Dr. Sarah Josephine Baker: Dr Baker was an American physician who helped to fight against the effects of widespread urban poverty and ignorance caused to children. Her work organizing the first child hygiene department under government control led to the lowest infant death rate in any American or European city during the 1910’s. She also is known for (twice) tracking down Mary Mallon, the infamous index case known as Typhoid Mary. Baker was in a long-term relationship with screenwriter Ida Wylie. Dr. Alan L. Hart: Dr Hart was a physician, radiologist, tuberculosis researcher, writer and novelist. In 1918, he was one of the first trans men to undergo hysterectomy and gonadectomy in the United States. He pioneered the use of X-Ray photography in tuberculosis detection. Dr. Hart was instrumental in developing tuberculosis screening programs at the time that TB was the largest disease killer in the US. Dr. Hart’s efforts with screening programs saved thousands of lives. Using his system, doctors cut TB death tolls to 1/50th of previous levels. Dr Louise Pearce: Dr Pearce's research led to a cure for trypanosomiasis (African Sleeping Sickness) in 1919. Belgian officials, impressed and grateful for her results, awarded her the Ancient Order of the Crown and elected her a member of the Belgian Society of Tropical Medicine. For many years, Louise Pearce lived with physician Sara Josephine Baker and author Ida A. R. Wylie and is even buried alongside them. All were members of Heterodoxy, a feminist biweekly luncheon discussion club, of which many members were lesbian or bisexual. Bruce Voeller: Bruce Voeller was an American biologist, gay-rights activist, and AIDS researcher who pioneered the use of nonoxynol-9 as a spermacide and topical virus-transmission preventative. Before the 1980s, AIDS was known by various names, including GRIDD (Gay Related Immune Defense Disorder). Because this term was inaccurate, Voeller coined the term “Acquired Immuno Deficiency Syndrome.” At the time of his death, Voeller’s research centered on the reliability of various brands of condoms in preventing the spread of diseases. Dr. John Ercel Fryer: Dr. Fryer was an American psychiatrist and gay rights activist best known for his anonymous speech at the 1972 American Psychiatric Association (APA) annual conference where he appeared in disguise and under the name Dr. Henry Anonymous. This event has been cited as a key factor in the decision to de-list homosexuality as a mental illness from the APA’s Diagnostic and Statisical Manual of Mental Disorders. Fryer was the first gay American psychiatrist to speak publicly about his sexuality.

What is Self-esteem? Self-esteem is one’s perception of themselves and their self-worth. It is how they think and feel about themselves and how much they ‘like’ themselves. Having low self-esteem can make one feel inferior to others, and essentially feel like a failure. As medical students, many of us were amongst the best achievers in school or college and our self-worth can be highly linked to our accomplishments, which helped us enter medical school in the first place. This could be ingrained in us from childhood, where parents or teachers would only praise us when performing our best. Medical school itself can be a concentrated environment of high achievers, making some of us feel inferior. Knowledge and clinical skills content in medical school is extensive and much more demanding to learn compared to what we were used to in previous education. Being top of the year in this context is a much greater challenge. Failing exams in medical schools can be a terrifying and unexpected reality for some students. The different nature of exams means that students who have never failed in the past can struggle and fail in medical school. Failing can trigger or exacerbate feelings of failure and low self-esteem and could sow seeds of self-doubt and what is known as imposter syndrome. What is imposter syndrome? Imposter syndrome in medical school can make one feel like they do not belong or do not deserve to be there. Low self-esteem and failure can leave us with low motivation to succeed, try new thing and socialise. It can even lead to mental health problems including depression and anxiety. The section below outlines some self-help techniques as well as signposts to further help such as counselling services and some useful links. Useful Resources Charities: Mind Support Line University: University counselling service Extenuating Circumstances Other online resources: NHS page on cognitive behavioural therapy Trent PTS Let's Talk Wellbeing Insight NHS page on self-esteem Mind Health talk Books: The Confidence To Be Yourself: How to boost your self-esteem by Dr Brian Roet

What does it mean to live a healthy lifestyle? A person living a healthy lifestyle engages in a range of habits that improve their health. Some diseases are unpreventable; but a healthy lifestyle lowers the risk of serious illness and early death. Based on guidance given by the NHS and WHO, here are some suggested changes you can incorporate into your daily life in order to have a healthier lifestyle. Controlling Unhealthy Habits Tobacco, Alcohol and Substance Abuse According to the mental health organisation, smoking leads to a large release of dopamine resulting in temporary feelings of pleasure. Positive emotions can also result from consuming alcohol and other substances. Hence why those with poor mental health often use these methods as a coping mechanism. Cessation is the most healthy option. But, reducing the use of said substances i.e. not binge drinking or chain smoking, can also have huge health benefits such as reducing the risk of cardiac and respiratory complications in the future. There are many organisations and resources online that aim to support you in reducing the use of tobacco, alcohol and other substances which you will find below. Nottingham GP Alliance Stop smoking service This Nottingham based service allows you to have a personalised smoking cessation programme with professional support throughout the whole process Frank Nottingham Recovery Network The FRANK recovery network provides support and treatment for people who misue alcohol and drugs Good Nutrition Staying hydrated As most of us know, approximately 60% of our body is made of water. So staying hydrated is key to allow our body to function properly. It aids in digestion, maintaining your core body temperature and overall cardiovascular health. NHS choices recommends that we drink 6-8 glasses of fluid a day. So get drinking! Don't skip breakfast As medical students with very busy schedules, we are more prone to skip larger meals and resort to cheaper, tastier, more convenient snacks throughout the day. More often than not, those snacks are not the healthiest. However, research suggests that breakfast is the most important meal of the day and helps reduce the risk outcomes of conditions such as cardiovascular disease. By having breakfast we provide our body's enough energy to get on with our day and reduce snacking! Found below are some quick, tasty and nutritious breakfast ideas! There is no pressure to have a full breakfast every morning but if this is a habit you can form, once or twice a week is a great start. Food prep Food prepping has many benefits such as, saving time making food in your busy life as a medic; lowering your stress regarding what to eat every day and ensuring you have all the macro and micronutrients to make a nutritious meal. Prepare food in a safe and hygienic way is recommended and you can also steam, bake, boil or microwave to help reduce the amount of added fat. Remember that balance is key! You don't need to be overly controlling of the food you consume. However, by taking small steps to look after your physical health you indirectly look after your mental health. Below you will find some suggestions on the different types of food that are recommended for a well rounded diet Base your meals of higher fibre starchy carbohydrates Starchy carbohydrates should make up just over a third of the food you eat. They include potatoes, bread, rice, pasta and cereals. Choose higher fibre or wholegrain varieties, such as wholewheat pasta, brown rice or potatoes with their skins on. They contain more fibre than white or refined starchy carbohydrates and can help you feel full for longer. Taste the rainbow It is important to eat a variety of vegetables and fruits, preferably fresh and local, several times per day (at least 400g per day). At least 5 portions of a variety of fruit and veg every day is highly recommended. They can be fresh, frozen, canned, dried or juiced. Getting your 5 A Day is easier than it sounds. Why not chop a banana over your breakfast cereal, or swap your usual mid-morning snack for a piece of fresh fruit? A portion of fresh, canned or frozen fruit and vegetables is 80g. A portion of dried fruit (which should be kept to mealtimes) is 30g. A 150ml glass of fruit juice, vegetable juice or smoothie also counts as 1 portion, but limit the amount you have to no more than 1 glass a day as these drinks are sugary and can damage your teeth. Eat a nutritious diet based on a variety of foods originating mainly from plants, rather than animals. Cut down on saturated fat Control fat intake (not more than 30% of daily energy requirement) and replace as much of your daily saturated fat intake with unsaturated fats. Why not try meat free Mondays where you can replace meat products with beans, legumes, lentils etc. If that is too much of a challenge, you can try substituting fatty meats such as beef and pork with fish, poultry and lean meat. Reduce you sugar and salt intake Select foods that are low in sugar, and eat free sugars sparingly by limiting the frequency of sugary drinks and sweets. Total salt intake should not be more than one teaspoon (5g) per day, including the salt in bread and processed, cured and preserved foods. (Salt iodization should be universal where iodine deficiency is a problem) Physical Activity Keeping active and improving your physical health can be good for improving your mental health. Studies show that exercise helps reduce anxiety and depression whilst increasing self- esteem and cognitive function. Gym Due to the current lockdown gyms are not open. However, there are some great online classes that you can do from the comfort of your own home. You can find them here ! Go for a walk or a run Exercise doesn't have to just be about going to the gym. So, if hitting the gym is not your cup of tea, the University of Nottingham also have a lot of amazing initiatives to encourge us to walk and run whilst enjoying our beautiful campuses. Walks Active trail During the active trail you are encouraged to walk around campus and do a variety of exercises at the various outdoor 'stations' Sunday walks This initiative allows you to go on long walks as part of rambiling hiking society Friends of University Park The friends of University Park offer engaging guided visits of the different historic buildings and gardens around campus Nature Walks If you are interested in geology/flaura and fauna, the university's sustainability department have put together maps of walking routes that highlight these aspects on campus. Due to corona virus, unfortunately a few of these initiatives have been put on hold. However, that shouldn't stop you from taking your daily walk around campus, Highfields lake or even at Wollaton Deer Park. Running Park Run There are local parkruns held in Nottingham in both Beeston and at Forest Recreation Ground Forest Recreation Ground Beeston Run Talk Run Run Talk Run is a weekly 5km gentle jog, their mission is to "increase accessibility to mental health support through running & walking peer support groups" Cycling Cycling can be a great form of physical activity for those of us that want less strain on our joints. Follow this link to have a look at the different cycling trails in Nottingham If you are interested in more competitive performance cycling this will be perfect for you ! Social Sports You can also join social supports at any level of proficiency. Head over the the SU website where you can find medical and non-medical sporting societies. State of Mind Good sleep hygiene Sleep hygiene is used to describe healthy sleep habits. Research suggests that good quality sleep is important for wellbeing, to de-stress and help you improve your memory. Here are some tips to improve your sleep hygiene if you struggle to get to sleep/ wakeup Mindfulness Mindfulness and yoga can get a bit of a bad reputation, but it has some great benefits in terms of clearing your mind and focusing. This can be good when one is getting overwhelmed with lots of different things to slow down and focus on one task at a time to better cope with the stressful situation. There are plenty of apps that can help you create a habit out of practicing mindfulness. Headspace Buddhify Calm Keep a journal Writing your worries on paper can really help, and writing things you’re grateful for can help boost mood long term, top tip: buy a nice notebook to write in 6- minute mindfulness diary Volunteering The altruistic feeling of volunteering may be a great way of de-stressing whilst giving back to the community. There plenty of oppurtunites to volunteer in Nottingham such as Street doctors, Soup runners and Food print to name a few. More volunteering oppurtunites can be found here Expanding your interests Read a book, an actual book not a medical textbook https://www.telegraph.co.uk/news/health/news/5070874/Reading-can-help-reduce-stress.html Colouring books/knitting/crochet - something crafty you can get lost in Talking to others Tell someone you trust that you’re struggling, they may not be able to help but just explaining how you’re feeling can really help Self Care Do something just for you it can be small like lighting a scented candle or big like booking a mini break Why don't you try and challenge yourself to self-care bingo !

What are eating disorders? Eating disorders are a group of mental health conditions that involve persistent eating behaviours that may negatively affect one’s emotional and physical health, as well as their ability to function in their social and occupational lives. They can manifest in many different ways, and often people may not realise that they have an unhealthy relationship with food, body image or exercise. Although medical students and medical professionals may feel that they know more about eating disorders through their education and expertise, this does not make them immune to developing them. It goes without saying that the competitive and stressful environment of the medical course can lead to reduced self-esteem and greater self-criticism in certain people, and there is limited but growing evidence that this may predispose medical students to developing eating disorders. There is an unspoken mentality that doctors need to be perfect, but that is not the case You’re only human, and there should be no shame in reaching out to a friend, a family member, your personal tutor or your GP for help if you feel like you are struggling with your relationship with food, your body image or exercise. Useful Resources EDISS Nottingham (Eating Disorders In Student Services) To book an appointment: e: info@firststepsed.co.uk t: 01332 367571 w: firststepsderbyshire.co.uk You can also self-refer on their website here BEAT: The UK's Eating Disorder Charity w: https://www.beateatingdisorders.org.uk/ What are the types of eating disorders? This is not meant to be a ‘diagnostic’ guide – never try to diagnose yourself or make assumptions about others! This is simply to educate yourself about the different ways eating disorders can present themselves. Anorexia Nervosa People with anorexia nervosa may: Restrict their food to very small amounts Sometimes calorie counting obsessively Be obsessed with losing weight, being thin, reaching a certain goal weight etc Avoid certain foods for fear of making them gain weight/fat Exercise excessively to lose weight Fast (go without eating for certain periods of time) to lose weight Think of themselves as being too fat, even when they’re very thin (see Body Dysmorphia below) Avoid eating in front of people The dangers/consequences of anorexia nervosa mostly revolve around getting to a dangerously low weight or level of body fat. These include: Anaemia Multi-organ failure Being cold all the time Dry skin, brittle hair and nails Fainting and low blood pressure Depressed immune system Infertility and amenorrhea (in women), poor testicular function (in men) Constipation – possibly leading to bowel obstruction Bulimia Nervosa Bulimia is very similar to anorexia in terms of its main features (food restriction, obsession with thinness and losing weight) but one of the key differentiating factors is a behaviour called purging. Purging is making oneself throw up to avoid absorbing the food they’ve eaten. Bulimia is extremely dangerous not only because people may get to dangerously low weights, but also because repeated vomiting can lead to: Tooth decay Constant nausea and abdominal pain (especially if in conjunction with bingeing) Cardiac irregularities Esophageal damage Binge Eating Disorder People with binge eating disorder tend to eat large quantities of food in a short span of time (‘binge’) past the feeling of being full. In some people it is triggered by food restriction or emotion. Bingeing is different from overeating – it can be difficult to differentiate, but here are some key features that make binge eating different: Followed by intense feelings of guilt/self-loathing The feeling of being out of control while eating – some people say they feel like they ‘zone out’ Eating/bingeing in private The bingeing may follow food restriction or purging, forming a vicious cycle. Eating until one feels physically ill Other kinds of disordered eating Even if your/your friend’s situation may not seem to fit with the above descriptions, if someone’s eating habits are causing them any sort of distress or impacting on other aspects of their life (school/work, relationships, finance), please do not hesitate to find help. Other things to look out for are: Obsession with healthy/’clean’ eating (orthorexia)/fear of unhealthy food Diabulimia – People with Type 1 Diabetes that may skip their insulin injections in order to lose weight Exercise addiction How can I find help? Within the university… Talk to a friend you trust If you are worried about someone else, please try to respect your friend’s privacy and be careful about who you talk about your concerns to! It is probably best to approach your friend before approaching anyone else, in most cases! E-mail or meet up with your personal tutor MedSoc Support Talk to student supporters who will maintain your confidentiality and will not judge. Find them on their FB page @NottsMedSocSupport to either message the page or find your year group’s supporters. Alternatively, you could e-mail them at medsocsupport@nottingham.ac.uk Talk to your medic parent or peer mentor Talk to your parents and family. Nightline This is a confidential, anonymous and non-judgemental listening and advisory service you can contact by various means. Tel: 0115 951 4985 Int: 14985 (from UoN Hall Phones) Email: nightlineanon@nottingham.ac.uk Instant Messaging: www.nottinghamnightline.co.uk/IM Skype: 'nottingham.nightline' Seeking professional help ... EDISS Nottingham (Eating Disorders In Student Services) To book an appointment: e: info@firststepsed.co.uk t: 01332 367571 w: firststepsderbyshire.co.uk You can also self-refer on their website here Book an appointment with your GP It takes a lot of courage to tell someone you’re struggling, and many people might even find these problems ‘embarrassing’, even though there’s nothing to be ashamed about! If the idea of talking to your GP about this makes you nervous, it might be helpful to write a few bullet points on a post-it note so that you remember everything you need to say.

What are panic attacks ? The ICD-10 defines panic attacks as a discrete episode of intense fear or discomfort. They start abruptly, reach a crescendo, last at least some minutes and involve autosomal arousal symptoms (pounding heart / accelerated heart rate / sweating / trembling / shaking / dry mouth). Panic attacks can be isolated or part of a panic disorder, can be associated with a specific object or situation, or can happen spontaneously. They are very intense physical and mental experiences and can leave you feeling emotionally and physically exhausted. If you or someone you know is suffering with panic attacks, the pace and intensity of medical school means the condition can become debilitating and isolating. Here at Nottingham, the medical school can support you with your treatment and recovery, with catching up on lost work, and with exam support and extenuating circumstances. The first step is to reach out and tell somebody if you’re struggling There are many ways to do this: you can talk to a MedSoc supporter, a lecturer or a clinical sub-dean, you can submit a support form on behalf of a friend or yourself, or you can contact the welfare team in person or via email. Useful Resources Books : Overcoming Panic - A self-help guide using cognitive behavioural techniques by Vijaya Manicavasagar, Derrick Silove Other Online Resources: CBT4panic: Understanding panic CBT4panic: When you have panic Apps: My Possible Self Beat Panic Calm Headspace Useful Websites: Anxiety UK Mind - Panic attacks No Panic Top UK - The OCD and Phobia Charity Self-referral for CBT & other talking therapies: Trent PTS Insight Let’s Talk Wellbeing

By Laura Owler What is the difference between stress and anxiety ? It can be hard to distinguish the fine line between stress and anxiety. Stress is a situational emotion which, using the correct coping mechanisms, can be overcome and manageable. Anxiety is a mental illness which is debilitating. Stress is a reaction to certain circumstances and if you take away the circumstances then the stress goes away. Anxiety creeps into every aspect of your life. It is a condition which needs to be carefully managed. What is avoidance ? Avoidance is a coping strategy, understandably, used by many people struggling with anxiety. However, it will perpetuate the problem and exacerbate your anxiety. It will also isolate you and reduce your ability to function in everyday life. What should I do if I'm struggling with anxiety? If you are struggling with anxiety please first of all see your GP as your first port of call. Your GP will most likely discuss a number of options including medication (either short-term symptomatic measures or long-term antidepressants to help stabilise your mood), talking therapies (CBT is extremely effective for anxiety) and self care and close monitoring. It is also worth informing the medical school so that they can put in measures to help support you. Useful Resources Charities Anxiety UK Student Minds MIND Books How Not To Worry - Paul McGee A to Z of Being Mental - Natasha Devon Notes on a Nervous Planet - Matt Haig Podcasts Life after the letters - S1E5 Doctors Have Anxiety Too Happy - Fearne Cotton

“Each year 40% of us have quite severe feelings of depression, unhappiness, and disappointment. Of these, 20% experience a clinical depression, in which low mood occurs with sleep difficulty, change in appetite, hopelessness, pessimism, or thoughts of suicide.” This is the introduction given to depression in the Oxford Handbook of Clinical Specialities and the sentiment is one we want to reiterate: we all have down days, and we all get sad, but those with depression are blanketed by such exhausting symptoms that these feelings of sadness, hopelessness and fatigue are all consuming. Sometimes these painful feelings lead to cries for help, in the form of self-harm, or in severe, extreme cases, suicidal attempts. Not all self-harm is suicidal, but both are signs that your depression is severe, and you should be accessing professional help with urgency. Suicidal ideations are thoughts of no longer wanting to be alive, or the desire to take your own life. It is not a normal part of depression, but it is by no means a sign of weakness. Depression cruelly takes away the belief that tomorrow could be a better day, but we promise, even if it gets worse beforehand, it will always, always get better. Seeking help, admitting weakness, and acknowledging struggle is inexplicably brave. But there is help out there. There are people who can listen. There are things that can be done. All that’s left for you to do is to reach out. If you are at all worried about yourself or someone you know, please consider using the resources below. Useful Resources Medical school contacts: Medsoc support - medsocsupport@nottingham.ac.uk Medsoc welfare officer - mzyimw@nottingham.ac.uk Welfare team - SS-Welfare-QMC@exmail.nottingham.ac.uk Pre-clinical: personal tutor, senior tutors – mbzdm1@exmail.nottingham.ac.uk (Deb Merrick) Clinical: personal tutor, clinical sub deans - Dr Nathan If you are worried about a fellow medical student or yourself, you can fill out a Support Request form University resources: University Mental Health Advisory Service (referred via GP/university staff or NHS) NHS services BMA 24/7 phone line open to all doctors and medical students 0330 123 1245 Charities:

As the world opens back up, it's completely normal to feel anxious. This year has been completely different to anything else we've experienced. Don't feel bad for cancelling plans, or feel pressured into doing things that you're not comfortable with. Take everything at your own pace. You may be apprehensive about socialising again, or get easily burned out when you do. These are normal feelings after having our social interactions limited over the past year. It might take some time for you to feel confident in a return to normal - and that’s okay. Each person will be able to take these steps in their own time. To avoid feeling isolated or lonely if you have to turn down plans with friends, reach out and explain how you’re feeling. People will understand and be accommodating to you. Your friends may also help you acclimate to increased social interaction. For those of you who have friends who are nervous about going to places, places that you might not think are a big deal, be patient and understanding. What’s easy for one person is not easy for another. If you notice one of your friends being more recluse than usual, try reaching out. If you are struggling during this time, our website has a plethora of resources available to you. Mental health problems don’t have to be isolating. As always, if you want to share any of your experiences at medical school with us, email us at welfarehub.nottsmed@gmail.com.

You got the offer, and you’re coming to Nottingham! You might be wondering what’s coming next. Coming to university is one of the most stressful things, and having at least a bit of an idea about what to expect can really help to ease some of your worries. Here in this guide, we’ll give a brief overview of what to expect at medical school. When You Get Your Offer: Once you’ve got your offer, you’ll be expected to do a DBS check. This costs £46, with the amount payable upon you starting the course. You’ll also need to sort out your accommodation for the coming year. You can stay on campus in catered accommodation, off campus university accommodation that’s self catered, or organise your own accommodation through a private landlord. Find more details here You’ll also need to send off your photo for your student card. Once You Get Here: Once you get to Nottingham, your first week will be focused on settling in and moving in to your accommodation. You’ll have an induction week, where you’ll receive a welcome talk. There’s usually lots of welcome week activities run by the student union, so keep an eye out on the website for these! You will also be paired with a personal tutor, a member of staff who will support you throughout your medical school journey, with the opportunity to discuss your progress with them. You will be allocated a peer mentor, a student from the year above who has been trained in supporting you. Finally, you’ll be given a medic parent, a more informal connection with the year above. There is a myriad of support available to you. Semester 1: Teaching will start the week after welcome week. In your first semester, you’ll be revisiting topics from A-level, such as enzymes and proteins, as well as new topics such as embryology and pharmacology. Don’t worry if you don’t understand everything straight away! You’re still settling in and getting used to the demands of university life. During your first semester, you will have two formative exams: usually one in October, and one in December, six weeks apart. These exams are purely for your own benefit - the marks do not count towards anything other than giving yourself an opportunity to experience exam-style questions and to assess your understanding of the content covered. In your first semester, you will also be contacted by occupational health. In order to be cleared for placements in general practice and hospital rotations, you will be asked to have a series of vaccinations. You will be offered the hepatitis B vaccination, which is three vaccines spread over semester one and two, and the TB vaccination, usually having to have a blood test before being given it. The university’s GP service may also offer you the MenACWY vaccine if you have not already had it. If you are anxious or worried about having your blood drawn, or scared of needles, don’t worry, you’re allowed to take a friend with you for some support. You will also have some clinical skills sessions, which will go over some basics like hand washing, pulse taking and how to take someone’s blood pressure. These will usually be done in the clinical skills centre of the medical school. In semester 1, you will also be given an introduction to the dissection room. Semester 2: After your Christmas break, your anatomy teaching begins! This might be the part where you really feel like you’re preparing to be a doctor. Each week of teaching will have an accompanying case study, which will be relevant to and feed into what you’re learning that week. In your practical sessions, you’ll be able to look at pro-sections of the anatomy that you’re learning about. Once again, you will have two formative exams covering the content that you’ve learnt about. At the end of semester two, usually in June, you will have your summative exams. You need to pass these exams in order to proceed into year two. If you fail an exam, there are opportunities for resits in the summer/early autumn. These exams will cover all of the content that you have learnt over the past year. Teaching usually ends in early May, so you will have ample time to revise. Overall, medicine at Nottingham is really fun, exciting and rewarding. You have so many opportunities to join great societies and to really engage with the topics that you’re interested in. I hope you have the best time! As always, if you want to share any of your experiences at medical school with us, email us at welfarehub.nottsmed@gmail.com. If you’re struggling with any other issues, have a look at our website to find some resources that may help you.

“What happens when I graduate?” You may have thought this to yourself before, but have been too embarrassed to ask the question. After all, isn’t every medical student supposed to know exactly what lies in their future? But that’s not the case. Especially for students who don’t have any family who are in medicine, the future can be confusing. So whether you’re in first year thinking ahead, or in your clinical years needing a brush up, here’s our guide on what happens when you graduate. In your last year of medical school, you will apply for foundation training. You will be ranked in score order nationally against other final year medics. how well you score will determine where you are placed for your foundation training. Once you have been allocated a place, you will undergo two years of foundation training. After your first year of training, you will be a recognised doctor with the GMC. During your two foundation years, you will be supervised in placements across different specialities. This will allow you to develop your skills as a doctor. You will have 3, 4 or 6 month placement rotations. This will be alongside 3 hours of formal training a week. there will be opportunities for you to build your portfolio, arrange extra placements and educate medical students. At the end of each foundation year, you will need to demonstrate you have met the standards of the Foundation Programme Curriculum. Instead of a written exam, you will be assessed by case based discussions, mini clinical examinations, observation of your procedural skills, a logbook of procedural skills and teaching development assessment. This is all recorded in your portfolio. Once you have finished your foundation training, you can progress to speciality or GP training. The time it will take for your speciality training is dependent on the speciality that you decide to do. However, not everyone chooses to progress to specialty training right away. You can take a year out for research, or do volunteer work. There are many options after the foundation year, and your career can go down many different paths. “How do I pick a speciality?” There are so many specialities out there, that it can seem like you’ll never find the right one. Throughout medical school, it’s a good idea to attend talks from a range of specialists to get a feel for what you’re interested in. Once you move onto foundation training, aim for placements in areas that you’re interested in to gain some experience. “Once I pick a speciality, am I stuck with it?” No, and that’s one of the great things about medicine. There’s lots of variety and opportunity for change. If you’re willing to put in the time in training, you can go back and train as a different speciality, go on to teaching, or into research. A career in medicine can seem overwhelming at times. Breaking things down into simpler and more digestible steps will make things easier and give you an opportunity to manage your time effectively. There are more intricacies that you will learn as you go, you don’t need to know everything all at once! It’s perfectly fine to have no idea what speciality you want to go into, or to change your mind. Your career will be whatever you make it and whatever you want it to be. There are lots of opportunities to extend your portfolio beyond your role as a doctor, sometimes you just have to seek them out. There’s a Med School Life blog post here if you want to find out more. As always, if you want to share any of your experiences at medical school with us, email us at welfarehub.nottsmed@gmail.com. If you’re struggling with any other issues, have a look at our website to find some resources that may help you.

Finances for any university student can be daunting. For a lot of people, this is your first time having to balance paying for your rent, food, and other expenses. It can be really hard to figure out where to spend what, and before you know it, you’ve run out of money. Hopefully, this guide will help you to avoid that. Funding for medical school isn’t the same as other courses, and figuring out what’s going to happen in your later years can be confusing. Not only that, figuring out your financial situation can be anxiety-inducing, and feeling as though you don’t have much money can really get you down. Years 1 to 4: You are eligible to receive tuition fee funding and a maintenance loan from student finance. Your maintenance loan can be used towards living costs such as rent and food, as well as any other things you want to do. Your tuition fee loan will get paid directly to your university to cover the costs of your tuition. You have to reapply for these loans each year of your study. These loans are repayable once you start earning a certain amount. More information can be found at https://www.gov.uk/repaying-your-student-loan/what-you-pay?step-by-step-nav=18045f76-ac04-41b7-b147-5687d8fbb64a Year 5: Medical and dental students can apply for an NHS bursary in the later years of their course. The NHS will cover the cost of your tuition fees and this will be paid directly to your university. If you are eligible for the NHS bursary scheme and regardless of whether or not you benefit from it, you’re entitlement to an SF maintenance loan is reduced to approximately 60%. A £1000 maintenance grant is available for all students eligible for the NHS Bursary. These are the basics of what you are eligible for as a medical student. Having an understanding of what your financial future may look like gives you an opportunity to prepare earlier on. This will hopefully take away some of the stress later down the road. You may be eligible for other types of funding. The NHS has different grants available depending on your circumstances. More information can be found here: https://www.nhsbsa.nhs.uk/nhs-bursary-students/medical-and-dental-students Each university will have different types of support available for students. The University of Nottingham has a range of scholarships and bursaries that you can apply to. These can be found here: https://www.nottingham.ac.uk/studentservices/support/financialsupport/bursariesandscholarships/index.aspx Once you know how much money you’ll be getting, it’s important to know how to manage your money. Student Banking: As a university student, you can apply for a student bank account. A lot of these accounts may come with perks such as railcards or student discount cards. These accounts will also usually make you eligible for an overdraft. An overdraft lets you borrow money through your current account by taking out more money than you have in the account. However, you may be charged extra for using your overdraft, so it’s important to read the terms of your account before using it. Budget Planning: Having a budget planner is really helpful to work out how much money to spend. It will allow you to put money aside for your essentials, such as rent and food, and then for other things such as going out, buying clothes, and other recreational things. It’s up to you how you plan your budget. There are apps where you can set a monthly spending limit. Save the student has a budget planning spreadsheet which you may find helpful: https://www.savethestudent.org/student-budget-worksheet.xls. Getting a Job: Before getting a job at university, it’s important to consider if having a job will impact your education and your mental well-being. Only having time for medical school and working won’t be beneficial to your mental health if you have no free time.If you do want to get a job, it's important that it is flexible for you. The university has a scheme called Unitemps which allows you to find work that fits around your studies: https://www.nottingham.ac.uk/studentservices/services/unitemps.aspx Sites such as MyTutor allow you to choose how many hours that you work. Throughout the year, paid student ambassador positions at the university may also be available. Meal Planning: Planning out what you’re going to eat can make your food shopping cheaper! It means that you don’t have to rely on last-minute takeaways or deal with any food waste. Online shopping can be more convenient, but it may come with additional delivery costs that can end up making your shopping more expensive. Looking around for the cheapest prices can save you money in the long run. Credit Cards: Student credit cards are a great way to build up your credit score and help you spread payments over a longer time. However, they are not risk-free. You have to pay back any money that you spend on a credit card, and missing a payment can put you in debt and negatively affect your credit score. It’s really important to consider how you use a credit card or overdraft. Creating debt for yourself can cause a lot of anxiety - if you find yourself in this position, it’s important to ask others for help. Travel Costs: Sometimes, travel costs may be unavoidable. Luckily, students are eligible for many discounts, such as a railcard if you travel by train regularly. Nottingham City Transport (NCT) offers discounted bus travel for students, with options for both the academic (£259) and calendar (£279) year. Student Discounts: Finally, many websites offer student discounts. These can be found through apps such as UniDays or Student Beans. It's always worth googling to see if you can save yourself a bit of money! Hopefully, after this guide, you feel more confident and clear about your finances in medical school. This is not an exhaustive list, and it's always worth doing some research to find other things that may work for you. Although money management may seem like a lot of hard work, with a little bit of time, you can save yourself a lot of stress by planning your finances out. As always, if you want to share any of your experiences at medical school with us, email us at welfarehub.nottsmed@gmail.com. If you’re struggling with any other issues, have a look at our website to find some resources that may help you.

Sometimes studying medicine can feel like you’re doing multiple degrees at once: pharmacology, cardiology, psychology, anatomy, epidemiology, and so much more. As medics, we are expected to know a huge amount of information, and that can feel really overwhelming at times. Pulling your hair out, you ask yourself, “Do I really need to know every enzyme in the TCA cycle?” This answer is no. You don’t need to know everything, and we aren’t expected to, at any stage in our medical school career. We aren’t expected to get 100% in every exam or to know the side effects of every drug or to know the intricacies of every single bone in the body. That’s why we’re students. We’re here to learn and to make mistakes and then learn some more. Even in your clinical years, you’re not going to get everything right, and at times it can be really demoralising. Am I supposed to be a doctor? Am I good enough? Aren’t I supposed to know everything? These thoughts have gone through my head a number of times. Sometimes it can feel as though doctors are always expected to be perfect, infallible saviours. Even the oldest and most experienced consultants were in our shoes, fretting over protein synthesis. The greatest doctors aren’t perfect. The greatest doctors are the ones who make mistakes and then learn from them. So as exam season comes up, remember that you are here to learn and grow. Take breaks and breathers, and be kind to yourself. We are all capable, we all belong here, and we are all more than a grade. We have some wonderful posts in our ‘Exams 101’ series that explains some of the ways that you can deal with exam stress, especially as we come up to end of year assessments. Please check these out! As always, if you want to share any of your experiences at medical school with us, email us at welfarehub.nottsmed@gmail.com. If you’re struggling with any other issues, have a look at our website to find some resources that may help you.