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Studying Neurosurgery Abroad: Mariam Ishaque in London

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Author: Mariam Ishaque | Category: Beyond The Bench | M.D./Ph.D. | Radiological Sciences (Ph.D.) | March 23, 2016

In preparation for my transition back to medical school, I wanted to supplement my graduate training by organizing a focused clinical/research traineeship over winter vacation. I hoped to gain exposure to a medical specialty of interest to me while also observing a distinct category of clinical research. 

I was fortunate enough to organize such an endeavor with world-class physician-scientists at Imperial College of London’s Neurosurgery Department in England. 

I sought to work with a certain functional neurosurgeon in this department who is leading remarkable research in deep brain stimulation (DBS) therapy for patients with Parkinson’s disease. 

With a resounding thanks to Dr. Bob Clark, Dean Dr. David Weiss, and other supportive parties from the Institute for Integration of Medicine and Science and Graduate School of Biomedical Sciences, I was able to undertake this extremely enriching and personally important experience in academic neurosurgery, in the United Kingdom!

My first time in the UK, I did not entirely know what to expect (on multiple levels) for the few weeks I would be there. As soon as I arrived at Imperial’s Charing Cross Hospital, I was swiftly welcomed into ongoing clinical and research activities within the department. 

Nearly everyone I encountered was extremely enthusiastic and willing to help me learn. I was able to assist in patient assessments in clinic, participate in ward rounds, shadow/scrub-in to surgeries, and attend resident seminars and associated activities. 

Importantly, I was able to share my research with several faculty members and trainees and learn about their projects as well, both within and beyond functional neurosurgery. I left with much inspiration and many ideas for pursuing further clinical research in my own career. The entire traineeship proved to be tremendously fruitful!

During the trip, some things definitely stood out to me and are worth sharing here:

(1) Physicians do not wear white coats in the UK! (For patient safety reasons:

(2) Vernacular can be problematic. I encountered a fair amount of unfamiliar terminology—both medical and non-medical—on my first day. I consequently had a steadily growing list of words to look up when I got home. Luckily, I had recently finished the memoir Do No Harm: Stories of Life, Death and Brain Surgery by British neurosurgeon Henry Marsh (highly, highly recommended!), so I was versed on some basics, such as to refer to operating rooms as ‘operating theatres,’ residents ‘registrars,’ attendings ‘consultants,’ and surgeons ‘Mr.,’ not ‘Dr.’ The last was particularly difficult to mentally overcome!

(3) The effectiveness with which each resident and attending I followed communicated with their patients left a deep impression on me. There was a level of cordiality, patience, and information disclosure that was extremely useful for me to witness as a nascent physician. Even the more (so-called) tense discussions I observed came off rather graceful. Granted, the fact that this was in the midst of the holiday season may have been a confounding factor.

(4) Unsurprisingly, there were some differences in the healthcare system as compared to the U.S. What was surprising to me, though, was the several, several times I heard various medical professionals—and patients—express dissatisfaction with the National Health Service (NHS), England’s public healthcare system. Some junior doctors even voiced desires (and burgeoning plans!) to pursue their training in other countries. A senior anesthesiologist (‘anesthetist’) austerely looked me in the eyes during our introduction and warned, “Never work for the NHS.” 

(5) Finally, being immersed in all things ‘brain’ for a few weeks was thrilling. A young neurosurgeon described to me how operating on someone’s brain and treating neurological disease is nothing short of a privilege. I whole-heartedly agree.

When not working, I explored the stirring city of London and got to cross some longstanding things off my bucket list. Of course the London Eye, Buckingham Palace, Big Ben, etc., were major points-of-interest, but my physicist side was also delighted to see memorials for Michael Faraday, Ernest Rutherford, and Isaac Newton in Westminster Abbey. 

I also made it a point to visit the grounds of Wimbledon, my favorite tennis tournament. Such a neat experience! (It looks much larger on television). I was also able to daytrip to Oxford (where I proceeded to sign up for a city walking tour amid torrential downpour…). 

It was more than worth it to visit the stunning campus buildings and historical sites (e.g., Thomas (Circle of) Willis’ house!), the many marvelous museums, the oldest pub in Oxford, Turf Tavern (thanks Dean Weiss for the recommendation!), and much more. At no point was there a shortage of places to go (or food to try)! 

This traineeship was a fantastic experience for which I am extremely grateful. I had the opportunity to improve my patient assessment skills, significantly increase my knowledge in both clinical and research aspects of neurosurgery, and connect with inspiring, brilliant people. 

The type of highly clinical research I observed undoubtedly supplements my current training and informs future trajectories using my neuroimaging background. It was also very valuable to gain perspective on a foreign country’s protocols and healthcare system. 

For these reasons and many more, I have no doubt this experience will serve my personal and professional development tremendously well. 

Extra Photos

Sightseeing on Christmas night – nearly empty streets!

Centre Court, Wimbledon


Mariam Ishaque is a dual degree student in the M.D./ Ph.D. program. She is currently working with Dr. Peter Fox.

The "Beyond The Bench" series features articles written by students and postdoctoral fellows at the Graduate School of Biomedical Sciences at The University of Texas Health Science Center San Antonio. 

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