Jour

nalo

fthe

Ass

ocia

tion

ofSu

rgeo

nsof

Gre

atB

rita

inan

dIr

elan

d.N

umbe

r39

,Mar

ch20

13

TAST

ING

NO

TES

used to evaluate anti-microbial dressings in amilitarily relevant setting.

Data from animal work has also lead to thedevelopment of physical models of the thorax;one to simulate the effects of blast (shock) waveson the chest and another to simulate behindarmour blunt trauma. Both these models havelead to advancements in body armour for militarypersonnel and allow armour to be evaluatedwithout the need for live animals. These models,however, do not allow the determination complexpathophysiological processes that occur as a resultof injury, nor the assessment of treatmentstrategies post-injury, hence the continued needfor appropriate animal models. The expertise ofthe research group at Porton Down in complexblast models is recognised internationally as partof the UK’s involvement in a five nationcollaborative network (Australia, Canada, NewZealand, UK and US), and scientists from bothCanada and USA have visited the facility.

Much of the work undertaken at Porton Down ispublished in the open literature, but there aresecurity, political and media sensitivities makingpublication of manuscripts challenging andfrustrating (it is demeaning to suggest that civilianreviewers do not understand; they often do so, alltoo well). Trauma research has not been wellsupported or funded until recently; the MRC’strauma research centre closed over 10 years ago.There has been resurgence for improved traumacare with the appointment of Professor Willett asthe National Clinical Director for Trauma, andfinancial support from the NIHR, and the openingof the Centre for Surgical Reconstruction and

Microbiology in Birmingham in January 2011.Funding from sources other than from the MoD,such as the MRC, the Wellcome Trust, theDepartment of Health and EPSRC, shouldencourage a range of establishments to participatein trauma research that will benefit both civilianand military personnel.

In summary, military trauma research has a longhistory at Porton Down. Battlefield injuryresearch, though often of a sensitive nature, findsmore general application in the management ofcomplex trauma in civilian practice.

References

[1] Payne L DWound Ballistics Research before 1945Scientific Foundations of Trauma (Cooper G J,Dudley H A F, Gann D S, Little R A, Maynard R Leditors) 1997; 3-11Butterworth-Heinemann

[2] Mossadegh S, Tai N, Midwinter M, Parker PImprovised explosive device related pelvi-perinealtrauma: anatomic injuries and surgical managementJournal Trauma and Acute Care Surgery73[Suppl 1] S24-S31; 2012

[3] Wollley T, Midwinter M, Spencer P, Watts S,Doran C, Kirkman EUtility of interim ROTEM values of clot strength, A5and A10, in predicting final assessment of coagulationstatus in severely injured battle patientsInjury. Epub ahead of print 2012

[4] Kirkman E, Watts S, Cooper GBlast injury research modelsPhilos Trans R Soc Lond B Biol Sci 2011; 366 (1562): 144-159

31

TAKE A DIFFERENT COURSE:WINE WISDOM AT THE WINE& SPIRIT EDUCATION TRUST®

Ed FitzgeraldGeneral Surgery Registrar, Chelsea andWestminster Hospital

It’s a question of nature or nurture. No matterhow diligent a student you were at medicalschool, or how prolific your PubMed citationshave become since then, not all of us spent ourstudent days scratching an academic itch. So whyis it that so many of us still end up testingourselves with new educational challenges? MBA,anyone? LLB or MSc? Perhaps the intrinsic natureof medics draws us all into the pursuit of lifelonglearning, or perhaps we have all becomeindoctrinated into it by the system. Or both. Orperhaps some of us just really need a Consultantjob. Either way, next time you feel an itchdeveloping for a postgraduate course, why notpour some wine onto it to calm things down? Justsign up for a wine tasting course instead.

Now, I’ve said before to anyone who’ll listen thatmedicine and wine are natural partners (althoughnot necessarily at the same time). Doctors as aprofessional group have an unusual (or ‘worrying’,as my friends often say) interest in alcoholic

beverages of all varieties. Whether this is natureor nurture is, again, debatable, as I fear a degreeof willing indoctrination also occurs in this area atmedical school. Nonetheless, learning about theart, science and culture of wine can be achallenging academic pastime. What better way toquench a thirst for knowledge than with such apleasurable and social activity as taking a winetasting course?

I say this with some modest experience, havingrecently completed 15 weeks of evening classesat the Wine & Spirit Education Trust (WSET®) inBermondsey Street, London*. Having spent agood part of my medical school holidays driving(or rather navigating) my family crazy around thevineyards of Europe and ‘exploring’ (wineeuphemism alert: ‘exploring’ = drinking) theworld of wine, I fancied enrolling on whatessentially amounted to a justification for openinga good bottle of wine on a Monday night. As ifmost of us need one.

The Wine & Spirit Education Trust is a registeredcharity (No. 313766) and was established in 1969,long before wine courses were as fashionable asthey are now. This was an era when the UK winetrade was the centre of the vinous universe,although this hub of commercial gravity may nowbe gradually shifting eastwards to Asia. Foundedby the historical ‘Holy Trinity’ of the British wine

trade, the Vintners’ Company, the Wine & SpiritAssociation and the Institute of Masters of Wine,WSET® was tasked with developing high qualityeducation and training for the wine trade or thoseplanning on joining it.

This is the way it remained for many years and, infact, non-industry students only started attendingtheir courses in 1990. Since then, WSET® hasdeveloped rapidly and is now accredited by Ofqualas a UK Awarding Body within the NationalQualifications Framework (NQF). Their winequalifications are internationally respected withinthe wine trade, with courses in 17 languages,exams sat in 58 countries and 43,254 candidatesattempting a WSET® qualification last year.Although most still hail from the UK, candidatesfrom Hong Kong, USA and China took second,third and fourth places respectively last year.

Details of the different courses and qualificationsoffered are provided in table 1. Timing is flexible,with many running simultaneously, and participantshave the option of enrolling on day-release courses,continuous blocks or evening classes. I opted forthe latter, based at the tasting rooms at the headoffices of the WSET® in Bermondsey Street.

FOUNDATION LEVEL COURSES

WSET Level 1 Award in Wines• Introductory one-day course• Basic wine knowledge and matching food

with wine

WSET Level 1 Award in Wine Service• Entry level one-day course• Wine service and practical skills in the

restaurant setting

WSET Level 1 Award in Spirits• Entry level one-day course• Basic product knowledge and skills in

service and marketing

INTERMEDIATE LEVEL COURSES

WSET Level 2Intermediate Certificate in Wines and Spirits• Major grape varieties and where they are grown• Wine styles and the production of spirits

and liqueurs• Systematic approach to tasting with approx.

45 wines and 4 spirits• Minimum 16 hours of teaching delivery

time, with further self-study• Assessment: 1 hour paper with 50 multiple

choice questions

WSET Level 2Professional Certificate in Spirits• Main categories of spirits and liqueurs• Influences of production methods on the

different styles• Systematic approach to tasting with approx.

60 spirits and liqueurs• Minimum 12 hours teaching delivery time,

with further self-study• Assessment: 1 hour paper with 50 multiple

choice questions

ADVANCED LEVEL COURSES

WSET Level 3Advanced Certificate in Wines and Spirits• In-depth knowledge of a wide range of

wines and spirits• Factors that influence style, quality and

price of wines and spirits • Systematic approach to tasting with approx.

76 wines and 6 spirits• Equivalent to A-Level/AS-Level course

standard• Minimum 28 hours teaching delivery time,

with further self-study• Assessment: 50 MCQs, 5 short answer

questions and a blind tasting

DIPLOMA LEVEL COURSES

WSET Level 4Diploma in Wines and Spirits• Internationally recognised as the premium

wine and spirit qualification• Divided into 6 units, including business and

commercial aspects• Systematic approach to tasting with over

250 wines and 50 spirits• A prerequisite for entry onto the Master of

Wine study programme• Equivalent to university ‘Certificate’ course

standard• Minimum 118 hours teaching delivery time,

with further self-study• Assessment: Mix of MCQ, theory papers,

assignments and blind tastings

WSET Level 5 Honours Diploma• Attained on completing a dissertation

following the Level 4 Diploma• Includes undertaking a literature review of

the subject area chosen• Project length: 4,000–5,000 words

Table 1: Wine & Spirit Education Trust Qualifications

Before my Level 3 course commenced, Ireceived a bulky package through the post,although my initial excitement deflated quicklywhen I realised this consisted solely ofpreparatory reading rather than the fine wine Ihad envisaged. Nonetheless, these coursematerials were excellent, with a 278-page bookcovering the whole world of wine from regionsto regulations and production to packaging. Inaddition to this was a comprehensive syllabus toguide your reading and a spiral-bound study guide

Jour

nalo

fthe

Ass

ocia

tion

ofSu

rgeo

nsof

Gre

atB

rita

inan

dIr

elan

d.N

umbe

r39

,Mar

ch20

13

TAST

ING

NO

TES

32

Burgundy

Jour

nalo

fthe

Ass

ocia

tion

ofSu

rgeo

nsof

Gre

atB

rita

inan

dIr

elan

d.N

umbe

r39

,Mar

ch20

13

TAST

ING

NO

TES

33

including helpful practice MCQs and short-answer questions.

The following 15 weeks were great fun, perhapsmore so for me as an interested amateur. Theclass of 20-odd students was a fantasticallyinternational group and split 50:50 between thoseactually in the wine or restaurant trade and others,like myself, just there to follow their passion. Forthose actually in the trade, many were funded bytheir companies, which brought obvious addedpressure to their studying. There’s a lesson in thatfor the NHS and our dwindling study leave…

Over the 15 weeks, we enjoyed a vinous tour ofall the world’s main wine regions, interspersedwith some of the more technical and commercialaspects of vineyards, winemaking, retail andconsumption. Each two hour class had a particularfocus and the six wines or spirits tasted werecarefully chosen to illustrate that evening’slearning objectives. This ensured the classesremained ‘hands-on’, but also gave an opportunityto go into a detailed tasting of the wines guidedby an expert in the area. Some people arenaturally gifted at finding gooseberries in theirsauvignon blanc and blackberries in their cabernetsauvignon. I am not blessed enough to be one ofthem. Thankfully, the course teaches the WSET®‘systematic approach’ to wine tasting. I wasrelived to discover that PubMed and meta-analysiswere not required for this particular systematicapproach, rather a stepwise analysis of technicalfactors such as the clarity, acidity, tannin, alcohollevels and suchlike, in addition to the often-lampooned descriptors of taste and flavours.

The tasting didn’t always end at the class either;the course was a great opportunity to meetlikeminded enthusiasts (another wineeuphemism: ‘enthusiast’ = wine nerd) and wewere soon staying on for dinner locally andorganising separate wine tastings together withthe excuse of ‘exam revision’. This proved to bea remarkably good excuse for popping the corkson some great wines!

The end of the course came all too quickly andwas accompanied by a not particularly welcomeexam. For the Level 3 Advanced course, thisconsisted of 50 MCQs, five short answerquestions and a blind tasting of two wines. Eachof these required a detailed tasting note withconclusions regarding development, value and anattempt at identifying the particular wine from arange of options. A couple of sample MCQ

questions are given in table 2. The exam was noteasy, set at an equivalent level to A-Level/AS-Level, and I was relieved to subsequently pass; anumber of other students didn’t make the grade.

Q. Which one of the following is the keyfactor in determining the quality of thewines in Ribera del Duero?a) Maritime influenceb) Altitudec) Summer raind) Cold air descending from the Pyrenees

Q. Which one of the following is a finingagent?a) Potassium bicarbonateb) Sulphur dioxidec) Kieselguhrd) Bentonite

Table 2: Level 3 Advanced Course Sample MCQs

What did I learn? For someone who thought heknew something about wine, this course mademe realise that there are huge wine producingareas (mainly outside of Europe) that I really haveembarrassingly little knowledge of. So for theenthusiastic amateur, that alone is a great reasonto undertake these classes – just think of all thosenew wines waiting for you to broaden your plateand discover them! But more than that, thecourse gives you a solid grounding in other areasyou might otherwise gloss over: the factorsinfluencing wine quality, price and even aspects ofalcohol law and social responsibility.

Was it worth it? Absolutely, yes. While these sortsof advanced courses don’t come cheap, you won’tbe charged much more than a current BasicSurgical Skills course, and the WSET® varietytastes a lot nicer too. Put all that into contextand either the WSET® sourced my 78 glasses ofwine for the course very cheaply, or someonesomewhere is really overcharging for pigs’trotters.

So, no matter how severely afflicted you are withrecurrent medical course-itis, there’s a lot of funto be had from nurturing your vinous intereststhrough evening classes such as these. Enjoymentof wine is what nature intended.

*Other wine courses are available. Always read theinstructions before use.

For further information on accreditedcourses across the country andinternationally check:http://www.wsetglobal.com/

WSET39-45 Bermondsey StreetLondonSE1 3XF

The WSET® is a Registered Charity (No. 313766)

With thanks to David Wrigley, GlobalCommunications Director at WSET® London,for providing the background information.

Hard at work, revising over dinner