Neuroscience in Krakow

I returned on Sunday from the wonderful city of Krakow which hosted the IBRO/IRUN NEURONUS 2013 forum. The city is spectacular, with some magnificent architecture and a rich albeit tumultuous history. I travelled with a group of friends from Berlin, and we managed quite a bit of sightseeing in the scarce free time we had. We toured the historic landmarks of the old city and visited Schindler’s factory (now a museum exhibiting the history of Krakow during World War Two).
The forum itself was very interesting, with speakers from around the world including Poland, the United Kingdom, Germany, the Netherlands and Canada. Aimed at students, the forum covered a wide range of topics from cellular and molecular aspects to clinical and affective neuroscience. There was truly something for everyone during the four action-packed days of intensive lectures, interactive sessions and poster presentations. I had some lively discussions with some of my colleagues from Poland about Alzheimer’s disease and stroke during the poster sessions, and learned a great deal about the cutting-edge research on disorders of consciousness from a world-renowned expert.
Although there were (unfortunately) no speakers from Edinburgh, I learned about some fascinating research being done in Cambridge in collaboration with a group at the University of Edinburgh and the Medical Research Council on multiple sclerosis. I also attended an interactive medical case report session of rare and interesting neurological illnesses presented by local medical students.
Now I’m back in Berlin, for another three weeks of lectures followed by my final exam in early June, and I’m also continuing my Laboratory Medicine module for the MSc Internal Medicine at the University of Edinburgh.
I’ll be posting more about the forum soon! 🙂

Some photos from Poland:

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NEURONUS 2013

Greetings from Krakow! The 2013 NEURONUS neuroscience forum is in its third and final day. I’ve had a really busy schedule the past few days, with lectures and teaching sessions all day mixed in with sightseeing and tourist events. Thus, I haven’t had much time to post about the conference but I will be doing so soon (there are so many interesting things going on here!). For now, I leave you with some photographs of Krakow and the forum.

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A prelude to Poland

In anticipation of my upcoming trip to Krakow, where I will be attending a neuroscience forum (NEURONUS 2013), I thought I would post about the rich history of medicine in Poland.
While I am tempted to begin with Copernicus (1473-1573), perhaps a slightly more recent review of Polish achievements in medicine is more relevant. In my field of neurology, two names immediately come to mind when Poland is mentioned – the German psychiatrist Alois Alzheimer who spent the later stages of his career at the University of Breslau (now Wroclaw) and French neurologist of Polish descent Joseph Babinski who described the abnormal plantar reflex occurring after damage to the pyramidal tract. Others who are more intimately linked to Poland are neurophysiologist Napoleon Cybulski, who discovered adrenaline and Samuel Goldflam who helped describe the autoimmune neuromuscular disorder myasthenia gravis in the late nineteenth century. Goldflam studied under neurology legends Karl Friedrich Otto Westphal (German) and Jean-Martin Charcot (French) but spent most of his life in Warsaw. Edward Flatau is another name worth mentioning, he studied in Moscow under such great names as Sergei Korsakoff and worked with famed anatomist Heinrich Von Waldeyer-Hartz. Flatau made major contributions to our knowledge of migraines, the spinal cord and pediatric neurology.
Although I always unconsciously tend to make things all about neurology, Poland’s contribution to medicine extends far and wide across all disciplines. A few of the most noteworthy pioneers include Albert Sabin (Polish-born American) who developed the now widely used oral polio vaccine, Andrew Schally (Polish-born American) who received the Nobel Prize in Medicine for his work on peptide hormones in the brain (he received an honorary doctorate from the Jagiellonian University which is hosting the NEURONUS forum) and Tadeusz Krwawicz, an ophthalmologist who pioneered the field of cataract surgery.
So, my next post will (hopefully) be from the exciting city of Krakow! 🙂

”So you’re an MD?”

That’s a question I tend to get a lot. People always like to know if I have an MD whenever I mention that I went to medical school or that I’m a ‘doctor’. I used to reply, ”Not exactly, I’m an MBBS.” and then proceed to explain what that means (Bachelor of Medicine and Surgery). Recently, however I’ve given up and answered with a plain and simple ”Yep.”

So I decided to delve a bit deeper into why differences exist between the nomenclature of primary medical degrees. Worldwide, I was surprised to find out that most countries in fact use MBBS or a similar post-nominal letters such as MBBCh.It’s mainly just the US and Canada that use MD to refer to the primary medical degree. And yet, even here in Europe, I get a confused response when I try to explain the difference (thanks to the likes of ER, Grey’s Anatomy, House, I suppose). What was even more surprising, however, was that the US actually took the idea of the letters MD from the UK, Scotland to be specific. Until the 19th century, Scotland actually awarded medical graduates with MDs while the rest of the UK awarded MBBS, MB BCh, etc. Medical schools in Scotland, including the University of Edinburgh, award MBChB.

In the UK, Commonwealth nations, as well as in Sudan (where I earned my primary medical degree), MD is a postgraduate qualification usually awarded after a doctor is specialized and after he/she has done significant research – so it’s almost like a PhD in a sense.

In Germany, medical graduates don’t receive a post-nominal title. Instead, they are awarded the pre-nominal ‘Dr.med’.

Who needs an MRI? Welcome to the Third World

This post was inspired by a comment made by one of my professors during a lecture last week. She was explaining to the class how older, experienced physicians (from ‘way back when’) can pinpoint lesions with great accuracy based on symptoms and signs alone, without the need for fancy modern equipment such as MRI scanners. This is of course true, but it got me thinking of my own medical education.

One of the advantages of having studied medicine in a Third World country is that I was taught from early on to rely on clinical features to come up with accurate and precise diagnoses. While I am certainly no expert in doing so, I think people who practice in underdeveloped countries have a distinct advantage over their more technologically-oriented counterparts in developed countries. This is particularly true for emergency situations – MRI machines (and even CT scanners) are few in poor countries – laboratory tests are often outdated and transiently available and immunologic or genetic testing are especially cumbersome to locate. Thus, a junior doctor quickly develops the prowess of analyzing a patient’s presentation to come up with a single faulty aspect to be blamed.

In no other discipline is pinpointing precise lesion locations more important than in neurology. In fact, that is what neurology is all about. If we were to remove this aspect of the discipline then the specialty as we know it would cease to exist. In the preface to the first edition of one of my favorite books: ‘Introduction to Clinical Neurology’, neurologist Dr. Douglas J Gelb asks that very question – Is neurology obsolete? At least it lives on in developing countries, for now.