Saturday, March 17, 2012

O&G Theatre Week

So far so good! I'm enjoying this placement 100% more than my paediatrics placement. I feel much more comfortable and it's a nice feeling to be looked after. Yes it is annoying that someone is keeping a hawk eye on your progress and your work, BUT at least someone cares. In my last placement I felt like I could get away with anything and there wasn't enough motivation/pressure for me to work hard. I'm working much harder in this placement and I am learning loads. This week was my theatre week and as you probably know - I'm a bit biased towards surgeries as I really enjoy surgery. If you tell me to stand in theatre from 9-5 and watch surgery all day...I will happily do that - no complaints. If you tell me to stand in the ward from 9-5...I'm pretty sure I won't be as happy about that. I don't know what draws me to surgery so much. It's just nice being able to fix things immediately right there and then.

Anyways all in all the week had its highs and lows. Monday and Thursday were my two highlight days of the week. Oddly enough these two days were the two days where I had theatre sessions with my supervisor (Mr R). Right before joining Mr R for theatre, I was told by his registrar that he enjoys quizzing his students in theatre. I found it quite weird as when I was in clinic with Mr R, he didn't seem to be the "quizzing" type of consultant. Before surgery even started, I was grilled about common gynaecological problems. Luckily the questions weren't too challenging and Mr R seemed fairly impressed with my knowledge. I was just lucky that I had clinic prior to theatre which covered the conditions that Mr R quizzed me about. Phew. After the grilling, Mr R invited me to scrub in and to assist in the surgery! I was obviously very excited and it was nice being right at the table and I got to actually assist. I felt a part of the team and I felt like I was helping out. Unfortunately, this gave Mr R the opportunity to quiz me on the pelvic anatomy (which was VERY rusty). My lack of knowledge in the pelvic anatomy was not exactly impressive and I was promptly told to review my anatomy. Oops. Other than that I was able to get my hands in and I learned quite a lot as I did not get a female cadaver dissection specimen during my 2nd year so it was nice to be able to actually see the organs. I was also lucky to help out in a total hysterectomy as it was an open surgery so I got to see the organs more clearly. As the days went by I realized this was the only open surgery I will be watching as the rest of the surgeries I saw were laparoscopic surgeries. Pretty lucky to be honest. When surgery finished I had a good time and had some good banter going on during the surgery. Got to know my supervisor and the registrar better. No joke I really felt welcomed and I didn't feel so much like a medical student. I didn't feel like a joke in the theatre. People were taking me seriously and the nurses were all very friendly to me and I got along with everyone. Definitely a good start.

Tuesday I was with a different consultant for surgery and then realized to appreciate my supervisor as this consultant did not teach me at all. We were performing laparoscopic excisions of endometriosis and these were fairly complicated surgeries in general so the consultant was busy concentrating and I felt forgotten. I casually stood at the the back of the team as I was not offered to scrub in so I just observed. It was horrendously boring and I was getting fairly restless. After a fairly boring/dull Tuesday morning I went to look back at my schedule and realized I have the same consultant that I had in the morning on Thursday. I did a bit of snooping around and found out Mr R had a day theatre list Thursday morning so I decided to make amendments to my schedule and decided to follow Mr R. You would think why would I want to follow Mr R as he loves quizzing and it's quite a lot of pressure as this is my supervisor who will be assessing me at the end of my placement. After following a different consultant on Tuesday, I realized that despite all the quizzing, I learned a lot more with Mr R and in general had a lot more fun in theatre. Yes it's nice not needing to use your brain, but because I'm interested in surgery I rather get quizzed and learn things. On top of that Mr R lets me scrub in and help out so it really makes my experience a whole lot better. I guess it's a give and take situation.

Unfortunately I caught Mr R on a bad day on Wednesday and managed to "anger" him as I didn't know I was scheduled in for an audit in the afternoon as it wasn't on my schedule. Because I had my schedule in advance I decided to arrange a few meetings on that day in the afternoon as I assumed I had a half day. I had to explain to Mr R why I cannot attend the audit and he was not impressed whatsoever. I was properly pooping myself as we have been getting along and he's been pretty chill. I didn't think he would care that much about me missing an audit. I obviously felt really bad on Wednesday so I knew I had to redeem myself on Thursday. Wednesday night I decided to dust off my anatomy text books and revised my pelvic anatomy very well and read up on various gynaecological conditions. I also found out that Mr R consents his patients at 8am on Thursday prior to starting theatre so I decided to head in early and join him in his consent clinic. Let's just say he was pleasantly surprised that I was there so early and I managed to get consent from all the patients for the list in order to allow me to do examinations while she is under general anaesthesia. When in theatre I was promptly grilled on common gynaecological problems and because I had done my revision I was able to answer his questions with ease. To be was extremely satisfying. On the first patient I was told to put on a pair of gloves and to quickly do a vaginal examination. I was a bit disappointed I wasn't asked to scrub in, but I assumed Mr R was still annoyed with me from the previous day. Fair enough. I was essentially ignored for the rest of the procedure and then I guess Mr R remembered about me and then quizzed me on the pelvic anatomy. Again having revised anatomy the night before, I named all the parts with ease and Mr R was very impressed. He gave me the nod of approval and again I got that sense of satisfaction. It felt really good. Had a bit of banter in between patients and because I had "passed his test", I earned the right to scrub in for the rest of the list. It was amazing. I got to move the uterus into position for the procedures and the quizzing stopped. Yes it may sound daft "maneuvering the uterus"...big deal right? But something that small can make a huge difference to your experience in theatre. Yes I was doing a pretty dull job, but I knew I was making it easier for Mr R to perform the procedure with his registrar. I was then taught how to properly do a vaginal examination and was also taught how to do a speculum examination. I think this was the first time where Mr R took the time to teach and explain things thoroughly. Usually Mr R briefly explains things and is usually quite vague, but this time he was detailed and was really patient with me. He made sure I got a hang of it and made me do all of this with all the patients in the list. By the last patient I was doing the examinations with ease and was getting good at maneuvering the uterus. Haha. Was in a VERY good mood for the rest of the day. I was really proud of myself and it was nice getting praised by my supervisor. He seemed very impressed and I felt like I redeemed myself from the previous day's mishap. What a day.

At the same time I was a bit sad that it was my last proper theatre session for the rest of the placement. I will miss it a lot. My whole of next week are clinics and I'm not a huge fan of them. Will be a hard change and I'm sure I will be craving to go back into theatre. It was a shame I only got 2 sessions with Mr R in theatre as I learned so much. And with his quizzing, I realized I remember things much better. I guess in the end he ain't that bad of a teacher. I guess first impressions aren't always that accurate.

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