Turning the World Upside Down – global health, frugal innovation and the new age of well-being by Dr Hannah Brooks Specialty Registrar in General Practice, London Deanery and Dr Anas El Turabi, Specialty Registrar in General Practice, East of England Deanery

Judging from the turnout of the last Diagnosis salon, Global Health remains a popular topic for many doctors-in-training. Chaired by Pam Garside and held in conjunction with the Institute of Global Health Innovation at Imperial College, the salon boasted an all-star line up: Ara Darzi, former Parliamentary Under-Secretary of for Health; Richard Smith, former editor of the BMJ, now Director of United Health’s Global Chronic Disease Initiative; and in an unbilled cameo, Liam Donaldson, former Chief Medical Officer for England.

Ara Darzi’s talk focused on the convergence of health challenges between different health systems and the need to share successful innovations. Drawing on his experiences as a health minister and Director of Imperial’s Institute of Global Health Innovation, Lord Darzi made the case for revising traditional views of global health innovation.

Using examples like the Aravind Eye Care System in India, which is pioneering low cost, high quality ophthalmic care to some of India’s poorest populations, Lord Darzi highlighted the globally dispersed nature of innovation in health service delivery. In an argument reminiscent of the ‘reverse innovation’ advocated by GEs Jeff Immelt and ‘Jugaad innovation’ studied by Radjou, Prabhu and Ahuja, Lord Darzi challenged the audience to look beyond the traditional models of health system innovation, to discover new ways of adapting systems of care to meet healthcare and economic demands. (It was not clear whether Lord Darzi was ever aware of Pam Garside scribbling the words ‘Healthbox’ behind him in big letters).

‘Turning the World Upside Down’ was a theme that continued as Richard Smith challenged the salon to rethink what future priorities should be for global health. During a whirlwind tour of contemporary global health challenges, taking in the rising burden of chronic non-communicable disease, as well as a salutary introduction to the importance of Michael Marmot’s work on the social determinants of health, Dr Smith highlighted how changing patterns of global morbidity demanded a new approach to priority setting for global health.

The post-2015 development agenda will see the Millenium Development Goals superseded by the Sustainable Development Goals. With the SDGs still in development, Dr Smith argued that now is the time to be rethinking how we measure the success of global health endeavours. ‘Well-being’ he suggested might replace traditional measures of economic and health progress such as GDP or QALYs; an idea already being considered by the UK Government as part of its recent efforts to develop measures of national well-being.

With such high-profile and thought-provoking speakers, discussion was vibrant and wide-ranging. Amid nihilistic arguments of economic determinism in global health and less nihilistic arguments that all the world needs is more psychiatrists, Sir Liam Donaldson lent his considerable experience in global health, bringing a welcome clarity and insight to proceedings. What was more impressive however was how late into the evening discussions continued for many attendees. Proof again of both the draw of global health as a topic and the success of Diagnosis’ salon format.

Summer internships at HSJ and BUPA by Mr Ruslan Zinchenko 4th year Medical Student UCL

Spending four weeks at the Health Service Journal was an invaluable opportunity for me, and gave me a chance to experience many aspects of journalism and the news industry. Being an international student I have always struggled to convey information and concepts in writing. There were plenty of opportunities to practice this at the HSJ, and obviously this allowed me to greatly improve my writing skills. Questioning to find out information was an everyday job as well, and I had to interview a number of important people, who were heavily involved in health policy. In this task active listening and understanding relevant points was crucial as I found out with time. I was also required to present to an audience made up of my colleagues during team meetings on Wednesdays. This was a useful hour during which I could get feedback on the work and research I was doing from experienced journalists. Their contribution helped to keep me on track and also helped with difficult situations. Everyone was friendly and willing to teach you, despite being overloaded with work, which I thought was great! In addition, as part of my research I had to analyse numerical and graphical information, something that I don’t get a chance to do at university as part of my course, and is a useful skill to have in the current competitive job market. Lastly, my research made the front cover of the journal (of course after some intense editing from my senior colleagues), which was something I never expected to happen, and knowing that your work is going to be read by thousands of people and make an impact was a nice feeling.


During my 6 weeks at BUPA I was given several projects as well as a number of side jobs. Since BUPA is an insurance company, I had to switch on my business acumen straight away. I was required to think strategically and try to see the wider picture, which was much more difficult that I have ever imagined. You always hear people say: “look at the bigger picture”, but when you actually come to doing it, you are overwhelmed with the complexity of the situation. My manager was quite keen on me taking initiative and always pushed me to think about problems in my own way rather than follow the standard corporate approach. Having never worked for an insurance company before I had to absorb new information quickly, which was good practice for the future, as we will always find ourselves in novel environments. As part of my projects I had to gather information and come up with creative solutions for BUPA in the near future. This generating of entrepreneurial ideas was something that I have always enjoyed, and an opportunity to do in the real world whilst working on real projects was exhilarating. Lastly, BUPA is an organisation with a lot of people, which meant that I had to collaborate with others to achieve goals, as well as adapt to their needs and styles.


In conclusion, I would like to say how grateful I am to DIN for organising these two internships for me, which gave me an opportunity to experience something else to medicine and develop a number of skills which are just not taught in medical school.