Expectations.

Everyone has his or her own expectations for certain things. In my case: I had my own expectations for this placement (Obs & Gynae). Before I even started this new year and embarked on my specialty placements, I had already made up my mind about some of the specialties. And I have once again been proven wrong and again shouldn't be making judgments before even starting a specialty. You would think I would learn by now not to judge so early. Before I started O&G I constantly told myself that it is going to be my worst placement ever and I will truly hate it. I was not looking forward to it. I even marked it on my calendar as: "Ugh." To make things short, I had extremely low expectations for O&G. And you know what, sometimes I like being proven wrong. Don't get me wrong I have respect for the specialty, it just never clicked with me. You get this whole: "Awkwardddd women's health...it's going to be weeeirdddd!". I think in general anything that deals with bits downstairs is a whole taboo subject.

So I went back to my archives and read up on my blog post that I typed up before starting the specialty:

"My next placement is Obstetric and Gynaecology. I'm actually really scared for this as I don't really know what to expect as well. Should be interesting as I'll definitely be able to go to theatre (YES!); however, it'll be dealing with quite a sensitive subject so I'll definitely need to change from being playful in Paeds to professional for this specialty. Hopefully I'll be able to compose myself and try to enjoy this specialty as much as I can. First I'll need to go to a week of lectures before commencing my placement. I much rather having lectures first before going to placement as at least I'll have some basic knowledge prior to going to the hospital so I won't look like an idiot in front of the doctors. I also hope I'll have a really nice/easy going/chill supervisor. My last supervisor on paediatrics was very easy-going, which made the placement much more enjoyable. Crossing my fingers that I'll be just as lucky this time with Obs+Gyn. Another 7 weeks of Obs+Gyn and then Easter Holiday! I can't wait for holiday. To be honest...I kinda need one now!"

I really can't blame myself for being scared as it is a sensitive subject, but in terms of changing my behaviour from playful to professional was something I was a bit unsure about as I'm naturally a "happy-go-lucky" so I was a bit nervous for that change. Thinking back through the last few weeks, I haven't had so much fun on placement. Even more fun than my paediatric placement. Yes I have to be professional and build a good rapport with patients to talk about more sensitive things, but I realized that if I'm having a good time, the rapport comes naturally and you as a person become a bit more easier to approach and get along with. In paeds I was told that it was "written all over me" that I was not enjoying my placement. For this placement, yes I went in knowing I'll hate it, but I really wanted to make sure that I didn't make it obvious that I'm not enjoying the attachment. Because I went in with such low expectations I was open for anything and had little expectations. This actually helped me be a bit more welcome to anything and I think a lot of the staff and my supervisor could see that. I was even told by the nurses that some of the patients thought I was a "breath of fresh air" as I was always smiling on the wards and just enjoying my time. A patient told me that most of the staff look bored, but I look interested and just trying to have fun. Because in my last placement in paeds I looked super bored, it was probably the main reason it took me a bit longer to get to know the staff and interact with the patients.

And I can't really call it luck anymore with getting a nice/easy going/chill supervisor. I've said it before, but at the end of the day, a consultant/supervisor is a person as well. Yes they too have expectations for me and I try to meet their expectations, but because they are also people, you can certainly have some good banter with them. I got to know my supervisor and probably saw my supervisor the most out of the rest of my group so I guess he got to know me better than the others. Definitely made the attachment more enjoyable as I could feel that my supervisor genuinely cared about my learning and it's also nice to get to know your supervisor as it'll keep my blood pressure and heart rate from shooting through the roof whenever I see him. In some placements I would purposely avoid my supervisor just to avoid getting told off/being quizzed. For this placement, I didn't mind bumping into my supervisor on the ward or even in the corridors. I think we also had a "mutual understanding". He knew what my personality is like and what sort of student I am so he didn't form unrealistic expectations for me so that put me at ease and allowed me to feel comfortable in the hospital.  Again it is a two-way process. I know when my supervisor didn't want to see me and I guess I'm fairly good at telling when I can be cracking jokes. I guess it is a skill I definitely cherish as like I said I'm a "happy-go-lucky" and a bit of a prankster/joker who is quite cheeky as well...so I definitely need to know where to draw my line with each person.

All in all, I think this attachment has worked out really well and essentially exceeded my expectations. I have definitely gained a heck lot more respect for the specialty and it has definitely changed my view on the specialty. It really ain't that bad at the end of the day. The doctors are also pretty cool people as well so it was good. The hospital was great as well and was really good at making sure medical students are learning and interacting. Following a doctor around is one thing, but being able to assist and do things is a whole other ball game that makes your attachment so much better. This could be the very last time I'll be doing O&G for the rest of my career, but hey if I do get a rotation in it in the future, I won't mind doing it again. Hate to say this, but this is easily the best placement I have ever had so far. Who would've thought I would be saying this 7 weeks later. I wish all my placements can be this good. Now I'm scared about my future attachments as this placement has set the bar so high. How can I go back to just following a doctor around? How can I go back to standing in theatre not scrubbed in and peering over the surgeon's shoulder? Will I get along with my next supervisor how I got along with my supervisor now? What are my expectations for my next placements now?

Thank you for proving me wrong and giving me the best 7 weeks of my medical degree. What a placement. Damn. Can't believe it is over. The one time I am dreading for the end of a placement. I guess one good thing about this is that I finally get a much needed 3 week holiday.

Side note: Will be on holiday for the next 3 weeks and I, most likely, will not be posting as I really need a break. Sorry! 

O&G - Done!

One of the most stressful days ever. Let's just say this placement never really got my heart rate and blood pressure up until today (my last day). Waited to do my final assessment with my supervisor and I was really stressed out. Hate waiting around. You see if this was one day earlier, I would not be as stressed out. I was a bit of a smart ass and booked to leave for home 1 day before official holiday. Seriously talk about luck. Supervisor couldn't do my assessment until my final day...5 hours before the departure of my train to go to the airport. Essentially, we are allowed to resit our assessment if our supervisor believe we are incompetent. You would usually resit the assessment immediately or the week after, BUT because we are doing our assessment in the final week  on my last day of placement, I don't really get another go. So that means I have ONE shot at this assessment. I pass...I pass. I fail...let's just say that is NOT an option. I essentially needed a bit of skill (to pass the assessment) and a heck lot of luck to not only pass my assessment, but to also catch my train. Doing an assessment is already stressful enough especially when you've got only 1 shot at it. Travelling is also another very stressful thing. Put the two together (assessment AND travelling) is the formula for a heart attack. Yes why should I be worrying about my assessment? I worked hard. I came in every day. Didn't skive. Studied...a bit. Practiced my examination skills quite a bit. So why am I not confident? Simple. Anything can happen eg. bad luck such as getting a difficult patient, blanking out aka brain fart, nerves, etc. I think I'm pretty chill with my supervisor and I don't really "fear" him that much, BUT at the end of the day yes he is a person...but he is also my SUPERVISOR, which I cannot forget. He essentially is the one who determines whether I pass or fail this placement. Kind of hard not to be a bit scared/nervous/stressed/intimidated.

Anyways luckily I passed my assessment and it all went very well. Got all my forms signed off, handed in my locker keys, and next thing I knew, I was saying my goodbyes to the staff and shaking hands with my supervisor: "I guess that's it. 7 weeks. Done. I really enjoyed the placement. Thank you. Maybe we will meet again in the future, maybe not. It was a pleasure to meet you and your team. Thanks again." It was probably the first genuine "thank you" I have said to a supervisor at the end of a placement. These last 7 weeks have opened my eyes and taught me not to judge. I have never done so much active learning in one placement. Best bit: I wanted to learn. I wasn't forced. What a great overall placement. I guess the only way to show your gratitude towards a placement is to work hard and show that you have learned. Actions certainly do speak louder than words. Even my good friend said that if only my supervisor saw what type of student I was on placements and how much I have changed in terms of motivation and work ethic - only then it is obvious how much I enjoyed this placement.

What a placement. Who would've thought.

Request: Top Tips for Managing the Workload.

Alright so this has been requested by one of my readers so I'll try my best to answer this request: Top Tips for Managing the Workload.

1) Stay on top of reading and lectures.

Let's be honest here...it's not exactly the easiest thing to do. So it's pretty unrealistic to constantly be on top of it and I have always struggled with it. I mean try your best to do recommended/relevant reading, but there are days where you just don't have time/there is way too much to read - to the point it is ridiculous. At the end of the day, you start asking: "How much reading should I be doing?" To be honest, it depends on your lecture. Sometimes I have amazingly detailed lectures, so I tend to skip out on the reading unless I need some clarification/extra details. Now if I had a lecture which was incredibly brief as in the lecturer spent maybe a total of 20 minutes talking about his confusing topic, then I will definitely need to read and make notes. It's really hard to say exactly how much reading is needed. You really have to judge that yourself as every school's lectures are different and every lecturer is different. I think another way to stay on top of lectures (if this is available to you) is to read next day's powerpoint/lecture the night before. For my university, our lectures' powerpoints get uploaded online for us to download so we can read what will be covered. Even if it doesn't make sense, just reading it helps a bit as when you get to the lecture you'll be more focused on what the lecturer is talking about and will probably make better notes as you know what to expect/know what he/she will be talking about. Also taking notes during lectures is also a great way to help you remember stuff...and it'll make your life a bit easier when it comes to revision as your notes will be ready for your revision.

2) Staying awake in lectures/Go to lectures.

I don't know about you, but I surely have difficulties staying awake in some lectures. Yes they can be horrendously boring, BUT it makes such a big difference when you're actually paying attention as no matter how little attention you're paying, you will absorb some info and the lecturer may even highlight a key point that you need to know for exams.  And same thing with staying awake...if you ain't at the lecture...how are you going to know if it is important or not. There are lectures for a reason - go to it! I can't stand it when people think they'll be clever and skip lectures. Then when it comes to revision time they call me up and start asking me about the lecture that they missed. My answer: "Well if you actually cared and bothered coming to lecture, you wouldn't be in this position would you?!" It's not rocket science.


3) Use your weekend effectively.

"YAY WEEKEND!" Unfortunately, weekends are great at distracting you from your work. By all means go have fun. I usually go out and play sports on the weekends, but I do dedicate SOME weekends to working/catching up (most likely doing more catching up than anything else). It's the perfect time to catch up on work. If you have caught up with notes and have no plans, spend an hour just reading for the topics for next week, then you can ease the amount of work you have to do during the week.

4) Take a break!

Hey, no one can work forever. Take a break from time to time! No one said shut yourself in your room and become a hermit to do your work. GO OUT! Catch up with friends. YOUTUBE! Watch some TV! Do something else OTHER THAN medicine, plus it'll make your life a bit more interesting. When you take breaks, you become more effective at working. Work for short periods vs. doing a long haul. Well that depends on your personality. I'm horrible at working in short periods as it takes me quite awhile just to get going/working. I'm a long haul worker however that means I take really long breaks. For example: Recently I had my essay due for this attachment...I spent the entire Saturday doing nothing/being distracted/staring at a blank word document. From 1am - 7:40am, I managed to write up 4200 words for my essay. Went to sleep...Sunday - finalized my essay and it was ready to hand in for Monday. I like to say I'm quite efficient, and again it'll depend from person to person. You know yourself best. Do what works for you. "If it ain't broke, don't fix it."

5) Make a revision schedule.

I know some of you who are already in medical school will probably have exams coming up pretty soon. Go do yourself a favour and design a revision schedule EARLY.  Predict how long you'll need for each topic. For example in 2nd year I dedicated 5 days per topic I had over an 8 week revision period. I tried my best to stick to it, but I always give myself a 1 week grace. So I aim to finish revision 1 week prior to exams just in case anything goes over time or takes longer to revise. If I finish revision on time, then I have the week to go over anything I'm not very sure about or to solidify some things. I also use the week to go over sample papers and any past formatives/quizzes that we got throughout the year. By making a revision schedule, this will probably temporarily cause your stress levels to shoot through the roof, but eventually it'll actually keep you from cramming and you'll feel like you know what you need to still study/you can keep track of your revision progress.

6) Don't leave everything to the last minute.

Aka do not procrastinate. It is extremely tempting to procrastinate, but we ALL know what happens when you procrastinate. Stuff gets real and you start stressing out because you realize you haven't done a lot of work and everything has stacked up. It is tempting to leave your lectures to stack up and just go over em over the weekend (I'm very guilty of that), but in the end, if you are busy on the weekend with sports or whatever, then the work just keeps piling up. The best thing to do is to PREVENT this from even starting in the first place and to avoid procrastinating. It is natural to procrastinate so don't think you're weird or you've got issues. I think every normal person procrastinates. Like some of you have noticed...I am very guilty of procrastinating, but thankfully I'm fairly efficient/effective when it comes to deadlines as I'll work my heart out if that means staying up all night to meet deadlines.  Guess it is a give and take world and like I've said already - only you know how you work. Optimize it and use it to your advantage.

7) Get your work done EARLY.

Again just stressing the previous point - don't procrastinate. Yeah the deadline is like 2 months away, but if you get your assignment done now...well you don't have to think about it anymore. Done and dusted. No need to stress you out anymore. I'm actually very glad I finished my essay 2 weeks earlier than my colleagues as they are now stressing out as my placement is coming to an end. Me? I'm just chilling. Supervisor is off my back as he doesn't need anything else from me as I've finished my essay. Happy supervisor = happy student. Get your work done early. You'll never regret finishing work early...well ok maybe you might...but UNLIKELY you will regret finishing your work early. So just get on with it!

8) Be organized.

When you're organized, you're on the winning side of the workload. Organize your notes into binders or split them out. Cardiovascular notes in one binder. Respiratory notes in another and so on. I'm horrible at keeping my notes organized and every single time when it comes to putting notes away into binders after going through 2+ topics, I start regretting not staying on top of my organization Print out lectures if you can, type out notes if that's what you do, etc. Put them into the respectful binder and you'll be happy with yourself and it is less likely you'll lose those notes when they are slotted into a binder and when it comes to revision - everything is there and ready for you. Easy.

...I can't think of another 2 points to make it a nice round 10 points, but I will think about it. For now here are 8 points. I hope they are useful. I'm just telling how it is. No student is perfect...so I think the general rule is if you stay on top of your work early - less regrets at the end. I will openly admit that I am very guilty of not always staying on top of my work and I do stress about it near the end. I have no one else to blame but myself as I got to manage my time better/not procrastinate. If you know you're going away for the weekend/busy on the weekend/busy for the week...do your work ahead of time. Don't let it get out of control. Easy to say - extremely difficult to do.

Anyways good luck! If you readers have any requests for me...I'll try to write up a post for you. If you've got a question, I'm sure other readers will think the same. Obviously when I'm busy, I won't be able to get to requests as quickly, but I'll try my best.

More posts to come! :)

Design of the Blog.

So I've had this blog now for over 2ish years and I am going to be having some free time. I was wondering what do you readers think about the design of the blog? Should I update the background? What do you think of the layout? Any feedback? This blog is not just for myself but obviously for you readers so I want to make sure this blog is easy to read and easy on the eyes as I do realize that I do have some fairly lengthy blog posts. Please leave your comments/feedback as it would be greatly appreciated as I always want to be improving my blog and keeping you readers happy. :)

More blog posts to come later this week! :)

O&G Ward Week.

You can hardly call this my "Ward Week" as I probably spent more time in clinics than on the ward. This week also marks my last timetabled week of my placement and I have been seriously trying my best to enjoy every day of it as there is a bit more flexibility with my week.

Spent Monday morning in Gynae clinic. I managed to see a lot of prolapses such as cystoceles (proplapse of the bladder). Luckily the consultant has gotten to know me as I've been in a few of his clinics with him so I got to do a vaginal examination on almost every patient. It was interesting to feel a prolapse as it is definitely very different and then feel the difference when a shelf/pessary is inserted as a temporary treatment for the prolapse. Patients with cystoceles tend to classically present with a "dragging" feeling down below which becomes quite uncomfortable as the day progresses. There is also a "heavy" feeling, which again gets worse as the day progresses especially when stood up for a long time. Some of these patients also present with urinary symptoms such as urinary frequency and hesitancy. I think by coincidence these patients also present with some form of urinary incontinence as well. Usually elderly women would not be offered a surgical repair where stitches will be placed to reinforce the anterior wall of the vagina (where the bladder prolapses through) as these patients are usually unsuitable to go under anaesthesia.  By the looks of it, most of the women are fine with the pessary and it seems to sort out their problems quite well.

Then I wandered onto the wards with one main goal in my mind: Take as many gynae patient histories as possible. Why so keen? This is because my assessment is taking place the following day. Essentially we are required to take a full patient history with an assessor sitting alongside. This assessment either makes or breaks me. If I fail, I would obviously have to resit the assessment which would go down on my records that I had 1 failed attempt. If I fail the second time, then I will have to repeat the entire 7 week placement all over again. I mean I'm having a good time on this placement, but if you asked me to do another 7 weeks, it might be a bit of an overkill. Anyways I took about 4 patient histories in the afternoon and had a good time talking to patients. It's nice to see patients enjoying talking to me as I guess for them it is better than sitting in silence and day dreaming as the hospital is pretty boring in general.

So I had my assessment...and oddly enough...I wasn't too nervous for it. Actually I was so calm it was worrying. I was struggling to take the assessment seriously as before I went in to take the patient history I was chatting away with my colleagues (well I did the talking...they just listened as they all looked very nervous). I kept telling myself to take this assessment seriously but I struggled. I was fairly annoyed with myself, but at the same time - if I'm in a good mood I tend to take better patient histories and form much better rapport with the patients, which is key for the assessment. Luckily, my patient wasn't too complicated (vaginal hysterectomy and anterior wall repair). I finished my history quite quickly and  I thought I did quite well. Didn't have any difficulties whatsoever. Huge contrast from my last placement (paediatrics) assessment. In my last placement I was properly pooping myself prior to my assessment and I was dead scared. I was much more confident for this gynae assessment - night and day in terms of confidence between my last placement assessment and this one. My assessor had no difficulties in passing me and even gave me an "above average" mark which I was quite chuffed about. I was quite proud of myself as I was only expecting a "meets expectation" as my supervisor is known to be quite strict with marking.

Since my next assessment isn't until next week, I knew I can relax for a bit and return to enjoying my placement. Oddly enough I thought I was going to be quite bored on the wards as there isn't much a medical student can do on the wards, but I was actually quite productive on the wards. The doctors were all really welcoming and actually allowed me to write in the medical notes and sign off on them (of course the doctors reviewed and counter-signed my notes). I also got to clerk in a few patients, which is always interesting. It's weird seeing how seriously some of the patients treat me. I mean at the end of the day I'm just a medical student, but these patients really take everything I say seriously and show a lot of respect. It's quite nice to not be treated as a joke and it definitely makes me feel much more responsible.

Because my next assessment is on obstetrics and I haven't had much exposure to it on the wards, I decided to spend my day on the obstetrics ward and practice my obstetrics examination skills. And jeez....I suck at obstetrics examination. I swear I cannot feel a thing. In our assessment I'm supposed to be able to tell the position of the baby, the engagement of the head, the lie, etc. I feel like my hands are dead stubborn as I swear the bum of the baby feels the same as the head! Yes I know one side is flat and the other is round like a ball, but at the same time I'm too scared to palpate deeply in fear of hurting the mother. I definitely need to get more confident in doing this examination or else I will fail my final assessment. Not looking good. I thought I could get away with just a full day of practice, but I definitely need to go back to the obstetrics ward next week to examine more pregnant women. I think I did leave a good impression with the midwives as they seemed keen to have me around and that I am welcomed to come back next week to practice some more.

1 more week until holiday...well not even. Technically only 2.5 more days of placement left as I have a half day next Thursday (and Monday is a bank holiday and I get Friday off).  Can't believe it's already been 7 weeks. I can still remember my very first lecture for O&G like it was just yesterday. This placement seriously went by way too fast...and I'm having such a good time. Argh.