Monthly Archives: February 2016

How many classes of <4 are you taught in?

by reestheskin on 28/02/2016

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“When I first looked at the Robbins report some years later, I was amazed that students had been surveyed on how many hours they were taught in classes of one to four, as I had no idea that university teaching ever occurred in such small groups”.

Nick Hillman in the THE.

FWIW, during my intercalated year (Newcastle, 1980/81), the core teaching over a summer of 3 months or so, had a mode class size of n=2.

Posh professors.

by reestheskin on 28/02/2016

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Private schools teach 7% of Britain’s pupils, but account for half the country’s senior civil servants, cabinet ministers and leading journalists. Seven in ten generals and judges went to independent schools, according to the Sutton Trust, a charity. In some jobs the proportion has even increased. A decade ago, half Britain’s senior doctors were privately educated; today the figure is 61%. The share has risen in the law, too.

Feels like it too. Economist.

Tech and the classroom: deja vu all over again.

by reestheskin on 24/02/2016

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From the Chronicle of Higher Education.[via Audrey Watters].


Its dermatology Jim, but not as you have heard it before

by reestheskin on 24/02/2016

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Hywel Williams gets lyrical about atopic dermatitis. Worth a cwtch, as we might say.

What role, if any, do I want to have within this field?

by reestheskin on 23/02/2016

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There is a very insightful blog post in the THE from a final year med student at the Karolinska. He writes:

However, there were also negative aspects of medicine that made me question my career choice. For instance, I quickly realised that clinical decisions are heavily based on protocols and algorithms, leaving little room for individual reasoning. Moreover, the time with the patients seemed to be very limited, and the conversations almost always followed the same patterns. The monotonous work was in deep contrast to the adventurous job I had imagined.

To remain motivated, I had to answer the sensitive question that I had not previously addressed: what role, if any, do I want to have within this field?

These are pretty pertinent and sharp insights. His solution is to try and pursue research as well as clinical practice, but this too has its own drawbacks. It is the comments about protocols and how much medical practice is so time constrained, that chime with my dissatisfaction with so much NHS practice (and it is getting worse). Reminds me of Paul Seabright’s comments in his book, The Company of Strangers,

‘It is both an admirable and melancholy fact that training and and the standardisation of working methods are designed to reduce the impact of personal idiosyncrasy on the job’

If medicine is to keep attracting the best, medical jobs need to radically change; and those of us used to the old world, need to map out a new one and appreciate that talent in not infinite. But one of his lines is a good starting point for all students: what role, if any, do I want to have within this field?

by reestheskin on 22/02/2016

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Andrew Oswald in the THE

‘A key purpose of a PhD is to destroy a young person’s ability to enjoy leisure. Presumably, this is what it is like to be in the SAS’

But adds (salvation is on hand)

The world does not prosper when humans are consumed by duty.

Knowledge spaces

by reestheskin on 22/02/2016

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Yes, this is an old one, but it came up in a recent conversation. Of course, at one time, I might have wondered where medicine should figure on this gradient. Now I know better: it shouldn’t. This isn’t to say there is not lots of biology, or other domains referred to in medicine, it is just that medicine occupies a different dimension.

The rental business for student accommodation

by reestheskin on 21/02/2016

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From an article in this week’s Economist:

  • 1:4 students live in purpose built halls of residence
  • in 2006, 82% were owned by universities; the figure is now 59%
  • private halls are 40% more expensive
  • London rent average is £220 per week ( in digs in 1978, in Newcastle,
  • I paid a rent of £1:85 per week, although the building  was subsequently condemned)
  • private halls have increased their rents by 20% since 2012.
  • ‘UCL have put up rents by 56%’ since 2009 (UCL put the figure at 40%)


Travel broadening the mind and sharpening the scalpel.

by reestheskin on 19/02/2016

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This article about a UK trainee who went to Brazil to increase his clinical experience in plastic surgery is worth a read. Several things caught my eye:

[He] gained more surgical experience during a two month elective in Brazil than during his two year foundation training

The Instituto Ivo Pitanguy runs a three year residency programme—separate from the national plastic surgery programme—with a focus on technical surgical training. [emphasis added]

Successful applicants need to have completed two years of general surgery before passing the entry examination. These residents pay a fee of 4000 reals (£700) a month for the duration of the residency and are not paid. This might not seem like an enticing prospect, but trainees usually support themselves through locum work, and in return they receive three years of outstanding training and operating experience.

The clinic is always busy, so the 60 residents have plenty of opportunity to perform operations as they progress through the programme. First year residents assist the surgeons and are responsible for closing wounds. Second year residents have a greater role during operations in preparation for the final year, when residents perform around 80 operations as lead surgeons, with an unscrubbed supervisor.

MOOCs, and being dragged, kicking and screaming.

by reestheskin on 18/02/2016

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Nice post from Donald Clark:10 ways MOOCs have forced Universities into a rethink.

One morsel of clickbait, which just happens to be true, is:

A common question when MOOCs are mentioned is, “How do you monetise MOOCs? It’s usually delivered with a ‘Gotcha’ tone. The financial and business models in education are complex. However, we can be sure of one thing, the current University system can’t monetise itself. The whole structure is propped up by state spending and huge loan books.

Of mice and men

by reestheskin on 18/02/2016

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It’s no secret that therapies that look promising in mice rarely work in people. But too often, experimental treatments that succeed in one mouse population do not even work in other mice, suggesting that many rodent studies may be flawed from the start. Nature

As it says, ‘no secret’. Science is usually self correcting, but the time period may vary. What has always puzzled me is how in the areas of biology I know something about, mouse work has been so informative; whereas in others, all is seems to be good for, is publication is high impact journals. For those interested in pigmentation, mice have been wonderfully informative, whereas for those other bits of skin biology I am familiar with (ahem), like inflammation, mice have been less helpful. A part of me wonders whether some of this is  due to whether you are trying to identify potential pathways, or whether you are trying to build interventions based on particular pathways. And finally, lest there be any confusion, I am not one of those who believes we haven’t learned a lot from animals.

Neanderthals and seborrhoeic keratoses

by reestheskin on 17/02/2016

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This made me laugh. I have got used to MC1R mutations and red hair in Neanderthals, but this article (full research paper in Science here) brought a smile to my face, even if I am still a little hazy on the genetics.

JBS Haldane once commented ‘that God would appear to be inordinately fond of beetles’, based on the observation that the world was so full of different species of beetles.

I have long had similar thoughts about seborrhoeic keratoses. God must be inordinately fond of them. Seborrhoeic keratoses are benign skin tumours, some of which contain identified mutations: they generally attract little serious research interest (apart from yours truly, of course). However, their significance clinically is enormous. This is because they are incredibly common as people move into their fourth decades and beyond, and because they vary so much in their morphological appearance. They mimic everything, including melanoma. So, most things referred as possible melanomas in many clinics, will turn out to be harmless seborrhoeic keratoses. Of course, a more cynical view is that since seborrhoeic keratoses are such great mimics, they in effect create lots of work for dermatologists. I suppose I should say thank you, next time I bump into one of my distant cousins, but the basis of the link — if confirmed — also deserves some serious mechanistic thought.

Not something you see too much these days: analogue innovations

by reestheskin on 17/02/2016

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But sounds great……MXR analogue

Red hair (again)

by reestheskin on 15/02/2016

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Nice  BBC radio programme. Impressed with the presenters, rather than yours truly.

OA, CC and ‘Confusion will be my epitaph’.

by reestheskin on 15/02/2016

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I had thought I ‘got’ Open as in terms of OER, Creative commons and the like, but clearly I am missing something (and in truth I have suspected I am missing something, for quite a while). This is from Stephen Downes:

Your new word for the day is ‘copyfraud’. Here’s the definition from Wikipedia: “Copyfraud refers to false copyright claims by individuals or institutions with respect to content that is in the public domain. Such claims are wrongful because material that is not copyrighted is free for all to use, modify and reproduce.” In the current case, copyfraud also applies to materials that are license CC-by. As Peter Murray-Rust writes in the GOAL mailing list, “Springer took all the images published in its journals and stamped COPYRIGHT SPRINGER over all of them and offered them for sale at 60 USD. This included all my publications in BioMedCentral, a CC-BY Open Access journal…” In another post he notes that Oxford University Press is “charging large prices for re-use of CC-BY articles (e.g. 400 USD for use in an academic course pack for 100 students.”

Clearly my idea of what CC-BY meant is wrong. There are other issues however I don’t understand. You use material from the web marked CC-BY-SA in a lecture or video that is hosted on a private site (say a university VLE). How does this work?

Students flocked to his evening classes

by reestheskin on 14/02/2016

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Marvin Minsky has died. There is a wonderful description in Steven Levy’s ‘Hackers’ about Minsky and The Tech Model Railway Club and Midnight Computing Wiring Society at MIT. It is inconceivable now to imagine a university tolerating such a state of affairs: the state of affairs that was key to the development of the modern world. Rebellion and discovery are often of a piece.

The people in charge of the lab, particularly Marvin Minsky, were very understanding about these things. Marvin, as the hackers called him (they invariably called each other by last name, knew that the hacker ethic was what kept the lab productive, and he was not going to tamper with one of the crucial components of hackers. On the other hand, there was Stu Nelson, constantly at odds with the rules, a hot potato who got hotter when he was eventually caught red-handed at phone hacking. Something have to be done. So Minsky called up his good friend Ed Friedkin, and told him he had this problem with an incredibly brilliant 19 year old who had a penchant for getting into sophisticated mischief. Could Fredkin hire him?

Stewart Brand’s description nails it:

I think that hackers — dedicated, innovative, irreverent computer programmers — other most interesting and effective body of intellectuals since the framers of the US Constitution….. No other group that I know of has set out to liberate a technology and succeeded. They not only did so against the active disinterest of corporate America, their success forced corporate America to adopt their style in the end. The quietest of all the ‘60s subcultures has emerged as the most innovative and powerful. 

Professor Nicholas Negroponte, co-founder and chairman emeritus of the Media Lab, says:

“Marvin talked in riddles that made perfect sense, were always profound and often so funny that you would find yourself laughing days later.”

And from the Economist’s obituary.

He also, almost by the way, did other things, such as inventing a confocal scanning microscope and robotic “seeing hands” for surgery. His own intelligence continually leapt between postulations and speculations, all delivered with an endearing smile: what a thinking machine would have to notice when it drove down the highway, whether robots could be made tiny enough to beat up aphids or dexterous enough to put a pillow in a pillowcase, what would happen if you wrote “Eine Kleine Nachtmusik” to a different rhythm. Students flocked to his evening classes, never quite knowing what mental challenge he would toss out next.

Defence expenditure

by reestheskin on 10/02/2016

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 With a research budget increasing to $71bn in 2017, at a time when the overall defence budget is shrinking, new technology is a key part of US efforts to maintain its military edge over China and Russia.

FT [direct link to this aside] 

Pharma not the place for drug discovery

by reestheskin on 10/02/2016

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Martin Wolf, the influential economist, wrote in the FT sometime back that the public might soon view pharma companies in the same way many viewed banks (or at least bankers). Here is a news item from today’s FT.

A number of Pfizer scientists have told the Financial Times that they fear the company will move closer to the Allergan approach and step back from discovering new drugs, putting their jobs at risk.

Dr Mikael Dolsten, president of worldwide research and development at Pfizer, said he was aware of the unease but that the combined company would occupy a “sweet spot” in R&D.

Further on:

Brent Saunders, Allergan chief executive, has questioned the efficiency of discovery research conducted by big pharma groups. In an interview with the FT last year, he argued that smaller companies and academic centres were better suited to this sort of science.

Since then, he has modified his position somewhat, arguing that drug discovery has a role at big pharma companies, providing it is has a high chance of success and is targeted at illnesses where the company already has a strong selection of drugs.

This is all about the merger between Allergen and Pfizer. The arguments may be more nuanced than I want to believe, but this is what happens when ‘financialization’ becomes more important than invention (and long term value). Lets just call it: the no James Black syndrome.

And can we please skip the dreadful ‘sweet spot’ terminology.

Publishing: compare and contrast

by reestheskin on 09/02/2016

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Remember those compare and contrast questions (UC versus Crohns; DLE versus LP etc.). Well, look at these two quotes from articles in the same edition of  Nature.

The first from the tsunami of papers showing that ‘Something in rotten in the state of Denmark Science’ — essentially that the Mertonian norms for science have been well and truly trampled over.

Journals charge authors to correct others’ mistakes. For one article that we believed contained an invalidating error, our options were to post a comment in an online commenting system or pay a ‘discounted’ submission fee of US$1,716. With another journal from the same publisher, the fee was £1,470 (US$2,100) to publish a letter. Letters from the journal advised that “we are unable to take editorial considerations into account when assessing waiver requests, only the author’s documented ability to pay”. 

The second is about attempts to piggyback on the arXiv server. An earlier article and blog post from Timothy Gowers says more.

Discrete Analysis’[the journal] costs are only $10 per submitted paper, says Gowers; money required to make use of Scholastica, software that was developed at the University of Chicago in Illinois for managing peer review and for setting up journal websites. (The journal also relies on the continued existence of arXiv, whose running costs amount to less than $10 per paper). A grant from the University of Cambridge will cover the cost of the first 500 or so submissions, after which Gower hopes to find additional funding or ask researchers for a submission fee.

Well done the Universities of Cambridge and Cornell (arXiv). For science, the way forward is clear. But for much clinical medicine, including much of my own field, we need to break down the barriers between publication and posting online information that others may find useful. This cannot happen until the financial costs approximate to zero.

Nor did Mann have to worry that a good idea would struggle for funding. Whereas many government research heads fret about budgets that don’t at least keep pace with inflation, past DARPA directors are surprisingly blasé about the agency’s finances. “I never really felt constrained by money,” Tether says. “I was more constrained by ideas.” In fact, aerospace engineer Verne (Larry) Lynn, DARPA’s director from 1995 to 1998, says he successfully lobbied Congress to shrink his budget after the Clinton administration had boosted it to “dangerous levels” to finance a short-lived technology reinvestment program. “When an organization becomes bigger, it becomes more bureaucratic,” Lynn told an interviewer in 2006.

A little about what makes DARPA tick. This reminds me of come of the comments from Xerox PARC (from John Seely Brown? — I can’t remember) about how important it was to keep the research budget (not the D, of R+D) below 1%. Any higher, and the bean counters would get interested, and start trying to manage the budget. [See my previous post from Alan Kay]. Not all increases in funding are a good idea (unless the success metric is money, rather than discovery)

[direct link to this aside]