sharp Scratch: a podcast for med students and new docs

In an episode to coincide with The BMJ's themes issue on racism in medicine, this week we talk people getting your name wrong, other microaggressions, and how racism can literally break your heart. We also hear from Professor David Williams on the physiological impact of discrimination and being a person with prejudices.

You can hear David's full interview in The BMJ podcast.

This week's expert contributor:

David Williams is a Professor of Public Health at the Harvard School of Public Health, as well as a Professor of African and African American Studies and of Sociology at Harvard University.

His research has focussed on the health effects of racial discrimination, as well as the public health implications of marginalisation.

As a medical student you often only get a short amount of time on a new ward, so this week we're talking about how we can make sure we build good relationships with the rest of the team, as quickly as possible.

Our expert guests and contributors:

Helga Lawrence is a student mental health nurse at Anglia Ruskin University. This week we chat with her about the annoyance of having medical students on the ward, and how a student nurse could be your best friend on placement.

Wendy Preston is a Consultant Nurse in respiratory medicine and is Head of Nursing Practice at The Royal College of Nursing. You can find her on Twitter.

Carolyn Cairns was previously a manager in the NHS, but is now a second year medical student! She's on Twitter.

If you're interested in the work done by Civility Saves Lives, you can find out more at their website.

January is traditionally a time when people make all sorts of promises to themselves - often around food, exercise or work. But sometimes these New Year's Resolutions might put us at risk of putting ourselves under too much pressure. In this episode, we discuss the resolutions you might like to make to protect your physical and mental wellbeing in 2020.

 
Our expert guests and contributors:
Abi Rimmer is Careers Editor at The BMJ and has been heavily involved in The BMJ's wellbeing campaign. You can find her on Twitter.

Juliet Laycock is a surgical trainee, who provides us with some advice about making the most of a long commute. Abbie Tutt is a graduate entry medical student in Warwick, who has an unusual source of support at university! She's on Twitter and also runs a blog.

Isra Husain is a final year medical student in London who loves to sing! You can follow her on Twitter.

To read the article Abi mentioned about gardening, take a look at BMJ Careers' 'Why I' series.

Christmas bells are ringing! It's a day that comes for all those who work shifts: your first holiday season at work.

How can you bring a little festive cheer to the ward? We hear from some clinicians about their working Christmases and discuss how you can make the most of the holiday period in the hospital, as we try to convince Declan that working Christmas Day might not be as bad as he thinks...

Our expert guests and contributors:

Jo Talbot Bowen is a consultant psychiatrist and psychotherapist with a special interest in stress in clinicians.

Sally El-Ghazali is an anaesthetics trainee who has actually chosen to work over Christmas in the past!

Rahul Pankhania is a surgical trainee whose Christmas day on the ward was once saved by a gift of a mince pie...

it's happened to every medic: relatives start telling you off for your dinnertime topic choices; non-medical friends probe and then sit in shock as you tell your latest morbid hospital joke. Some people - like Adam Kay - have even made a career of it. How much is too much gallows humour? And in a time of overstretched resources and clinician burnout, is dark humour an important way of bringing together people who have seen the best and worst of the healthcare system? 
Our expert guests and contributors:
Benji Waterstones is a senior psychiatric trainee and stand up comedian. He's performed his comedy at the Edinburgh Fringe in the past, and joins us this week to unpick the art of medical comedy. You can find Benji on Twitter and Facebook, and if you'd like to see him live, his 'giggle' list is on his website.
Brian Goldman is an emergency physician, author and radio host. He wrote a book called 'The Secret Language of Doctors' and hosts show 'White Coat Black Art' on Canadian Broadcasting Company Radio 1. He's on Twitter and Facebook.
If you're interested in this topic, you might like to read this article by Dr Katie Wason.

Sharp Scratch is all about bringing the hidden curriculum to light - so it's time to get real about another hidden aspect of medicine: the financial commitments of studying and being a junior doc. Hidden costs are everywhere: so how do you anticipate them and how can you weather financial storms? Join the team as we hear from med students and junior docs about their money worries, and quiz our expert guest about where we can get help.

Our expert guests and contributors:

Kathryn Runswick is an employment advisor for the BMA and Liverpool Medical School, and the mother of a newly qualified doctor. For advice on managing your money at medical school, the BMA produces financial guides.

The Royal Medical Benevolent Fund also provides money advice and signposting to hardship funds.

We heard from some medical students and junior docs:

Nishita Gadi Instagram: nishitagadix

Oliver Arscott Twitter: @OArscott

Pedra Rabiee Twitter: @pedrarabiee

Lewis Hughes: Twitter @LewyHughey

Med students and doctors often use social media for work and leisure. We all hear the same spiel from our med schools about being safe online - but social media can also be used for good! Join Laura, Anna, Ryhan, and our expert guest Dr Dominique Thompson as we discuss all the 'dos' of social media, rather than the 'don'ts.'

Follow the guests and contributors on social media:

Dominique Thompson's career as a GP with a special interest in adolescent and student mental health means she's spoken to thousands of students about social media. She's recently done two TEDx talks and published a series of books called The Student Wellbeing series. She loves social media so much, she's on Twitter, Instagram, Facebook, Linkedin & Youtube!

Becky Fisher is a junior doctor on an F3 year, who found mentors and opportunities through her use of Twitter

Mark Khurana is a medical student at the University of Copenhagen. He recently founded a think tank on underrepresented health issues, and often uses Twitter for educational purposes.

As med students and junior doctors, we encounter death more than the general population. But what do you actually do when you're called to the ward to see a patient who has died - and what happens after you've confirmed a patient death?

Join Laura, Anna, Declan and our special guest, Robert Cast, anatomical pathological technologist, as we take a dive into the world beyond the wards, to find out how we can keep caring for our patients after they die.

Tell us what you think about the episode and your ideas for topics to cover later in the series by leaving a review or by using #SharpScratch on Facebook, Twitter or Instagram.

For more on the podcast, including how to follow Laura, Anna, Declan and Robert on social media, visit www.bmj.com/sharpscratch.

Our expert guests and contributors:

Robert Cast is a trainee anatomical pathological technician at King's College Hospital. In his job, he looks after patients after their death every day. On Sharp Scratch, he helps us figure out what's important to get sorted for our patients after they die. You can follow him on >Twitter.

Daisy Shale is a Chief Medical Examiner's Officer in Sheffield. As a CMO, she helps doctors and families who have concerns about patient deaths.

Susan Mullane is a Bereavement Officer in South London. Her role involves making sure all the paperwork is in order for patients after they die, and helping bereaved relatives. She wants all junior docs to know that help is out there if you're confused about death certificates - you just need to know where to look.

More on documenting death, and the work of APTs at the Royal College of Pathologists

And this article is a really useful guide for managing sudden death in hospital, including what the police and the coroner may need to know.

As med students and junior doctors, we'll encounter death more than the general population. So how do we cope with the emotional strain this can bring? How do you support colleagues who are grieving? And is it ever ok to cry in front of a patient?

Join medical students Laura and Ryhan, and junior doctor Chidera as they talk about coping with death, and hear from Stephen Barclay, GP and palliative care doctor, and who taught Laura and Chidera about death and dying.

Our expert guests and contributors:

Stephen Barclay is a palliative care consultant who also teaches medical students at the University of Cambridge. He's previously been a lead for end of life care in the Cambridge and Peterborough area. You can find out more about him on his Cambridge University webpage

Chantel Meystre is a palliative care consultant who researches >Schwartz Rounds. She set up the rounds at her own hospital trust and has been studying the results.

Marika Davies works for Medical Protection, and wrote the article Death is part of a doctor's job for The BMJ. She has talked to lots of doctors who are looking for advice about coping with patient death. You can find her on >Twitter

Last time we talked about getting ill, and taking some sick days - but what happens when you realise that your illness doesn't have an end date, and if you're going to return to work at all, then you're going to return to work with your illness.

What is it like? How do you talk to colleagues or patients about it? Can you come to terms with yourself as a doctor with a long term illness? And how can you access support to continue working?

Our expert guests and contributors:

Anne de Bono is the >President of the Faculty of Occupational Health. She's worked with lots of doctors and allied health professionals who need help returning or at work in her career. You can find her on Twitter.

Greta McLachlan is a surgical trainee and past Editorial Registrar at The BMJ. She's got lived experience of being a sick doctor, as she needed help coming back to work after suffering from migraines. She's on Twitter

Med students and docs face pressure to keep working when they are poorly - compulsory classes, stretched rotas and knackered colleagues, and pride or stigma masquerading as self discipline or resilience. So against the tide of pressure, how sick is sick enough? And what are the costs of working while poorly?

Join medical students Laura and Declan and new panel member Anna Harvey and welcome back Sharp Scratch alumni James Macguire. We also talk to microbiologist Sarah Wylie about why throwing up between patients means you definitely need to go home.

Our expert guests and contributors:

James Maguire is our beloved ‘grumpy med reg' from episode 2. Having worked in the NHS for a while, he's had his fair share of awkward sick days, from himself and his team. You can connect with him on Twitter & LinkedIn

Sarah Wylie is a consultant microbiologist in Portsmouth, so she's an expert in all things infectious disease!

Who's off limits when it comes to dating, how renal physiology can ruin your chance of romance, and whether you should put that you're a doctor on your Tinder profile.

Dating as a newly qualified doctor brings some challenges that we don't face as med students: unpredictable hours, exhaustion from night shifts, and professional boundaries with colleagues. And maybe there are some lines we should not cross. How hard is it to find romance while adjusting to life as a doctor?

Our expert guests and contributors:

This week we hear from some med students and junior docs on their own love lives:

Divolka Ganesh Twitter | Instagram

Alyssa Stroud Twitter | Instagram

Dipesh Gopal Twitter

We're joined again by Rob Hendry, the Medical Director of Medical Protection. He's a Fellow of the Faculty of Forensic and Legal Medicine, and has an interest in teaching medical students. You can find him on Twitter

The secrets of true love, how being a new doctor affects your sex life, and whether it's a good idea to date a medic in the first place.

Becoming a doctor brings new challenges to romantic relationships: shift work, commutes, and emotional burdens from work. How can we prepare to carry relationships through this transition? Are linked job applications wise? Is it tougher (as a junior doctor) to date someone who is a junior doctor too than someone in another career?

Our expert guests and contributors:

This week we hear from some med students and junior docs on their own love lives:

Michael Phillips Instagram 

Richard Johnson Twitter | Instagram

Catriona Renison Twitter | Instagram

Julia Bland is a consultant psychiatrist and psychotherapist who works with the BMA as part of a service called DocHealth. She sees couples and families, some of whom include medical students and junior docs, and helps them to navigate their relationships. You can find out more about her on the >South London and the Maudsley website.

Your first day of being a doctor is very different to anything in medical school. What can we learn from those who have just finished their first year? What do they wish they had known

Our expert guests and contributors:

This week we hear from some junior doctors, who tell us all the things they wish they had known about actually being a doctor:

Shivali Fulchand >Twitter 

Fi Ozin

Luke Chan Twitter

Sacha Dowling Instagram

Greta McLachlan is a surgical registrar and Editorial Registrar at The BMJ. She can be found on on >Twitter 

Looking for more tips? Read nine pieces of advice for new doctors from Abraar Karan, an internal medicine resident at the Brigham and Women's Hospital/ Harvard Medical School. Plus, more tips from doctors who have just finished their first year of being a doctor.

What counts a mistake, what to do when it all hits the fan, and how one doctor picked herself up after a mistake that led to a manslaughter conviction.

You've made a mistake. What goes through your mind? How do you share this with your team? Why is it important to recognise the role of systems and human factors in making mistakes? And how do you move on to become a better clinician?

Our expert guests and contributors:

Andy Heeps is a consultant obstetrician and chief operating officer of North Middlesex University Hospital. He has a Masters degree in Leadership and Quality Improvement in Healthcare with The Health Foundation and Ashridge Business School, and has made his fair share of mistakes in his time as a doctor. Connect with Andy on on Twitter or LinkedIn

Jenny Vaughan works as a consultant neurologist, but is better known for her medicolegal work. She's campaigned for changes to the ruling of gross negligence manslaughter as applied to healthcare professionals, and worked on both the David Sellu and Hadiza Bawa-Garba cases. Jenny is on >Twitter and >LinkedIn

Rob Hendry is the Medical Director of Medical Protection. He's a Fellow of the Faculty of Forensic and Legal Medicine, and has an interest in teaching medical students. You can find him on Twitter

What happens when you're treating a patient, and they say something offensive - do you have a duty to continue treating them? Is it OK to walk away? And whatever you choose, will there be consequences on your colleagues or your organisation?

Join medical students Laura and Ryhan, newly qualified doctor Chidera, and Nadeem Moghul, who changed the way in which his hospital dealt with a racist patient.

Our expert guests and contributors:

Nadeem Moghal is a nephrologist and Senior Clinical Fellow at the Nuffield Trust. He's got lived experience dealing with patients who have made racist remarks.  He also writes for the Health Services Journal. You can follow him on Twitter or connect with him on LinkedIn

Liz Viglianti is a critical care physician in the US. She wrote >this article in The Lancet, about dealing with a patient making sexual remarks. She's on Twitter

We've all met doctors and med students on placement who we just can't stand - or who make us feel >this< small. But, for the sake of our patients, we will have to work in teams with those doctors, and we'll have to do it well. How can we work with people like that, and who do we talk to if we see behaviour we think is just plain wrong? What can we do if we suspect we're the one being an arsehole?

Join medical students Laura and Ryhan, newly qualified doctor Chidera, and Simon Fleming, orthopod reg and founder of #HammerItOut - which is a campaign to stop bullying in the NHS. We also have an interview with Anne Stephenson - GP, who teaches undergraduate medical students professionalism at King's College London.

Our expert guests and contributors:

Simon Fleming is an orthopaedic registrar and founder of the Twitter movement #HammerItOut, which addresses bullying in the workplace. He's big on Med Twitter and also has a website

Anne Stephenson is a GP and the Professionalism Lead at GKT School of Medical Education, King's College London. You can find her web page> here

It feels inappropriate to observe a CPR event as a medical student, especially as we may not be able to help the team within our competency. But as a new doctor, we will be expected to be competent, whether we're the first on the scene or joining a team already in action. How do we prepare for the real thing?

Our expert guests and contributors:

Resuscitation Council UK is a charity dedicated to making sure resuscitation guidelines are we well known as possible. You can find out what they're up to on Twitter, LinkedIn & Facebook

Ali Abdaal is a junior doctor and medical blogger. Find him on on Twitter,  Instagram and Youtube

Why projects fail, how one med student transformed her local emergency department, and why you should go looking for the people in the hospital basement.

It seems like loads of med students are rushing to get a publication out before they apply for foundation posts, and sometimes audits or small local projects seem like easy pickings. But such projects have the potential to change the environment—right?

If you want to learn more after this episode, check out Cat's recommended articles, How to get started in quality improvement, and Using data for improvement.

Our expert guests and contributors:

Cat Chatfield is Quality Improvement Editor at The BMJ. Follow her on Twitter

Sophie Corbett is a medical student at the University of Dundee. She worked on a quality improvement project that ended up changing practice in ward she was based on. She's on Twitter

Why the hospital switchboard is the friend you never knew you had, how using emotions can help you refer a patient, and what it takes to make a med reg hang up the phone on you.

We learn management for many of the cases will see - but often our algorithms end with ‘refer to seniors' or ‘refer to specialists'. How do we refer our patients to other doctors? What must we include, what could we include, how are we most likely to make a successful referral?

Our expert guests and contributors:

James Maguire, also known as the grumpy med reg, is a registrar in geriatric medicine and a National Medical Director's Clinical Fellow at NHSX. He's also had plenty of good and bad referrals in his career… Find him on Twitter & LinkedIn

Charlotte Durand is a junior doctor in Australia. When she started working on the wards, she found referrals a challenge - so she created the "referral cheat sheet," which you can learn more about on her Twitter or Instagram

Why nights shifts mess with your brain, how astronauts will cope with the time difference on Mars, and the power of frozen grapes when you need a boost.

We hear about the difficulties of life as a newly qualified doctor, one of which is the night shift. As a student, you may work late but (in the UK) it is unlikely you stay in hospital overnight unless you expressly seek out to do so. So how do you adjust and prepare for night shifts as a new doc?

Our expert guests and contributors:

Erin Flynn-Evans is the lead of NASA's Fatigue Countermeasures Group.

What the podcast is all about, why it got the name Sharp Scratch, and why all med students should join us in figuring out the stuff we need to know but don't really get taught.