Return to flip book view

October 2021 Issue 3 MEDICS TOGETHER FOR MEDICS BY MEDICS WELCOME TO ISSUE 3 Hi everyone welcome to our third issue of Medics Together written by medical students for medical students with a focus on our mental health and wellbeing With face to face university returning and a new academic year looming anxieties are understandably high for many of us and looking after our mental health is more important than ever In this issue we hear from students with lived experience of psychological distress get some self care tips catch up with what you ve been up to get some delicious recipes and lots more If you d like to join the Medics Together team or would like to submit a short article 200 words or so please drop us an email at medicstogethersubmissions gm ail com Trigger warning we do feature fearlessly honest articles about mental health issues such as suicidal thoughts and eating disorders in this issue FEATURED ARTICLES In my own company Reflection page 3 A borderline medic living experience page 4 Anorexia Recovery As a medical student living experience page 7 Things I would tell my fresher self reflection page 12

SEAL SPOTTING WUBU2 MED STUDENTS I have recently started my first year of placement This has been a big change but this means I am now in a new place So when we have finished placement for the week there is so much exploring to be done I am in a beautiful part of Yorkshire by the seafront We have dolphins and whales at this time of year however these are notoriously difficult to spot always seeming to turn up when we are on placement We also have seals My best friend and I on the recommendation of one of our lovely tutors here went to find a colony of seals We somehow chose the day after it rained and when there was thick fog This made our trip down the cliff slightly more difficult A wrong path and a few hours later we made it Alas all the seals were swimming and the beach was empty We did find one seal though so the trip can be marked as a success I think it s so easy to get sucked in to placement and university life forgetting to explore these new places Try to make the most of your off time We all need a break Erin 3rd Year Hull York Medical School GETTING BACK TO SOMETHING I LOVE WUBU2 MED STUDENTS 1 I have been part of the university dance society since my second year and my only regret is not joining in first year I was Vice President last year in what was a really difficult year when all I wanted to do was dance in person the novelty of online classes wore off very quickly after a couple of attempts at choreography in my uni room left me with various stubbed toes and questionable bruises I bet my housemates were just pleased I d left my tap shoes at home I signed up to teach modern classes this year and was so pleased when I found out we d be doing them in person no more injuries for me hopefully However on the day it went really well There was a great turnout and I had so much fun teaching and just moving I d forgotten how good dance is for me mentally and physically and just how much I became increasingly I enjoy it I can t wait for my nervous before my first class next week of classes and to as it had been so long since be back to something I love I I d danced my stretching hope that everyone can get routine also sloped off after a back to something they ve couple of months in missed over the past lockdown I was worried how 18months much choreography I could actually retain in my brain Eliza 5th Year University that was becoming full with of Sheffield revision

STARTING 4TH YEAR AS A FRESHER WUBU2 MED STUDENTS can be pretty uncertain at So it s the infamous fresher s week and somehow I have found myself thrust into the middle of it again After finishing 3rd year in summer and feeling very used to student life my city of Liverpool and my daily routine I ve now moved to a new university for the year to start my intercalation year in Psychology It feels very strange to be walking around a new city and campus pretty clueless like a fresher but also having a few years of university behind me It is also a little confusing to explain to my new flatmates that I am studying Psychology but also Medicine and I am also in 4th year I have only been here a week so far but have found myself fitting into many different categories a fresher a 4th year a medic an intercalating student and I can imagine that anyone else who is intercalating may feel the same This feeling of uncertainty is something which I would have struggled with when I first started uni but I think I have experienced how Medicine times and I have somehow come to embrace this and have a set of tools which can ground me in the moment Even though I have done freshers week before I feel that when you are somewhere new it is almost a rite of passage to explore the nightlife centre societies and what is going on Being taken out of my friendship group in Liverpool and coming here alone it does feel a little strange but perhaps a welcome push out of my comfort zone and the past 3 years of uni have definitely given me a lot of confidence to do that now After meeting the people on my course 7 of us compared to 300 in Medicine I am really looking forward to starting properly next week and having a different year on a course where there are not a lot of actual answers lots of essays and discussions and I have been warned statistics With this I can recognise the sense of uncertainty of how to tackle all of the content assignments and reading which floored me at the start of medical school when I tried to learn EVERYTHING However the past few years have taught me that having a strong foundation of knowledge is the most important thing making mistakes isn t the end of the world and can actually be a good thing and somehow you do remember it in the end I am aware that this small excerpt into my week is pretty all over the place and not much more than a brain ramble but I think it has helped me to recognise how many non academic skills that studying Medicine has given me the excitement of being able to explore a new course and that escaping your comfort zone is a great challenge Katie Intercalating University of Liverpool 2

IN MY OWN COMPANY HOW THE PANDEMIC FORCED US TO SEE OURSELVES Dear Me How should I choose to look back on the last 18 months My well cultivated quiz writing and video calling technological skills my overused walking boots my newfound appreciation for the little things in life that we were deprived of for so long Or the constant low level of anxiety that had me partially suffering an existential crisis much of the time I worked the first five months of lockdown from home as a teaching fellow motivating myself to get up and go next door to the spare room to get stuff done It certainly took on a different look to earlier glory days of swanning around the anatomy department as a demonstrator showing off my cannula technique in clinical skills and pretending I knew it all in seminars The sudden endless stretch of days sitting on my own working out how to work was terrifying and exhausting I attempted to have a routine made plans for daily yoga and exercise It slipped I berated myself I became more ineffectual and unmotivated and sank deeper 3 into the pit of my slowly grinding brain gears However I am lucky because I like my own company Past experience of backpacking as a solo traveller and spending time living alone has helped cultivate this I had a few years of practice compared to some of the students I was supporting who had never faced anything like this before It was a bizarre and surprising relief to take up weekend shifts on COVID wards in April and May 2020 a break from the monotony and uncertainty of sitting at home The certainty of sick COVID patients in front of me whom I could actively help was preferable to the safer but miserable ignorance of home I escaped into GP training in August 2020 but myself and I take our hats off to the early years students who continued to slog away at lectures from home awkward blackboard seminars and the neverending string of days that became months that became a year How incredible is it that they made it through all that They looked after themselves and each other toiled away and didn t give up I meet many doctors in my day to day work who are full of admiration for the medical students who have survived through the past 18 months I have learned so much from the students I have worked with in the past year who had to find other ways to cope other sources of inner joy who really looked at themselves this year and found inner strength when they thought there was nothing left There is something so powerful about knowing you can work with yourself rather than running away from yourself So this is a letter from myself to me and from me to you to say well done The fog is lifting We live in a country that is healing itself And we got through Good job me Love from Myself and I Dr Katy Owen GP trainee and honorary clinical teacher at Sheffield Medical School

A BORDERLINE MEDIC LIVING EXPERIENCE A diagnosis of emotionally unstable personality disorder more commonly known as borderline personality disorder is terrifying Whether I was a medical student or not being told your personality is not normal is awful Being a medical student it is not nice When I first saw this written down I was upset What did this mean for my future as a medical student and further as a doctor My first reaction was one of shock I was not surprised at the diagnosis it is something I have been aware of for many years My struggles with mental health were pervasive Courses of CBT and antidepressant medications were not successful I learnt important skills but my struggles with suicidality have continued I had researched in to this wondering why my hard efforts were not showing an improvement I was simply shocked that someone else thought I was emotionally unstable It felt like an insult Despite this the diagnosis and the feelings associated with it have allowed me to gain more knowledge and understanding Diagnoses of personality disorders are incredibly hard to receive The stigma from healthcare professionals is hard to handle Being labelled as problematic attentionseeking and unable to be helped is not fun As medical students and future doctors we need to step away from this We need to see personality disorders as what they are a collection of traits that are causing an individual distress They arise from trauma and neglect in childhood It is not something that people want it is not something which arises out of a desire to get attention There is help out there DBT has proven success rates if it can be accessed that is I am still awaiting treatment but I have a good team behind me I will be a good doctor not in spite of this condition but because of it I believe it and I think that is of the upmost importance When you meet people with a personality disorder take time understand their story Speak with them about the diagnosis find out their opinion on it We can often be distressed and sometimes sitting and listening can be all it takes to reduce these feelings If you are leaving their care team or will be absent take time and speak with them Secondary trauma is often part and parcel with EUPD and it is important we minimise this Anon Are you a medical student or doctor Do you have a story of lived experience self care tips recipes creative work or want to let us know what you ve been up to We would love to hear from you Certificates for your e portfolios provided Email us medicstogethersubmissions gmail com 4

SEA SWIMMING FOR STRESS RELIEF SELF CARE TIP I first heard about the benefits of open water swimming through a BBC Documentary in 2016 when Dr Chris Van Tullekan tried to replace a patient s antidepressants with wild water swimming But if you had told me I would be swimming in the sea in September I would have thought you were mad When I first found out my placement site for the upcoming year I was not thrilled I was going to be away from my beloved netball teams and from the cities with larger hospitals It is my first time out on placement so I was hoping to be somewhere I knew quite well However this change of scenery has been rather extraordinary Our accommodation is about a 3 minute walk from the sea So naturally we go swimming every week The first time I went in the cold really took my breath away To be completely honest it still does every time It makes everything else disappear you can only focus on the cold Is it warm when you get in Honestly No But it does get slightly better Swimming in the sea has been a great way to deal with the pressures of starting placement We finish the day with a trip to the beach and swim as the sun goes down We all know the benefits of exercise and the release of endorphins but open water swimming can help this further The cold water stimulates a fight or flight response putting the body under stress It has been suggested that repeated exposure to this through a positive experience can lead to diminishing the stress response Cold water has also been shown to reduce inflammation which is associated with depression Cold water exercise being in nature and spending time with friends leads open water swimming to be a great holistic activity to cope with stress Erin 3rd Year Hull York Medical School REDELIVERING A POSTCARD 75 YEARS ON GOOD NEWS 55 Stu Prince 62 is a postcards collectors living in Crewe Cheshire He had been diagnosed with leukaemia in 2019 and begun collecting postcards from online auction sites to occupy his time In 2020 in the midst of the pandemic Stu started a Facebook page titled Reuniting Postcards with Families to be able to trace the owners of the postcards and their relatives and reunite them One of the postcards he found dated back to 1946 and had been addressed to a one year old baby With the help of volunteers the baby now 75 year old Frimette Carr was found and reunited with the card written by her grandparents who died almost 50 years ago You can read more about his story here

A WELCOME BREAK IN BLACKPOOL SELF CARE TIP One of the perks of being on a Blackpool hospital placement is enjoying the sea air and seeing the sights I was feeling a bit fed up that I had only just settled back at Liverpool and now I had to haul my belongings to a different town Also having walked 25 minutes each way to the nearest shop I was reluctant to make the trip out to the town centre in case I got horrendously lost But I needed to discover some silver linings to my placement So I plucked up the courage and with a few new placement buddies we hopped on a bus to see the sights The sea air was refreshing after a long day I channeled my inner tourist and was enjoying the piers and snapping away taking photos of the sea It was a welcome break and made me realise to appreciate the opportunities given to us even if we are reluctant at first If you ve moved somewhere new or been somewhere for a while but haven t seen the sights take some time out to explore It might widen your perspectives of an area give you a well deserved break and you might make some new friends Happy exploring Laura 3rd Year University of Liverpool MOORHENS IN THE PARK WUBU2 MED STUDENTS After a few weeks apart I met up with a close friend for coffee and a catch up Getting away from screens and wandering around various parks instead has never disappointed me We decided to stroll through Crookes Valley Park and to our surprise all the tiny featherless baby moorhens are now unrecognisable This little guy was sat grooming himself for a while and I knew I needed to capture all the glimmering sunlight around him Rimpi 5th Year University of Sheffield 6

ANOREXIA RECOVERY AS A MEDICAL STUDENT LIVING EXPERIENCE I had suffered with disordered eating for some time and a combination of factors including the feelings of uncertainty that COVID 19 brought and Fresher weight gain resulted in my problems significantly worsening In my third year of Medical School I was diagnosed with Anorexia Nervosa and I am currently in recovery As a medical student I felt that I had a lot to lose I had worked hard to get where I was and deep within my disorder I felt that everyone was trying to take this away from me I saw Occupational Health as the enemy and found it difficult to see why my Fitness to Practice was ever being questioned I had gone to my GP to finally get advice regarding my secondary amenorrhea and I now had this diagnosis and it felt like I was being punished During therapy I sometimes felt that even my diagnosis alone was a personal attack on my Medical Student knowledge It was hard to hear you know you can t survive on X calories a day or you know what the physical consequences will be It was difficult to acknowledge this and realise that my disorder 7 made me feel invincible I learnt the hard way that eating disorders are evil My eating disorder made me believe that I was in control when really it was controlling me Eating disorders can make you believe that your life is better with it in it and can fool you into believing that you can have it all For me that meant anorexia keeping on top of my studies and having a good social life What saddens me the most is seeing how my eating disorder hurt those around me I became irritable and distant to my dearest friends and family At my worst I wasn t thinking about my friends and family at all and was just focusing on getting through each day of placement In hindsight as much as I tried my studies must have been affected by my disorder I had little energy and much of the time that I was working was clouded by my mental hunger I would find myself getting distracted calculating calories and planning meals browsing supermarket shopping websites and watching food challenges on YouTube In recovery I can now appreciate that the concern from my Eating Disorder Team and the Medical School was not a personal attack they were only trying to keep me and the patients that I was working with safe Anorexia recovery as a Clinical Medical Student comes with its own unique set of challenges It s easy to not have time for breakfast when you have a Surgical Placement that starts at 8am or skip lunch because the Ward Round overran In these times holding myself accountable and reminding myself of the life that I wanted to live helped If you are struggling with disordered eating then I can tell you that from experience choosing recovery is worth it It will be challenging You ll be going against the rules that have governed your life But you ll be living a freer life Accepting help was the best decision I have ever made and the one I am most proud of I hope that this has helped someone today Lily intercalating University of Liverpool

MAKING FRIENDS AT UNI TIPS FOR FRESHERS Starting university during the height of the Covid 19 pandemic was far from the usual fresher s experience of mid week club nights and crawling into lectures hungover the next day Societies didn t run everything was online and if you didn t stay in halls then it was nearly impossible to meet new people This year things are looking a bit more normal but lectures will still be online for many students So here are some tips for making friends in the age of Panopto recordings and group work on Teams 01 02 Check the group chat Get involved in events Chances are you have a big chat for everyone in your year on Facebook or WhatsApp keep up to date with what s being said in it society reps often use these chats to advertise their events and your classmates might use them to set up socials or ask questions about the course Fresher s week might be running a little differently but there are still likely to be some events put on for new and returning students Try to join in with these where you can as they are a great way to meet new people and make friends with others on your course 03 04 Join a society Participate in small group work At university you ll have the opportunity to join loads of different societies and clubs These can be a great way to meet people with similar interests and help you to get away from your desk for a while Hopefully there will be more in person events this year but if not a lot of societies will be running online meets so it s worth checking if there are any that interest you If you have online tutorials and small group sessions you ll likely be asked to turn your camera on It can feel a bit daunting at first but everyone is in the same boat and actively taking part in group discussions lets you put faces to names and helps you get to know the other people on your course 05 Don t worry You ll have plenty of opportunities to meet new people and you don t always have to stay friends with the first people you talk to though if you do that s fine too Just be yourself and you ll find your friend group in no time Anon 2nd Year University of Aberdeen 8

COVID 19 REFLECTIONS USEFUL READ COVID 19 drastically impacted the mental health of society particularly university students As a medical student myself I understand that university can be particularly intense Living under strict lockdown rules meant that many students were unable to see friends and family members which is an essential part in helping provide a good work social life balance However despite this technology played a significant part in helping students connect with others and in some cases enhanced family bonds and friendship It was clear that everyone was struggling in their own ways I was privileged to be given the opportunity to vaccinate people who were clinically vulnerable and wanted the vaccine I started vaccinating in March 2021 I was so excited to be able to help people and the experience was extremely rewarding I felt lucky to be able to meet a range of new people have a conversation with them and understand what they had been doing during COVID 19 It was particularly satisfying to hear that many people had started new hobbies cooking new dishes baking running and reading books I had also started developing my own hobbies I found myself running in a park nearby to give myself a break from work and making cakes for the very first time This summer as restrictions had lifted I was able to go to North Wales and Croatia One of the highlights of going to Wales was climbing up Snowdon It was great to have a break before the start of a new university year and I BATTLING MY INNER THOUGHTS LIVING EXPERIENCE When I was eight years old I started pulling in my stomach and sucking in my cheeks to look skinnier At age ten I started competitively swimming This involved exercising vigorously and monitoring my nutritional intake every day After a while this was second nature to me At this point sucking in my stomach made little difference but I was still unhappy with my body I thought if I lost a little more 9 weight my life would be so much better and I would be more attractive This continued until I was 18 Like most people I gained weight in my first year at university During that summer I went to work in an outdoor activity centre I was forced to eat the food provided for the children at the centre and had no time to exercise although was still active in my job I hated the lack of control I had over food and my life Both continued on page 10 When I returned to university my obsession with food and exercise began to spiral out of control I started running every day and ran until I felt like I was going to collapse I found excuses to avoid social circumstances that involved eating and drinking alcohol I ate as little as possible with some days eating nothing at all I felt in control again I spent Christmas working at university to avoid spending it with my family At the end of March we were put into

continued from page 9 love going on adventures COVID 19 taught me a huge amount Life can be extremely short you can t predict what will happen to you regardless of your age It is so important to enjoy life and try to reduce your stress levels as much as possible It can be particularly difficult for university students to do this Mental health and physical health are equally important Explore the area you live in join societies play a sport or a musical instrument continued from page 9 lockdown and I was stuck at home I started eating less and exercising more than I already was I would lie so people would stop worrying but I continued to lose weight I was close to being admitted to the hospital when my twenty first birthday hit in August This was the turning point for me I reached out to student support at the university and started trying to eat more It was probably the toughest thing I ve ever done but I didn t want to spend the rest of my life fearing food To this day I still struggle I have bad days Take every opportunity you get and participate because you reallywant to and you know you will enjoy it COVID 19 demonstrated that plans don t always go ahead and circumstances can change but that s why it is so important to live each day fully Take a break from work when you feel too stressed look after yourself and have extra curriculars I promise you it s worth it Charlotte 4th Year University College London where I miss my eating disorder but thankfully I have a great support system I can rely on Eating disorders are not uncommon In fact the prevalence of eating disorders among medical students is 10 4 in comparison to approximately 5 in the general population If you ever find yourself in a similar position or have negative thoughts around eating or exercise please reach out to someone This can be family friends your GP your university or charities Challenge those negative thoughts You are never not ill enough to get help I continue to fight the voice telling me to stop eating and use my family and friends as support One day I hope sooner rather than later I will stop having these thoughts and be able to enjoy food again Anon 4th Year University of Aberdeen 10

MENTAL ILLNESS IN SURGERY THE UNTOLD STORY USEFUL READ Already in 2014 a BMJ article highlighted how surgeons had a greater incidence of mental health problems than other medical specialties 55 of the cohort of surgeons that have asked for help from the Practitioner Health Programme PHP scheme experienced common mental health problems listed as anxiety depression OCD etc and 30 experienced complex mental health problems listed as bipolar disorder psychosis etc both these figures being in higher incidence compared to other medical specialties This is all in addition to an underrepresentation of surgeons in this Mental Service scheme perhaps reflecting surgeon s unwillingness to disclose their mental illnesses or accept help and higher suicide rates 11 amongst surgeons compared to the general population Given the high incidence of mental illness in surgery one would assume it would already be normalised However it remains incredibly difficult to find physicians sharing their experience about living with mental illness whilst being a surgeon Reasons for this do include simply respecting one s privacy which is completely valid However fearing stigma shame or risk to their career were among the reasons listed as to why many surgeons keep their silence With so much advocacy for BAME widening participation women in surgery etc why should mental illness in surgery be any different Why continue to adhere to bygone prejudice and taboos It s time to open the conversation to address the topic with engagement and understanding until we succeed in creating an environment where talking about mental illness wouldn t result in surgeons fearing discrimination in their career and personal lives There are plenty of glass ceilings to break and many long standing assumptions and prejudices to challenge But the reward a safe healthy thriving surgical environment representative and supportive of each and every individual is certainly worth advocating for BMJ article https doi org 10 1136 bmj g 2764 Diana 3rd Year University of Edinburgh

THINGS I WOULD TELL MY FRESHER SELF REFLECTION Hi I m Amy a third year medical student from the University of Liverpool Last year I joined the course via the graduate entry programme so I have been able to experience being a fresher twice albeit the second time during COVID As a new year of university starts I have been thinking about the advice I would give my 18year old self just starting university Here are some of the ideas I came up with You don t need to drink alcohol to participate in the fresher s lifestyle I feel there can be a huge pressure to go out and get drunk every night of fresher s week and then every weekend during the year especially with a lot of socials involving alcohol I feel like this isn t said enough but it is okay not to drink alcohol at university It is your choice and you don t need to have a reason when somebody asks you You are not alone either There are lots of like minded people at university and I am seeing increasingly more events that are more inclusive and do not revolve around alcohol Just be you It can be very tempting to want to reinvent yourself at university as you may feel more likely to fit in and be cooler University is a huge place with so many different people from a variety of backgrounds Being yourself can help you find like minded people and make friends for life instead of hanging out with people that have different values and being dishonest with yourself Just be yourself and don t waste energy being someone you re not University is a great time to grow and have a fabulous time I hope these tips have been helpful and that you enjoy your time at university because it a lot of it really can be the best time of your life Make the most of societies There are so many societies on offer at university it can be a lot to take in I remember when I first started university and went to Freshers Fair and felt bombarded by all the stalls and societies and ended up too over overwhelmed initially to join any I also found myself confused as to how to join any societies and found the expense of membership quite stressful For this reason I only ended up joining a society in the January of first year after a friend recommended one to me If I could go back in time I would have loved to have gotten involved sooner It can be a great way to connect and make new friends outside your course and accommodation whilst also relaxing Try not to drown in societies though Personally if I was a fresher again I would do one thing I ve done before university and then try something new to push myself out of my comfort zone For me this involves bouldering at an indoor climbing facility As seen in this photo Amy 3rd Year University of Liverpool 12

ANXIOUS PERSON AND AN ANXIETY DISORDER LIVING EXPERIENCE Hi my name is Joy and I am a 4th year student at Hull York medical school I have struggled with my mental health and used to be so scared about speaking out about the my struggles and the fact that I needed to take medication As I am a medical student I had concerns that it would impact my career But this is completely false Mental illness in no way means you can t be a doctor Of course there are examples where mental illness may affect your safety practicing but this is incredibly rare It is more damaging to have this stigma where health professionals don t want to talk about their mental health as it means they don t get the right support they need at work to do their job the best they can I actually think having my experiences with mental health helps me as a medical student as I can relate to things patients tell me more So a bit about my mental health story I have always been an anxious person as long as I can remember When I moved to medical school my anxiety 13 13 became the worst it has ever been and completely overwhelmed and consumed me Sometimes I feel when I tell people I struggle with an anxiety disorder people feel as if it s just a bit of anxiety and it isn t that big of a deal but for me having generalised anxiety disorder has impacted my life a lot Now I am finding my anxiety is so much better I look back at how I used to be and it s interesting as I can reflect on all the things I wouldn t have done a year ago because of anxiety For me anxiety would feel like I was constantly on a treadmill but it was always going faster than I could run and I was constantly feeling that I wasn t in control of my life and was having to run to keep up I would always feel something terrible would happen and always felt on edge I don t think I ever really felt relaxed Anxiety impacted my sleep and appetite massively I found when my anxiety was worse I lost a lot of weight as anxiety would make me feel full and sick so I didn t want to eat My anxiety would mean I would stop going to things mostly social events as I forced myself to go to lectures and university teaching sessions then would come back and that few hours of teaching would have totally drained me Therefore I still may have appeared okay to a lot of people during this time as would put on a brave face during these few hours This lead to me becoming incredibly isolated This especially happened during my first term at University when I found all the new experiences too overwhelming Anxiety can be an incredibly lonely place but you are not alone This overwhelming anxiety at the start of medical school lead to my mood becoming very low I felt like the world was just going too fast for me leaving me constantly zoned out I was constantly at the point of tears At the time I felt like it would never get better and that it would feel like this forever I felt like such a failure I had worked so hard to be at medical school and this was where I wanted to be more

than anything so this was supposed to be perfect Eventually I went to my GP but when I went there I had a terrible experience If the first doctor therapist or whoever you talk to dismisses you try another GP I have now had amazing experiences with doctors who have really listened to me A bad experience doesn t mean at all that you don t deserve help or aren t ill enough You know yourself best and if you feel you need support for your mental health then you deserve to get help This made me feel that there was no problem the doctor dismissing me and that I was just making it up After another few weeks where things were just continuously getting worse I saw another GP and was given antidepressants This medication helped me get to a point where I could do therapy as previously when I tried to talk I would cry which wasn t productive or useful We are all unique people so different therapies therapists or medications work for different people After 2 different therapists and medication I am now loving life Of course there are wobbles and I m not saying I m never anxious or low but I can now cope with these feelings so much better I am always so scared of becoming how unwell I was in 1st year but I don t think it ever will happen as I have learnt so much from my experience One of the key things I ve learnt is the signs that my mental health is deteriorating and getting help early Such as one time I had come off medication and started feeling unwell again and went back to the GP sooner rather than later to go back on medication If you told me when I was at my worst or even just a few months ago that I would feel this little anxiety I would have laughed and said No I m just an anxious person I will always be like this I made myself believe that anxiety was just a part of me and I would forever be anxious Of course I m not saying nowadays I m never anxious but I m saying I would have never believed that my anxiety levels would be this much better and I would be able to cope so much better If you struggle with anxiety and you think its just part of you don t let this put you off seeking help if the anxiety is affecting your life then you deserve help regardless of how long you have experienced the anxiety for Reach out for help you deserve it the right help it will get better 2 You are not a failure 3 Your thoughts are thoughts not facts 4 Mental illness isn t weakness You are strong and amazing 5 You deserve help 6 It s okay not to be okay We all need to work together and talk about our mental health to reduce the stigma As you can see I have a lot to say about mental health If you want to find out more about my experience of mental illness or to just follow my medical school journey follow my Instagram page thejoyfulmedic Joy 4th Year Hull York Medical School My key things to remember 1 Your brain may tell you it will never get better but with 14

MEET THE PSYCH STARS EMBARKING ON THE ROYAL COLLEGE OF PSYCHIATRISTS PSYCH STAR SCHEME 21 22 Hello I hope you are doing okay My name is Jed Winstanley and I m currently a third year medical student at the University of Liverpool This year I have the pleasure of stepping into the role of LivPsych s Community Lead meaning I get to oversee any wellbeing and fundraising events we decide to run over the upcoming year such as spreading the word about the Medics Together newsletter I thought it d be good to write up an article for the newsletter because this year I ll also be taking part in the Royal College of Psychiatrists Psych Star Scheme Now that I think about it it may be interesting to do a series of articles regularly updating you all about what us Psych Stars get up to throughout the year let me know if that is something you d like to see For those of you that don t already know the Psych Star scheme is a one year scheme open to medical students that are interested in psychiatry and wish to increase their awareness and knowledge of the specialty Successful applicants are paired up with a mentor are financially supported and and get to act as ambassadors for psychiatry the best specialty in my humble opinion You can find more information here https www rcpsych ac uk be come a psychiatrist medstudents awards prizes andbursaries psych star scheme We had our first meeting towards the end of August and it was super exciting to meet the other Psych Stars albeit virtually Dr Kate Lovett the Presidential Lead for Recruitment at the Royal College of Psychiatrists and Immediate Past Dean warmly congratulated us on being successful then we took turns introducing ourselves and why we each applied to be a part of the scheme If I may I d like to share with you why I applied to be a Psych Star Continued on page 16 15

continued from page 15 As a graduate entry medicine student I am very fortunate to have had time on my side in terms of my experience to date Prior to starting medical school I worked for a few years as a psychiatric healthcare assistant on a diverse range of inpatient units across a multitude of NHS trusts I ve always jumped at every opportunity to broaden my experience working within NHS mental health services and gain a deeper insight into how contemporary psychiatry is practiced on a day to day basis The opportunity to learn from my allocated mentor is just one of the reasons I applied to the Psych Star Scheme Additionally I m aware that psychiatry teaching often takes place in the latter years of medical school so I d really like to come up with ways to help medical students gain exposure to psychiatry and hopefully learn how amazing it is earlier on in their medical education If you readers have any ideas or just general questions please do not hesitate to reach out to me on Twitter jedw_96 Jed 3rd Year University of Liverpool REFLECTING ON MY TIME AT GP REFLECTIONS Whilst on my GP placement a case which I have found useful to reflect on was the case of an elderly woman She had presented to the GP after her BP had been checked in her routine Hypertension review and was found to be over 140 90 despite medical intervention The patient was therefore called to discuss a potential increase of medication or complete change of medication The patient was contacted via a telephone consultation when discussing the BP and potential routes to go down with the patient she explained that she had stopped the medication as she was experiencing side effects such as ankle swelling and just feeling off The discussion as to what would be the most appropriate course of action to do now was stopped by the patient as she felt that this was not her biggest concern now She went on to explain that her work had become an increasingly stressful time for her and that she once took her BP during work and it was up above 190 systolic and so she felt that there was a direct link between her hypertension and the and the stress of work She had decided that she would rather the consultation focus on her low mood and anxiety rather than the hypertension itself With the change of focus on the consultation she expressed that she wanted to be put back onto anti depressants She explained that she had previously been put onto antidepressants due to low mood and so the way she was feeling now was like the way she had felt prior to starting these The GP prescribed her Sertraline and agreed that they would have a follow up in a week to review the antidepressants and a follow up in a month to decide what the next steps would be regarding her hypertension Prior to the consultation along with the GP I did feel like there was a clear path as to what to do next regarding the Hypertension and I felt 16

REFLECTING ON MY TIME AT GP Continued from page 16 confident in understanding how to best care for this patient However once the consultation started and the patient made clear her intentions of not wanting to start her anti hypertensive medications but rather focus on her depression I understood that although the hypertension was essential to get under control what was probably actually more urgent was talking about her recent depressive episodes and what her potential trigger was and what medication would be suitable to help that When she was initially diagnosed with Hypertension the GP followed the NICE guidelines for Hypertension in adults Per these guidelines lifestyle advice was offered such as cessation of smoking if suitable and cutting down salt intake as well as eating a low fat balanced diet It was also decided with the input of the patient that a calcium channel blocker Amlodipine would be given as a first line treatment According to guidelines a calcium channel blocker was offered as a first line instead of an ACE inhibitor as the patient 15 was over the age of 55 A common side effect of Amlodipine is swelling of the ankles the patient had decided to stop her amlodipine as she was experiencing this and felt that the potential benefits of this medication was not worth the side effects caused by it In such a case as to Amlodipine not being appropriate a different type of calcium channel blocker could be given such as Verapamil or an ACE inhibitor could be given as an alternative to the calcium channel blocker if it doesn t seem suitable for this patient According to NICE guidelines as the patient was elderly she should aim to have a clinic BP of 17

medication as she was experiencing side effects which resulted in her feeling fizzy She was eventually prescribed Sertraline which she found to be incredibly effective for her She had therefore asked to have this prescribed the second time around The GP prescribed Sertraline and both agreed to review in one week On subsequent discussion with the GP regarding what type of SSRI to prescribe she explained that it usually just depends on the individual patient and that antidepressants vary in effectiveness with each individual patient This case to me demonstrated how a doctor can be under the impression prior to the consultation that it is supposed to go a certain way but when the consultation takes place the patient may have different intentions that require invention sooner Moreover this consultation also emphasised to me the importance of asking a patient s intention as the patient herself realised that her depression was the most important health concern at this time and that most likely had a direct link with her hypertension Lastly I learned that in regard to antidepressants they work differently with every patient and it is often a process of testing out different antidepressants and finding what works best such as in the case of this patient she felt that the initial anti depressant she was prescribed fluoxetine was not effective and so Sertraline was given instead When encountering similar situations to this in the future I will remember the importance of patient communication and that if a consultation doesn t go down the route that it was initially intended then it may be in the patient s best interest to focus on their main concern at the time and come back to yours either later in the consultation or in subsequent consultations Nice org uk 2021 online Available at https www nice org uk guida nce cg90 resources depressi on in adults recognition andmanagement pdf975742636741 Pathways nice org uk 2021 Depression NICE Pathways online Available at https pathways nice org uk p athways depression path vie w 3A pathways depression depr essionoverview xml amp content vi ew node 3Anodesprinciples of care Charlotte 4th Year University of Aberdeen Nice org uk 2021 online Available at https www nice org uk guida nce ng136 resources visualsummary pdf 6899919517 Nice org uk 2021 online Available at https www nice org uk guida nce ng136 resources visualsummary pdf 6899919517 18

SUPPORTING FRIENDS WITH GENERALISED ANXIETY DISORDER LIVING EXPERIENCE Anxiety is often talked about at least a lot more than it was previously From the informal comments about how anxious and stressed one is feeling to the occasional and sometimes inevitable anxiety attacks and breakdowns It s relieving to see how much more normalized and acceptable this and though we still have a long way to reduce the stigmas around mental health I believe we are slowly improving in this regard In this article I m offering the perspective of having close friends with GAD how I try to support them and the impact this has on me Of course I am in no way trying to dismiss or diminish the difficulties one has when living with GAD without having GAD myself it would be hard for me to describe or comment on this So I am instead offering the only perspective I do have that of a friend When my first close friend told me they had GAD I immediately tried to 19 reassure them that it was alright that of course this didn t make me see them any differently and that I would always be there for them if they ever needed to talk Being only in high school at the time I hadn t had much experience with mental health disorders and didn t realise what a huge undertaking always being there for someone would be Without realizing it I took on the role of a very junior very inexperienced therapist listening to my friend s worries and trying to appease them helping them calm down when they asked me to staying up much later than was physically and mentally healthy for me just talking with them and making sure they were alright The guilt at seeing their missed calls while I had my phone switched off during class or while sleeping was immense and I remember spending nearly a year in a state of constant high alert stress and fear I don t remember giving much advice just being there to listen and share my thoughts with them which in retrospect I did well My big mistake though was not to prioritise myself at all in this relationship a mistake that would cost me my wellbeing my relationship with other friends and family and my grades While it was my initial instinct to try and help as much as possible perhaps what I really should have done was encourage them to see a therapist someone who properly and professionally knew how to deal with the mater rather than put myself in a tenuous position of being their first and I wrongfully believed only port of call Much more recently when another close friend informed them of their GAD my heart initially sunk thinking back to the time I had in high school But with this past experience I now had at least had something to learn from to know what not to do I reassured this friend as well but also let them know that I would support them if they wanted to get professional help like that of a therapist which I believed would be more useful than just me being there From the start I

continued from page 19 informed them that I would happily try to support them if they needed me to but that I also would have to prioritise myself in this and that I would let them know if it was too much for me and thus that I shouldn t be their only port of call I was scared on how they would take it believing myself to be selfish when they were I believed knowing that they have other suffering a lot more than I places to get support was But there was no reason to have doubted They were Anon 3rd Year University really understanding and of Edinburgh appreciated that I had a wider life and needed to look after myself as well I am still here to listen to them whenever they need me to but don t stress as much about as I once did or let their mental health overtake my life GROUNDING TECHNIQUES SELF CARE TIP Grounding techniques can help anchor us into the present moment when we are particularly overwhelmed and help to bring us some calm Why don t you give some a go the next time you feel overloaded 1 The 5 4 3 2 1 technique Name 5 things you can see 4 things you can feel 3 things you can hear 2 things you can smell 1 thing you can taste 2 Splash your face or run your hands under cold water 3 30 second dance party 4 Try some puzzles or a word search Anon 2nd Year University of Sheffield 5 Spray your favourite fragrance on your sleeve 6 Eat a mint or chew some gum 7 Can you think of 4 things that start with each letter of the alphabet 8 Count back from 100 in 7 s 9 Grab an object and describe it How does it feel What does it look like Is there anything else that stands out about it 10 Orientation Where are you What day of the week is it Do you know the month and year What season is it What is the weather like 20

STUDENT SUPPORT GENERAL Support apps websites Are you struggling with suicidal thoughts Please make contact with your GP and see someone as soon as possible Reach out to a friend tell someone how you are feeling you are not alone Headspace Free guided mindfulness and meditation sessions They are offering a 10 day free trial for new customers www headspace com Online Phone Support Open 24 7 contact the Samaritans for free confidential support Phone 116 123 Email jo samaritans org HOPELineUK has phone text and email support and is open 10am 10pm weekdays 2pm10pm weekends 2pm 5pm bank holidays Call 0800 068 4141 Text 07860039967 Email pat papyrus uk org Shout Crisis Messenger 24 7 confidential support Text 85258 https www giveusashout org Saneline 0300 304 7000 4 30pm to 10 30pm Campaign Against Living Miserably 0800 585858 https www thecalmzone net 21 Togetherall Formerly Big White Wall Togetherall is an anonymous platform that provides a safe space online to get things off your chest explore your feelings get creative and learn how to self manage your mental health and wellbeing It provides 24 7 peer and professional support from trained counsellors It is free for University students https togetherall com en gb UNIVERSITY OF SHEFFIELD Sheffield Flourish Sheffield Flourish is a charity that works closely with the university to support student mental health Their website has lots of useful resources and stories from Sheffield residents that have experienced mental health difficulties or distress www sheffieldflourish co uk Are you struggling with university work Need extra support Email the student affairs team medical_student_affairs sheffield ac uk They are currently providing email phone and video support to students Sheffield University Central Support The University have a welfare team to support students experiencing any personal difficulties that are significantly impacting on their ability to study They can also provide support for family friends who may be worried about a student s wellbeing The university also provides specialist support for other issues too such as housing finance and immigration issues Access central support here https www sheffield ac uk s ss ssg Sheffield Nightline sheffieldnightline co uk E listening nightline sheffield ac uk 0114 222 8787 8pm 8am HULL YORK MEDICAL SCHOOL If you are struggling at University there is support available from both HYMS itself and the partner universities

HYMS Email studentsupport hyms ac uk anyone that feels they need confidential non judgemental listening Hull Contact Student Service via MyHull Portal Online Phone Support Alternatively call 01482 4622 Breathing Space 0800 83 85 87 https breathingspace scot York A free confidential phone Opendoor Available to both service for anyone over 16 in Hull and York based students Scotland experiencing low Email opendoor york ac uk mood anxiety or Complete the online referral depression You can just call https www york ac uk students if you are feeling health help open door overwhelmed and need someone to listen They can York Nightline also offer advice if you ask www yorknightline org uk for it and can make you 01904 323735 8pm 8am aware of other places to get Email help locally listening york nightline ac uk Health in Mind Wellbeing Line 0808 801 0614 UNIVERSITY OF https www health inEDINBURGH mind org uk about_us news_a nd_blogs i2314 new_wellbein In Person Support g_line_for_young_people aspx A new free phone line The Chaplaincy https www ed ac uk chaplaincy specifically designed to provide 16 25 year olds with A really welcoming place for a chance to talk to someone people of all faiths and none about how Covid 19 has located besides Portter at the affected their lives It is University of Edinburgh Bristo available from 14 00 18 00 Square Mondays Thursdays and The Chaplaincy Centre is open Fridays and 11 00 15 00 for walk in appointments during the weekend Tuesdays Thursdays from 10 30 16 00 They also offer a listening service on weekdays rom 9 00 17 00 which can be done either in person or by phone email or video call for The Advice Place 0131 374 4581 https www eusa ed ac uk s upport_and_advice the_advic e_place A really welcoming service located inside the Potterow building at the University of Edinburgh Bristo Square However for the time being they are only available via telephone or email If you have any queries be it wellbeing related or otherwise the advice place is a great port of call They will ensure you are listened to and will do their best to help you solve your problems and point you towards resources specific to your situation Edinburgh Crisis Centre 0808 801 0414 http www edinburghcrisisc entre org uk wordpress A telephone service that is open 24 7 for anyone who feels like they are experiencing a mental health crisis They help you deal with feelings or thoughts experienced at a time of crisis including anxiety panic attacks and self harm They also provide practical support by providing access to information welfare benefits and accommodation Feeling Good App Free for University of Edinburgh students Edinburgh Nightline https ednightline com 0131 557 4444 8pm midnight 22

STUDENT SUPPORT UNIVERSITY OF LIVERPOOL UNIVERSITY OF ABERDEEN Want tips on staying healthy and happy Live Well Liverpool https www thelivewelldirector y com Wellbeing Liverpool http www wellbeingliverpool c o uk If you are in need of urgent help call 999 or NHS24 on 111 Brownlow Health Mental Health Resources https www brownlowhealth co uk mental health resources Uni of Liverpool Wellbeing Resources https www liverpool ac uk stu dentsupport advice resources Other organisations and information which could help support your mental health Talk Liverpool https www talkliverpool nhs u k If you re struggling at university Mental Health Advisory Service https www liverpool ac uk stu dentsupport mentalhealthadvis oryservice Mental Health Guidance https www liverpool ac uk stu dentsupport counselling selfhe lp mentalhealthproblems Long list of sources of help https www liverpool ac uk stu dentsupport counselling other helpinformation 23 Request support appointment button You will find this button on the homepage of MyMBChB It will send a message to student support who will get in touch with you to arrange a meeting Everything discussed is confidential You can also email student support abdn ac uk Personal tutor reagent https www abdn ac uk stude nts support pastoral supportand guidance php You will be given a reagent for medical students or personal tutor all other students when you start in first year This person should remain the same during your time at university They are a great option for support particularly when it comes to university work and should be in contact with you on a regular basis AUSA advice ausaadvice abdn ac uk or 01224 274200 Advisers are available for academic housing and general wellbeing advice University counselling counselling abdn ac uk The university provides talking therapy with a qualified counsellor to explore issues that may be causing you concern or distress Student helpline in partnership with Care first Student Helpline freephone number 0800 197 2980 This is available whenever the university support services are closed The Care first service can be accessed by going to www carefirst lifestyle co uk username uoastudent password aberdeen Aberdeen Nightline listening aberdeen nightlin e ac uk 01224 272829 8pm 8am Are you a medical student or doctor Do you have a story of lived experience self care tips recipes creative work or want to let us know what you ve been up to We would love to hear from you Email us medicstogethersubmissions gmail com

SOME SELF CARE TIPS SELF CARE TIPS Have something in the week to look forward to whether it s a takeaway night out or cinema DON T COMPARE DON T DOUBT YOURSELF Don t push yourself to please others stick to what you are vibing with Try not to get flustered if you weren t able to get done what you wanted in the week take your time and plan the next one and take it by bit Eat If you re having a weird mood order food Exercise does help Good music in the background Keep talking to people don t shut yourself off Decorate your room to what you like DON T COMPARE If you are really feeling weird buy a small pet Anon 4th Year University of Aberdeen 24

MOZZARELLA STUFFED ARANCINI COOKING CORNER Total time 40 mins Servings 1 2 depending on leftovers Ingredients For the arancini Left over Risotto 1 cup plain flour Pinch oregano Pinch of salt and pepper 2 eggs beaten 1 cup of breadcrumb 500ml vegetable oil Chunks of Mozzarella For the sauce 2 cloves of garlic diced 200g passata Method 1 Carefully heat some vegetable oil about 5cm depth in a saucepan or pre heat the deep fat fryer 2 In one bowl pour the flour mixed with oregano salt and pepper In another beat 2 eggs 3 In a third bowl season breadcrumbs with oregano salt and pepper 4 Flatten a tablespoon of cold risotto in your hand and wrap it around a chunk of mozzarella 5 Roll it in flour then the egg then the breadcrumbs Repeat until there is no risotto left 6 For the sauce pan fry your garlic in chilli oil until browned and add your passata Leave to simmer 7 Fry your arancini until golden brown Very big balls can be cooked through in the oven to save them from burning 8 Serve with your sauce and enjoy Anna 4th Year University of Aberdeen LOVE ON THE SPECTRUM TV RECOMMENDATION Netflix released a second series of Love on the Spectrum 1 week ago and despite my best intentions not to binge it I have already finished it The documentary follows a group of Australian individuals who are all on the Autism spectrum and looking for a romantic relationship If you haven t seen series 1 get watching I think this show handles the complexities of dating for those who are not neurotypical really sensitively It is brilliant at showing the huge range in presentations of autism highlighting 25 differences between men and women and those with additional learning disabilities or mental health issues It includes all types of romantic relationships including LGBTQ This show is so enjoyable to watch as the individuals involved are treated with such respect and who doesn t love love For a feel good TV programme I highly recommend giving this a try

SALMON PASTA FOR CONVERSATIONS WITH FRIENDS COOKING CORNER PREP 5 MINS COOKING 20 MINS DIFFICULTY EASY SERVES 5 With most of us back in the same space for the first time in a long time the desire to be social has never been quite so intense Clubs bars and restaurants are open all filled with long missed voices and some definitely not missed dance moves However memories of the past 18 months haven t been completely abandoned and these busy environments can feel overwhelming after all this time spent internalising social distancing That s why for all the forbidden thrill of public spaces there s just no way to catch up quite like over a bowl of pasta carb of your choice and a glass of wine For my friends and I dinner together has been the perfect opportunity to check in with each other about our mental health and wellbeing both through the past year and the current slightly rocky reopening phase Sharing and listening to each other s experiences with a full belly and without the filter of a screen to get in the way has been cathartic and I can only recommend To get you started I invite you to try this quick and foolproof recipe with your pals Ingredients 500g spaghetti 1 tablespoon olive oil 2 cloves of garlic finely chopped 1 bag of spinach approx 200g 100g smoked salmon 200g cream cheese 1 lemon Salt black pepper Method Boil spaghetti in salty water While the pasta is cooking heat a large frying pan over medium heat Throw in garlic cloves and fry for a couple of minutes Add spinach and cook until wilted depending on the size of the frying pan you might not be able to add all the spinach at once but don t worry keep adding it in as you can Slice the smoked salmon into strips and add to the spinach Once this is stirred through add the cream cheese and juice of 1 lemon At this point your pasta is probably cooked add some of the pasta water to the frying pan until the sauce reaches a saucy consistency Season with black pepper to taste Drain the pasta and add to the pan to combine with your delicious sauce This recipe has had a 100 success rate so far my friends and I have laughed cried and schemed our nights away over bowls of this pasta and I hope you yours will too 26

CARROT CAKE COOKING CORNER This recipe submission is from Ying Hui Tan Ying Hui studies Medicine at the University of Edinburgh In her free time she enjoys baking anything and everything especially birthday cakes for her loved ones Follow her baking adventures on Instagram chocolatefudgebrowny and look out for her bake sales Modified from https sallysbakingaddiction com myfavorite carrot cake recipe STEP 1 CAKE Ingredients 260g chopped walnuts 1 cup for cake 1 cup for garnish 150g packed light or dark brown sugar 50g granulated sugar 240ml vegetable oil or canola oil or melted coconut oil 4 large eggs 133g smooth unsweetened applesauce or blend up 1 medium apple 1 teaspoon pure vanilla extract 312g all purpose flour 2 teaspoons baking powder 1 teaspoon baking soda 1 2 teaspoon salt 1 and 1 2 teaspoons ground cinnamon 1 teaspoon ground ginger 1 4 teaspoon ground nutmeg 1 4 teaspoon ground cloves 2 cups 260g grated carrots about 4 large 27 Instructions 1 Make the cake Preheat oven to 150 C Line a large baking sheet with parchment paper or a silicone baking mat Spread the chopped walnuts on the sheet and toast for 7 8 minutes Remove from the oven and allow to cool for 10 15 minutes 2 Turn the oven up to 180 C Grease two or three 9 inch cake pans line with parchment paper 3 Whisk the brown sugar granulated sugar oil eggs applesauce and vanilla together in a large bowl until combined and no brown sugar lumps remain In another large bowl whisk the flour baking powder baking soda salt cinnamon ginger nutmeg and cloves together Pour the wet ingredients into the dry ingredients and using a rubber spatula or wooden spoon fold the ingredients together until just combined Fold in the carrots and 1 cup of the toasted walnuts 4 Pour spoon the batter evenly into the cake pans If using three cake pans bake for 20 24 minutes If using two cake pans bake for 30 35 minutes Test the centre with a toothpick If it comes out clean the cakes are done If not continue to bake until cooked through Do not over bake Allow the cakes to cool completely in the pans set on a wire rack The cakes must be completely cool before frosting and assembling

CARROT CAKE STEP 2 CREAM CHEESE FROSTING Ingredients 450g full fat block cream cheese softened to room temperature 115g unsalted butter softened to room temperature 270g confectioners sugar 1 Tablespoon 15ml heavy cream or milk 1 and 1 2 teaspoons pure vanilla extract Pinch of salt to taste Instructions Make the frosting In a large bowl using a handheld or stand mixer fitted with a whisk or paddle attachment beat the cream cheese and butter together on medium high speed until smooth about 2 minutes Add the confectioners sugar cream milk vanilla extract and a pinch of salt Beat on low speed for 30 seconds then increase to high speed and beat for 3 minutes until completely combined and creamy Add more confectioners sugar if frosting is too thin more milk if frosting is too thick or an extra pinch of salt if frosting is too sweet Frosting should be soft but not runny Ying Hui 3rd Year University of Edinburgh 28

BILLIONAIRE S SHORTBREAD COOKING CORNER This is my favourite recipe for a sweet treat Everyone thinks it is really fancy because it is a self made caramel But it is actually really really easy Perfect for making new friends in PBL or group learning INGREDIENTS Shortbread 200g Unsalted Butter room temperature 100g Caster Sugar 275g Plain Flour Caramel 200g Unsalted Butter 3 Tbsp Caster Sugar 4 Tbsp Golden Syrup 1x 397g Tin Condensed Milk Topping 200g Milk Chocolate 100g White Chocolate METHOD Preheat your oven to 180C 160C Fan and line a 9x9inch square tin with baking paper 29 Cream together the sugar and butter we just used a metal spoon Then mix in the flour until a dough is formed It will be a bit crumbly but the ingredients will be evenly dispersed Firmly press the mixture into the bottom of tin prick it with a fork all over and bake in the oven for 25 minutes until pale gold Once baked remove from the oven In a large saucepan pour the condensed milk butter sugar and golden syrupand melt on a medium heat till the sugar has dissolved do not stop stirring Once the sugar has dissolved turn the heat up to max and let the mixture come to boiling point and boil for 5 7 minutes DO NOT STOP STIRRING Continue until it has changed to a slightly darker golden colour and has thickened to hold its shape for a few seconds after you mix Pour the caramel onto the shortbread base Bake for 10 minutes this helps it set later Once chilled melt the chocolate Add a tablespoon of oil to each to prevent it cracking Pour over the caramel Swirl them together with a cocktail stick fork piece of uncooked spaghetti so it forms a pretty pattern Chill the shortbread back in the fridge for until the chocolate has gone hard Chop your shortbread into the separate pieces and enjoy I would recommend leaving it out the fridge for 5 minutes before you do this Run your knife under hot water for cleaner cuts Tori 2nd Year Hull York Medical School

Are you a medical student or doctor Do you have a story of lived experience self care tips recipes creative work or want to let us know what you ve been up to We would love to hear from you Email us medicstogethersubmissions gmail com 30

CONTRIBUTORS This newsletter was created by Sheffield Psychiatry Society This issue received contributions from 5 psychiatry societies across the UK SHEFFIELD PSYCHSOC Eliza Bradley Inclusions Officer Deepika Sharma Events Officer Manisha Bumma Vice President Nicole Hammond Mental Health Officer HULL YORK MEDICAL SCHOOL PSYCHSOC Erin McCabe President Joy Bannister Vice President Maddie Jacobs Events Coordinator WELLMED UNIVERSITY OF EDINBURGH Diana Meirinho Domingues Newsletter Coordinator UNIVERSITY OF ABERDEEN Charlotte Taylor Vice President Megan MacFarlane President LIVPSYCH UNIVERSITY OF LIVERPOOL Jed Winstanley Community Lead Will Smith President Dr Katy Owen Academic Proofreader GP trainee and clinical teacher in Sheffield We would like to give a massive thank you to everyone who contributed to this issue and to our sponsors AUTP Association of Teachers of Psychiatry for their continued dedication to promote medical student wellbeing