Friday, May 3, 2013

Urology - Week 1

Sorry for the lack of updates. The weird thing with this rotation is that I'm running through all the other specialities: ENT, Ophthalmology, Urology, Haematology, Dermatology, and Oncology. I only get either 1 or 2 weeks in each specialty. You can imagine I only get a quick glimpse of everything and so far nothing interesting has happened.

Because I am now on Urology and have got 2 weeks here, I thought it would be worth doing a bit of an update. So we were inducted into the specialty on the Monday and were pretty much scared stiff. The urology department at our hospital is an academic department as well so they have academic ward rounds and really encourage full participation from students. You will probably wonder: "So what's wrong with that? That's great isn't it?" Well yes, that's great as we get loads of teaching, but that means we got to work twice as hard as we are expected to do presentations. I don't mind working hard, it's just our presentations have to  be a case study on an inaptient. With how our schedules are, we don't have much time on the wards as we are timetabled to be in clinics/theatre. We were also told that consultants expect us all to be prepared for clinics/theatre and expect us to do our reading beforehand.

Biggest heart sinker? On theatre days we are expected to go to Theatre Admissions Unit (TAU) at 7:30am to get a brief patient history for all the patients on the list and be prepared to tell the surgeon all about the patient in theatre. Don't get me wrong, I love going to theatre, I just don't enjoy this horrifically early wake-up. I've been quite lucky with not needing to go to TAU in prior placements as the consultants I have been placed with don't require me to go to TAU and talk to the patient ahead of time so I usually get to theatre at around 8:30am. Anyways so Tuesday was my theatre day and I was placed with the academic lead for Urology (perfect...). Being a bit scared, I obviously head to TAU at 7:30am and talked to the 2 patients who were on the theatre list. As I was finishing up the consultant shows up and was actually quite surprised to see me in TAU. I was then promptly quizzed about the 2 patients and about their procedures. Luckily I did a bit of reading before I saw the consultant so everything was fresh in my mind. Think I impressed him as I got the nod of approval and the brief grilling seized.

At theatre, I met with the registrar and was warned I will probably get a full grilling on anatomy and should do some reading while the consultant isn't around. Read up on the prostate and bladder, which wasn't too difficult. I've always remembered the general rule for surgery is to know the blood supply, lymph drainage, and nerve supply for that organ, and you'll be alright. 30 minutes into a cystectomy, the consultant asked me for the blood, lymph, and nerve supply for the bladder. Check. Check. And check. The greatest bit was when he looked over to me in awe and proceeded to go quiet until lunch time. Just going to dust my shoulders off now. Now here comes a curve-ball, I was then shown a muscle and was asked what it was. Thankfully due to my "love" for orthopaedics and hip/knee anatomy, I immediately recognized the muscle as the psoas. Then another dead pan from the consultant who then went quiet again. Then he asked about the path of the Obturator nerve and what it innervates. Easy as I've been quizzed on that before by an orthopaedic consultant for fun not too long ago. As I finished my answer, the consultant put his scissors down and remarked that he'll sign me off for the next 2 weeks. He seemed really impressed and well I obviously felt good for once and not like a complete idiot. I was quite lucky with the questions though as usually it is a hit or miss. Was a fairly good day!

Rest of the week was fairly...dull. Went to a haematuria/cystoscopy clinic and did a bit of ward work, where I found myself being the cannula/bloods monkey again. Was nice being able to put cannulas in again as it has been awhile since I've put one in and I was worried I would lose the skill, but looking at my 100% in one go rate on the ward, think I'm still alright! All in all - okay week. Not very stimulating. Not very interesting. Escaped presentation - think it was partly due to my "good play" in theatre. Hopefully next week will go just as well!