SO WHAT TO DO WITH THIS TIME AT THE REST STOP COMMONLY KNOWN AS F3? Locum:you have your full registration now, so you are not bound to a particular school or location. Many take up the opportunity to join locum agencies or even bank agencies at a hospital they are familiar with and like working at. You can have your pick of which jobs to take, tailor your working schedule and swell up your depleted financial coffers in the process. It also helps to be strategic when it comes to locuming in F3, as you can speak about all those specialty locum jobs you worked at your chosen specialty interview (if you are that way inclined). And as a locum, you can engage in annual appraisals and take up opportunities to advance your CV. Enhance Your Specialty Experience:if you do begin to have an idea of a chosen specialty, or you were not able to get a desired specialty post first time round, use the time to enhance your CV by collecting more experiences. Establish contacts and do some work experience, spend some days shadowing at a facility. Attend workshops, seminars and conferences. Sort out your portfolio! Now you have the time that someone who may currently be in training may not have – use it to your advantage! Travel:All that time climbing the ladder and most of us never stopped to take in the view of the world around us! Yes there was elective, but that whizzed past us in a flash. For some, an existential foreboding and desire for adventure/rest grants the push of the ‘STOP’ button allowing you to get off, take off your stethoscope and lanyard, pick up your shorts and passport and head for blue seas and blue skies. Explore Other Interests and Hobbies, or Set Up a Venture:it’s amazing how much time you may find yourself spending during training working through on-calls, and rushing to complete your portfolio in the midst of your day-to-day workload. Some may place almost everything else in their lives on the backburner. F3 year grants you the time and space to pursue those things you love. Some medics have even used the time to set up websites, blogs, businesses and charities and get them up and running before jumping back onto the career wagon. Spend Time with Loved Ones…and REST!:An F1 car needs to stop at a pit-stop to have some time out of the race to get fixed-up and made fighting-fit again. While it is easy to fill up such a break with a jam-packed timetable, make the most of your free time to spend time with those who love you most. Life will teach you that such moments are priceless. And if you have found yourself burning out or crumbling down with exhaustion, take the time to rest and heal your mind, soul and body. THINGS TO THINK ABOUT Think about how much time you are taking off:Will it be one year? Two years? In your decided time period, will you be working and if so how regularly? Set yourself SMART goals for your break and make sure you have back-up plans in case your preferred activities fall through. Think about your finances (!):This is a major point. When you are on a training programme you have a steady flow of income. Will you be able to support yourself if you take a year out? If you have plans to travel or plans which do not involve working agency shifts, have you saved enough money to withstand any unexpected hits to your pocket? Speaking of locuming, consider your options when it comes to agencies:There are some very good agencies out there, so ask around and ask colleagues/friends about their experiences and preferences. Also keep in mind that it can take a while to sort out your paperwork and complete registration before you are good to start working shifts for an agency. So if locuming is on your heart, get the ball rolling as early as possible. Another thing to think about is joining the bank staff at a hospital, particularly if you’ve really enjoyed working at a hospital in your training or would like to work at a hospital closer to home. Bank jobs tend to pay better than locum jobs and can be less hassle. Think about work destinations:If you have sights on pursuing a job in warmer climes, sort out the logistics as early as possible and apply early! Particularly if you are headed to the increasingly-popular Australia and New Zealand areas. Stay Updated, Stay Protected:Keep tabs on your GMC registration, and also take out some indemnity insurance…just in case! Become The Person Your Specialty Is Looking For!:If you begin to fall in love with a specialty during your time out, review the specialty’s Person Specification (via the link at the end of this post). What things are you missing at the moment off of your potential application? Use the time you have to fill in the gaps in your CV and bump up your chances of a successful application! Ask around:As with anything in medicine, ask your peers and colleagues about their experiences or experiences of those they know. You are not the first to walk this F3 path and you won’t be the last. Find out what’s worked, what hasn’t, and figure out what may be best for you! As you approach the end of your time away from training, remember to be honest with yourself.Reflect on your career expectations and the additional (life) experiences you have gained. Hopefully you will now have a better understanding of what lies in wait for you and which road you believe lies ahead. It is important to remember that F3 is not for everyone. If you have that fierce drive and determination to press on into specialty training and race onto that road to consultancy, and you want to keep that momentum going, go for it! Let that fire rage on! If you have decided to keep on keeping on, that’s great! But there are many who have found themselves exhausted, buckling under the workload and now apathetic towards medicine. Those who have been rattled with confusion as to what the next step in life entails, or wide-eyed with fear as their specialty application fell through. Don’t feel that you need to make a career choice by force, or feel any pressure from your peer group. Take the time if you need to! Sometimes taking a pit stop in training is all it takes to remind you of why you made the decision to enter this rewarding profession, and crystallise in your mind the right place for you! I will end by advising this: It is oh so better to take one or two years to make sure you are doing the right thing and going in the right direction for you, than to press on and realise a decade into the future that you made a mistake which you could have avoided if you had simply taken the time… Written By Dr Jermaine Bamfo

The race to reach the top of the tree in Medicine is one that can be relentless. Many of us have engaged the zeal, determination and relentless drive (traits which are required to reach the medical summit) at various stages of our educational life. From Secondary School, we pressed on and pressed hard, jumping over every barrier placed in front of us – whether it was achieving your expected grades, to passing entrance exams and interviews; jumping straight into medical school or finally arriving there by way of BSc. Even when the euphoria of passing your finals deteriorates into stress and toil as you meander through the first few weeks of foundation training, your innate drive will likely begin to pressure you into thinking forward towards the next big hurdle you need to jump over in your career – the process of specialty training applications and making the difficult decision of which specialty you will be entering into. For some, they have the special grace to have known what specialty they want to pursue a career in. But it also appears that a growing number of people come to the end of their foundation years with no real consensus regarding what specialty to choose, with the path forward appearing even more fuzzier than it did at the start of F1! Only 43% of junior doctors in 2017 entered straight into a UK specialty training programme on completion of F2,which is a substantial decrease from 71% in 2011.This drop in numbers can be partly explained by the rise in popularity of the option of taking an ‘F3 Year’. Why the rise? There are many potential reasons. For some, they may have reached that period in F2 where specialty applications take place none-the-wiser as to which training branch they want to enter, or undecided as to even whether they want to pursue specialty training at all. Some may not get their desired training post/job and have nothing concrete planned for the next year. There are those who have been burnt out by F1/2, those who have become disenchanted with the system as they’ve waded through the thick mud of red-tape and poor working conditions which can be found in various corners of the NHS. There will be those who have encountered physical or mental health issues, or have more extra-curricular responsibilities which they want to address. SO WHEN? Should you take a break after medical school? Well truth-be-told it’s advisable to jump straight from medical school into foundation training. Not only is it the well-worn path, and one taken when you arguably have the greatest amount of general medical knowledge you’ll have in your life (keyword:arguably); but the support of medical schools in helping you cross that threshold into foundation training and help you get those training wheels off and hit the ground running cannot be underestimated. The additional support of your peer group is also important, for F1 can be daunting and heavy and particularly stressful and great comfort can be taken knowing that you are in a group of people having similar experiences. Also remember that you need to complete F1 year to complete your provisional registration with the General Medical Council (GMC) and attain your full registration and become eligible to practice independently. It is rare to take a break between F1 and F2, as such a break can be extremely tricky to arrange and the vast majority of posts are applied for as an F1/F2 combination rather than as separate entities. In saying this, there are some Foundation Schools that allow for F2 year to be spent abroad or offer support to take an interim break between F1 and F2. It’s best to ask the powers-that-be at your Foundation School to consider what options are out there. This all brings us to the most practical and most popular period where people take a break – time after completion of F2. Colloquially termed ‘F3 year’ it’s a time where you can constructively spend time deciding on your next steps with enough tools in your armoury to help you on your way. By this point, having completed F1 previously you will be fully registered with the GMC and you will have a broader base of knowledge and more experience in medicine. At this point you will also have a better idea of the realities of working day-to-day in the NHS on the ‘shop floor’. You will have a better idea as to what you personally hold up as most important in your life. Did you find the sensation of FOMO (Fear Of Missing Out) too difficult to take while you were stuck on heavy rotas and missing weddings and birthdays? Did you come to realise that work/life balance and spending time with loved ones is more important to you than you originally thought? Did you flourish during your endless on-calls, or did you pray fervently that your on-call shifts would whizz on by? Did you discover that Grey’s Anatomy sold you a dream of what medical/surgical life really is like, or do you now see yourself ready to take on your mantle as the next Dr House? ‘F3 year’ is even a misnomer – some people take two years out, or even more time out of the picture. Some may not even return to medicine. While taking a training break is most common after completion of F2, another natural break presents itself after completion of core training in the non-run-through specialties like medicine and surgery. These breaks are a time where people shift through their thoughts and feelings, as it is common to experience doubt over your originally preferred specialty or even your choice of career! https://www.bma.org.uk/advice/career/applying-for-training/out-of-programme https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications Dr Jermaine Bamfo

The last 4 years of medical school have not been easy and as I begin my intercalated year, I have begun to reflect on my time at medical school so far. Although I have had some fun, memorable experiences that I wouldn’t change for the world, there are definitely some things that I would change, and some advice I would give myself just to help me along at every step of the way. First year: Sleeping Beauty My first year was the best year of medical school. This was probably because I didn’t act like a medical student at all. I was the only black student on my course, so naturally I decided to make friends with students from other courses, who I decided were “more like me”. Whilst this gave me a sense of comfort and made me feel more at home, I found that I had no friends on my course. I had friends elsewhere so this wasn’t always a problem for me.  By tricking myself into believing I started lectures at midday like my friends, I found that I was often the one asleep in the lecture after my 3rdnight out of the week. Make the most of your first year.  Go out if that’s your kind of thing, but remember that while your mates are sleeping at 10 am, you have an anatomy session. Labels stick, and 4 years on, I’m still known as “The Girl Who Sleeps In Lectures”. Looking back I don’t regret having friends on other courses, it meant the conversation didn’t revolve around “Grey’s anatomy” everyday. However, it’s important to get to know other medics. Whether you like it or not, medicine is a challenging course, and you will have a different lifestyle to everyone else; no one understands that more than other medics. It’s also really hard to practise a respiratory examination on yourself so even if you don’t really “click” with the people on your course, its wise to keep them around. Second year: “Work twice as hard” The phrase, “work twice as hard” has been embedded in me all my life. I’ve almost come to see it as a family mantra. My parents always highlighted the fact that as ethnic minorities, we would have to work twice as hard to be seen as equals to our white colleagues; and even then there was a glass ceiling that we would probably spend our whole lives trying to break through. This worked out well for me during secondary school, I worked twice as hard as everyone else and I was one of the smartest people in my year. After sleeping my way through first year, I decided second year was time to bring that mantra back and shake off my new label. Second year was arguably the hardest year of medical school so far and unfortunately my old secondary school tricks proved fruitless. Yes I worked twice, maybe even three times as hard, but I still found myself in the middle of the year. I had never been average in my life and even after killing myself for these exams, I didn’t come out on top. Even though I passed, I couldn’t celebrate. So instead of enjoying myself, I spent my time trying to figure out where I went wrong. I’ve now realised that everyone in medical school was the smartest in secondary school, so I wasn’t that special. I still believe we have to work twice as hard as everyone else, and this was especially true for me being the only black person on my course with an embarrassing reputation for sleeping. However, if I could go back I wouldn’t beat myself up about not passing with merit or being in the top 10%. Being a medical student is such a huge achievement, and as cliché as it sounds, we should be proud of ourselves for each year we get through. Third year: Finding my place Third year is when I really started getting into my stride. The course was suddenly much more interesting and I found my strength in clinical medicine. Consistent hard work and a genuine interest meant that I went from the middle, to the top of my year group. With all my friends being busy with dissertations, I decided to make some medic friends and found that, surprisingly; some of them were “more like me”. There’s not much I would change about this year, (other than making the term a bit shorter) however one mistake I made was focussing too much on my written exams rather than the OSCE’s, which were weighted more heavily. My advice is to make sure you know the weighting of each exam. This doesn’t mean you should only revise for one, but it’s good to know which one deserves a bit more of your attention. Fourth year:  Finals? I don’t know her Finally we’ve come to fourth year, when I sat my final exams. Funnily enough I didn’t realise they were my finals until about a week ago, at the time I just thought they were important. Note to self: make sure you know what exams you’re revising for. Despite this I worked hard, and did relatively well. Finals are no joke. These exams were extremely difficult and I still get flashbacks to the all nighters I pulled in the library. Although it was stressful at the time those all nighters were worth it, and I don’t think I could’ve worked any harder even if I did realise they were my finals. At the end of my fourth year I went on my elective, which has been the highlight of my degree so far. Early planning and saving meant I was able to have an amazing time full of unforgettable memories. Even if you can’t afford to go abroad, use this as an opportunity to do a speciality you really enjoy and make the most of your time there. Medical school has been a rocky journey and I won’t lie, there have been times when I wanted to give up. But I’m glad I didn’t. Its so easy to lose sight of why you applied in the first place when you have huge exams looming over your head, but once you get into your stride not even finals will discourage you. As I enter my fifth year I hope to take all of the lessons I’ve learned with me, and finally shake off that label. Written By Ife Williams

Getting back into the swing of Medical School after a long, hot summer can be difficult and it is so important to try and start the year on your best foot. All too often people underestimate the impact of the way you start. Not starting right tends to have a knock on effect not just in your studies but in all areas of your life; from your social life to your peace of mind. Don’t get me wrong finishing right is what is most important but starting right sets you up for an excellent finish and saves you a lot of energy. Below is some of our tips to making sure that you get off to the best start this academic year. MINDSET/ RESET YOUR BODY CLOCK Now first thing is first, you need to be in the right frame of mind. University is challenging so you need to be mentally prepared for what the year might bring. I like to start by gradually getting myself back into the process of waking up early as that is something I normally struggle with. Start thinking about what is coming up and what you need to do in the run up, this will help to easily adjust to life back in university. HANDBOOKS Be clear on what is expected of you. So much will be going on through out the year and the handbooks are there to guide you through it, so make good use of them. Of course they can be a pain to read but hidden inside are often some key tools to make life just that bit easier for you during the academic year. Don’t just look at them once, go back to it through out the year. ASSESSMENTS & DEADLINES Writing down what assessments you will have through out the year and deadlines will help you to stay focused and up to date. Make sure you put it somewhere you can easily see it, giving that constant reminder to leave yourself enough time to adequately plan and prepare for them. SUPPORT Make sure you are aware of the various avenues of support available. Every Medical School has Medic Support, make sure you know how to contact them. Never forget your family and friends, make time for them and try your best to keep in contact with them. Medical School is tough, please remember you are not alone. IDENTIFY YOUR STRESSORS As humans, we tend to exhibit the same patterns of behaviour and similar things seem to be the ones causing us stress. It is important to recognise what your stressors are and establish ways to alleviate your stress. You can’t necessarily remove all stressors but you can change the way that you handle the stressor. TALKING TO PEOPLE IN THE YEAR ABOVE Have a chat with someone in the year above you, they are the best person to go to for advice, after all they’ve just been through what you’re about to go through. Don’t just speak to them once, stay in contact! PASSION PROJECT – MAINTAINING YOUR INTERESTS As a student it is crucial to maintain your interest. What is it you are passion about? Do you have a passion project? This may be some voluntary work you do on the side, writing or a setting up a social enterprise. We will elaborate on this another blog post in the future. SET YOUR GOALS FOR THE YEAR Make sure you know what you are working towards. When writing your goals try and be specific and think about what you need to do to achieve it. Make sure your goals are realistic and regularly review them to keep you on track. MAKE THE MOST OF OPPORTUNITIES Medical School is about more than just getting a degree, it is also about utilising the opportunities to develop as an individual and preparing for not just your future career but also additional endeavours. This is your chance to make the most of opportunities to pursue areas of interest, meet new doctors and work with different people, so don’t be shy. We have a range of blog posts to help you out with this next academic year: Time Managements Tips Dealing with the Workload Starting your Clinical Years Spaced Repetition

As we all know, Medicine is not an easy course. There are many highs and lows throughout the years, a number of which involve many stressful moments. Having the ability to cope with the intense study requirements and heavy workload is vital for completing medical school with both good grades and fond memories! We discovered mindfulness during a 5-week course set up by our university and wanted to share our experience with others. Mindfulness is an up and coming method for stress reduction amongst medical students which is being used in both formal and informal settings. Studies have shown that mindfulness practice in medical education has a role in stress reduction and depression (1). In short, Mindfulness practise is the art of becoming increasingly self-aware as an individual learns to live more in the moment. We found that the different methods of mindfulness worked differently for us. One method that we really enjoyed was bringing awareness to pleasant and unpleasant events. In medical school, there is always a lot going on around us, as a result of this, we often start focusing on the more negative aspects of our lives rather than the positives. For example, when on the wards, we worry so much about getting procedures done and being signed off which can be really daunting. However, whilst completing the procedure, we never stop to think about the beneficial impact it has on our learning and professional development as well as the impact on the patient. We don’t appreciate the fact that gaining this experience boosts our confidence nor do we appreciate the help of the kind clinician who signed us off. Mindfulness helped make us aware of these small but impactful positive experiences. Another method of mindfulness that we liked was the Body Scan. This involved lying down on a soft mat whilst listening to either a mindfulness audio tape or to the tutor; who would speak in a calm manner as we slowly became aware of different aspects of our body. From our head to our toes we felt a new experience as we blocked out other senses to bring our thoughts simply to ourselves and our body. Although this proved to be incredibly tiring at times, especially after a long day on placement where all we wanted to do was sleep (and we did let this happen at times!), it was still an enlightening and calming experience. An interesting exercise that we did during the mindfulness course was mindful eating. Yes, sounds funny, we know. This involves eating food whilst thinking about how it feels, smells, sounds and tastes. Mindful eating was one of the more unsuccessful yet memorable methods that we learnt. This is because, we had to hold a raisin which we then proceeded to roll between our fingers to feel the ridges and the texture. The raisin was then squeezed lightly between our fingers to appreciate the quiet sound that it made. Next, we smelled it and were surprised by the sweet fragrance that it had. Finally, we placed the raisin in our mouth and rolled it around in our mouths whilst being told not to chew in order to fight our natural auto-pilot which subconsciously makes us eat our food. As this was very funny, it did not enable us to understand the reasoning behind the activity because we were too self-conscious of looking foolish whilst listening to a raisin and disliked having to eat the raisin after having handled it for so long. Above were a couple of examples of how mindfulness can be achieved. There are many more exercises available, a webpage on Medical News Today titled ‘Six mindfulness techniques for physicians’ mentions a few of them. Mindfulness is not only useful for us but is also used in the clinical setting for people suffering from chronic conditions which are strongly related to stress. So, we hope you think of mindfulness the next time you are in a stressful situation or even in a clinical environment thinking about different methods of patient management. We thoroughly recommend trying some of these techniques in your own time as it really is important to find some form of stress relief in the busy environment that we live and work in. References: Daya, Z. and Hearn, J. (2017). Mindfulness interventions in medical education: A systematic review of their impact on medical student stress, depression, fatigue and burnout. Medical Teacher, 40(2), pp.146-153. Medical News Today. (2018). Six mindfulness techniques for physicians. [online] Available at: https://www.medicalnewstoday.com/articles/317986.php [Accessed 24 Aug. 2018]. By Khadija Owusu, Maathu Ratnaraj and Vdhuja Sivabavanandan

Sometimes we can lose sight of the fact that our lives are made for living. Not just working day in, day out. Not just trying to get the highest grades or getting into medical school. Living. At different points in your life, it can seem like you have so much to do and so many people to please. All this pressure and no idea what to do about it. Maybe you’re worried that your GCSEs aren’t quite up to par. Or maybe they went amazingly and now you’re worrying about how your A Levels (or equivalent) are going to go. Maybe you are stressing over your mocks, or your UKCAT/ BMAT, or starting university and making friends, or making it through medical school and going into your job. Or maybe it’s just life itself. Do you recognise yourself in any of these people? Countless numbers of us have been there or are currently there. It’s nothing new. My advice? Some days, just stop. Take a breath. Think (or stop thinking, if that’s what you need). Just take a moment and stop. It doesn’t have to be for long. Just enough to calm yourself down. Whilst the world won’t magically stop turning, and time won’t afford us the privilege of putting it on pause, we do still hold some power in our hands. We can’t control every outcome, but we can control our reactions. Sometimes stress can help us focus and motivate us to meet deadlines. But this isn’t always the case. Excessively stressing yourself out about all these different things can be detrimental to your health, both physically and mentally. But you probably know that, right? So why do we do it? Stressing out is completely natural and part of being a human. We’ve all done it. I can say I’m probably the number one perpetrator. Deciding to pursue a career in medicine, regardless of the stage you’re at (GCSE, A Level, university and even in the job itself), is inherently stressful. It’s a big decision and one that I imagine you didn’t take lightly. While we can’t anticipate all the stressful things we will go through on our journey, we can try and develop our coping mechanisms to allow us to best deal with the issues. I can’t tell you the best way to cope – that’s up to you. Maybe you just need advice from someone with more experience than you. Maybe you just need a second to gather yourself and refocus your mind. Or maybe you just need a couple of minutes to cry and get everything out of your system. But if you take a second to stop and think, you’re giving yourself a chance to stop that spiral thinking and put your mind on pause. Then keep going. You can do it.

Congratulations on meeting your offer, you are now officially a medical student! It is such an achievement and something to be so proud of. Well done! I will never forget the joy I felt when I found out that I got into medical school. The feeling is truly indescribable and I just couldn’t believe it! However this excitement was short lived as the reality of medical school hit me. I started thinking about the hard work, the long hours and all the exams that I’d have to sit. I began questioning my ability to make it through the year BEFORE I had even started! All of this negative thinking made me anxious and set me up for a rocky start. If I could go back to the start of my first year here are some things that I would have changed to better prepare myself for the transition. Have a positive mindset and be excited! You worked so hard this year to get this place at medical school so be excited about starting this beautiful journey! You deserve your place at medical school. One of my biggest worries was that I wouldn’t be smart enough. I knew that I would be surrounded by students who were incredibly intelligent with a natural ability to learn new information and I didn’t perceive myself as such. This was the wrong mindset to start the year with. If you got the grades to get into medical school, you are more than able to do well. Start with the mindset and the belief that you are smart and most definitely capable of excelling during this year. You are no less than anyone in your cohort. So get excited! You deserve this place at medical school! Be prepared for the hard work to continue I personally found the workload intense as it is much heavier than A-level. However, I quickly realised that the content isn’t incredibly hard, there is just a massive volume to learn. The most difficult thing is finding your feet and adjusting to this new way of teaching and learning. To do this, try your best to keep on top of your work so that you don’t fall behind.  Attend all lectures, tutorials, dissections/prosections and other scheduled teaching. Remember, you are paying for tuition so make the most out of it! Also, it is key to integrate as much as possible with your course mates. You will meet people who will become your support system and some of your closest friends during your time at university. Also, find out your style of study as early as you can. How will you take notes during your lectures? Will you handwrite them or type them up? How will you write your study notes? Will you use flashcards, posters or mind maps? Are you a fan of group study? Asking yourself these questions before you start will have you well prepared for the rest of the year. Most importantly, make a plan to track all of your commitments whether it be studying, attending a society event, catching up with friends or having time to yourself – planning will keep you organised and less stressed during this year. Work hard, play hard Your first year is the best time to be as active as you can be in societies as your timetable tends not to be as intense as later years. Use Freshers week as time to get to know your course mates, make new friends, become more familiar with your campus, the local area and your surroundings. Use your first term to adjust to your new environment and the medical school lifestyle. Attend the freshers fair and get involved with as many societies as possible. Joining a society will allow you to have some “me time” after studying and they can be a great way for you to relax and have some fun! You can also learn new skills that you can use to build your CV. So be sure to check your universities student union website before you start so you can get an idea of societies that may interest you. Always remember your why You may sometimes find that you are struggling with your work as the workload intensifies during your first few weeks. In these times it is easy to forget why you are here as you start to lose sight of the bigger picture. It is important to remind yourself of why you want to be a doctor and use this to restore your motivation. Also, getting involved in medical societies that interest you can serve as a great reminder too. Most importantly, when things become a little overwhelming and you feel like you are struggling, please speak up and seek support from those around you. You can talk to your friends, family, your personal tutor or the well-being services provided by your student union. If you are struggling with anything, please don’t be afraid to ask for help. Focus on self-care and balancing your health with your academics – you will excel this year. Good luck, you’ve got this! Written by Sarah O’Connell

“Do what you can, where you are, with what you have.” – Theodore Roosevelt A health professional is noted as one who provides health care for the community through the means of knowledge and practicality. Furthermore global health plays a pivotal role in ensuring that a high standard of healthcare is provided to all communities in an equitable manner. Leadership within global health is paramount to ensure that these mandates are established and this article wishes to celebrate the revolutionary global health leaders, both in the past and present, which have done so! DR DANIEL HALE WILLIAMS. Dr Daniel Hale Williams is notably known for performing the first successful heart surgery which repaired a wound. It was documented in 1893 as a successful pericardial sac surgery which led to a post 20 year survival for the patient. Moreover, Dr Daniel Hale Williams is celebrated for providing solutions for health education in a global context. In 1891 he founded the first racially integrated staff hospital (Provident Hospital) as he was concerned with the lack of equality within training professionals. Furthermore in 1895 he founded the first professional body, National Medical Association, which allowed African American members to be admitted. These establishments have played a remarkable role in global health education in America. DR J. SOKA MOSES. Dr J. Soka Moses is a Liberian medical doctor who faced the Ebola outbreak as a junior doctor at the Redemption Hospital in Monrovia. He has described it as a ‘virtual biological bomb’ and ‘medical tsunami’ which led to the dismantling of health protocols and order.  During the outbreak he worked to establish and charge the biggest Ebola Treatment Unit (ETU) in Monrovia where more than 600 patients were treated. To ensure that there was a strengthening within the public health and infectious disease epidemiological field; Dr J. Soka Moses went to enrol onto the MSc Control of Infectious Diseases at the London School of Hygiene & Tropical Medicine. Presently he work with researchers from NIH and the National Institute of Allergy and Infectious Diseases (NIAID) to conduct innovative epidemiologic research which actively contributes towards global health. PROF. AGNES BINAGWAHO Prof. Agnes Binagwaho, former Minister of Health for Rwanda, began her clinical practice in Belgium and France. Upon her return to Rwanda she was spurred to focus on global health issues where she has actively and successfully contributed to the reshaping of the Rwandan Health care policies and systems. Throughout her career she has accumulated endless accolades such as commissionaires, advisory and board positions. She has broken barriers related to gender, age and geographics to ensure that there is an effective delivery of health care solutions. Currently she has been appointed as the Vice Chancellor and Chief Executive of the University of Global Health Equity in Rwanda. She is also a lectuer at Havard Medical School, Geisel School of Medicine and Dartmouth College. PROFESSOR DAME SALLY CLAIRE DAVIES, DBE, FMEDSCI, FRS Davies has a medical background where she qualified as a doctor from the University of Manchester and went to gain a Master of Science degree from the University of London. She became a consultant haematologist in 1985 at the Central Middlesex Hospital in Brent. Furthermore she has contributed to the healthcare profession through the means of research, in particular where she is a specialist in Sickle Cell Disease. Notably, Davies is known for being the first female to hold the position of Chief Medical Officer in 165 years and Fellowship of the Royal Society (FRS) in 100 years! Her medical leadership role means that she works to advise and employ global health issues at the forefront. HELENE D. GAYLE Gayle is prominently known for being an expert on global development and issues.  She is a board certified pediatrician who completed her residency in pediatric medicine at the Children’s National Medical Center in Washington, D.C. During her clinical career she pursued a public health interest where she directed programs at the Bill & Melinda Gates Foundation and spent 20 years at the Centers for Disease Control and Prevention (CDC).  Since 2005, she became the CEO and president of CARE which is a humanitarian agency which governs international development projects; it is known as one the largest organization aids which are focused on fighting global poverty. Health care professionals play an important and pivotal role towards the advancement of global health and development of innovative schemes. It is important to note that influential leadership can be demonstrated within universities, local communities or global organisations, it is not limited. Thus; if you have a passion within the global health context, pursue it! Written By Jade Okene

The build up to A-Level Results Day is a very stressful period and it is extremely important to be prepared. PREPARATION Research alternative courses and universities and list their details/ telephone numbers. Universities will list available courses before Results Day, so there’s no harm in doing some research beforehand. Know what subjects you’re looking for, and make sure you have thought about why you want to study them. Contact details for your firm and insurance university Pen and Paper, Mobile Phone & Charger A list of any questions you have about the university or the course, Exam certificates on hand (universities may ask you to send them scanned copies of relevant qualification certificates) Have some breakfast CHECK UCAS TRACK Hopefully you’ll get the exam grades you need, but if you just miss out, the university or college might accept you anyway. You might get a place on either your firm or insurance choice, depending how well your exams go. You might be offered an alternative by the university/college – a ‘changed course offer’ (which you’ll need to accept or decline). You might not get a place, but you can search through our Clearing service to see what courses still have vacancies. If no decisions are showing, your application might still be under consideration by your university, even if you have missed your grades, give your universities or colleges a call to find out more. CLEARING Whether you missed your grades and as a result did not receive any offers or maybe you rejected all your offers; UCAS Clearing allows you to apply to universities with places on courses still available. If you have decided to reject your offer, request for the university to release you into clearing, once your Track status says ‘clearing has started’ or ‘you are in clearing’ you are eligible to go through clearing. Before rejecting your offer please consult with your teachers, parents or advisers. Use the UCAS website to search for courses you are interested in, then contact the university directly and make sure you have your Personal ID number as well as your Clearing Number on hand so they can access your application (also make a note of your GCSE and A Level grads prior as you may forget them in the heat of the moment). The phone call may be treated as a mini-interview and they may ask questions such as why you are suitable for the course, why you are interested in the course and what you would bring to the university. Also feel free to ask questions about the university and the course. If they are happy with your application, the university may give you a verbal offer, once you have received the offer you can log onto track and add the choice through clearing. This verbal offer usually stands for 24 hours, this gives you time to consider other options afterwards as it is extremely important that you don’t rush into a decision and choose a course in a university that is right for you and that you are happy with. Have a support system (e.g parents, friends and siblings), it is a stressful time Make notes during the conversations, you may speak to several universities in one day Be prepared, as mentioned earlier have everything you need on hand https://www.ucas.com/ucas/undergraduate/apply-and-track/results/no-offers-learn-how-clearing-works ADJUSTMENT Did you perform better than expected and perhaps want to reconsider your options and enrol on a better course at a higher ranked university? Similar to UCAS Clearing, UCAS Adjustment allows you to apply to universities with places on courses still available and aims to give students the chance to enhance their university experience, not hinder it. Adjustment is not compulsory, if you have exceeded your expectations and are happy with your original offer that’s fine. Although Adjustment lasts from Results Day until the 31st of August, you are only given five days to find an alternative course or university from the time you register in Track, so the quicker you register, the more likely you are to secure a place at a university or on a course that you want. Again talk to an adviser at your school, college, centre or careers office or your parents so you can decide if Adjustment is a good choice. To register for adjustment you must have met and exceeded the conditions of your initial firm offer and click ‘Register for Adjustment’. If you don’t contact any other university about applying through adjustment your initial firm offer will remain. There is no list to indicate vacancies in any universities for Adjustment so you have to search courses and contact the admissions offices at the university to ask about any vacancies. Mention that you are applying through adjustment and are just gathering information, have your Personal ID on hand and make sure you don’t agree to a verbal offer until you are entirely sure you want it. Beware that once your new university has put the offer into Track, your original firm choice will be rejected automatically; there’s no going back, so be sure to have a think before you commit to anything. https://www.ucas.com/ucas/undergraduate/apply-and-track/results/ucas-adjustment-%E2%80%93-if-you%E2%80%99ve-done-better-expected DEFERRING YOUR COURSE If you wish to defer your offer until the next year after receiving your grades, be sure to call the university and ask if this option is possible, be aware that not all universities will agree. Make sure you have a good reason for your decision as you may be asked about it and explain your intentions for your gap year. Simply enquiring does not affect you confirmed offer. GAP YEAR Taking a Gap Year is an excellent opportunity for to learn and gain invaluable skills and experiences as well as giving you time to reflect on what you’d like to do next and possibly travel or enhance your CV. You may decide to volunteer, travel, work full time, take up part-time courses or gain work experience related to your field of study. Planning your gap year is very important as time can go really fast and you do not want to waste your break from full-time studying, so decide why you want to take a gap year and what you specifically want to achieve and devise how you will go about achieving these goals. Also consider how much time you will be away, how you will fund your gap year ideas and what is available. Be sure to make use of online resources and get advice, there’s a lot of help out there! DON’T WANT TO ACCEPT YOUR OFFER? You can either decide to be released into Clearing or register for Adjustment. If university isn’t for you anymore you can decide to apply for an apprenticeship You may decide to retake you’re A-Levels and reapply for next year’s entry Forget about University for the moment and take a Gap Year DID YOU NARROWLY MISS YOUR GRADES? Contact your university, they may still accept you or offer you an alternative course which you must choose to accept or decline. You can also choose to get a Remark; make sure you inform the university that you are getting a Remark and then apply for a Priority Re-mark as this is the only way it will come in time to meet the conditions of your offer by August the 31st. Melanin Medics wish you the best of luck on Results Day and hopefully all your hard-work will pay off. If you have any questions or suggestions, feel free to Contact Us,we’re happy to help.

Exercise is something many of us dread. We fear that early morning gym session. The thought of jogging for more than 10 minutes is terrifying and to couple with this, we must try and eat healthy as well? Why is this the case? I think many of us see exercise or physical activity in general as a chore and not something that is enjoyable which should not be the case at all! Most medical students and even the public already know the positive physical benefits that exercise has, but I think a lot of us ignore or don’t recognise how physical activity can improve our mental health. Mental health and talking about it has always had some sort of stigma attached to it, especially with males. However, in recent years, people have started paying more attention to it and shedding an increasing amount of light on issues regarding mental health and what we can do to tackle them. Unfortunately, depression and suicide rates have risen in the last decade which has forced us to take it more seriously. Certain professions and fields, such as medicine, have also seen a marked rise in depression and suicide rates which begs the question; what exactly is wrong, and why do we fear opening up about things to do with our mental health? I believe part of this can be attributed to the society we live in today and our current generation. The demands placed on us today, without undermining what our parents and grandparents have gone through, are ever pressing which has not been helped with the likes of social media. We care so much about appearing to be ok that we fail to face and deal with underlying and deep rooted issues. As a male especially, we are somewhat programmed into putting on a brave face or being the ‘man’ that our current or future families require. Whilst one must learn how to deal with the situations that life throws at us accordingly, this does not mean that we should be afraid of speaking up or seeking help when the going really does get tough. Individuality amongst males and constantly trying to do things on our own accord is also a pressing issue that we must try to get rid of. It is clear to everyone that society is very much changing. Males are no longer required to be the sole bread winners of the family as an increasing number of women are going to university, going to work and doing many of the roles a previous patriarchal society would have deemed not possible. Thus, equity within our society has relieved some of the pressures and allowed us to take a break when needed. During these breaks, I find it vital that we analyse not just our physical health but also our mental health and if we are really ok and not just appearing to be ok. As mentioned previously, a great way to not only improve our mental health but also prevent it deteriorating, is exercise. “It is exercise alone that supports the spirits, and keeps the mind in vigour” Marcus Tullius Cicero The department of health recommends that the average adult should do around 2.5 hours of moderate intensity activity a week, which equates to 30 minutes five times a week. Whether this be a leisurely walk to work instead of taking the train, or taking a trip down to your local gym, it is important that we try and achieve this to reap the potential rewards. There are several ways that exercise can help our mental wellbeing and here are just a few: EFFECTS ON OUR MOOD Evidence has shown that physical activity can have a profound positive effect on our mood (Penedo and Dahn, 2005). Researchers in a study found that participants felt more awake, content and even calmer compared to those who were inactive. Kanning and Schlicht (2010). This just goes to show that a quick run may help to lift us up when we’re feeling down in the dumps. EFFECTS ON STRESS Stress is something that we all go through on almost a daily basis and is a natural part of human life. To help combat it and to prevent it overwhelming us, we can engage in physical activities to relieve this stress. A study on employed adults showed that very active individuals tend to have lower stress rates compared to those who are less physically active Kouvonen et al (2005). EFFECTS ON DEPRESSION AND ANXIETY The fact that physical activity can be an alternative treatment for depression alone signifies its benefits. It can be used as a standalone treatment or in combination with psychological therapy/medication (Department of Health, 2001). Although those that are depressed may struggle to find the motivation to exercise, once conducted, the benefits will only ever be positive. The stigma attached to mental is slowly but surely being peeled off. Although we live in a fast-paced society with increasing demands, this same society has made reaching out to people and seeking help that much easier. There are numerous websites and numbers that are one google search or a few screen taps away that will enable you to talk to someone who cares about how you are feeling. If you don’t feel comfortable talking to a stranger then please reach out to your family and friends because you’d be surprised how many of them are going through something similar or who will be willing to sit and listen to the struggles you are facing. As well as this, engaging in physical activity and keeping fit are also a couple of other was to preserve your mental wellbeing. You may struggle to find the motivation but the start is always the hardest part. Once you push through that first barrier, the rest become a whole lot easier. “Your present circumstances don’t determine where you can go, they merely determine where you start” Nido Qubein Written by Allan Nathans References: Penedo, F.J. & Dahn, J.R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current Opinion in Psychiatry. 18 (2), 189–193. Kanning, M. & Schlicht, W. (2010). Be Active and Become Happy: An Ecological Momentary Assessment of Physical Activity and Mood. Journal of Sport & Exercise Psychology, 32 (2), 253–261 Department of Health (2010). Healthy Lives, Healthy People: Our strategy for public health in England. London: The Stationery Office. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216096/dh_127424.pdf [Accessed on 04/11/15]. Kouvonen, A., Kivimaki, M., Elovainio, M., Virtanen, M., Linna, A. & Vehtera, J. (2005). Job strain and leisure-time physical activity in female and male public sector employees. Preventative Medicine, 41 (2), 532–539. Department of Health (2001). “Exercise Referral Systems: A National Quality Assurance Framework.” Available at: http://bit.ly/1N31ONs [Accessed on 04/11/15].

Summer of every year marks the time for graduation season for universities across the country. Every year the pictures of peers receiving their degrees and dawning their caps and gowns proudly plaster every social media outlet. And most importantly , it marks the end of an era of education and the beginning of a new life and career and a welcome into the adult world. It’s a great time of celebration and I’ve always found it inspiring and motivating witnessing such achievements. As a medical student though , with a course that spans 5 years , far longer than most other degrees it’s hard not to find yourself feeling a bit left out in all the celebrations. I’ve felt a feeling of FOMO since the second year of my course and I felt I needed to explore why and if I was the only one. WHAT IS FOMO? Urban dictionary defines it as the ‘fear of missing out’ , particularly missing out of an opportunity or exciting event and so leading to feeling uneasy or anxious that you are unable to do something. Now, given my feelings I think I should give a bit of context. Having taken a gap year prior to starting medical school I already had seen my peers and friends start university a year before me and I’d accepted that for my journey into medicine this was a sacrifice that had to be made. I didn’t mind too much being in my gap year as I knew that I would eventually be accepted into medical school and start my university experience too. MY 1ST FOMO EXPERIENCE This came in my second year of medical school, which for my peers and friends would have been their final and graduating year. In this case seeing friends of mine who had been able to start university straight away  graduating was bitter sweet, but my feelings of FOMO were short lived . On one hand I was extremely happy that I was now doing my chosen degree to pursue the career I’d always dreamed of, but I can’t deny that I felt slightly left out as I knew I had a much longer time left before I could have my own celebrations and begin my career. However, like I mentioned I didn’t feel too left out because after having to take a gap year to pursue my degree , it didn’t matter that my journey to my chosen career would take me a little longer. Also at this stage , I was barely equipped to save lives yet and I was pretty happy to avoid adult life for a bit longer. So as quickly as the FOMO came it was gone and I was happily carrying on into my 3rd year. MY 2ND FOMO EXPERIENCE Finishing my third year , I’ve successfully managed to survive the start of the clinical years. A whole year of clinical placements had come to an end and it had felt for me one of the longer years since unlike the preceding years we have a shorter summer break. Having a taste of what could be, a representation on working life in various specialities. The majority of F1s I’d encountered had been so settled and content in their roles which only made it more attractive. More so this year I’ve felt more ready to want to start my career and also now being at university for 3 years the length of the course has started to show more. But in all honestly even now after 3 years I’m still only a baby in the grand scheme of medicine, again not quite ready to start saving any lives. Now graduation season 2018 has come along in full strength and I’ve felt the FOMO a lot more. This time not only are peers graduating but now I’ve also spent the same amount of time at university. Reflecting upon it ,although I’m fully aware that my course is 5 years long it really hits home how long it is this year. In some ways it feels like whilst others will be moving on with life , I’ll almost have to play catch up once I’ve finished. This season especially I thought , could I be the only one feeling this FOMO, so I asked my friends and peers. Thankfully I wasn’t , which ruled out insanity but it was interesting as to why people felt that way. Everyone had their own reasons for having and not having FOMO and here are some: • “Feeling like I’ve spent the same amount of time at university and worked hard and yet can’t start living life yet or have anything formal to show for it” • “Not so much now because I’m still young but maybe later on whilst others have moved on and I’m still at university” • “No, since I’ll be graduating one day , but it does remind me of how long you have to go” • “Yes and no : I would want to experience the day and it can make it seem longer but it makes me even more excited for the day I can finally call myself doctor” • “Initially I had FOMO , but I realised that when I graduate as there isn’t as much of a struggle to be employed straight away and we’re more protected going into the real world” APPRECIATING MY JOURNEY Some of the views from my peers were similar to mine and some were very different and I realised that it’s something that many of us as medical students may experience at some point during our journey to becoming doctors. I haven’t had very strong feelings of FOMO , but I’ve had to acknowledge that I have those feelings and reflect on why. As medical students it’s especially important to reflect on such things because they may be reoccurring themes during the course of our degree.  Although I’ve felt through this graduation season a sense of FOMO, it doesn’t take away from what I’ve already  achieved so far and what is yet to come. I’ve accepted that medicine is a long stint and it is so for a reason, being responsible for the outcomes of people’s health and lives is not a small feet and the course is designed to prepare us for this. I know that at the end of the day, I will graduate and will be well equipped to take on this responsibility. When it comes to starting to live my life, I have to look past the FOMO and realise that I already am living it. Becoming a doctor is what I have always wanted to do and the process leading up to that is part of that life dream. I think for all of us it is important to remember this especially through such times but also realising that it’s okay to have FOMO and you shouldn’t feel as though you’re alone in your thoughts. It’s a natural feeling to have and for many of us may crop up through the years, but as I’ve realised it’s made me even more excited for my own graduation and especially the beginning of the career I’ve worked to pursue. Its important though not to let FOMO take away from your progress or discourage you during the course but to remember that as a medic our journey will always be unique in its own way Written by Michelle Chirimuuta

March 2016: 4 rejections received. March 2018: 1st year medical student at King’s College London. After receiving 4 rejections from my chosen universities to study Medicine during my first application cycle, admittedly I felt defeated. But as A-level exams drew closer, I knew I had to redirect my focus towards achieving the grades I knew I could. My burning desire to study Medicine was not going to go away that easily! Deciding to take a gap year was not an impulsive decision nor was it one that I entered into lightly and making that decision earlier on in the process allowed me to plan out my year effectively. The main aim of my gap year was to secure a place at medical school of course, but it was also a time in my life where I wanted to make personal growth, to experience new things and become more independent. October 2016 rolled around soon after results day and I found myself starting my first day at my new job as a healthcare assistant at my local NHS hospital. As the keen new employee, I was elated at the chance to experience healthcare from a different perspective: as one of the staff as opposed to being on the outside looking in as a work experience student. My ward – a combination of Rheumatology, Elderly Medicine and Infectious Diseases – depicted the chaotic, busy NHS we often see plastered across the front pages of newspapers. It accommodated 21 patients at any one time and very rarely did we have empty beds! Cardiac arrests, sudden deaths and patients with distressing and uncomfortable conditions became part of my everyday working life. However, above all else, what brought me into work for my 12-hour long days and night shifts were the patients. The gratitude I was shown for the little things I did for them confirmed within me that working in healthcare was going to give me the personal fulfilment and lifetime satisfaction I wanted for myself. A chat with a patient; helping them to brush their teeth in the morning; offering a cup of tea and even the tasks that made up my job role such as toileting and washing were some of the moments where I realised I was making a change, contributing to improving the quality of life of each patient I came across, however small that may have been in the grand scheme of things. Needless to say, working at a hospital was far from easy. Surrounded by sick people and anxious relatives for majority of your day has a toll on both your physical and mental health. I would listen to nurses tell me how stressed and tired they were; junior doctors who’d been working 4 16-hour shifts in a row that they’d forgotten what a good night’s sleep felt like and student nurses querying if this was really the career they set out to pursue. The NHS is undeniably understaffed and overworked – a deadly combination that is slowly but surely destroying morale and not giving us the chance to be the compassionate, kind human beings we are (which is why nearly all of us decide to enter the healthcare profession). Sitting down and having a chat with a patient is a luxury before somebody else needs you. It made me reflect on how my role would change when I graduated from medical school in years to come. What could I do to make a positive contribution to the NHS? What could be done to make it more viable and live up to its core principles: that it meets the needs of everyone, that it be free at the point of delivery and that it be based on clinical need not ability to pay? These questions along with always having wanted to travel made me wonder what healthcare was like abroad and so, my annual leave was spent in the Dominican Republic with the Gap Medics programme. As opposed to my healthcare assistant role which was ward-based care, the Gap Medics programme threw me into the more surgical side of things. I had witnessed surgeries I won’t have the chance to see before my foundation years as a junior doctor here in the UK! Procedures ranged from C-sections to hysterectomies to cosmetic procedures like abdominoplasties and vaginoplasties (yes, vaginal reconstruction). I noticed the dexterity and concentration surgeons had to have in the operating room as well as the care that they must continue to give to the patient on and off of the operation table. I could barely stand up for a 4-hour abdominoplasty, but it was light work for them! During my 3 weeks stay I saw private, public and community healthcare in action and how that differed from the UK 4248 miles away. Private healthcare was where I witnessed most surgeries and it was of a pristine standard – hence why it was only provided if you could afford it, something we have strived to avoid in the UK. Public hospitals lacked the standard of hygiene and infection control we take so seriously in the UK, but the common denominators remained: the public hospitals were poorly funded and understaffed. Community healthcare was an entirely different experience and took place in Bateys (sugar worker towns). Here, most of the residents were Haitian and had travelled to the Dominican Republic to harvest sugar cane for a living. They lived in communities with poor hygiene and sanitation, often hours away from hospitals as sugar cane grows in rural areas. We would set up clinics (much like our local GP surgeries in the UK) and hold consultations with the doctor, prescribing and supplying medications to those who needed them. It was eye-opening, and our team saw around 150 patients in a day’s work. As well as our healthcare work experience, every Thursday evening we would visit the local orphanage Orfanato Niños de Cristo and teach the children English. The orphanage welcomed children from the Dominican Republic and Haiti who had been abandoned and/or abused or who have lived in dangerous and unsanitary conditions. Because government funds are extremely limited in the Dominican Republic, the orphanage is one of the few ways that these children have a better chance at life. I met a lovely girl who really enjoyed learning English with me and anticipated taking Snapchat photos every week I saw her. In addition to this, I made lifelong friends from all over the globe during the programme who hope to work in healthcare whether that be as doctors, nurses or community providers. We got involved in a range of fun activities around the amazing country such as snorkelling, boat trips, horse riding and quad biking. I will never forget my once-in-a-lifetime experience there. Apart from missing the Dominican Republic so much, coming back to work made me appreciate the NHS and I was proud that I got to live in the only country in the world that had a healthcare service like it. Throughout the rest of my gap year I worked, travelled (some of the places being Rome, Spain, Morocco and Paris) and even passed my driving test and bought my first car! All of which changed me as a person – I felt as though I’d accomplished and grown so much! Most importantly, I was invited to interview at all 4 of my medical school choices and as you can see, I had so much to talk about! My transition was from uninformed, nervous sixth form student who thought she wanted to study medicine to an adult who had a much deeper understanding about the degree I was going into from my experiences and wider reading who knew she wanted to study medicine. I secured offers from 3 out of 4 of my medical schools and I have thoroughly enjoyed my first year at King’s College London so far! Every day I feel as though I am transitioning; changing and growing as I progress through my degree and in the future, in my career. Medicine is more than just a job – it’s a life commitment – and the transition from medical student to doctor will be the biggest one yet. Written by Jessica O’Logbon