As we celebrate Black History Month, Melanin Medics have had the privilege of interviewing some great individuals doing amazing things for the black community within the world of medicine. This week we had the pleasure of getting to know more about Dr Patrice Baptiste. Dr Baptiste founded a medical careers company in 2016 called Dream Smart Tutors and has a YouTube channel to support medics through their journey (aspiring medics, medical students and doctors). Please kindly introduce yourself and what you do? My name is Patrice and I am currently employed by my practice as a salaried GP, I work part-time and I have a number of roles alongside that. I started a Medical Careers company in 2016 called Dream Smart Tutors, and as well as that I am a GP tutor and an examiner for Queen Mary University and for the GMC. I also do some writing and I have recently had the opportunity to do some one-off pieces for Blue Stream Academy. Although it may look like a lot, thankfully they do not take up too much of my time and some of these roles are quite seasonal for example the examining, I can choose the days when I able to do them. I like this because it allows for flexibility and variety and allows me to enjoy doing them even more! Tell me a bit more about your journey into medicine From the age of 4 or 5 I always wanted to be a doctor, I don’t know if there was anything in particular that helped me make this decision but I think it was more of a combination of the things I saw growing up. My school wasn’t the greatest (but it wasn’t the worst), it was a comprehensive school and it wasn’t really equipped to support students that wanted to apply for competitive courses such as medicine. I have a very supportive family and luckily my dad worked in a private hospital and I was able to get work experience which helped my application stand out. My teachers were supportive, but at the same time I always had that focus, and I was sure that I was going to do medicine. I got into University College London to do medicine, which is where it all began. I also did my BSc in Speech Science and Communication. So my journey into medicine was more of a linear path, however after medical school I went onto complete my foundation training and then took a gap year in the form of an F3 year. During this time I actually thought about leaving medicine. I took some time to think about my career in medicine and the reason why I did not want to continue with it. This was around the time of the change in the junior contracts and so I soon realised it wasn't me, it was the NHS. Once I discovered this I had to think about how I wanted my career to look. I then decided to become a GP. What inspired you to start this initiative/project? I am passionate about teaching, possibly due to the experiences I have had in the past from school to medical school. I have had good and bad teachers. I really never want students to feel nervous or embarrassed, this is not a conducive learning environment. I started volunteering at my old school and at other schools to help reviewing personal statements and doing some teaching. As I went through these experiences I realised there was a need for supportive services for young people who need research and advice into getting into medical school, which was also a part of the reason why I started my YouTube channel. I also wanted to go back to all of the things that I enjoyed doing and one of those things was writing. I had written so many poems (and I have actually self-published a poetry book this year!) I submitted an article to GP online and they asked me to start writing for them. What has been the most rewarding part of this project so far? The most rewarding part is being able to help someone. As a GP, you get to treat people's issues and as you talk to them more you can dig deeper and find out there is so much more going on. Not only can we help in a pharmacological way but also a lot of the time psychologically as well. I just really enjoy seeing someone’s quality of life improve even from just a small adjustment. So what does a typical week look like for you? My typical week includes a combination of clinics and writing. I work two and a half days a week, and the rest of the time I can work on my own projects. I am working on a few books at the moment. Currently I am crocheting a blanket, I also do a bit of yoga and also of course my lesson planning. How are you able to balance this with your work commitments? I always rely on a to-do list. I prioritise and stagger my work and I will start on a project or assignment quite early on. For example if I have to do a presentation at the end of the month, I will start it early on in the month and just keep adding to it. I am not very good at doing things last minute and get quite anxious doing things under pressure, so spreading out my commitments works best for me. Where do you see yourself and/or your project in the next 10 years? My hope is that they would be more established. Even with my YouTube channel I have been doing some re-branding and hope that it is able to reach more people. I would also like to do more writing, more teaching and possibly a masters in Medical Education, since I enjoy teaching so much, it would be good to get a qualification in it. Since I've become a doctor and GP, I've achieved my main goals so I believe that everything else is a bonus! What developments in medicine would you like to see in the next 10 years? I would definitely like the system to listen to trainees and doctors more so that they feel more valued. I would like to see more opportunities for less than full-time training and job sharing. I feel this way they will be able to retain doctors more, as we know retention of doctors (especially middle grade doctors) is an issue in the UK. But we must stay positive! If you have any advice for our current medical students and aspiring medics, what would it be? Advice for current medics or aspiring medics, would be to think about what you enjoy and who you are as a person. Think about what kind of life you would want to have in the future. What are the practical things of the career that will draw you to it and be open minded. Another would be to stop worrying. It is so easy to say however not so easy to do. I remember at medical school I was always worrying about passing exams, worrying about publications, or what I would do over the summer. So looking back I can definitely say that I have let a lot of worries go. What is the best way to support or get involved with your project? Please subscribe to my YouTube channel called Dr. P. Baptiste. Check out the Dream Smart Tutors website and you can follow me on Instagram: @drbaptiste and LinkedIn: Dr Patrice Baptiste. With thanks to Dr Patrice Baptiste for taking the time to chat to us, keep doing the amazing things you're doing! YouTube Channel: https://www.youtube.com/channel/UCXn5IGCUVcH5sGIJZrtArUQ Website: https://dreamsmarttutors.co.uk/ Instagram: @drbaptiste Twitter: @drpbaptiste LinkedIn: Dr Patrice Baptiste

During Black History Month, Melanin Medics have had the privilege of interviewing influential individuals who are doing extraordinary work for the black community, within the field of medicine. This week we had the pleasure of talking to Dr Kaylita Chantiluke: a paediatric registrar in Melbourne and the organisations lead of dftbskindeep.com. Please kindly introduce yourself and what you do? My name is Dr Kaylita Chantiluke and I’m currently a paediatric registrar in Melbourne, Australia. I am the organisations lead at @dftbskindeep, an initiative aimed to provide a free, open-access bank to photographs of medical conditions in the paediatric population in a range of skin tones; led by Don’t Forget The Bubbles (DFTB) and Royal London Hospital (RLH). I also have a blog with over 13,000 total views @musings_of_a_black_medic, https://kaylitac.wixsite.com/website. Tell me a bit more about your journey into medicine I know it’s a bit cliché, but I’ve always wanted to do Medicine, and I’ve always wanted to be a paediatrician. I would say this stemmed from a drive that I’ve always had from primary school, and this was useful as it guided my GCSE and A-level choices. My mum is also a paediatric nurse, so I’d spend time on the wards with her and her colleagues, whenever my father, my sisters and I would pick her up at the end of her shift. Most children find hospitals scary, but I’ve always felt comfortable in the hospital environment. I did pre-clinical Medicine and went onto study Medicine at the University of Oxford. It was here that I noticed that I was a woman of colour in a very white dominated space. After my preclinical years, I deferred the remainder of my degree to do a PhD in Child and Adolescent Psychiatry, focusing mainly on neuroimaging, at King’s College London. What inspired you to contribute to these initiatives/projects? The Skin Deep project started as part of DFTB in 2020, by a team of paediatric emergency doctors in both Royal London Hospital and Sunshine Hospital in Australia. It is a global initiative with 300 images and over 20 submissions every day. I felt passionate about getting involved as I was astutely aware of the effects of racism in healthcare and the need for more diverse skin in medical educational resources. Skin Deep is a unique organisation as it focuses specifically on paediatric dermatological presentations. We are also fortunate enough to have links all over the world which enable us to include images of skin conditions and their presentations in a wide range of skin tones, including Indigenous Australians. My role is getting different organisations on board to support us and provide images e.g. Royal College of Paediatric and Child Health, British Association of Dermatologists, British Skin Foundation, Black Medical Society, Societi, the UK Kawasaki Disease Foundation, Eczema Association Australia and many more. I started my blog in January 2020. I have always been creative from a literary point of view and I had lots of thoughts on various topics which I felt needed a creative outlet. I write on topics such as medicine, racism and feminism as well as their intersectionality. I’ve had over 13,000 collective views on my most popular blog posts “Why the Best Medical Students Make the Worst Doctors” and “Sorry, But I Want a White Doctor”. What has been the most rewarding part of these projects so far? The most rewarding aspect of being organisations lead for Skin Deep is seeing how many people are using it as an educational resource, like my own work colleagues and the organisations we’re working with. We’re creating a resource that is unlike any others out there, as it is specific to paediatrics. I’ve actually used the resource myself when working in the paediatric ED, where I found myself treating a dark skinned child with a burn. I remember researching “superficial burn black skin” and being faced with endless results of burns on pale skin. Using Skin Deep helped me in this situation, and showed me how my own work is changing my own practice. It’s such a vital resource. In terms of my blog, the most rewarding part of it is knowing that something I created has had the ability to change peoples’ minds and thought processes for the better. I have even had people reach out to me and say, “I really needed to hear that today”. Those positive words make me feel empowered to change systems in place that make things difficult for people of colour (POC). So what does a typical week look like for you? It’s still a strict lockdown in Melbourne in response to COVID so things are a little different than usual. My typical week includes 4-5 10hr shifts a week on paediatric medicine. I’m also heavily involved in academic research and currently doing a neonatal hypothyroidism audit, in addition to working on several other papers pertaining to race and racism within medicine. I normally spend the rest of my time working on my commitments at Skin Deep, where I manage a subcommittee team. I enjoy exercising 3 or 4 times a week and I have also been learning Spanish for 2 years. Other than that, I am revising for Part 2 of my paediatrics exam! How are you able to balance this with your work commitments? My system involves the psychological process of intervention – counselling. I would recommend it to everybody. We always look after our body. Going to the gym or going for runs is normalised, and if you ask someone why they’re exercising they’ll usually respond and say it’s preventative i.e. to maintain physical health. I think we should do the same with our mental health. Since doing counselling I have been able to reflect upon how I can give myself time to rest despite my busy schedule. Often, I have to check myself and ask myself – why are you doing this particular “To Do” task? Is this important and do you need to do it right now, or could you take some time for yourself? I find that, as medics, most of us are overachievers and leave little time to relax. We work so hard that I think if we want a day where we want to sit and watch Netflix and chill, we should be allowed! Where do you see yourself and/or your project in the next 10 years? Wow. That’s a good question. In 10 years, I see myself in Scotland doing academic paediatric neurology, split between clinical and research. I also see myself married, with a nice family and a nice little life! In 10 years, I hope Skin Deep can be the equivalent of paediatric DermNetNZ in regard to its scope and popularity. I hope it will provide a unique paediatric angle and be significantly more diverse than existing educational resources. We are hoping to get to the stage where we will have a range of skin tones for each condition – from lightest to darkest, to show a spectrum of what the disease may look like. I also imagine we’ll be using a lot more advanced technology to fit in with the current direction the ‘digital world’ is heading in. What developments in medicine would you like to see in the next 10 years? I’d like to see significant structural changes made to decolonise the healthcare system and make it a more equitable place for POC who are patients and/or working in the healthcare system. I feel like there’s been a lot of chat – but this is nothing if it’s not followed by action. When I’m a professor of paediatric neurology, I hope to look out and see a lecture theatre that’s representative of whichever country I am working in. I hope to see people of all skin colours and socio-economic backgrounds. I hope to see students with physical disabilities that do not have to sit isolated at the top of the lecture theatre because of their wheelchair. I hope to see individuals that can wear clothing that fits their gender identity, and to wear that with pride. I would like for everyone to have the same opportunities regardless of their background or circumstances. If you have any advice for our current medical students and aspiring medics, what would it be? I have done a lot – achieved an intercalated PhD, moved to Israel to volunteer in Nazareth hospital and moved to Australia. Yet, through all of this, my word of advice would stay the same for everybody – you are enough. It’s taken a lot of time for me to come to this realisation as a lot of the time I think we believe our self-worth and productivity are intertwined, which should not be the case. Medicine is wonderful and tough, but remember, whichever test you fail or whichever job you don’t get, you are enough. As you are, and right now, you are enough. You are valuable and important. What is the best way to support or get involved with your project? Promo would be super helpful! Please spread the word about Skin Deep, especially if you know anyone who is eligible or able to submit pictures, as anyone from the public can submit pictures. We also rely a lot on other hospitals for collaborations, so if you’re a medical student and you are interested in getting involved, please get in touch with a doctor or potential supervisor while you’re on placement and let them know about the work we’re doing! It would also be helpful if you would check out my blog @musings_of_a_black_medic and share with friends, colleagues, and people. I also have multiple journal article publications on ADHD/Autism which you can find on PubMed if you’re interested! With thanks to Dr Kaylita Chantiluke for taking the time to chat to us, keep doing the amazing work you're doing! Facebook: https://www.facebook.com/DFTBSkinDeep Instagram: @dftbskindeep Twitter: @DFTBSkinDeep

As we celebrate Black History Month, Melanin Medics has had the privilege of interviewing influential individuals who are doing extraordinary work for the black community, within the field of medicine. This week we had the pleasure of talking to Olamide Dada, the Founder and Chief Executive of Melanin Medics: an organisation for black current and aspiring medical students and doctors. Please kindly introduce yourself and what you do? My name is Olamide Dada and I am the Founder and Chief Executive of Melanin Medics. Melanin Medics advocates for black medical students, aspiring medical students, and doctors. As Chief Executive, I oversee the organisation’s activities and developments, as well as managing the team and taking part in public engagements on behalf of the charity. Tell me a bit more about your journey into medicine I always knew that I wanted to study medicine but I was not always confident that I would get in. The area that I grew up in was relatively deprived and I knew that if I wanted to maximise my chance of getting into medical school, it would be best to attend a sixth form in a different area. However, when starting at a new school, the teachers do not really know your track record. My new Chemistry teacher did not want to give me the predicted grade that I needed for medicine even though I had performed well at AS Level. This was a big blow for me because I had finally summoned the courage to apply for a place at medical school, but it felt like that decision was now in the hands of a chemistry teacher. This was not fair and luckily my dad intervened! He spoke to the Head of Sixth Form who changed my predicted grades. I ended up achieving those predicted grades, getting three interviews and two offers, and I am now in my final year of medical school. What inspired you to start this initiative/project? At the beginning of Year 13, I found my mentor, a black female GP who had grown up in the same area as me. She was extremely influential in my medical application process. When I got to medical school, I remember looking around the lecture hall and wondering where all the other black students were. I started to question why there were not so many of us. Was it because we were not applying? Was it because we lacked support? Was it because we did not think that we could get into medical school? What was the problem? I started Melanin Medics to address these issues and increase representation of African and Caribbean people in medicine. Initially, I wanted to help people successfully gain a place at medical school, so I started a weekly blog to share my experiences and tips. As time progressed, I realised that there was a lot more to the problem than met the eye and that there were many factors influencing representation in medicine, throughout a person’s medical career. This realisation triggered the growth of the organisation! What has been the most rewarding part of this project so far? That’s a difficult one! I’d have to say meeting people who don’t know that I am a part of Melanin Medics and hearing them talk positively about the charity. For example, I’ve met people in the lower years of my medical school who have benefited from our support and achieved a place at medical school. It’s wonderful to see the influence that we have had on people, even if only in a small way. So what does a typical week look like for you? As I’ve mentioned, I’m still at medical school so I attend my placement every day from 9-5. I normally wake up early and take some time for myself - no emails or notifications. The silent mornings are definitely the best part of my day! I then head into placement and usually fit in a lunchtime meeting or work on my to-do list. Once placement has finished, I go home and make dinner, and probably have another meeting. Next, I get on with studying. Finally, I make sure that I get in contact with at least one of my friends or family at some point in the evening. I also take time to do some reading for pleasure before bed. How are you able to balance this with your work commitments? Managing my time can sometimes be difficult as final year can be quite demanding. I like to be organised and know what I have coming up. I structure my week to make sure that meetings and other commitments do not impede on my studying time. I also have a triaging system to decide how urgent things are - must do today, must do tomorrow, must do this week. Additionally, I try to be intentional about doing things that I enjoy. I believe that there are enough hours in the day to do what is important to you, it’s all about priorities. Where do you see yourself and Melanin Medics in the next 10 years? I hope to be stable and settled in my career. I aspire to be a GP and so would like to think that I will have completed my training in ten years time. I am also interested in getting more involved in healthcare leadership and management, particularly in the area of diversity and inclusion. I would like to advocate for the health of black communities in policy and public health initiatives. I am also very passionate about creating resources and mentoring young leaders, particularly as I founded Melanin Medics when I was quite young. As for Melanin Medics, I see the organisation growing and having an international reach - specifically with regard to interactions with black doctors in North America who are also very underrepresented. Melanin Medics will redefine what it means to be a black doctor wherever you are. As black doctors, we have a lot of influence in our communities, often without even realising it. It is therefore important that we spread positive images of what it means to be a black doctor and advocate for black patients. As for policy and medical education, I hope that our training gets established as a vital part of the medical school curriculum. We will also be in a position to continue to drive policy change and continue to promote diversity in medicine. What developments in medicine would you like to see in the next 10 years? In 10 years time, I would love for medicine to have made substantial progress in better understanding of how to support diverse groups in medicine, what it means to have a diverse workforce, and I would love for there to be more diverse leadership. I wish to see black current and future doctors thrive in their medical careers without being fearful of racism, discrimination, differential attainment and disciplinary action. The freedom to be their authentic selves! It would also be great to see more black people in academia and at the forefront of change. Equally, I would like to see a reduction in health inequalities as it affects the black population. If you have any advice for our current medical students and aspiring medics, what would it be? Remember that anything is possible. There are so many incredible resources available to guide you on your journey. There are also a lot of people who want to give back - you don’t have to look far to find a role model that looks like you! Believe in yourself because you are more than capable of achieving your hopes and dreams. What is the best way to support or get involved with your project? Follow us on our social media and donate to our organisation if you can! We also have many opportunities to volunteer through mentoring and outreach events - sign up to our Networks for more information! With thanks to our Founder and Chief Executive Olamide for taking the time to chat to us, keep doing the amazing work you're doing! Website Facebook Instagram Twitter

As we celebrate Black History Month, Melanin Medics have been lucky enough to interview several exceptional individuals who are doing amazing work to improve the health outcomes of the black community. This week we had the pleasure of talking to Dr Annabel Sowemimo, a junior doctor working hard to educate us all on the impact that different factors have on sexual and reproductive health in minority groups. Please kindly introduce yourself and what you do? My name is Dr Annabel Sowemimo and I’m a Community Sexual and Reproductive Health registrar. I work between gynae and sexual health clinics which usually involve unplanned pregnancy, miscarriage, endometriosis, termination of pregnancy and general gynaecological conditions. I also founded a collective – Decolonising Contraception, which aims to address the structural and historical determinants of sexual and reproductive health. Lastly, I’m a writer and I have a column for gal-dem called Decolonising Healthcare. Tell me a bit more about your journey into medicine Like most medics, I was introduced to medicine through family friends and my dad, who is a GP. When I was younger I had scoliosis and had to have back surgery at 14. Before the surgery, I wasn't really aware how much my life would change as a result as I now live with chronic pain. I'm glad I had the surgery but as a young person - nobody really explained the details to me as I think they thought I'd freak out. This made me realise that medical professionals are quite powerful people and how much we have a say, and how educated patients are can be very variable. Therefore we need to build more health literacy. I had this at the back of my mind when I went to medical school, but at the time I didn’t know much about the history of medicine and the different dynamics within medicine. I studied anthropology in my third year of medical school and after learning about the colonial history of medicine, I felt like there was a lot of ignorance around medicine. So I decided to start Decolonising Contraception to address that in my own sector. One reason why I decided to specialise in SRH is because I think it’s one of the specialities that is more open to change. I also felt like it aligned with a lot of my interests. Why Medical Anthropology? When I was applying to university I considered studying anthropology so I already had an idea of what it was. I’ve always had an interest in writing, I did English A-Level and have always enjoyed History and Drama. Intercalating in Medical Anthropology seemed like an opportunity to do something different and incorporate my love of writing into my medical career. During medical school, was it important to you to maintain your creativity? It was very important to me and luckily I was able to find creative outlets. I was on the drama committee and I directed plays at university until my third year. I was also the editor of the global health magazine and later, president of the society. One thing I found difficult about medical school is that I had so many other interests but our curriculum was so intense, but I managed to balance everything. What inspired you to start your company? It was partly out of frustration. When I went into my speciality I thought it would be different. I already knew the experiences of black women and reproductive health. It was weird to me because I felt as though no one was aware; I was faced with a lot of ignorance. Nobody seemed to connect the dots that it was the same demographic that didn’t go for their cervical smears, the same demographic that had poor health outcomes, had poor sexual health. I felt like everyone in my speciality sounded the same. I believed we needed new conversation. I wasn’t even sure if DC would work, how it would be received or if it would resonate with people. Up until six or seven months ago people found it uncomfortable to discuss decolonisation and it is only recently that the atmosphere around this has changed considerably. Why do you think things have things changed? Covid-19 and Black Lives Matter have meant that some people have had to do some internal reflection because there is no medical reason why people of different descent should be dying from Covid in such disproportionate numbers. People are being forced to reckon with the social determinants of health. But we already know that if you improve someone’s life circumstances, their health will inevitably get better. What has been the most rewarding part of this project so far? One thing I enjoy is connecting and engaging with medical students and younger doctors. I remember feeling really lonely in medical school, as no one else understood the problems I had with our syllabus. They didn’t understand how I felt towards medical school. Back then I didn’t really know what the problems were or how to articulate those feelings until now. I really find it rewarding when I see medical students who have been inspired by our work, going to start something at their university and challenging the status quo. For me this shows that my work is working. So what does a typical week look like for you? My days are quite varied as a CSRH trainee. It’s a combination of gynae clinics and sexual health clinics so this can range from a menopause and general gynae clinic to a termination of pregnancy and GUM clinic. I also have time to work on projects such as Quality Improvement Projects. Decolonising Contraception is a full time job in itself so I check my emails in the morning before work and at several other points during the day. I go to the gym a few times a week in the evening and from around 7 pm to 11 pm I do work for DC. On the weekends I’m usually writing an article or doing more DC work. How are you able to balance this with your work commitments? I don’t really have full days off; I usually have time off. For example, I might do work in the morning and give myself the rest of the day off. I’m lucky to have very understanding friends and family around me. I’m also getting better at delegating so we have different roles at DC, and I try to touch base with the different team members every few weeks. If you love something, you find time for it. I was coming to the end of my tether because things at Decolonising Contraception were becoming quite hard. But the love of something will push you to a point where you find reserves you didn’t know you had. You also need to remember that medicine is a marathon not a sprint. You don’t need to be busy all the time. Where do you see your company in the next 10 years? I hope that we are still around to advocate. I hope that more organisations are building the narrative that we discuss so we aren’t as necessary anymore. It’s a beautiful thing if your organisation ceases to exist, because it means the problem you set out to solve is cured. I would like Decolonising Contraception to have changed the conversation and I’d like to see this reflected in improving statistics in the UK. I’d like people to use some of our strategies and improve SRH globally. What developments in medicine would you like to see in the next 10 years? I hope that medical curriculums start to tell the truth and tell the actual history of medicine. We need to talk more about doctors themselves and their own prejudices and biases. If you have any advice for our current medical students and aspiring medics, what would it be? Don’t doubt your own capabilities. It’s very easy to get bogged down by self doubt at medical school because someone is always smarter than you or doing more than you. You are enough and you are good enough. Whatever happens at medical school does not define how you’ll be as a doctor. What is the best way to support or get involved with DC? We have projects that run throughout the year that we sometimes need volunteers for, so feel free to email if you’d like to get involved. We are also always looking for illustrators to work with. Sign up to our mailing list on our website. You can donate to us through our patreon and paypal. Check out our social media. We are always looking for youth organisations and universities to visit, so get in touch if you’d like us to speak. With thanks to Dr Annabel Sowemimo for taking the time to chat to us, keep doing the amazing work you're doing! Facebook: https://www.instagram.com/decolonisingcontraception/ Twitter: https://twitter.com/DecoloniseContr

As we celebrate Black History Month, Melanin Medics have the privilege of interviewing some great individuals doing amazing things for the black community within the world of medicine. This week we had the pleasure of getting to know more about Malone Mukwende who produced the resource called Mind the Gap: a handbook of clinical signs in black and brown skin. Please kindly introduce yourself and what you do? My name is Malone and I am a third year medical student. I study medicine at St George's, University in London. Aside from that, I am an Arsenal fan, and of course, I like to have fun! Tell me a bit more about your journey into medicine My journey into Medicine was very complicated and haphazard. I was actually rejected before interview stage by four medical schools – Birmingham, Nottingham, Leicester and Oxford. However, on results day, I was accepted into St. George’s to study Medicine, via clearing with 3A’s. So, I guess it all works out in the end. What inspired you to start this initiative/project? There were quite a few things that inspired me. Firstly, there was not any substantial teaching in my medical school about dermatological presentations on darker skin. I also found it ironic that, whenever I learnt content in dermatology, why is it that when I went onto the wards and met a patient with darker skin, I could not tell what their condition was? But, as soon as I saw a white patient, I instantly knew what condition they were presenting with. I was always second guessing the presentation and diagnosis in darker skinned people that I met on the wards, leading me to wonder why this was the case. From then, I was searching for answers from my lecturers. However, deep down, I knew that I would not get answers any time soon, so I wanted to do something about it. I wanted to create that answer. That is how Mind The Gap came into fruition. I always wrote down my ideas on paper, and I knew that I wanted to get this information out. Even though at some points, it felt as though I was ‘collecting scraps’ with lack of information and resources, I did not give up despite the difficulty of this project. What has been the most rewarding part of this project so far? It has been so heart-warming to see that Mind The Gap is revolutionising healthcare, and changing medical practice. It has been rewarding to see that people out there are genuinely being helped by Mind The Gap. For example, I recently received a handwritten letter from someone in Sweden praising Mind The Gap. Also, a GP has recently reached out to me to inform me that he has been using Mind The Gap, which is greatly supporting him in his practice. I am not even a qualified medical doctor yet, so it is honestly so rewarding! Mind The Gap is raising awareness in the medical world, and changing the bias that exists in healthcare. I always say, it makes me sleep at night, knowing that there is also someone out there who is sleeping at night because of Mind The Gap. So what does a typical week look like for you? Well, that is very hard to answer because of the current COVID-19 situation! My typical week is ever-changing. On Monday afternoons, I have Problem-Based Learning (PBL), whereby we discuss topic-specific case studies. Currently, we are learning about HIV and Malaria. On Tuesdays, I have lectures. On Wednesdays, I have clinical skills, in which I recently practiced venepuncture and drug prescribing. On Thursdays, we have lectures again, and on Fridays, we conclude our week again with PBL. How are you able to balance this with your work commitments? I am always asked this question and I believe that, everyone, including myself, has time. If I look at the screen time on my phone and see how many hours I have used, I realise that, I could have used even a few hours to do something more useful. Doing things to better myself every day, will eventually compound into something big. With small steps, you can always make progress. That is the same principle that I used for Mind The Gap. At medical school, no matter what stage I am at, I know that it is better to fulfil my responsibilities in the present moment, rather than later. This is to avoid my responsibilities building up too much. To sum it up, I read a very good quote recently: “time works against people with bad habits; but those with good habits have time on their side”. Where do you see yourself and/or your project in the next 10 years? Personally, I see myself just having fun! I just want to be happy in life, no matter where I am. In terms of Mind The Gap and the Black and Brown Skin website, I see them becoming the number one resource for images of clinical conditions on darker skin. Essentially, a comprehensive encyclopaedia with thousands of dermatological presentations on darker skin. What developments in medicine would you like to see in the next 10 years? I would like to see the medical world becoming more diverse and inclusive. Also, I would like to see medical professionals dismantle the biased and outdated medical ideologies used today, although established many years ago (justified by inhumane acts). I would like to see these developments rather than just accepting the outdated ideologies and the problems that we face today. If you have any advice for our current medical students and aspiring medics, what would it be? For current medical students, I would like to tell them that your voice and value is worth a lot more than you think. Sometimes, I feel as though we, as medical students, devalue ourselves because we think that we are at the bottom of the social hierarchy in terms of consultant levels, junior doctors etc. We actually have so much knowledge! So, we should always be courageous and know our worth. For aspiring medics, please know why you want to pursue medicine as a career. It is definitely not a straightforward road. In fact, it is sometimes very bumpy, so I advise that you make sure that you are certain on pursuing medicine. If you know why you’d like to study medicine, this reason will become your driving force when things start to get difficult during the process. What is the best way to support or get involved with your project? Please share, download and inform others about Mind the Gap handbook. There is also a feature on the Black and Brown Skin website that allows you to submit a non-identifiable image, relevant and appropriate for our website, about clinical skin conditions on darker skin. Or, you could share a story which will be posted on the website. These will start to get featured on the website from October, if you would like to get involved! With thanks to Malone Mukwende for taking the time to chat to us, keep doing the amazing work you're doing!

MONDAY... My first day after a very relaxing weekend was a very busy on call shift. A surgical on call shift runs from 8am to 9pm and we are the surgical “take team”. This means we see all the referrals from A&E and GP, and we also attend trauma calls. The team usually consists of an FY1, SHO and registrar. There is also a consultant on call, and all the patients are admitted under them, but they usually cover the emergency theatre list during the day whilst we see the referrals. We didn’t get many referrals in the morning, so I kindly helped out with the normal ward round. Around midday we got our first trauma call – a road traffic accident. A trauma call is attended by the on call surgical team, orthopaedics and the anaesthetist. I really enjoy attending trauma calls as you usually get to see some pretty interesting stuff, however there isn’t much for the FY1 to do so we’re usually a spare part. This time, however, I was asked to put in a cannula whilst they assessed the patient. It was a very high pressured situation so I got performance anxiety and couldn’t insert the cannula – luckily everyone was too busy to notice and the A&E nurse quickly swooped in to take over! Two months in and my cannula success rate is only about 50% but I’m getting there... I hope! After the trauma call, the referrals started coming in one after the other and I spent most of the day running around the hospital clerking patients. It took me 2 months but I finally know my way around the hospital. My average step count is about 12,000 per day but today it’s been 15,000. Who needs the gym when you’re an FY1 on general surgery?! TUESDAY... When I started this morning I still hadn’t recovered from the day before, so I decided to quickly get a coffee before I went onto the ward. In our hospital NHS staff get free hot drinks, so you can imagine how many times I go there in one day (hint: at least twice). I’m glad I decided to squeeze in that coffee because today was equally as busy, for some reason all of our patients had multiple jobs that needed to be done. I spent a significant amount of time begging the on call radiologist to approve my CT requests then chasing the results of these scans and updating our registrar who was doing the emergency theatre list. One thing I’ve learnt about being an FY1 is that the bulk of the job is administrative work. You’ll spend a lot of time ordering and chasing scans and bloods – particularly on general surgery. The only time you get to clerk a patient is when you’re on call so I’d recommend making the most of this time – it gives you a chance to practice those communication skills they drilled into you at medical school! Before I left I sat down and updated “The List”. On our first day the registrar stressed how important it was that the list was updated everyday to ensure the ward round runs smoothly so I make sure to do this before I leave each day! After work a few of us decided to get some drinks to vent about our days. One great thing about being a surgical FY1 is that there are so many of us which is great for getting know one another, and teams often help each other out when it gets a bit crazy! WEDNESDAY... Today we only had 20 patients on our list, which is pretty average for us! I was the only FY1 in my team today, but luckily I had 2 SHO’s and 1 registrar with me which helped! When you have a good team, it makes a huge difference and can often be the deciding factor on whether you leave on time or not! Today’s ward round was particularly long; we didn’t finish until around 12.30 pm. By the end of the ward round I was dying for a coffee but I had a meeting about exception reporting with the medical education lead at our hospital. Exception reporting is when you report days where you stay late and log your hours. You either get time off in lieu or paid for those extra hours. Things have calmed down now but there were many many days in the beginning where was I staying nearly 2 hours late every day. I didn’t exception report then, but I’ll definitely start now! Our medical education lead stressed how important this is as I was initially worried that it would reflect badly on me. However she explained that it helps the department identify where extra support is needed. After the ward round I got started on the jobs, had lunch and then continued with jobs for the rest of the day. At around 4 pm everyday we go through the list again with the registrar and check the bloods for our patients. Today we were a bit delayed so this didn’t happen until 4:30, where we discovered our patient had a potassium of 2.8. We followed protocol but it took about 3 of us to decipher the ECG (TIP: always ask for help!) where we discovered some ECG changes so quickly initiated treatment. The patient was stable so panic over – I made it home on time. THURSDAY... Our team was slightly smaller today but we had the same registrar as yesterday so our ward round was super speedy! I was feeling very pleased with myself, having completed all my jobs by 3pm when I got a call that one of the patients I was looking after had become unwell. She was spiking a very high temperature and vomiting. I went up to see her and quickly escalated to my registrar who came to see her with the consultant. I was asked to take blood cultures peripherally and from the picc line – the latter of which I had never done before. What started off as a very chill day had suddenly become really busy! Before I became a doctor, I was terrified of the idea that I’d have to look after sick patients, but in reality you’re very well supported. I’m the queen of escalating early as I’d rather my seniors are aware of the problem before the patient starts to deteriorate even further. I left slightly late today but I wanted to make sure my patient was stable before I handed over to the on call FY1 who was covering the wards from 5 – 9pm. I was exhausted when I got home so cancelled my dinner plans (a recurring theme) and instead had a very early night. FRIDAY... The “Friday feeling” doesn’t hit the same when you know you have to work over the weekend! It was a very erratic morning as two separate consultants wanted to see their patients halfway through the ward round. I understand the logic but it usually means the ward round takes much longer than it needs to be! Luckily we were very well staffed so most of were finished by 2pm! On Fridays we usually make sure to write a weekend plan on “the list” so that the weekend team know exactly what to do. When you’re working over the weekend, you usually cover an entire ward so you don’t know a lot of the patients. Therefore, it’s really helpful when there is a very clear weekend plan so you know exactly what the regular team would like you to do. After all the jobs were complete, my team kindly let me leave 30 minutes early so I could rest up before my 13 hour shifts this weekend. Unfortunately, I have house viewings all evening so not quite resting but I’m glad I can leave early for once! Today was a pretty typical week for me, if I’m being honest it’s been quite quiet! Surgery can be a very busy speciality but I’ve learnt a lot and I’m slowly getting to grips with things! I’m very lucky that I have very supportive seniors and a great team, it makes those busy weeks slightly more manageable! Written by FY1 (Anonymous), General Surgery, London Join the Melanin Medics F1 Doctors Mess Online Group: Virtual support network for African and Caribbean F1 Doctors in the UK https://forms.gle/mDhxzVfwxBfLbHRP6 Cover Image Reference: Getty Images. 2020. https://www.gettyimages.co.uk/videos/black-female-doctor?phrase=black%20female%20doctor&sort=best

WHAT IS THE AFP? The AFP is a type of Foundation Programme that provides a dedicated time for foundation doctors to get involved in either academic research, education, management, leadership and other areas such as health informatics and quality improvement projects. It includes either a 4-month block in your FY2 year or it can be integrated into your second year, for example as a day release (1-2 days a week) throughout FY2. There are a minority of AFPs that are integrated into the two years. It is dependent on the ‘Academic Unit of Application.’ These are a group of foundation schools that have joined together for the purpose of AFP application. For example North West Thames, North Central, East London and South Thames are the London AUoA. You will be required to work on a project that either you have formulated yourself, or a predetermined project, or joining a team on an ongoing project. The level of autonomy and flexibility is AUoA and project dependent. The post comes with an academic supervisor who will oversee your work and there is usually a local university affiliated to your Foundation school that will support your learning during your academic post. Some AFP posts come with an element of clinical work such as on calls or a half day in a clinic that allows you to maintain and update your clinical knowledge. Whilst some may have no clinical commitments in the 4-month academic block. WHY AFP? People choose to do an AFP instead of the FP for various reasons, such as:- As a route into academia for people that already know they want to go into academic medicine. However It is important to know that you do not have to do an AFP to be able to get into academic medicine. As an opportunity to explore whether an academic career is desired. As an avenue for networking, teaching, CV building, some AFPs (especially those with educational and leadership involvement) come with the opportunity to complete a PGCert which can either be fully or partly funded by the Trust. For some, it is a way to guarantee being in a location and or getting desired job rotations. HOW DO YOU APPLY FOR AFP? The application process is done via Oriel similar to standard foundation programme application just with the addition of one extra section on the form. You will be required to rank the academic jobs within the AUoA that you are applying to (you are not required to rank all of them). You can apply to a maximum of two out of 15 AUoAs. The application allows you to add more achievements (e.g. publications, presentations) compared to the standard FP. Once you apply, shortlisting is carried out by the AUoA who then invites you to an interview. AFP shortlisting score is determined by adding academic decile score to the AUoA score. The shortlisting process varies across different AUoA and the achievement may be weighted differently according to the AUoA. Point based- used by all AUoA Ways to score points include:- Other degrees- up to two additional degrees (compared to the standard FP which only allows one additional degree). Presentations (National and International)- up to ten. A poster only counts once i.e if you present the same poster at several conferences, it will only get 1 point. Academic publication- up to ten Prizes- up to ten The London AFP selection includes longlisting, based on your decile score (between 38-42). Followed by shortlisting which is based on the points above and then an interview. White space- used by some AUoA Some AFPs require you to answer six open-ended questions on why you want to take part in the AFP. These questions are unique to AUoA, and are released when applications open. They are usually centred around your academic experience, pertaining to the AFP that you are applying for as well as determining soft skills such as teamwork, organisational and leadership skills. It is best to approach these questions in the same way you would write a personal statement using the ‘STAR’ framework. Shortlisting is either based on the points or by a combination of points and white space answer scores. If you are shortlisted, you will be required to attend an interview. INTERVIEW PROCESS Interview styles vary across AUoA and deaneries. I had interviews for London and EBH/East Anglia so I will talk a bit more about them. London splits the interview into two parts - clinical and academic - each lasting 10 minutes. You will be provided with a brief for the clinical case and academic abstract shortly before the interview starts. The clinical part is usually centred around an emergency case for you to talk through the management options while taking into consideration other ethical and safeguarding issues that might come into play. The academic part, however, may be based on an abstract of a peer reviewed paper or your personal research/publication. You might be required to do a quick critical appraisal of said paper or answer specific questions about the paper. Regardless of the interview structure, the key point is that it is a chance for you to show your passion for academia, demonstrate your competence in clinical medicine and show off your breath of experiences. The EBH/East Anglia AUoA introduced a new interview style in 2020. This interview consisted of three stations with 1-2 questions per station. You might be asked to prepare a plan on how you might approach one of the modules of the AFP. This would also form one of the stations. It is advisable to research the interview style of your AUoA ahead of time and ensure you get lots of interview practice. Candidates find out the outcome of their applications from mid-January, at which point you will have 48 hours to either accept or reject the offer. There are usually multiple cascades for offers, so if you did not get an offer in the first cascade, there might still be a chance with the second or third cascades. The Academic Foundation Programme is competitive as spaces are very limited. If your AFP application is unsuccessful, then you will be automatically included in the FP application for that year. So, if you are considering applying for an AFP but you are worried that you will not get in - apply anyway as you have nothing to lose! Nevertheless, it is important to remember that there are also other ways to get involved with academic medicine besides the AFP. Top tips Firstly, make sure the AFP is for you. Would it meet your goals? Will you enjoy it? Does it come with job rotations that you like? Is there a level of flexibility in the projects (if desired)? etc. Do your research. Try to get into contact with anyone who has done or is doing the AFP that you are interested in. They will usually be able to give you more details about what the job entails. You can also contact the assigned supervisor for any questions prior to your application. Prepare for you interviews- VERY IMPORTANT. It is useful for a small group of peers for interview preparations. Ask for help- Reach out to friends/mentors/academic tutors to proofread your white space questions if applicable or help you with interview prep. Myths I need to have published lots of papers to be able to get in. You do not! There are many ways to score points for your application. Seek and take up opportunities to get involved in research as a student but if you have not published a paper by the application time, do not let it stop you from applying if you really want to do an AFP. Remember there are other ways to score points: Presentations (National and International) Academic publication- must have a PUBMED ID Prizes, Posters Other degrees Decile score Interview performance 2. The AFP is my way out of doing the SJT exam Every applicant must take the SJT. Technically, it is not used in the allocation process for AFP but if you have a very low score, you might lose your AFP. Written by Dr Ekelemnna Obiejesie MBBS BSc AICSM, Academic Foundation Doctor at Brighton and Sussex University Trust References https://foundationprogramme.nhs.uk/faqs/academic-foundation-programme-faqs/ Cover Image ref: USA Today. Osose Obah. https://eu.usatoday.com/story/news/health/2020/06/26/u-s-doctor-shortage-worsens-especially-black-and-latino-groups/3262561001/ Image ref: https://careersblog.enterprise.co.uk/tips-on-using-the-star-technique-to-answer-job-interview-questions/

Reflecting on the last 12 months, I would never have guessed that my first year as a junior doctor would be so gratifying, terrifying, surprising, boring, funny, sad, exciting, puzzling, stressful, enriching… This year has HAD. IT. ALL. The 2.5 days of shadowing during induction left me feeling somewhat unprepared on my first day. Thankfully, I had a wonderfully supportive team and friendly colleagues to guide me as I bumbled through my first few weeks on the ward. F1 has inundated me with new experiences and the learning curve has been steep. I reviewed a patient with “abdo pain” only to diagnose them with a pulmonary embolism after convincing the on-call radiologist that a CTPA was absolutely necessary. After all, “I don’t take referrals from F1s for CTPAs”. I advocated for patients. I held their hands. I relieved an elderly gentleman of his painful paraphimosis preventing a urological emergency in a hospital which has no out of hours urology service. I told frightened family members their loved one might not make it through the night. I spent a whole morning liaising with radiology, gastroenterology, dietitians and a worried wife to organise a PEG (percutaneous endoscopic gastrotomy) extension for my patient, only for it not to go ahead. I was shouted at by frustrated patients and anxious relatives. I’ve clapped and cheered as Covid patients were safely discharged home. I watched as others didn’t make it. I cannulated. I catheterised. I laughed. I cried. Some of you may already have some stories to tell as coronavirus forced you out of medical school and onto the wards as doctors earlier than expected. Others may have volunteered for the NHS or worked as HCAs. Or maybe you focused on enjoying your “final months of freedom”. Whatever your circumstances and prior experience, starting F1 can be daunting. It would be impossible for me to try to teach you everything you need to know about being a doctor and *surviving* F1 so I will simply highlight a few points to remember. You are not alone Sometimes you may hear horror stories about F1s left on their own to manage a ward of 30 patients on their first day or dealing with a deteriorating patient with no senior support. Remember these are just horror stories! The overwhelming majority of foundation trainees do not share these experiences. In reality, you are never alone as an F1. There should always be an SHO, registrar or consultant responsible on your ward who you can call on (even if they are busy in clinic, surgery or seeing a referral elsewhere). You are not expected to know everything - especially in the first few weeks - so please ask even if it’s just for reassurance! Role play Recognise what is your job and what isn’t. Sometimes you may have jobs and paperwork pushed your way that isn’t really your responsibility. There are ward clerks who book appointments and arrange transport, discharge co-ordinators who liaise with social workers about social care, nursing staff who change dressings and administer medications. Whilst it is not unreasonable to help your colleagues when you have the capacity, it is generally quicker, safer and better for your patients when the correct person completes the job they have been trained to do! What can I do for you? Learn how to delegate when necessary. If you are on call covering the wards and you are asked to review a sick patient, always ask the nurses to obtain any useful investigations (e.g. ECG, blood sugar, neuro obs) and check if they can take bloods, cannulate or run blood gases. They won’t necessarily volunteer to do these things if you don’t ask. They can help you get a head start in managing the patient before you have even stepped onto the ward. HELP! It’s an emergency! MET (medical emergency team) calls and cardiac arrests Many new doctors’ ask, “When is it appropriate for me to put out a MET call?” Answer: If you’re worried about airway compromise, put out a MET call. If you need more hands, put out a MET call. If you’re thinking about putting out a MET call, then it’s time to put out a MET call. If a patient arrests then it’s a no brainer, put out a MET/cardiac arrest call (it’s normally the same team). You will never be asked, “Why did you put out a call?” but you may be asked, “Why didn’t you put out a call earlier?”. If you ever do need to put out a MET call, remember to pull the emergency buzzer by the bed if you haven’t already and ask someone to put the call out for you. Never leave an unwell patient alone! Your hospital may also have a critical care outreach team (CCOT) comprised of skilled nurses with ITU and resuscitation experience. If your patient is unwell but the team on the ward is able to manage them without involving the medical emergency team, they are a very useful point of contact. They can assist you with your initial assessment and management and are very handy with cannulas and blood gases! Love to learn It may seem obvious that the aim of foundation training is to equip you with the necessary tools and “foundation” to become a good doctor. However, the NHS is a public service and system that relies on its staff to “get the job done”. It is easy to succumb to service provision (doing cannulas, writing discharge summaries etc.) and forget that you are also there to learn. You may no longer be a medical student but you are still training. Keep asking questions even if you don’t need to know the answer to do your job. Don’t be afraid to ask for teaching from your seniors or to learn new skills or procedures. You don’t need to be able to drain ascites or perform a lumbar puncture as an F1 but learning these skills makes the experience much more interesting! It can be difficult to learn or practise certain skills when SHOs and registrars are hunting for procedures they need to get signed off, but that shouldn’t completely obstruct your own learning. Your network is your net worth Take the time to know your nurses, HCAs, ward clerks, consultants, pharmacists, physios etc. Not only is it invaluable to have people you can rely on, but having a good working relationship with your colleagues means that if you need to make a questionable referral, ask for a sign off or request for TTAs to be authorised and dispensed after 5pm then you know who to call on. You will also have a more enjoyable work life if you have friends to laugh and commiserate with! Get involved There are always numerous opportunities to get involved during foundation training including teaching, leadership, management and quality improvement. You could plan weekly bedside teaching with medical students, organise events for the mess, advocate for your fellow junior doctors in the JDF (junior doctor forum) or design an audit/QIP. Don’t underestimate the value of getting involved in the medical community: locally within your hospital or more widely in national meetings, events and conferences. Remember this is probably the first time in a few years where you won’t have to come home to books, study and revision so you can maximise what you achieve during the working day. Getting involved does not only increase your non-clinical skills and your sense of belonging in the workplace, it can also help you in your career as in my next point. When I grow up, I want to be… If you’re like me and you have no idea what career you want to pursue in medicine then you’re probably not thinking about applying for your next post or training programme after foundation training. Unfortunately, if you’re not keen to take time out of training then you have less time than you think to develop your portfolio and apply for that next step. I’ve been enjoying F1 so much, I’ve only just woken up to the fact that applications open in November! Fortunately, F1 is a fantastic year to build up your portfolio simply by “getting involved” as I described in my last tip. Keep a record of any teaching you deliver and ask for written feedback from students. Write up your quality improvement project (QIP) and submit an abstract to a conference or journal. Request a letter of recommendation from the mess or JDF detailing your contribution to the welfare of junior doctors in your Trust. All of these things and more contribute to any application you make for training programmes after F2. There is considerable overlap between what different specialities and programmes are looking for in your portfolio. It doesn’t matter if you don’t know what you want to do yet. Taster days I’m sure many of you will have tried to choose jobs which cater to your interests or future career plans. However, if you don’t have that O&G job you really wanted or the ortho job of your dreams, then don’t worry. Tasters are a great opportunity to try out a specialty of interest or something completely new with which you are unfamiliar. You may be eligible to up to 5 taster days during F1. Completing taster days can show commitment to specialty. Even if you do not end up choosing that specialty as a career, it will serve as a talking point in interviews for why you decided on something else. I was fortunate to undertake several taster days in Paediatrics during F1 which were insightful. However, despite years of flirting with the idea of becoming a paediatrician, after my taster I realised that perhaps Paediatrics isn’t for me. Healthy mind, healthy doctor This job can be immensely rewarding but at times stressful and emotionally draining. Look out for each other at work and check in with your medic friends at other hospitals. Sometimes, you may be involved in particularly distressing MET calls or cardiac arrests or have difficult encounters with patients. It’s important to try and debrief with your colleagues or team afterwards to talk through what happened, how you felt and what could be done better in future. This doesn’t happen all the time and it isn’t always the culture especially amongst more senior doctors or consultants. Don’t be afraid to initiate this as it can be very cathartic and beneficial for your wellbeing and professional development. Sharing some of these challenging experiences with your housemates, friends and family (medical and non-medical) is important and you will need a network of people to turn to throughout your career. Home time Leave on time! You don’t always need to be a hero. There is a system in place that should enable you to hand over outstanding jobs to the next shift. Obviously, don’t abuse this by handing over work that could easily have been completed during the day. Always ask yourself, “If I don’t do this now, will it jeopardise my patient’s safety or unnecessarily delay their discharge?”. If the answer is no, it can wait until tomorrow. Remember, leaving just 15 minutes late every day for a month adds up to 5 hours of lost time! Exception reporting If you do have to leave late or if you find you’re having to come into work early in order to carry out your normal duties then please exception report. Exception reporting is the system whereby you inform your employer that your actual work differs from your agreed work schedule i.e. you have worked beyond your rostered/contracted hours. The report is sent to your educational supervisor, clinical supervisor and guardian of safe working or director of medical education. You should try to exception report within 2 weeks of the incident or 1 week if you want to claim payment. For any additional hours you work (this can be as little as 15-30 minutes!) you are eligible to either time off in lieu or additional pay. The exception reporting system exists not only to ensure that you are properly remunerated for any excess hours you work, but to highlight any issues with your work schedule. For example, if enough doctors submit exception reports enough times regarding the same rota then it suggests that the work schedule is inappropriate and needs adjustment. This can translate to the work schedule being changed in the future to accommodate the 30 minutes at the beginning of every shift that you need to update the ward list or the extra hour needed every other week to complete your Horus portfolio. “App”-solutely brilliant! There are lots of useful apps available to support you during F1. Below are some apps I regularly use: Microguide Search for your trust and download their guide to access the most up to date trust guidelines on antibiotic prescribing. Find the correct antibiotic, dose, route, frequency and duration based on the indication and alternatives in case of allergy. Please note that some trusts have additional guidelines available to view on Microguide for example; • Barking, Havering and Redbridge University Hospitals Trust - “Pharmacy Clinical Guidance” with useful prescribing information on replacing electrolytes amongst other guidelines • University of Southampton NHS Foundation Trust - “DiAppBetes” for diabetic emergencies and more • Oxford University Hospitals NHS Foundation Trust – “Pain Guidelines” for pain management in different patient groups Always remember to refer to your Trust or national guidelines first before looking at others! Induction Again, search for your hospital and save it to your favourites. You can find the extension and bleep numbers for every ward and department in the hospital. The data is crowdsourced from staff members so occasionally the information is out of date. However, it’s very easy to add new numbers, edit existing ones or flag when the data is incorrect. BNF Despite being vital for the PSA exam, the BNF is not necessarily the “know-it-all” resource for prescribing. Some drug monographs are very detailed and allow you to discern the correct dose of apixaban, for example, stratifying by indication, stroke risk factors and dose adjustments if there are bleeding risk factors. However, other monographs are quite vague. For example, if you want to know the exact dose of thiamine and vitamin B compound to give to a patient at risk of refeeding syndrome then expect to find a range of doses to choose from. You will find what you prescribe may come down to personal preference, trust guidelines or the classic method of “choosing the lowest dose” or “the one in the middle”. If you’re ever stuck, ask a senior or your helpful ward pharmacist! MDCalc Now that you’ve finished medical school you don’t necessarily need to calculate the Glasgow score for severe pancreatitis from memory. This app will do it for you! Just sign up for free access. Other commonly used apps and websites Dr Toolbox – available on the app store. Requires a Trust login. PocketDr – available on the app store for £2.99. Requires a Trust login. TOXBASE – requires a Trust login. Medusa – requires a Trust login. Whatever happens please don’t forget to… ENJOY IT!!! FY1 is an incredible year. It is the first time in your career when you can call yourself a doctor and the only time you will have so little responsibility as one. You may just be starting now but before you know it your first year as a junior doctor will be over. Enjoy it whilst it lasts! Join the Melanin Medics F1 Doctors Mess Online Group: Virtual support network for African and Caribbean F1 doctors in the UK https://forms.gle/mDhxzVfwxBfLbHRP6 Written by Dr Stephanie Ezekwe MBBS BSc (Hons) Academic Foundation Year 2 Doctor in North Central and East London

The last week has been hard. Traumatic. Exhausting. Frustrating. Everywhere you turn, you cannot escape from the harsh reality of racial injustice. The social media timeline littered with the video of a black man being murdered in the name of ‘law enforcement’. “I can’t breathe.” – one of the final statements George Floyd uttered before his death. I’m not sure what makes me shudder the most. The fact that I watched a man be brutally killed in broad daylight. Or perhaps it was the lack of empathy of the police officer as he continued to exert disproportionate force on the man’s neck. Or maybe the fact that the man’s outcries of pain were ignored. “I can’t breathe”. In medicine, this is probably one of the most worrying statements to hear. We’re trained to assess medical emergencies in the order of priority: Airway, Breathing, Circulation etc. The statement “I can’t breathe” raises immediate alarm bells, knowing fully well that life may be at stake. Yet in this situation it did not matter. It’s difficult to carry on as normal after seeing a man be killed. A man that could have been your loved one or anyone you know. A man who was a victim of someone’s racist judgment that ultimately lead to his life being tragically lost. It's becoming all too frequent. George Floyd, Ahmaud Arbery, Breonna Taylor and Belly Mujinga all lost their lives at the hands of racial injustice. It is irrational to even question the existence of racism at this point. It is even more ridiculous to question why Black lives matter. Black lives should matter to every medical professional. It is by no coincidence that the BMJ published an issue on ‘Racism in Medicine’ this year. Racism impacts us all. Racism impacts our patients. Racism impacts our colleagues. Racism impacts our interactions. Racism impacts Medicine. At its worst, racism kills. We cannot ignore this. The evidence is striking. Data analysed and collated by Dr Amile Inusa and Olamide Dada Health inequalities: Black women are 5x more likely to die during childbirth than white women in the UK. Black people are 4x more likely to die with COVID-19 than white people in the UK. The ethnicity pay gap means that for every £1 a black female doctor earns, a white female doctor earns £1.19 and a white male doctor makes £1.38. 95% of the frontline doctors that died because of COVID-19 were from an ethnic minority within the first month. Ethnic minority doctors are reported to the GMC more than twice the rate as white doctors. Ethnic minority doctors are more likely to be referred to the General Medical Council, have their cases investigated, and face tougher sanctions than their white colleague Black NHS staff report the highest incidence of bullying & harassment from their colleagues and leaders. Doctors from ethnic minorities are still twice as likely to be affected by discrimination at work and are at increased risk of experiencing bullying and harassment from both colleagues and patients In NHS healthcare leadership, 92% of board members in NHS trusts are white. This is the reality for Black medical professionals in the UK. We can’t run from it. The dark shadow of racism looms over us wherever we go. Whether it be overt or covert, it is there. To ignore the damaging impact of racism is to ignore the pain of a people. It is tiring to explain repeatedly why we matter or how institutional racism affects us, but we do it anyway. We want people to understand why things need to be changed for the better. We desire change not just for ourselves, but for the generations to come. We advocate. Even when the going gets tough. Even while experiencing the effects of our own racial trauma. We advocate because the future depends on it. Our vision is paramount to the work we do: We envision a future where diversity in Medicine thrives and every person is able to fulfil their maximum potential irrespective of their race and socioeconomic background. We are dedicated to supporting individuals of Black heritage in Medicine to the best of our ability and we are committed to doing all that we can to stand against racial injustice. If you are non-black person reading this, know that your colleagues need you. Know that your voice is equally as crucial to the conversation. Know that your actions matter. We all have a part to play to support each other and the prevention of further heinous crimes which are incited by racism. What can you do? SIGN THE PETITIONS Take meaningful action. Every signature represents a voice saying that the situation should not and cannot be ignored. DONATE There are a number of fundraising pages to support the loved ones in raising funeral costs of those who tragically lost their lives. You can also donate to charities and organisations actively fighting against racial injustice. BE INFORMED Speak to people and recognise what you don't understand and be willing to learn. There are a number of resources e.g. books, podcasts, article and media that can be used to educate yourself. BE VOCAL To understand is the beginning, to act is the result. "Anti-racism is the commitment to fight racism wherever you find it, including in yourself. And that's the only way forward." - Ijeoma Oluo CHECK IN ON YOUR BLACK COLLEAGUES For your colleagues performing their daily duties can be difficult; plagued with the fear of not knowing who is for you and who is not simply because of the colour of your skin. This an emotional and traumatic experience. Ask how you can provide support. Donate to Melanin Medics: www.melaninmedics.com/support Relevant Links: www.bit.ly/bellymujinga www.bit.ly/blacklivesmatterMM www.bit.ly/detroitbailsupport www.bit.ly/georgeflloyd www.bit.ly/ahmaudMM www.bit.ly/MMgeorgefloyd www.bit.ly/MMbreonnataylor www.bit.ly/bellymujingapetition Written By Olamide Dada

The coronavirus does not discriminate between individuals. It can affect anyone and no one is immune from its impact. However, recent data suggests that the severity of the COVID-19 infection amongst the Black And Minority Ethnic (BAME) population is disproportionate. What is the problem? Data from the Intensive Care National Audit and Research Centre (ICNARC) suggests that 34% of the critically ill coronavirus patients are from BAME backgrounds. This research was based on 3300 patients from ICUs across England, Wales and Northern Island. The first 10 doctors to die in the UK from COVID-19 were all BAME. 70% of the 54 front line healthcare workers that have died in the UK because of COVID-19, were BAME. These numbers worsen on a daily basis. According to the 2011 census, just 14% of the UK population are from BAME backgrounds. In the US, both the overall number of confirmed cases and deaths is broken down by ethnicity. In Chicago, approximately 70% of the coronavirus victims were black, despite black people representing only a third of the population. Similar numbers have also been seen in New York, Detroit and New Orleans. What could be the reasons? Several reasons could be underpinning this, but we know that Coronavirus has amplified the racial and economic disparities that still sadly exist in our world today. The Science It is widely known that certain diseases are more prevalent in particular ethnic groups. Although the precise mechanisms are unclear, it is likely that genetics play a huge part. For example, people from Afro-Caribbean or Asian descent are more likely to suffer from cardiovascular disease and diabetes than their European counterparts. Two conditions that have been shown to be associated with more severe outcomes from COVID-19. Although the direction of cause and effect is yet to be determined, many healthcare professionals attribute the racial disparity of COVID-19 deaths to this reason. Additionally, the biopsychosocial effects of racism may lead to high levels of stress, which is a known risk factor of hypertension and as a result, cardiovascular disease. This suggests that the increased prevalence amongst the BAME community may be the result of a complex interaction between genetics and environmental factors; wherein a genetic component is further exacerbated by social stressors. There may indeed be genetic differences or factors of genetic susceptibility, however this disproportionality is occurring across different ethnic groups; making a genetic cause less likely. This highlights the pressing need for further research before any solid conclusions can be made. Nonetheless, we must not forget that the overwhelming determinants of health are socially created. Socio-economic factors UK BAME communities rank poorly in socio-economic indicators of poverty and deprivation; an outcome of longstanding structural inequalities in Britain as well as the institutional racism in government policies relating to immigration, housing, criminal justice and social welfare support. A large proportion of the BAME population having public facing occupations. They make up a large share of jobs considered essential in tackling the virus, the very roles that are making our self-isolating process more manageable; from the essential cleaners to the healthcare professionals; customer assistants in our local supermarkets to delivery staff, transport workers and many more. However, this means that the racialised aspect of the crisis is further compounded. So whilst many of us are able to stay at home, they cannot. Therefore, their risk of contracting the virus is substantially greater. Cultural differences Another factor to consider is different cultural beliefs and behaviours. Amongst BAME communities there is a stronger culture of multi-generational living. This is when multiple generations in a family live in the same home. As a result, there is over-crowding in households and under recent circumstances, places the elder population and those with co-morbidities at a greater risk. Researchers at the University of Oxford have suggested that this factor contributed to the accelerated spread and crisis in Italy, as a large proportion of their population are elderly and people are more likely to live with their grandparents. The message needs to be clear. Is enough being done to ensure that everyone is fully receiving and comprehending the guidance that is out there? Is the information being translated for those whom English is not their first language? Due to new policies in preventing the spread of disease, family members are no longer allowed to visit their relatives in hospitals and therefore are not able to assist in translating. As many of our readers are BAME healthcare professionals, it is key that we use our voices to properly educate our families, friends and our respective communities and debunk the many, many myths (many of which are arising from the hundreds of forwarded WhatsApp messages) and spread information not fear. What next? Both the British Medical Association (BMA) and the Labour Party have called on the government to launch an enquiry and urgently further investigate this disparity. On the 16th of April, the government announces that they will be launching a formal review into why people from a black and minority ethnic background appear to be disproportionately affected by COVID-19. This enquiry will be particularly beneficial by providing an intersectional analysis exploring associated the risk factors of COVID-19 and ethnicity-based data in order to better inform healthcare providers and prevent the further loss of lives. This will undoubtedly uncover more evidence on the complex yet striking relationship between health and racial inequality in Britain. BAME healthcare workers make up a significant proportion of the victims of this virus. Although there may be several reasons underpinning this, this unfortunate situation has further revealed the underlying inequalities facing BAME communities as a whole. We need to ensure that all healthcare workers are safe and appropriately protected with Personal Protective Equipment (PPE), our population is safeguarded, and the government takes action. The NHS has always heavily relied on its ethnic minority staff. They make up a significant proportion of the NHS workforce and unfortunately many are losing their lives in the battle against COVID-19. To all the healthcare professionals; the vast majority of whom came from overseas and gave their lives to the NHS to save others, as well as our other essential key workers who have sadly lost their lives, may their souls rest in perfect peace and our condolences to their loved ones. Written By Khadija Owusu, Olamide Dada and Ife Akano-Williams

Recently the government announced that the lockdown period was to be extended for a further three weeks. Whilst we understand that this is necessary for the safety and wellbeing of the general public, we also understand that social distancing may be frustrating for some of you! We have put together a list of (social distancing friendly) suggestions to help you preoccupy yourself during this time. Exercise It is well known that physical activity helps to improve your mood and help with anxiety. Although gyms are closed, there are still many ways to get that endorphin rush that comes from exercise. Right now home workouts are your best friend, and YouTube is filled with so many great videos that you can do from the comfort of your bedroom. From yoga to HIIT there is something for everyone, no matter how big or small your space is. If you want a gentler form of exercise – take advantage of the daily outdoor exercise allowance and go on a walk. If you have any green spaces around you this is even better as being around nature may help to still your mind and help you recharge after a long day. IDEAS: Home workout challenges (Youtube, Instagram Live) Walk or Run Cycling Skipping Nourish your social life We know this phrase might seem a little bit crazy right now because how can you have a social life when you can’t leave your house! Luckily there are several ways to stay connected with friends and family during this time *cue Houseparty, Zoom and Facetime*. Some of you may be social distancing alone but feeling connected to people is important, more so right now. If you’re able, reach out to your friends and family; it may give you a different perspective and give you some extra support. IDEAS: Write down a list of all the people you want to contact that week and plan to call different people on different days, spreading over the course of the week One-to-one calls or Group calls Organise an online Games Night with friends Self-care The current situation is impacting everyone and we are all worried about our own health and that of our loved ones so it is completely normal to feel anxious during this time. Whenever you can, take some time out of your day or week to focus on yourself. Self care looks different for everyone but the overriding principles remains the same. It is any activity that you purposely do to take of your physical, emotional and mental wellbeing. One good way to practice self care is to do something therapeutic. As mentioned earlier, self-care is unique to each person so this may mean doing a face mask or practicing make up skills! Meditation and mindfulness is something a lot of people find calming and there are a lot of free apps that can make your mindfulness and meditation journey a lot easier. Another effective way to practice self care is to take care of something else. There are many on-line plant nurseries that are still open so you could invest in some plants and start an indoor garden; a great way to bring nature indoors. There are many things you can do to take of yourself and if you know that a particular activity makes you more relaxed, set time aside to do it. IDEAS: Set a designated self-care day Schedule rest days Restrict your use of social media e.g. limit your use to only certain hours of the day Gardening Read and set targets Online Courses (Check out the FREE online courses offered by: Ivy League Open University Try something new We’ve all got something we’ve always wanted to do but never got round to it; that really interesting hobby you’ve always wanted to try but kept putting off. Now is the time to dust off those old ideas and bring them into fruition! Home baking is a great way to kill some time and there will always be a guaranteed reward at the end of it, the quality of which will of course depend on your baking skills, however! Social media is showing us that everyone has a top chef hiding inside of them, why not grab some bananas during your weekly food shop and whip up some banana bread! Home improvement For many people, a tidy space means a clear mind. Spring is in full force and so there is no better time to do some spring cleaning! Declutter your space – take a few things out of room that you don’t use regularly and donate it to charity. Start an arts and craft project and create some nifty handmade storage containers so you can store away some items! If you’re lucky enough to own your home, you could fix up that area of home you’ve always wanted to improve! Some examples include installing some shelves for photos or books, or even creating a makeshift home office space. Order your supplies from an online store and get it going. Make it a Habit Do something for the Soul e.g. meditate, mindfulness, read Do something for the body e.g. exercise, yoga, workout Do something for the brain e.g. study/academic work, an online course, puzzles, learn a new skill Do something productive e.g. chores, organising, planning out the things you need to do Do something for the heart e.g. call family/friends, hobbies, paint, bake, read, cook Do something fun e.g. chill (e.g. Netflix, movies), social media, board games Do something to wind down e.g. journal, express gratitude, sleep, pamper yourself Spend time outside (if you can) e.g. read outside, work outside, workout Source: Twitter - @plntbasedcutie We all have free time on our hands, and a lot of us don’t know what to do with it. There are several ways to tackle this problem, and in the process improve our physical, emotional and mental well-being. Written by, Dr Ife Akano-Williams

With our country facing one of the biggest challenges in history, it was no doubt that an army of volunteers would be required to support our beloved NHS as it is stretched beyond measure. We wanted to share first-hand experiences of medical students volunteering in the NHS to help give you an insight into what it is really like, dispelling some of the myths and showing how you can make a difference. Kwarteng Sarfo's Experience In 2014 when I started this medical school journey, I honestly didn’t think this is how it would end. Medical finals reduced to three online tests, a respiratory illness sweeping the nation and a bunch of Instagram challenges. Regardless though, I have seen the good in it. I have seen the hidden side of the NHS. Following my graduation, a week ago, I decided to volunteer, hoping to provide assistance to the various sectors within Imperial NHS Trust that needed. Part of it was the innate altruism that I regurgitated during my medical school interview, but I will be honest, I needed to get out of the house. 24 hours with the family was getting a bit too much. Before I left, I received some serious prayers from my worried mother, in addition to the misleading WhatsApp messages sent from the aunties and uncles, about how to deal with coronavirus. You could say I was “ready” to do what I could to tackle coronavirus. Sunday evening, I moved into the Imperial provided accommodation and completed our online induction modules because you know, social distancing. Later on, I got the email detailing my allocation. “You have been allocated to the Surgery cancer and cardiovascular management department” The who of the who department? I thought I was going to be honing my skills of cannulation, venepuncture and catheterisation because when I thought “shortage” I thought it meant only “clinical shortage.” I was wrong. For the past week I have been working as a validator tasked with two jobs: Job number 1 ⁃ In normal circumstances, when doctors see a patient, in addition to writing structured notes they are supposed to conclude the consultation. In broad terms, a patient is either discharged or in need of a flow up. Unfortunately considering the ongoing pandemic, this task has been left incomplete by many doctors. This is where I come in. My first task in simple terms, is to look through past consultation and assign a conclusion to the case. This involves looking through clinical notes and making a decision of finality or continuity Job number 2 ⁃ With this upsurge in coronavirus, various patients have had their elective surgeries cancelled in order to curtail the spread of covid-19. This is a brilliant approach, unfortunately, NHS have a policy that doesn’t help the situation. In order to understand this policy, you need to understand the term RTT. This stands for referral to treatment time, that is, the time taken from a patient’s referral to be received at a hospital to when the patient is treated. NHS says, 92% of hospital referrals, their RTT should ideally be 18 weeks. Meaning the time taken from your referral to be received to when you get treated should be within 18 weeks. Another part of this policy is that NHS has a zero tolerance on an RTT of 52 weeks. So, you shouldn’t be waiting for a year to get treated for something you were referred to the hospital for. Of course, this is a brilliant policy but...Coronavirus. This pandemic has caused many hospitals to remove many off the elective surgery list. Inadvertently, this delays a patient’s RTT and with every week a patient is over the 52 weeks threshold, a hospital gets fined a hefty amount, we’re talking pounds in the thousand. This is where I, a recent medical school graduate, who struggles remembering his NHS email password, comes in to “help.” It has been a super steep learning curve, but I have learned so much! I’ve had a week’s training in Cerner, Microsoft teams and excel and I honestly couldn’t be better prepared to deal with IT related stuff as a foundation doctor. I have come to appreciate the diligent staff that work in the shadows of NHS to ensure the patient we booked 6 months ago attends their surgery on time and at the right date. I have come to appreciate that a hospital isn’t just the medical staff that make clinical decisions rather it includes the superheroes that look through some doctors indiscernible notes, to identify if a patients elective surgery, that was cancelled due to coronavirus, is of a high or low priority. Yes, my current role is very different to what I expected I’d be doing to help this pandemic. Yes, it would be great to find a juicy vein for venepuncture, but I am learning something new I didn’t appreciate before COVID-19. There’s more to the NHS than the front-end assembly of doctors and healthcare staff. We have some unappreciated superheroes in the backend ensuring you are receiving adequate care in adequate timing. Charlene Khoza's Experience Eye-opening. That’s how best I can describe my experience of volunteering so far. I chose to volunteer in a non-clinical role, working to organise and distribute the PPE that the clinical staff need. I have learnt just how much work goes into ensuring there are adequate supplies of the gloves, masks and other essential clinical equipment that keep the hospital going. It is hard. I have learnt about the secret tunnels, doors and routes in the hospital basements that are used to deliver equipment. I have learnt what happens between ordering something and it arriving on the ward. Even though there may be shortages, there is someone working to make sure that staff get what they need. This role has also taught me that sometimes the best way to help is to offer a listening ear. Doctors, nurses and other healthcare staff are human too and just as afraid of this situation as the next person. They need someone to share those fears with and who can reassure them that they are doing a great job and that there are adequate supplies to keep them safe. Being the voice over the phone telling them those things has been a humbling experience. I started off feeling unsure about what I could contribute and what would be of most benefit to the hospital I am in. But as time has passed, I have realised that I do have something to offer. Even if it may be something as simple as smile – it makes a difference. Written by Dr Kwarteng Sarfo and Dr Charlene Khoza Are you interested in volunteering with the NHS during this time? We recommend searching for volunteering schemes at your local hospital. There are many other ways you can support those around you at this time too. Look out for our next article!