Thursday, September 29, 2011

End of Placement 2.

...where did my 3 weeks go?!

Seriously. These last 3 weeks actually blew by. Crazy. Couldn't believe that today was my last day on my placement in the peripheral hospital. Next week I will be back in the local teaching hospitals so I guess YAY no more 45-50 minute drives! Thinking back - I quite enjoyed my placement in the peripheral hospital. There were only 20 medical students at the hospital so the doctors were all really keen to teach and the staff were all very friendly. If only the hospital wasn't so far away. I've been hearing stories how the local teaching hospitals are absolutely packed with students; hence, patients are pretty annoyed with us and the consultants don't have time to teach.

Anyways this week has been really good. Did the standard ward rounds and finished up my first essay assignment that I handed in today. Got loads of teaching from Dr Y so that was really good. Saw some pretty interesting physical signs this week. Saw really marked dyskinesia in a patient with Parkinsons Disease. Today we saw a really interesting case. Patient presented to hospital with left sided weakness as well as facial weakness. This patient had a previous history of stroke. On examination, it was found that the patient had heminiopia and reduced corneal reflex in both eyes. Patient could not show her teeth/smile and could not open her mouth very wide. Arms and legs were not that weak. Both limbs seemed fairly normal and there were no changes in sensation except in the face. So what do you think she has?

Well she was just admitted so investigations have to be done, but it is suspected that she has bilateral facial palsy which is apparently quite difficult to make out. In general her face was emotionless which lead us to think that she may have bilateral facial palsy, and both corneal reflexes were reduced. The team didn't think this is a stroke but probably a pathology in the brain.

I personally thought this case was quite fascinating. It was different and it definitely makes you think. Thought I would share this case with you all.

Found out my next placement will be in General Surgery..........................AGAIN. General Surgery is great, but I have had enough. I'm so sick of it. I've done general surgery in my 2 weeks of placements in first year and then general surgery for my first placement this year. I want to see something else NOT GI related...PLEASE. I'm really interested in surgery and it's just so frustrating to be constantly placed in the same specialty. I really want to see the other surgical specialties and it's annoying how the medical school doesn't take into consideration your previous placements and what specialties you have been on. Pretty sure the school will come up with something like "Life isn't fair." But come on.

But yeah all in all - great placement out in a peripheral hospital. Definitely the complete opposite to my initial impression and have learned not to listen to other students as these students said that the hospital I was just placed in was hostile and unfriendly. Complete opposite and my experience has been fantastic. Really enjoyed it and have learned so much. Hopefully this continues in my next placement.

Saturday, September 24, 2011

Placement 2 - End of Week 2

Holy smokes what a crazy week. To be honest though there isn't much to talk about placement as I only went in 3 out of the 5 days. Well actually more like 2/5. On Monday I had my clinical skills assessment so I spent the whole day pooping myself and practising before my assessment. I was so nervous it was kind of ridiculous. I was nervous because I felt that I haven't had enough practice yet and there's just so much to think about whilst doing a clinical skill.

So it was finally my turn to do the assessment and thank goodness the assessors were REALLY nice. It was really informal and they told me that they don't expect me to be a pro at it and will guide me through each skill. Essentially I was tested on hand washing (easy), vital signs (BP, temperature, pulse, SpO2), venepuncture, cannulation, drug mixing, and finally setting up an IV drug. I didn't mind doing any of those EXCEPT for drug mixing and setting up an IV. I haven't done either of those skills since last year and I didn't get a chance to practice either of those skills prior to my assessment. I nearly started sweating bullets while doing those two skills but thankfully everything came back to me and I managed to pass all my clinical skills. That means I can officially do all of these clinical skills on real patients in the hospital as long as I am supervised.

Tuesday - standard - ward round and clinic. Clinic was really interesting. Saw 2 patients which some interesting case histories. Ward round...was a pain. Dr B was doing ward rounds which meant another grilling session. Also what I have realized is that he is PAINFULLY slow at doing ward rounds. Dr Y takes 3 hours to do a ward round....Dr B takes 4.5 hours and has the same amount of patients to go through. Anyways while Dr B was finishing writing notes in the patient's notes, my partner and I talked about the patient and the physical signs that we saw. Out of no where, Dr B turns around and snaps at us. He told us off for talking and said that if we keep getting distracted/aren't interested we can go to the library and do something else. My partner and I were like "....what?" We were confused because we were talking about the patient and what we saw, so we weren't distracted and obviously we are interested; hence why we were talking about the patient. Obviously Dr B was a bit grumpy today. The way he snapped at us really bugged us as it was uncalled for. So my partner and I had two choices: a) Piss him off more and just leave and go follow Dr Y or b) Bombard Dr B with loads of questions to show him we are interested and obviously to annoy him as much as possible. We chose to go with plan B and cue the waterfall of questions. We literally asked him about EVERYTHING. We looked at a patient's drug chart and asked Dr B about why he would prescribe these medications and why not alternatives. We started asking about the mechanisms of different drugs. I'm pretty sure Dr B got the idea that my partner and I were doing this on purpose and Dr B blazed through the rest of ward round. I guess that's one way of getting things done fast.

Wednesday - I didn't go to placement as I was helping out at the Medic's Fresher's Fair, which was quite tiring. Started setting up quite early and then had to wait for the fair to finish as I also have to help put away stuff. It was really nice meeting the new medics. Then I had an age crisis as some of these freshers look really young. I mean I saw some who barely even look 16 years old! It was crazy. We also got to showcase the Fresher's Video that we made. It turned out quite well and I think (hope) that the freshers enjoyed it.

Thursday was the usual, BUT Thursday night was the night of Medic's Fresher's Fever! I was really excited for it as there was going to be a hot tub and sand at the venue. In the end - I must say this was the best Fresher's Fever I have experienced. It had a really good vibe and for once all the Fresher's stayed til the end! The last two Fresher Fevers I went to, people left 2 hours into the party and essentially used the event as a pre-drink before going to another club. This time - people stayed all the way until the venue closed. I was so glad I got Friday off as there was no way I would've been able to go to placement. I got to get Friday off as there was another freshers event that I had to help out at: Buddy Scheme. That didn't start until 3pm....and I thought I would definitely be able to wake up for that. I ended up waking up at like 2:15pm and was literally running around my flat trying to get ready to get my butt out of the door. But yeah this week has been quite interesting. Highlight of the week must be Fresher's Fever. Yeah yeah I know I'm getting too old for it, but seriously it was amazing. Definitely a memorable night.

Saturday, September 17, 2011

Placement 2 - End of 1st Week

What a quick change. From sitting in lectures from 9am-5pm to being on my feet from 9am-5pm. Hands down: placement > lectures. There is just so much to learn and see on placements.

For my 2nd placement, I've been placed in the Stroke Unit. On the first day I realized that this is the first time I've been placed on a medical ward. For the last few hospital placements - they have ALL been in surgery. I was definitely preparing myself for the worst as I really do enjoy surgical attachments and I wasn't sure what to expect from a medicine attachment.  Also the fact that I was placed in the Stroke Unit was quite intimidating. In my mind Stroke = Neuro = intense. I was scared as heck on the first day and quite nervous, but also excited for the unknown.

The minute I stepped onto the ward, I was greeted by a really friendly receptionist who assured my partner and I that the doctors on this ward are really nice. We asked to see consultant X, but was then told that he no longer works at the hospital. What a great start to the day. We then muttered out another consultant name, Dr Y, and immediately the receptionist became very reassuring as she guaranteed us that we will be just fine with this consultant. Apparently he is very friendly and is a great teacher. I was starting to get excited. Right before going to the Dr Y's office we bumped into another consultant, Dr B. I must admit, I was surprised to learn that he was a consultant as he is quite young. He seemed really friendly...and perhaps a bit quite awkward. Then we met Dr Y. My first impression of him was: "What a boss." I know that sounded a bit weird but Dr Y seems to be a very confident/leader-like person. Very calm, and very approachable. He definitely looks serious, but we came to find out that he is a very patient man. Oddly enough, Dr Y quickly set out a schedule and several goals that he would like us to accomplish and what he aims to do with us. I believe this has been the first time where I've been sat down with a consultant and made goals and aims. I actually quite liked that as we are only 3rd year medics (1st year of clinical), so a little bit of guidance is quite nice as we don't really know what we should be doing in the hospital. He also arranged for some time to teach us about neurology/stroke. I was definitely liking the sound of this.

Anyways we then joined Dr B on ward rounds and pretty much got grilled to death by questions. I guess that's his way of teaching. Not exactly the method I would prefer to learn from as I do get quite nervous when put under pressure with a question, but Dr B is a really nice guy so I'm not too scared about answering a question wrong. He wouldn't put you down or look disappointed, he would simply acknowledge and explain the answer to his question. With this method of teaching, I guess things stick in my head for longer as you remember being grilled on that topic and stuff stands out a bit more.

Impressions of the ward? I'm really surprised at the range of ages on the ward. You would expect the whole ward to be elderly people, but to my surprise - there were quite a lot of middle aged patients. Made me realize that stroke isn't an elderly person's problem, but it can be a risk to anyone of any age.  The ward is also extremely friendly and relaxed. You don't feel pressured or watched on the ward. It's also nice that the nurses and junior doctors have welcomed us and do acknowledge our presence. Quite a difference from my last placement where I felt like an ignored object standing in the middle of a corridor looking really awkward and lost. Here, I feel a part of the ward.

I got to admit I have learned loads. I mean LOADS. Information overload. I have learned so much from both Dr B and Dr Y. They are really amazing at teaching. And it's really nice that they show us physical signs and teach us how to classify the signs as we do the ward rounds. I'm definitely looking forward to next week where we will learn more about stroke/neuro. From time to time, I do miss watching surgeries though, but it's good to finally experience a medicine attachment. Not a bad start I guess!

Wednesday, September 7, 2011


So I've been back for just over a week now and have started lectures. These lectures have literally made me question why I am studying Medicine. It has been a horrible week. 9am - 5pm lectures. I can fly back to Canada in that time period! I do not know what is going on with my medical school...but 9-5 lectures do not work. No one can concentrate for that long. I really have to admit it was tough. Not only was it tough, but I was dealing with jet lag so my days felt like weeks. I actually thought time had stopped as my days were going by so slowly.

All these lectures actually made me lose focus of my ultimate goal: to be a doctor. I was struggling to find my footing and was not motivated at all. I mean I have definitely found my footing again after having a good rest during the weekend. Yesterday I had Diabetes Teaching which was more interactive and practical. Definitely lifted my spirits and gave me a bit of motivation. I'm sure once placements come around again I will be inspired and motivated again.

After talking to a few good friends, I feel a bit better. One of my friends pointed out that I never give up in anything I do and giving up Medicine is not an option. And you know what, she is right. I never give up and I am not prepared to give up now. I'm halfway through my degree and it can only get better. Just need to put my head down and power through these lectures and assignments. I had a passion for medicine and when I really think about it - I still have a passion for it. There were some sparkles of hope today during our practical session and tomorrow I will be seeing diabetic patients. I am actually excited so I know my passion for medicine is still with me. Just need to get through 3 more days of lectures and I'll be back on the wards. I will be examined on my clinical skills soon so I'll be able to do some clinical skills on the wards. I just need to be patient and keep going.

You know while writing this post, it made me think. This is what medicine is about. Fighting adversity. Overcoming challenges. Pick yourself up and keep moving. On the wards - you will face challenges. You will have to make difficult decisions. There will always be ups and downs throughout your career and you have to learn how to deal with them. These days have been long and will only get longer when I become a doctor. Time to get used to it. This is reality.