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Raising horizons
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     The student group Medsin campaigns for more teaching on global health and more help for marginalised people. Geoff Watts asks its president, Claire Procter, how it survives

    Students agitate, campaign, and demand change—bigger grants, world peace, more halls of residence, that sort of thing. It goes with the territory. What the stereotype does not allow for is a group pressing, politely, for something to be added to the curriculum. The something in question is global health, and the body applying the pressure is the student organisation Medsin.

    "If you ask medical students about their public health teaching you often get the answer that it's rubbish, or they don't enjoy it or get much from it," says Claire Procter, a medical student at Newcastle and currently president of Medsin. The evidence for her assertion being anecdotal, it is hard to know if she is right. Either way, deans dismayed by this damning comment on what their schools provide may be cheered by Ms Procter's next comment: "But students really do want to learn about international health issues."

    A couple of schools already offer an intercalated bachelors degree in international health—the Royal Free and University College Medical School and Leeds University Medical School. Medsin would like to see more such courses—and, in the meantime, a bit more global health in the curriculum for all students. Asked if these requests find a sympathetic response from medical schools, Ms Procter claims that they do. In one case at least, Medsin has even helped out with ideas about what to put into a course.

    Although motivated by the bigger picture in health, Medsin is realistic about what its student membership can achieve. "Medsin is an organisation for raising awareness about humanitarian issues," says Ms Procter. "It's all about educating ourselves on the different things that affect people's health and on what we're going to have to know working as doctors in a global society. But it's also about taking action on projects locally." Hence Medsin's slogan—global vision through local action.

    The name of the organisation was originally an acronym for Medical Students International Network but is now simply its brand name, since the group includes not just medical students but students from other healthcare disciplines.

    The local actions that the organisation promotes comprise a clutch of projects and campaigns that are typically started by one branch of Medsin and which, if they prove successful, can be taken up by other branches. The national network spreads the word.

    Students Nadia Stock (left) Claire Procter (centre) and Ellie Lanning were all involved in the Medsin campaign to increase the number of bone marrow donors

    Several Medsin projects focus on what Ms Procter calls "marginalised groups"—refugees and the homeless. A Medsin project called Homed, for example, helped recruit students to take part in a recent count of people sleeping rough in London.

    Another, entitled Marrow, is the student contribution to the Anthony Nolan Trust. "Its aim is to get students on to the bone marrow register," says Ms Procter. "This is one of our oldest projects and really strong. I think about 25% of people on the Anthony Nolan register now have come through Marrow groups. Marrow started because a medical student died of leukaemia. A friend of his, a guy called James Kustow, who was then also a student, felt he wanted to do something about it."

    The basic life support scheme has students going out into schools to teach cardiopulmonary resuscitation. Sexpression, a peer led education project, aims to tackle teenage pregnancy and sexually transmitted infections: "It involves students who have had training on sexual health issues visiting schools and passing information on. They also talk to other students about sexual issues."

    Medsin has come a fair way since it was founded in 1951 as the UK branch of the International Federation of Medical Students' Associations, a body principally concerned with setting up student exchanges between different countries. Having helped to create the Association, Medsin UK seems to have entered a period of decline during which, Ms Procter admits, she does not know what it was achieving, if anything. The organisation re-emerged in its current manifestation in 1997. As other student bodies run by and on behalf of here-today-gone-tomorrow transients, its activity can fluctuate from year to year. But Ms Procter says that it currently has contacts in all British medical schools.

    The organisation operates on a shoestring. Students fund themselves, sometimes helped with expenses for travelling and the like by their medical schools. It gets a bit of outside assistance; the BMA, for example, helps out with printing and sponsorship of the national conference. But Ms Procter can still only dream of a regular source of income.

    Although originally created by and intended solely for medical students, Medsin is now open to students doing any health related degree—or indeed to any student sympathetic to its aims. "In medical careers we're always being taught about the importance of multidisciplinary teams and working together," Ms Procter explains. "A lot of people want to get involved in health issues. There are lots more people out there who could make a real difference to our projects." In practice, though, Medsin remains predominantly made up of medical students.

    Claire Procter herself came to her 12 month presidency of Medsin via a previous year of handling publicity. The job is no soft option. Having completed four years of her course at Newcastle, she is on a 12 month sabbatical. She gets some sponsorship from the university but mostly pays her way by working as a waitress.

    Her decision to read medicine dates from the age of 13. After school she had a gap year spent travelling through Africa and working for six months in South Africa. "As with many students who get involved with Medsin," she says, laughing, "I had this idea that I wanted to work abroad; I wanted to go and save people in Africa.

    "I always did think I would work for Médecins Sans Frontières—which, hopefully, I may still do." Before that she wants to get experience in emergency medicine, paediatrics, and obstetrics and gynaecology—subjects that she thinks will be most valuable if and when she finds a job in health abroad: "Through Medsin I've developed much more of an idea of where I would actually be useful, what's good and bad about working for non-governmental organisations."(Geoff Watts)