Exam time

So I realize it’s been a while since my last post (over two months, besides the last two which I actually started weeks ago but only just posted). The reason for this is, I’ve been swamped with lab work since mid-January, and I just handed in my final lab report and started a ten-day break from studying!

At least that’s what I thought, this week is my assessment week at the University of Edinburgh’s online distance learning MSc in Internal Medicine. This is the third such assessment week since I started last September, but it’s definitely the most challenging. Ten weeks of study culminating in one exam that includes all aspects of internal medicine bundled into 100 questions. From the kidneys to the brain, the skin to the liver – nothing is off-limits! I’ve been handling my lectures and tutorials well thus far, but I still feel like I should be studying more! The exam is in the style of the Membership of the Royal College of Physicians (MRCP) exams, which I hope to take sometime next year. I’m looking forward to the challenge of the exam, and I believe that the excellent preparation I received from the teaching staff at Edinburgh will serve me well. The program is brilliantly designed to guide it’s students through a wide range of topics, focusing on common illnesses, which is what the MRCP exam aims to test.

That being said, I may not have so much time to post anything this week, but I plan to come back next week with more exciting stories to tell! (And hopefully a victorious conquest of the exam)

Till then 🙂 !

What’s in a name? II. Giving credit where credit is due.

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Following up on my last article about eponyms, this time I move to the naming of organisms after their discoverers. For a long time, and to this day, the pathogen Pneumocystis jirovicii, which is a fungus that causes a specific type on pneumonia in immunocompromised people (such as those with HIV), is commonly referred to in the literature and among medical professionals as Pneumocystis carinii. The reason for this is that when it was first discovered, it was found in rats and named after the man who first described it – the Italian bacteriologist Antonio Carini. Later on, it turned out that the organism which causes human infection is different from the one initially described in rats. Not only that, but Carini mistook the parasite for a different form of another parasite, Trypanasoma cruzi (which causes Chagas disease). It was through the efforts of two French researchers that it was recognized as a distinct organism. To make matters even more complicated, P. jirovicii’s namesake, the Czech parasitologist Otto Jírovic, published his findings on the parasite ten years after two Dutch researchers had discovered that same organism! Anyway, the name was officially changed from P. carinii to P. jirovicii over fifteen years ago, yet the former still remains in common usage. There has been some debate regarding this change, with some people arguing that changing the name after such a long time is futile – that people will still use the old – and causes unnecessary confusion. I guess it just goes to show, you can’t teach an old dog new tricks. However, that doesn’t explain why I often use the old nomenclature too. At least I think it doesn’t.

What’s in a name? I. Eponyms and a dark history

Ask people what they think of the use of eponyms in science and you will get a mixed response. In medicine, eponymously named syndromes, structures, processes and laws are everywhere, though there is much debate about whether they should be in routine use. Personally, I’m a big fan of eponyms – they may not be descriptive or informative as the proper terms they signify, but I think they have a certain appeal. There’s a lot of history to be unearthed when encountering an eponym for the first time, and it’s status as a tribute to the discoverer/inventor is so … wonderful!

That being said, there’s a dark side to eponyms as well, one that I recently encountered after attending a tutorial (part of the MSc Internal Medicine program) at the University of Edinburgh. The topic was sexually transmitted disease, and a syndrome known as reactive arthritis came up. This disease, which describes urethritis, conjunctivitis and arthrits, is eponymously named ‘Reiter’s syndrome’ (the eponym was not used during the tutorial, and I had wondered why not). Now, I had heard this eponym being used very often during medical school, more often in fact than the proper term for the condition, but I had never known who Reiter was. So, after the end of the tutorial I did some digging and found out that the disease was named after Hans Reiter, a German doctor who was a member of the Nazi party and was convicted of war crimes for experimenting on people in concentration camps. Apparently, over the past decade the term Reiter syndrome has fallen out of favor within the medical community, and many people who generally oppose the use of eponyms are using it as an example of why they should be abandoned. Moreover, there are several other medical eponyms with similar Nazi histories, including the Clara cell and Wegener’s granulomatosis. There has been considerable effort so far to replace the use of these terms with other, more informative titles. What this means for the future of eponyms in medicine is not yet known.

On a side note: Living in Germany, it’s interesting to observe how people react to the country’s complex and distressing past. The Charité, the main university hospital and medical school in Berlin, was once home to many convicted Nazi physicians. I’m not sure whether similar eponyms are used here for the mentioned structures and diseases, but it would be interesting to find out.