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The Muddy Waters of Medical Humanitarianism

Introduction

My name is Ciaran Clarke and I am studying a masters in Humanitarianism and Conflict Response (HCR). My background is far removed from the history, international relations, and sociology which forms a large part of my degree. In fact, despite studying a postgraduate degree, I am still an undergraduate! I am studying the Masters between my fourth and fifth year of undergraduate medicine.

This is known as intercalation and is traditionally pursued by medics who want to study one aspect of science in greater detail, such as physiology or pharmacology. Manchester Medical School is particularly unique in the breadth of options available for intercalation. However, the HCR Master’s degree stood out for me. I have always wanted to undertake medical humanitarian work, but the multitude of issues surrounding this field have always left me feeling uneasy. I felt that the HCR Masters would give me an opportunity to grapple with these issues and develop a better understanding of how medical aid can be delivered effectively.

In Depth

The Masters programme has been incredibly rewarding, particularly for someone coming from a science degree. The complexity of humanitarian aid has been unveiled to me, going to a depth of understanding which I never imagined reaching. This has included asking myself questions which have never before crossed my mind, such as – is providing aid always good? A year ago I would have likely said yes, but through studying disciplines such as history, ethics and public health I have come to realise that no straightforward answer exists. For instance, there are instances of aid being used to extend conflicts, when it has fallen into the ‘wrong’ hands and been sold on a black market and provided funds for armed forces.

One of the great things about the Masters is the wealth of experience I have been surrounded with. It is difficult not be inspired when you turn up on a Tuesday morning and your lecturer starts telling you about his recent United Nations meeting or her trips to war torn parts of northern Sri Lanka to provide medical assistance. As a postgraduate taught (PGT) degree, for two thirds of the year my days are a mix of lectures, seminars and private study. After handing in my essays in May, I will then have the remainder of my degree free for my dissertation.

My dissertation gives me the opportunity to study one aspect of humanitarianism in real depth. My current focus is on the development of sustainable healthcare systems following humanitarian crises. Medical aid has often been directed towards specific diseases such as HIV/AIDS, Polio, Malaria or Tuberculosis, this is known as a vertical approach. While this can tackle specific diseases, when the money dries up it is unlikely that a robust healthcare system will remain. But many of the countries that have require medical aid have limited infrastructure and trained personnel for developing an all-encompassing or ‘horizontal’ approach. The question remains, how do we approach healthcare development in a sustainable manner without spreading resources so thin that they don’t have any effect? It seems that a compromise between the two needs to be reached!

The greatest challenge for me has been learning to adapt to a completely novel set of disciplines. Getting my head around and then critiquing theories of learning, international relations and in depth history articles has been a very different challenge to memorising the signs of liver failure!

Going forward, I still hope to undertake medical aid work in the future, but the Masters has made me realise that I must wait until I am a relatively independent practitioner. Therefore, I will continue on my medical training, hopefully pass my finals and then start as a junior doctor in 2017!

Going Further

For those of you who want to find out more about the incredible staff at HCRI then click this link

Medicins Sans Frontieres (Doctors Without Borders) website http://www.msf.org.uk/

An overview on the current state of the ‘humanitarian system’ http://www.alnap.org/what-we-do/effectiveness/sohs

The full range of intercalation options open to medical students at UoM http://www.mms.manchester.ac.uk/study/why-study-medicine-manchester/intercalation/

For an insight into some of the problems with aid watch the film “The Trouble with Aid” (2012) 

From undergraduate to PhD student

Introduction

If someone had asked me at the start of my final year of my undergraduate degree, ‘do you fancy doing a PhD when you finish uni?’ my answer would have been an outright NO! Yet, here I am, now in my second year of my PhD in the role of exercise on cardiovascular disease risk in psoriasis.  So what changed my mind? Well, it was only when I entered my final year of my undergraduate degree that I actually started to seriously consider my career options. My undergraduate degree was in Biomedical Sciences and I wanted to find out what I could do with my degree (aside from the obvious career pathways like Biomedical Scientist or scientific research).

In Depth

So, after hours of trawling the internet, numerous career appointments and countless chats with my academic tutors I had a much clearer idea of what was out there. However, despite all this time and effort I invested into researching potential future careers I still wasn’t 100% sure. Although, I particularly liked the idea of becoming a medical writer because writing is something I like doing and something that I enjoy. Also I had a lot of time for my subject area as I found it interesting and enjoyed learning about various aspects of science.

Another thing which interested me was intellectual property, which was first brought to my attention in one of my pharmacology lectures. I soon learned that I could become a patent attorney. The more I read about this area of work, the more it appealed to me. This career path is an opportunity to merge law and science. Naturally, because I don’t have a background in law (like the vast majority of patent attorneys according to my research) this career requires you to undertake training and sit examinations. This is something which doesn’t really bother me too much (after all I’ve already spent years doing it and a couple more won’t hurt!). Anyway, after reading up on what’s required for this type of career I found that a PhD is ‘preferable.’ Now I know this doesn’t mean a PhD is essential, however, I thought whether I decide to go into medical writing or become a patent attorney, either way a PhD will stand me in good stead.

So that’s when I took the plunge and began searching for a PhD. I had a specific criterion already in mind in terms of what I wanted from a PhD. The things I knew for sure was: a) I wanted to stay at the University of Manchester, b) I wanted a PhD with a studentship so I didn’t have to worry about funds for the next 3 or 4 years and c) I didn’t want a PhD that was solely lab-based (I didn’t mind a bit of lab work but I hated being in the lab for hours on end!). So with all this in mind I started looking at what was on offer and began to pick out projects which captured my interest.

Eventually, I decided to apply for two PhD projects. I realise this doesn’t sound like a lot but the way I saw it was a PhD is a huge commitment and I wanted to be sure that my chosen project was something I was interested in and something I wanted to dedicate my time and effort to. And so for this reason I was very selective in terms of my applications for PhD projects. Something else which really helped me decide on which projects I wanted to submit applications to was going and actually talking to the supervisors about the project and what exactly I would be doing as a PhD student on their project.

So… out of the two applications I submitted I was invited for interview for one of the projects along with two other candidates. The supervisor requested that each candidate put together a presentation covering various topics including: why did we want to do a PhD, why did we want to do a PhD in Manchester and why did we want this specific project. Each candidate was also sent a copy of the research proposal which we were asked to read and comment on in our presentations. We had to say how we would structure our approach/time to the work outlined in the proposal and also comment on how we would perhaps improve the proposal and what other ideas we had.

The interview itself was, as you can imagine, nerve-wracking and very stressful! However, it was a valuable experience. There were five interviewers on the panel, three of which were my potential supervisors. Personally, I found the interview particularly stressful as I was up against two other candidates who both had a Master’s degree along with other research experience, whereas I had just come to the end of my undergraduate degree and was expected to achieve a 2.1.

Anyway, after the stress of my final exams and the PhD interview I found out (just a few days after the interview) that I had been awarded the position on the PhD programme. Naturally, I was over the moon and accepted the place on the programme! Now here I am in my second year of my PhD and I am thoroughly enjoying the experience so far.

Going Further