Faye Gishen

University College London | UCL · Faculty of Medical Sciences

Fitness to practise processes are in place to safeguard patient safety and maintain professional standards. This article provides context for medical student fitness to practise in the UK and situates the process under the regulator and the university. The Tips examine some dichotomies and pitfalls in an increasingly litigious field and provide ope...

Background Digital health, data science and health informatics are increasingly important in health and healthcare, but largely ignored in undergraduate medical training. Methods In a large UK medical school, with staff and students, we co-designed a new, ‘spiral’ module (with iterative revisiting of content), covering data science, digital health...

Background Following student feedback, a Curriculum Map (CM) was commissioned in 2018 at UCL Medical School (UCLMS). After exploring key requirements of a CM, the second phase focused on building a prototype before its launch. This study evaluates this novel pedagogical intervention following its implementation, from the perspective of its primary...

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was...

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was...

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was...

Sequencing of cell-free DNA (cfDNA) in cancer patients’ plasma offers a minimally-invasive solution to detect tumor cell genomic alterations to aid real-time clinical decision-making. The reliability of copy number detection decreases at lower cfDNA tumor fractions, limiting utility at earlier stages of the disease. To test a novel strategy for det...

ADAPTeR is a prospective, phase II study of nivolumab (anti-PD-1) in 15 treatment-naive patients (115 multiregion tumor samples) with metastatic clear cell renal cell carcinoma (ccRCC) aiming to understand the mechanism underpinning therapeutic response. Genomic analyses show no correlation between tumor molecular features and response, whereas ccR...

Objective This paper examines the impact on doctors’ attitudes towards the General Medical Council (GMC) and on professional behaviours (reflective practice and raising concerns) following the Dr Bawa-Garba case. Design A cross-sectional survey designed using the theoretical lens of the theory of planned behaviour (TPB) was administered from Septe...

Background Feedback received from medical students at University College London Medical School (UCLMS) suggested a lack of clarity regarding the contents and subsequent assessment of the undergraduate curriculum. In order to address these issues, a specialist team was established with the aim of designing and implementing a Curriculum Map (CM), whi...

Generalist clinicians play a vital role as the spine of a modern healthcare system. As a result of the breadth of their practice, they require high quality continuous professional development (CPD) training to keep up with important developments in all areas of their practice. Specialist clinicians are often well placed to provide such training but...

The Decolonising the Curriculum movement in higher education has been steadily gaining momentum, accelerated by recent global events calling for an appraisal of the intersecting barriers of discrimination that ethnic minorities can encounter. While the arts and humanities have been at the forefront of these efforts, medical education has been a ‘la...

With the outbreak of COVID-19, there was widespread cessation of face-to-face teaching in medical schools from March 2020. 130 students in their first clinical year at a large London medical school were at risk of missing part of their clinical and practical procedure teaching. We mailed a teaching pack containing clinical consumables and gave inst...

Background One in three women in the United Kingdom (UK) will have an abortion before age 45, making abortion provision an essential aspect of reproductive healthcare. Despite this, abortion remains ethically contested and stigmatised, with variable teaching in UK medical schools and concerns about falling numbers of doctors willing to participate...

In 2018, UCL Medical School commissioned a programme ‘Curriculum Map’ (CM). As the project’s lead, I theorised, designed and co-constructed the CM. My adopted theoretical position equated curriculum with syllabus, acknowledging that whilst this reflected the ‘formal’ curriculum, it did not capture the ‘informal’ or ‘hidden’ curricular elements. Thi...

Background One in three women in the United Kingdom (UK) will have an abortion before age 45, making abortion provision an essential aspect of reproductive healthcare. Despite this, abortion remains ethically contested and stigmatised, with variable teaching in UK medical schools and concerns about falling numbers of doctors willing to participate...

Although thousands of solid tumors have been sequenced to date, a fundamental under-sampling bias is inherent in current methodologies. This is caused by a tissue sample input of fixed dimensions (e.g., 6 mm biopsy), which becomes grossly under-powered as tumor volume scales. Here, we demonstrate representative sequencing (Rep-Seq) as a new method...

Reflective practice Schwartz Rounds (SRs) were introduced to University College London Medical School (UCLMS) in 2014, the first medical school internationally to introduce SRs specifically for undergraduates. In the intervening 5 years, SRs have become a feature of the medical degree (MBBS) syllabus, as the next generation of doctors acquires skil...

: Introduction: The lesbian, gay, bisexual, and transgender (LGBT+) population experience health and social inequalities, including discrimination within healthcare services. There is a growing international awareness of the importance of providing healthcare professionals and students with dedicated training on LGBT+ health. Methods: We introduc...

Background: Medical education, as with other areas of healthcare education, is susceptible to cheating, with national and international examples cited in the literature. There are documented examples in the lay press, but limited scholarly activity in the field, which can be a challenging area to research and tackle. We have begun to explicitly add...

Background: Seeing women or girls from FGM practising communities can be a challenge for healthcare professionals, involving a complex interplay of professional duties, legal requirements, social and cultural understanding, and sensitive, skilled communication. Aims and methods: Robust training on how to identify and support women and girls who hav...

The correct use of opioids is the mainstay of effective management of pain in palliative care. This article describes the available analgesic options, reviews recent evidence and guidelines, and explores patients' and doctors' common concerns about opioid use.

Background: Doctors and medical students have a professional responsibility to raise concerns. Failure to raise concerns may compromise patient safety. It is widely known that medical students frequently encounter unprofessional behaviours in the workplace, but little is known about the barriers to raising concerns amongst medical students. This p...

Background: Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students. Innovation: A flipped learning session was piloted...

Background: Reflective practice provides a backbone to professionalism, a commitment to lifelong learning and competency-based education in the form of reflective portfolios. Changes in health care culture have promoted a move towards openness and reflection on challenging clinical encounters. Issue: Engagement with reflection has historically p...

Introduction Marie Curie recognises the contribution that carers make to the support and wellbeing of those diagnosed with terminal illness. ¹ Their 2012 report highlighted a lack of support for carers as well as the associated negative social and economic impact of caring for a dying relative. The Carers UK Report, 2014 ² found that nearly 6000 pe...

Introduction A Marie Curie review ¹ highlighted that the Jewish population, alongside Black and Minority Ethnic (BME) groups, are under-represented in utilising palliative care. ² Explanations may include concerns around gaining trust and being culturally understood. Preferred Place of Death (PPoD) has been used as a key performance indicator (KPI)...

BACKGROUND: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. AIMS: To...

The early detection of relapse following primary surgery for non-small cell lung cancer and the characterization of emerging subclones seeding metastatic sites might offer new therapeutic approaches to limit tumor recurrence. The potential to non-invasively track tumor evolutionary dynamics in ctDNA of early-stage lung cancer is not established. He...

Background: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. Objective: To survey attitudes of PC course organisers...

BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers re...

Whilst health care professionals embark on their careers with high ideals these can be eroded by the pressures and stress of the system. This paper explores the problems, which may lead both students and professionals, working in health care, to feel isolated and stressed. It considers the value of Schwartz Rounds as an initiative that can be used...

Background: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. Aims:...

Background Training to be a doctor and caring for patients are recognized as being stressful and demanding. The wellbeing of healthcare professionals impacts upon the wellbeing and care of patients. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance comm...

Background: Effective undergraduate education is required to enable newly qualified doctors to safely care for patients with palliative care and end-of-life needs. The status of palliative care teaching for UK medical students is unknown. Aim: To investigate palliative care training at UK medical schools and compare with data collected in 2000....

Introduction Appropriate training is essential to ensure PC is safely practised1. A proportion of newly qualified doctors report that undergraduate teaching has not adequately prepared them to manage PC patients.2 Little is known about how PC training is delivered across UK medical schools3. Addressing this requires key data; one group likely to ha...

Following a review of organisational culture in 2013, Schwartz Centre Rounds (SCR) were introduced to Marie Curie Hospice Hampstead (MCHH). Aiming to promote a 'one hospice' ethos, the SCR were chosen as an evidence-based tool to address psychological issues felt by staff managing the increasingly complex physical and emotional burden of palliative...

There is recognition that the nature of palliative care may be changing, as cancer survival improves and long-term conditions increase the complexity of the case load. Previous work has examined the accuracy of expert prognostication in patients with a life expectancy of less than a year. This piece of work also considers the accuracy of prognostic...

Background: This project endeavoured to improve the quality of endocrinology teaching to clinical medical students through the use of a new multi-stage process. Methods: We created a co-ordinated block containing 4-h teaching sessions (4×1 h) in which eight students in their first clinical year presented answers to questions based on clinical endoc...

CONTEXT Two million people across the U.K. are living with cancer, often experienced as a long-term condition. They may have unmet needs after active treatment. Rehabilitation aims to address these needs, maximize psychological and physical function, and enable minimum dependency regardless of life expectancy. OBJECTIVES We aimed to test, in a ra...

A woman in her early 50s presented with recurrent severe chest infections. Investigations revealed a low white cell count and a diagnosis of autoimmune neutropenia was made. Subsequently, an infiltrating thymic tumour (mitoses only) in the absence of myasthenia gravis was found. She underwent radical surgery. When neutropenic, she complained of pai...

GISHEN F. & TROTMAN I. (2009) European Journal of Cancer Care Bedside ultrasound – experience in a palliative care unit Little has been published on the use of imaging in palliative care. This paper discusses the use of ‘in-house’ ultrasound at the bedside in a specialist palliative care unit. The aim of this paper is to evaluate the potential uses...

The correct use of opioids is the mainstay of effective management of pain in palliative care. The authors describe the available analgesic options and explore patient and doctor concerns associated with their use. Copyright © 2008 Wiley Interface Ltd

A survey of 320 (175 male, 155 female) 19 year-old medical students showed that male students of South Asian origin in the top tertile for body weight or body mass index had a significantly greater conicity index than European males in these top tertiles. This difference in conicity was not significant in the group as a whole, or when ethnic pairs...