From TED.com: Can we eat to starve cancer? by William Li

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The obvious thing is to think about what we could remove from our diet. But I took a completely opposite approach and began asking: What could we be adding to our diet that could boost the body’s defense system? In other words, can we eat to starve cancer? — William Li

William Li, a cancer researcher, discusses how anti-angiogenesis can help to treat cancer and other diseases. Cancer, as he describes, starts out as a harmless microscopic tumor and gets larger when they gain access to enough blood supply and nutrients. Without these, the cancer cells are not deadly. What anti-angiogenesis does is to help prevent blood vessels from reaching cancer cells and thus, the tumor simply can't grow.

He then goes on to discuss how eating natural foods such as fruits and vegatables can help to prevent cancer.

Watch the 20 minute talk by clicking on the picture above.

Source: TED.com

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From TED.com: How do we heal medicine? by Atul Gawande

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Other than featuring stories from our students, faculty members and blog authors, we at upbeat also want to share interesting videos/talks with our readers. These videos and talks will of course, be medically related and are aimed at providing our readers with some "food for thought".

Today, we would like to share with you a talk from TED.com:

You can't make a recipe for something as complicated as surgery. Instead, you can make a recipe for how to have a team that's prepared for the unexpected. — Atul Gawande

In this 19 minute video clip, How Do We Heal Medicine? , Atul Gawande, a surgeon and public health journalist, discusses how doctors can improve their practice using a checklist for surgery. You might ask, why a checklist? Well, watch the video below to find out more!

You can learn more about him by reading his profile here.

Source: TED.com

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The new kid on the block

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Instagram photos by Siti Hanisah

Six months ago, I was spending most of my time after lecture sessions attending project meetings while working on my dissertation. Life as a final-year business undergraduate was hectic. Deadlines had to be met each week, 10 minute (yet crucial) presentations to prepare for and modules to revise. Today, I am a full-time working adult and am now into my third week here at Duke-NUS Graduate Medical School.  My name is Siti Hanisah (or Nisah, for short) and I am the new kid on the block.

As a fresh graduate, I am wearing a new set of glasses. Not literally, but more like having a fresh set of perspectives: one where I find life after university so new, foreign and interesting. I am in a transitionary phase, from student to working adult. Some people say that job-hunting can be one of the most difficult things you have to do in life and I finally understood the meaning of this. I remember sending out countless of resumes, waiting eagerly for calls and having a lot of pre-interview jitters. Instead of making me demoralized, receiving those rejection emails in my inbox spurred me on. I have learnt to see such failures as lessons instead of punishments.

Many have told me that the working life is tiring and that they would prefer to remain in school and study.  When I heard that, I immediately thought, “Study? I would rather work than to sit for the exams!” I was eager to be freed from my required readings list and memorizing of facts and theories for the exams. I was eager to see the world. I was eager to grow up. Of course, the grass is always greener on the other side.

As a young adult, there are so many things that I want to do and experience. Travel, learn a foreign language, volunteer in third-world countries, go sky-diving; the list goes on.  At the same time, I am well aware that I should work hard and play hard too. The hard and soft skills that I learn and develop now will be very important for my future. Network, build and develop more friendships. Save more and (try to) spend less on clothes and live concerts. Start investing, not just financially but also in learning more skills.

Time flies faster than a bullet train and my time here at the Admissions Office and at Duke-NUS has been pleasant so far. I have met so many wonderful people and my colleagues from the Admissions team have helped me a lot in terms of making me feel welcomed and adjust to the working life here.

So now you are probably wondering, how do I fit in upbeat” ?

 

Instagram photos by Siti Hanisah

Well, I am the social media girl. An active user of Facebook, a “Twitterer”, an addicted “Instagrammer” and a “reblogger” of Tumblr posts. I started to explore social media and fell in love with it since the early days of Friendster and have thus, moved on to Myspace and now, Facebook. This applies to blogging platforms as well: Blogspot to Livejournal to Tumblr to Wordpress and back to Tumblr again. In a nutshell, I will be posting Duke-NUS related stories, videos or links, which you will see every time you scroll down your facebook newsfeed or twitter timeline. Soon, I hope to be able to contribute posts to "upbeat”. Comments, “likes” and “retweets” are most welcomed and if you happen to see me around campus (or anywhere else), do come up and say hello!

With my new set of “glasses”, I cannot wait to embark on this exciting journey with Duke-NUS.

- Siti Hanisah

Duke-NUS Over The Years

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Contributed by Kizher, Class of 2012

The countdown is finally over; I am officially Dr. Kizher Shajahan Mohamed Buhary! It has certainly been a long and painful yet rewarding journey for all of us in the class of 2012.   

Year 1

I can still remember the first day of medical school at the old Duke-NUS campus at Jalan Bukit Merah. I remember being quite overwhelmed by the diversity of students in my class. I couldn’t help but wonder how I made it as one of the forty-nine students in the large teaching room that day. The reassuring words from the deans helped to calm our nerves. During the Foundations course, we got to know each other better and were introduced to our teams as well as to the team-based learning pedagogy. To be very honest, I found the first year of medical school to be the most challenging. Coming from an engineering background, it took me some time to adjust to learning large volumes of data. Having to watch eight to fifteen video lectures a week, reading multiple text books and memorizing vital facts did took its toll on all of us. However we were always reassured by the faculty that medical school learning is a gradual process and that we are not expected to remember everything medical! We developed team strategies to study such as transcribing the video lectures so that we could read from the slides rather than to simply watch the videos. By the time we started learning Body and Disease, most of us had acclimatized to the style of team-based learning. We started to enjoy the IRAs, GRAs and applications sessions. What could be learnt over 2 years in a traditional medical school was taught in a period of 10 months. This would not have been possible if not for the excellent program coordinators namely, Prof. Pierce Chow, Dr. Doyle Graham and Dr. Puthucheary.

A very important component of Year 1 was the Wednesday morning Practice Course. We were introduced to the art of History taking and Physical Examination by some of the best teachers from the SGH campus. We all looked forward to these sessions because we finally got to ‘pretend’ to be a doctor and put on our white coats. Basic procedures such as how to wear the stethoscope and how to take a patient’s radial pulse were taught to us meticulously. We are very grateful to the regular patients who have contributed significantly to our learning.

 

 

Wednesday afternoons were reserved for college meetings. Groups 3 and 8 were assigned to College 4 (back then, there was no name allocated). Dr. Kon and Dr. Guna were our wonderful college masters who made a point to attend these weekly sessions and lend us their listening ears as we vented about medical school. They helped shape our medical personality significantly by introducing to us the importance of community service as medical students. It was due to Dr. Kon’s efforts that we embarked on a project with the National Cancer Centre to educate patients on four of the most common types of cancers in Singapore.  

It was half way through Body & Disease that we moved to the brand new campus at College road. We had the privilege of being the first batch of students to use the LEAD room.

Year 2

We were all anxiously looking forward to Year 2 where we finally got to be in the wards and interact with real patients. Each of us paired up with another classmate, one who shared the same clinical rotations. My partner in healthcare was Shebani Sethi, whom I shared an excellent rapport with. I started with Internal medicine and in retrospect, I am glad I did because I was able to establish a good clinical foundation. Although there was some culture shock, I was able to adjust to working in a ward due to the guidance of some excellent teachers. The nurses and allied health staff were very helpful in helping us learn the procedural skills in the wards.  My second posting was Neurology at SGH. Being part of Prof Lim Shih Hui’s team was certainly a treat. Morning rounds were always an intellectual experience as there was so much to learn from him. We also looked forward to Dr. Puvendran’s Monday afternoon teaching rounds. Psychiatry posting at IMH was an interesting experience for all of us. The highlight of my Obstetrics and Gynaecology posting was being able to deliver a baby independently. We were also allowed to run a biweekly clinic which helped our learning tremendously. Surgery clerkship was what I looked forward to the most. I must say, it was one of the most challenging postings as well. There were days when we never saw daylight. Pre-rounds used to start by 5:30 am and we only left the theatre at around 6:30 pm. Under the guidance of Prof Koong, it was a very hands-on posting experience. We got to learn the basics of suturing, dressings and drains. My last posting was doing pediatrics at KK hospital. The pediatrics clerkship was very well organized. There were plenty of tutorials and clinic sessions to enhance our learning. The focus was on having a systematic approach to any condition. Personally, it helped me consolidate what I had learnt over the year.

Much to our dismay, at the end of Year two, we had a number of exams which we had to sit for within a period of 10 days such as the End of posting SHELF exam, Foundations of Medicine exam, Year 2 CPX and the CBSE (Comprehensive Basic Science Exam). We survived it.

It was during my second year that my college (College 4) finally got its name: Benjamin Sheares College. We also had the official opening of the new building by his Excellency Prime minister Mr. Lee Hsien Loong. 

Year 3

I had a change of surroundings during my third year of medical school. I was working with Prof James Hui, a pediatric orthopedic surgeon from NUH. I was back in a familiar territory (NUS), where I did my degree in bioengineering. I worked with familiar lab mates at the Biomechanics Lab and spent a large amount of my down time in the clinic with Prof Hui and in the OT.

I got the opportunity to sit in for quite a number of complex cases, including those on weekends when Prof Hui used to call me in. He was an excellent mentor and one of the nicest persons I have ever met. Apart from our research discussions, we used to debate quite a bit regarding the Barclays EPL games as Prof Hui is an avid Arsenal fan. I was given the privilege of being a presenter at the European Pediatric Orthopedic Society (EPOS) conference in Switzerland that year. I also worked with Prof Hui on two publications, which were approved earlier this year. Year 3 provided most of us with a lot of time to relax, reflect and yes, study for the USMLE step 1.

We also had to complete Family Medicine during the third year. My monthly attachments with the polyclinics and the GP in Lakeside gave me a good exposure to the importance of Primary care.

Year 3 was certainly the calm before the storm.

Year 4

Most of my classmates may agree with me, when I say that the fourth year was certainly one of the most stressful yet enjoyable periods in medical school. My classmates and I were quite concerned about going back to the wards. Our physical examination skills were rather rusty after the 3rd year “break”. The Sub-Internships (Sub-I) were certainly quite challenging and demanding (both physically and mentally) as we had to take on roles as interns/House Officers. We had some wonderful teachers, mostly HOs, who showed us the ropes to being a good intern. I also had the opportunity to work with final year students from YLL.

Year 4 also meant that we had to apply for residency in that current year. Since the chances of getting into residency programs are greater if applied straight after medical school, most of us had to go through the rigorous process of interviews. I was applying for Orthopaedic Surgery, which is considered as one of the popular residency programs. The interview format (much to our dismay) was changed at the last minute to a MMI (Multiple Mini Interviews), which comprises of 4 short independent assessments.

It was during this period that I was preparing for the USMLE Step 2 CK. Having done the Step 1 exam six months prior, it did help with the preparation. However, making plans to take the exam twenty-five days before my wedding was not a smart move. Yes, I got married to Farha whom I met during my 2nd year of medical school on 25th December 2011 (I chose the date so that I won’t forget our anniversary and not get myself into trouble!).

With the both of us being medical students who come from different countries, it does have its benefits (Come find me and I will share the rest of that story).

Soon after my wedding, I had to return to Singapore to complete the Internal Medicine Sub-I and apply for a US visa as I was heading to Duke to complete my final two electives.

I was accompanied by my wife to the US. I had a wonderful experience at Duke doing a Sub-I in Orthopaedic Surgery and in Emergency medicine. I learnt quite a lot during my stay there and also from the supportive faculty. There was a lot of curiosity about Duke-NUS at Durham. It may sound strange, but I felt as comfortable in the wards, OT and clinics at Duke as I did at SGH. I made quite a number of good friends during my time there and interestingly, quite a number of people were obsessed with my hair! My wife kept herself busy by volunteering at Church World Services, an organization that helps refugees. During the weekends, we did a bit of travelling. We visited South Carolina, the outer banks and also Washington DC. I also did my Step 2 Clinical Skills exam in Atlanta to complete the ECFMG certification.

Upon returning to Singapore, I had to start preparing for the Exit exam. It was during this time that the residency results were released. I was fortunate and relieved to be accepted into Orthopaedics at Singhealth. The exit exam was a blessing in disguise because we worked quite hard on polishing up our bed side skills. The last 4 weeks of medical school was spent on the Capstone Course. Most of the talks were very useful. It gave us time to reflect back on medical school, spend time with each other and share long meals before heading out to the real world.

Graduation was on the 26th of June 2012. It was an emotional day for all of us including the students, faculty and family.   

 

Acknowledgements

I would like to take this opportunity to thank the hundreds of patients I have seen over the last 4 years.  I would also like to thank our teachers who not only taught us, but also respected us and made us feel important. Thank you to my parents, brothers, nieces and friends for supporting me over the four years and helping me forget that I am a medical student when necessary. My wife deserves a special thank you for her encouragement and putting up with my stress-induced mood fluctuations! Lastly, a big thank you to the class of 2012 for being one of the best groups of friends I have ever hung out with. You all have supported and inspired me. I wish you all the very best and am looking forward to working with you.

 

Reflection: Project KARen

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Contributed by Zhou Yi, Class of 2015

During the periods of spring-summer, the 2012 Project Karen team set off as planned on 27th April and headed towards Chiang Mai, Thailand. Sixteen of us, including thirteen Duke-NUS medical students and three doctors, felt very excited about this mission trip and were ambitious in achieving our planned goals.

Six days passed by quickly, such that we didn’t have much time to gather our thoughts and reflect upon our accomplishments. Everyone returned to Singapore feeling physically and mentally exhausted but as I look back at what we have achieved from the trip, I felt proud yet wonder if we have done enough.

In less than a week at Karen Tribe, we conducted a local health screening for the kind villagers, a camp for the children and teenagers respectively, and another health screening for the poor orphans at an orphanage in Chiang Mai. Indeed, we managed to achieve our primary objectives, which was to conduct health screenings and promote health education.

Being a first year medical student, my classmates and I were able to systematically assess the patients’ general health conditions, elicit chief complaints and identified some physical signs during the health screenings.

The biggest challenge of the entire trip was language barrier. However, with the help of the local translators and having attended a simple crash course on the Thai language, we were able to come up with a comprehensive history list for most patients and provided appropriate treatment for their chief complaints.

In addition, I was involved in the planning of activities for the children’s camp. It was extremely gratifying to see the lovely kids learn basic health education such as the correct teeth-brushing steps, the 7 steps of hand-washing, first-aid bandaging techniques and the harmful effects of smoking.  

 

It may seem trivial to some but to these young children living in the beautiful mountains, they were able to learn and educate themselves with lessons that would benefit their health and their future.

In my opinion, this mission trip was a very fulfilling and successful one and there were two key points which I remembered the most.

Firstly, I was so touched by how the villagers and the young children appreciate the simplicity and purity of life itself.

Having lived in metropolitan cities throughout most of my life, I realized that there are too many things which I have taken for granted such as having delicious food to eat, a comfortable home, a good quality education, a variety of entertainment options and access to the internet. During my time in the mountains with the young children, surprisingly, I realized that life can be simple as I watched how the innocent children enjoy their lives with the minimum necessities that they have.

  

Although we could not understand each other using words, strangely enough, we were able to communicate well with our hearts and there never seemed to be any misunderstandings.

They played simple childhood games with us and accompanied us through the forest and fields to get to the village waterfall. No iPads, no PSPs, no toys, nothing. Walking hand in hand, we were so happy. They were so polite and friendly and some of them have the most beautiful smiles. The kind of smiles which I have not seen in a long time.

On our final day, the children woke up early to pick fresh flowers. They made it into bouquets and gave one to each of us.

I couldn’t help but wonder, what more can we do for them?

Although the villagers were very grateful for what we did, I could see it in their eyes, that they have a desire for a better life. Annual health screenings can be very beneficial to them, but if there was no proper follow-up on chronic conditions of the patients, the referrals that we have made and the temporary medication given, it would not increase the value of their health.

Similarly, even with the health education and free stationeries provided, the children may only be able to finish their education till primary school and then return to work in the fields. If nothing more sustainable is done, they may never venture outside of their village and see the world.

Therefore, from my perspective, future Project Karen teams should ask these questions themselves. Hopefully, our successors could explore greater options which could lead to more long-term benefits for the villagers.

The Project Karen 2012 trip has indeed been very memorable. Besides the medical knowledge and clinical skills, I have gained far more beyond: how to contribute to the needy people in the developing world, how to connect with patients on a personal level, and how to appreciate the simplicity of life and human nature in general. I could never have learnt any of the above in the classroom, and therefore, I am truly grateful for what the Karen Tribe has taught me. I believe that I will always miss the days when we played with the children under the starry sky in the remote Thailand mountains.