Shocker - I'm back! Most of you probably thought I fell off the planet or medical school had simply killed me. Actually what had happened is that after my placements in May I had left for my medical elective for 2 months. I went back to Canada to do my medical elective in..........you guessed it: Orthopaedics. It was tough - and that's putting it lightly. I have not worked as hard as I had during my medical elective than any of my last 4 years at medical school. So once I got back I was seriously burnt out while my friends were burnt from their lovely sun filled elective in the beautiful/tropic parts of the world such as: Thailand, Vietnam, Fiji...I am feeling my blood pressure go up again. To put it in even more simple terms - I was miserable during my elective and very jealous of my friends who had a tropical and fun-filled elective to discover themselves.
Why was my elective so tough?
Well North American medical school will always have its stereotype to uphold. My mornings started at 6:30 am and my day didn't end until 6pm and that's me sneaking off early. Despite being a visiting elective student I was expected to still do 24 hour on-calls. Yes there were a few days especially in the first 2 weeks where I wanted to go and hide in a corner and cry. I've never been told off so much in medical school as much as I had during my first 4 week rotation. Apologies I have to leave out details as it will make me very easily identifiable if I start specifying EXACTLY what sub-specialty I was doing. I remember telling my parents several times I would quit. I nearly walked out of clinic many times. I walked out of the operating room once after being unfairly treated. This elective definitely pushed my limits to the max. When I reached my 2nd rotation of 4 weeks - I was back in my comfort zone. Let's say the first 4 weeks was a very steep learning curve and one I hope to never go through again. Looking back at it, I'm glad I got my ass-whipped as not only did I never work so hard before, but I have never learnt so much before in such a short amount of time. I had to gain A LOT of self-confidence and was pushed to the deep end of the pool during my elective and I'm glad the consultant pushed me that hard. I would have never learned...but with that, I sacrificed the enjoyment of the elective. I guess it's a fine balance.
When I returned to the UK I was just so burnt out. I didn't get much of a summer holiday. I was back to placements and well let's just say placement seemed extremely SLOW compared to Canada. I had a hard time adjusting back and consultants thought I was overly too proactive. It's a very different system here in the UK. In Canada I felt like I had to fight for my learning opportunities and I learned by falling flat on my face a million times. In the UK, we are spoon-fed our learning opportunities. There isn't a huge competition atmosphere in the UK. I was with other medical students in Canada and I found myself fighting to get to scrub in and fighting to see patients. As a student in the UK I feel like sometimes we take it for granted the amount of learning opportunities we get. Anyways there isn't much to talk about my elective. If I had to sum it up in one sentence it would go like this: Worked my ass off, but came out more mature and wiser and perhaps a hell lot more worn out. To be honest I still don't know what to think of my elective. Don't get me wrong, I was lucky to have got an elective in Canada in a major city in a very popular specialty, so I don't regret it at all.
Hopefully I'll start updating a bit more, however, final exams are coming up so I am a lot busier than usual now. Currently doing my General Practice rotation so who knows maybe I'll find time. Sorry again for the lack of updates...just had a rough few months.
Showing posts with label challenge. Show all posts
Showing posts with label challenge. Show all posts
Sunday, September 15, 2013
Saturday, February 16, 2013
Final Week - Anaesthetics
Wow these last 4 weeks have blown by. Like I've said in my last post, I've seen a great improvement in my practical skills and confidence in doing invasive procedures. It really is true: practice makes perfect!
Because I have made quite an effort to get my logbook signed off early, I took my final week in anaesthetics as a "flexible week". I had a sudden urge to go watch some orthopaedic surgery so I decided to go observe a list. As I walked into the orthopaedics theatre and asked the consultant if I could observe, I was then offered the opportunity to scrub in (which made me very happy). It was so good to be back in orthopaedics and scrubbed in. Geek moment: I was pretty excited while I was scrubbing in. It brought back the good memories I had from last year whilst on my Orthopaedics attachment. Last year, I only helped drape the patient once or twice as there was usually a registrar there, so I would stand back and watch. Let's just say draping a patient for Orthopaedics isn't the "easiest" thing when you're still quite new at it. Because there are plastic walls around the operating area, you really have to be aware of your surroundings to make sure you stay sterile. The draping is also quite the task itself as there are quite a few layers to put on and I will admit that it required a lot of concentration and focus for me to make sure I maintained sterility. When the draping was complete and I didn't screw up, I couldn't help but feel like this:
Anyways, we did an exchange of a total knee replacement. It was fairly straight forward and it was nice being able to assist. Just felt really good. The tasks I were doing were fairly simple, for example, suction, diathermy, etc, but you still feel like you're helping...in a way. At the end I got to do some suturing and close up the wound. Admittedly quite rusty, but after 2 dodgy stitches, I dusted off the cobwebs and got back into it. Of course, being a responsible person, I redid the 2 dodgy stitches (in case you were wondering...). The consultant checked my stitches over and I got the nod of approval and then tidied up. The surgery took about 1.5-2 hours, but it certainly felt much shorter. We took a lunch break and I bumped into my anaesthetic group mates. They noticed that I was looking quite happy and some of them know me quite well could guess immediately that I got to scrub in and assist in surgery. I then bumped into one of my good friends and even he asked why was I oddly happy. When I sat down for my lunch and did a bit of reflection - I really do think surgery is for me. It makes me happy and I really enjoy it. I mean I've seen a few exchange TKRs last year, and it just doesn't get old. Every case is different. We had another operation in the afternoon which was quite straight forward. By the end of the day, I was quite tired and my feet were sore, but I was happy. I felt like I had a productive day. I felt like I learned a lot. I was at the hospital since 8am and got off at 5pm. I would usually be craving to go home, but after the list, I wanted to follow-up with the patients in recovery/post-operative surgical unit. It was a really good day. Probably the happiest I have been on placement this year.
The next day was a huge contrast. I went back to anaesthetics and met up with the consultant anaesthetist at 7:45am. The first thing he told me was that he is too busy and that there won't be any opportunities for me to get any hands-on. He also told me to be prepared to stand to the side for the rest of the day. I couldn't help but get annoyed as I made the effort to come in at 7:45am, ready to learn, and then to be told that I won't get to do anything. I thought the consultant was maybe just over-exaggerating, but I quickly found out that he really did mean it when he said I will be standing to the side. I just stood in the anaesthetic room in one corner and watched everything....and proceeded to zone out. All I could think about was that it was a huge waste of time. Then 2nd case, same thing. I was just stood there. I even asked if I could help out and was promptly ignored. I made the decision that I could be more productive if I went home. By 12pm, I grabbed my bag and told the consultant that I'm going home. He wasn't too impressed that I was leaving early, which surprised me. I was not learning anything and he wasn't teaching. What was the point in me sticking around? I firmly told the consultant that I could be a lot more productive at home and complete some of my assignments. I was fed up and just left. In a way it was rude of me to do that, but at the same time, the consultant knew he was going to have a student around and if he doesn't want a student around, then say something to the administrators so he doesn't get assigned a student. Ridiculous.
Despite the sour ending to my week, at least there was a very high point in this placement, which was unfortunately not anaesthetics related. I'll just treat the orthopaedics day as a treat to myself for getting all my work done early. A few years back, I used to want to do anaesthetics, but this attachment has reaffirmed that it isn't for me. I can see why people would enjoy it, but I really do think I am more suited for surgery. I just enjoy being hands on and fixing things. I enjoy the theatre life, but not sat at the head of the table. My next placement is A&E for 4 weeks. Again, I am quite nervous as I have been placed in the main hospital, which is quite busy. I know what to expect, but I'm not sure if I'm ready for its quick pace. We'll see. I'm excited in a way. Plus more opportunities to work on my clinical skills!
Because I have made quite an effort to get my logbook signed off early, I took my final week in anaesthetics as a "flexible week". I had a sudden urge to go watch some orthopaedic surgery so I decided to go observe a list. As I walked into the orthopaedics theatre and asked the consultant if I could observe, I was then offered the opportunity to scrub in (which made me very happy). It was so good to be back in orthopaedics and scrubbed in. Geek moment: I was pretty excited while I was scrubbing in. It brought back the good memories I had from last year whilst on my Orthopaedics attachment. Last year, I only helped drape the patient once or twice as there was usually a registrar there, so I would stand back and watch. Let's just say draping a patient for Orthopaedics isn't the "easiest" thing when you're still quite new at it. Because there are plastic walls around the operating area, you really have to be aware of your surroundings to make sure you stay sterile. The draping is also quite the task itself as there are quite a few layers to put on and I will admit that it required a lot of concentration and focus for me to make sure I maintained sterility. When the draping was complete and I didn't screw up, I couldn't help but feel like this:
Anyways, we did an exchange of a total knee replacement. It was fairly straight forward and it was nice being able to assist. Just felt really good. The tasks I were doing were fairly simple, for example, suction, diathermy, etc, but you still feel like you're helping...in a way. At the end I got to do some suturing and close up the wound. Admittedly quite rusty, but after 2 dodgy stitches, I dusted off the cobwebs and got back into it. Of course, being a responsible person, I redid the 2 dodgy stitches (in case you were wondering...). The consultant checked my stitches over and I got the nod of approval and then tidied up. The surgery took about 1.5-2 hours, but it certainly felt much shorter. We took a lunch break and I bumped into my anaesthetic group mates. They noticed that I was looking quite happy and some of them know me quite well could guess immediately that I got to scrub in and assist in surgery. I then bumped into one of my good friends and even he asked why was I oddly happy. When I sat down for my lunch and did a bit of reflection - I really do think surgery is for me. It makes me happy and I really enjoy it. I mean I've seen a few exchange TKRs last year, and it just doesn't get old. Every case is different. We had another operation in the afternoon which was quite straight forward. By the end of the day, I was quite tired and my feet were sore, but I was happy. I felt like I had a productive day. I felt like I learned a lot. I was at the hospital since 8am and got off at 5pm. I would usually be craving to go home, but after the list, I wanted to follow-up with the patients in recovery/post-operative surgical unit. It was a really good day. Probably the happiest I have been on placement this year.
The next day was a huge contrast. I went back to anaesthetics and met up with the consultant anaesthetist at 7:45am. The first thing he told me was that he is too busy and that there won't be any opportunities for me to get any hands-on. He also told me to be prepared to stand to the side for the rest of the day. I couldn't help but get annoyed as I made the effort to come in at 7:45am, ready to learn, and then to be told that I won't get to do anything. I thought the consultant was maybe just over-exaggerating, but I quickly found out that he really did mean it when he said I will be standing to the side. I just stood in the anaesthetic room in one corner and watched everything....and proceeded to zone out. All I could think about was that it was a huge waste of time. Then 2nd case, same thing. I was just stood there. I even asked if I could help out and was promptly ignored. I made the decision that I could be more productive if I went home. By 12pm, I grabbed my bag and told the consultant that I'm going home. He wasn't too impressed that I was leaving early, which surprised me. I was not learning anything and he wasn't teaching. What was the point in me sticking around? I firmly told the consultant that I could be a lot more productive at home and complete some of my assignments. I was fed up and just left. In a way it was rude of me to do that, but at the same time, the consultant knew he was going to have a student around and if he doesn't want a student around, then say something to the administrators so he doesn't get assigned a student. Ridiculous.
Despite the sour ending to my week, at least there was a very high point in this placement, which was unfortunately not anaesthetics related. I'll just treat the orthopaedics day as a treat to myself for getting all my work done early. A few years back, I used to want to do anaesthetics, but this attachment has reaffirmed that it isn't for me. I can see why people would enjoy it, but I really do think I am more suited for surgery. I just enjoy being hands on and fixing things. I enjoy the theatre life, but not sat at the head of the table. My next placement is A&E for 4 weeks. Again, I am quite nervous as I have been placed in the main hospital, which is quite busy. I know what to expect, but I'm not sure if I'm ready for its quick pace. We'll see. I'm excited in a way. Plus more opportunities to work on my clinical skills!
Sunday, February 3, 2013
Having a Bad Day?
Medicine is a constant reminder of how fragile and unfair life can be. Life can throw curve balls and do some pretty unexpected things. I was in clinic and met a lady who is 40 years old and have been getting treatment for cancer. Unfortunately, it has been found that it has metastasised to other parts of her body such as her bowels and her lung. What really struck me was that as I entered the room, having read the notes before seeing her, I was expecting a frail lady who would look quite ill. Instead, I was greeted with a very healthy looking lady. If I had seen her in the hallways, I would not have guessed she had been battling cancer for almost 2 years and now facing another fight against the metastases. While going through her medication list, she was on high doses of analgesics and one can imagine how much pain she is usually in. As we got further into the consultation, what once was a calm looking lady turned into a nervous and worried person. She is supposed to undergo radical surgery in a few days and I really do not blame her for her nerves. I was taken aback by how calm she was at the beginning. It really puts things into perspective. I had a bad week last week with back pain, but after hearing the patient's story, my back pain seemed like nothing. It is nothing compared to what she's going through. And it really amplifies the fact that if you think you're having a bad day, there are people having a much worse day than you. It's easy to forget how fragile life can be. 40 year old woman - most are fit and healthy. Cancer is something still seen as a disease that affects the older population. It was inspiring to hear about her fight and her courage. Pretty sure I didn't whine/complain about anything for the rest of the day.
Life can throw curve balls affecting you physically and your health. But I wanted to talk about mental health. By being in a stressful job, it is important to keep your mind "happy" and not allow work overwhelm you. Your emotions can greatly alter your way of functioning. Recently, there has been a lot of mental health awareness campaigns going on especially back home in Canada. I personally know quite a few friends affected by mental health issues such as depression. I thought it would be worthwhile for me to write a mini blurb here and raise awareness to those who read my blog. Statistically, about 1 in 4 students are affected by depression and approximately only 1 in 4 people seek help. The main reason for the lack of seeking for help? Stigma. Mental health is still a "taboo" subject and it shouldn't be one! It is a common problem affecting many people. Not many people want to speak up and get help. You can't just "laugh" off depression or mental health illness. I know way too many people suffering with this. What bothered me was how even in the health service, health professionals are almost afraid to ask about psychiatric illness. The number of times where I've seen various professionals very quietly ask if there is any history of psychiatric illness or if he/she suffers from depression. We ask about heart/lung/bowel problems loud and clear, but when it comes to mental health it gets all "hush hush". If there wasn't this "stigma" surrounding mental health, will there be more people seeking for help? I would like to think yes. I've had friends who suffered in silence and I have nothing but praises for those who gathered enough courage to seek help. From what I hear, it can get very dark and lonely. There is so much help out there. People shouldn't be suffering in silence. Stigma is unacceptable. The reason for raising awareness is to eradicate the stigma associated with mental health. 1 in 4 people are affected. That is common. Look at your group of friends. Live in a house with 3 others? Do your part and raise awareness.
Life can throw curve balls affecting you physically and your health. But I wanted to talk about mental health. By being in a stressful job, it is important to keep your mind "happy" and not allow work overwhelm you. Your emotions can greatly alter your way of functioning. Recently, there has been a lot of mental health awareness campaigns going on especially back home in Canada. I personally know quite a few friends affected by mental health issues such as depression. I thought it would be worthwhile for me to write a mini blurb here and raise awareness to those who read my blog. Statistically, about 1 in 4 students are affected by depression and approximately only 1 in 4 people seek help. The main reason for the lack of seeking for help? Stigma. Mental health is still a "taboo" subject and it shouldn't be one! It is a common problem affecting many people. Not many people want to speak up and get help. You can't just "laugh" off depression or mental health illness. I know way too many people suffering with this. What bothered me was how even in the health service, health professionals are almost afraid to ask about psychiatric illness. The number of times where I've seen various professionals very quietly ask if there is any history of psychiatric illness or if he/she suffers from depression. We ask about heart/lung/bowel problems loud and clear, but when it comes to mental health it gets all "hush hush". If there wasn't this "stigma" surrounding mental health, will there be more people seeking for help? I would like to think yes. I've had friends who suffered in silence and I have nothing but praises for those who gathered enough courage to seek help. From what I hear, it can get very dark and lonely. There is so much help out there. People shouldn't be suffering in silence. Stigma is unacceptable. The reason for raising awareness is to eradicate the stigma associated with mental health. 1 in 4 people are affected. That is common. Look at your group of friends. Live in a house with 3 others? Do your part and raise awareness.
Saturday, December 29, 2012
A Memorable Year.
1 year ago today, I was thankful and nervous at the same time. Last year's exam was probably the largest hurdle of my degree. I didn't do as well as I had hoped in my exam, but still managed to pass. I was incredibly thankful to be able to pass as many of my friends had failed the exam. Some of which had to repeat the year. I made a promise to myself that the year 2012 will be my comeback year. I was determined to start on the right foot and to never make the same mistakes again.
This year zoomed by. I believe I made leaps and bounds in terms of knowledge and self-confidence whilst on the wards and in clinics. I still got to give lots of credit to my placement in Orthopaedics. I cannot be more thankful to my supervisor. Even my friends have noticed that after my Orthopaedics placement, I was a different medical student. I was no longer afraid to speak up. I was no longer afraid to participate and be proactive. I realized that if you don't ask, you will never know what will happen. The worst answer you can get when asking something is "No". What is there to lose...other than a hurt ego. So one tip for all of you is to be confident. Don't be afraid to ask for help. Again, the worst someone can say is "No". If the answer is "no", just shrug and move on and don't take it personally.
As you move through the degree, Medicine slowly dominates your life and you really got to make an effort to have a social life. As the months pass and you have some free time to reflect, you realize your friends start to drift away and it may get a bit lonely at times. Medicine needs a lot of dedication, but I cannot emphasize enough how important it is to relax and take some time out. Giving yourself a break does not necessarily mean you have to go take a vacation. Taking a break is different for everyone. It may involve going to do something you enjoy or meeting up with friends, or even just spending some time at home to relax and watch TV. I didn't realize how important it is to take a break until this year when I have finally experienced a whole year of clinical placements, one after another. Work - Life balance. I know many people in my year who are taking a year out to do a BMedSci next year, not because they want to do research, but because they have burnt out.
To top off my memorable year, just earlier today I received confirmation that I have been accepted to present a my research poster at a national conference. Really unexpected as it's quite competitive, so I'm absolutely chuffed. What a way to finish up the year!
In general, I have made many new friends, matured as a person, and gained valuable skills for the future - I think this has probably been one of my most memorable year of my medical degree. Despite the many ups and downs throughout the year, looking back - overall it has been a very good year.
Got to thank those who have made my year so memorable and those who made my experiences so much better. Cheers to 2012, bring on 2013!
This year zoomed by. I believe I made leaps and bounds in terms of knowledge and self-confidence whilst on the wards and in clinics. I still got to give lots of credit to my placement in Orthopaedics. I cannot be more thankful to my supervisor. Even my friends have noticed that after my Orthopaedics placement, I was a different medical student. I was no longer afraid to speak up. I was no longer afraid to participate and be proactive. I realized that if you don't ask, you will never know what will happen. The worst answer you can get when asking something is "No". What is there to lose...other than a hurt ego. So one tip for all of you is to be confident. Don't be afraid to ask for help. Again, the worst someone can say is "No". If the answer is "no", just shrug and move on and don't take it personally.
As you move through the degree, Medicine slowly dominates your life and you really got to make an effort to have a social life. As the months pass and you have some free time to reflect, you realize your friends start to drift away and it may get a bit lonely at times. Medicine needs a lot of dedication, but I cannot emphasize enough how important it is to relax and take some time out. Giving yourself a break does not necessarily mean you have to go take a vacation. Taking a break is different for everyone. It may involve going to do something you enjoy or meeting up with friends, or even just spending some time at home to relax and watch TV. I didn't realize how important it is to take a break until this year when I have finally experienced a whole year of clinical placements, one after another. Work - Life balance. I know many people in my year who are taking a year out to do a BMedSci next year, not because they want to do research, but because they have burnt out.
To top off my memorable year, just earlier today I received confirmation that I have been accepted to present a my research poster at a national conference. Really unexpected as it's quite competitive, so I'm absolutely chuffed. What a way to finish up the year!
In general, I have made many new friends, matured as a person, and gained valuable skills for the future - I think this has probably been one of my most memorable year of my medical degree. Despite the many ups and downs throughout the year, looking back - overall it has been a very good year.
Got to thank those who have made my year so memorable and those who made my experiences so much better. Cheers to 2012, bring on 2013!
Happy New Year!
Thursday, December 27, 2012
Request: Tips for Revising for Exams.
So I had a request to do a post on tips for revising for your year-end medical exam. To be honest, every person will have a different way of revising. The most ideal way to revise for exams is to start from day 1 of the course. After every lecture/day, gather all your notes together and make sure your notes have enough info for you. If not, look at your recommended reading and add info to your notes. Or after end of each day is to consolidate all the things you have learned and to go over it. Some people like to consolidate their knowledge on weekends as most lecture days go from 9-5pm and by the time you finish your day, your brain will be fried. If you stay on top of your notes, when it comes to exam time, you should know your material quite well and just need to commit things to memory and you will not be needing to learn anything "new".
What I just described is the ideal way...but realistically, the chances of that happening is quite slim, unless you're quire organized and on top of everything. For me, that method got tossed out 2 weeks into my course. What actually happens is that you take notes during your lectures/print out your lecture slides. If you're having a good week and have some spare time, your notes will go into a binder so your room stays relatively neat and that you will be able to find your notes. If your university only does 1 year-end exam, like mine, on average, medics begin studying between 4-6 weeks prior to exams. You would think that's ridiculously too far in advance, but the sheer amount of material you learn in one year...it just as ridiculous. I personally need 6 weeks to go through a whole year worth of material, but do keep in mind...I don't really look at my notes again until my 6 week revision period. So here I will list some tips on how to get on top of your revision period:
1) Make a revision schedule. Try and figure out how many days/weeks you will need to go over a topic (eg. 1 week for Paediatrics, 5 days for O&G). How much time to dedicate to each topic will depend on how well you know a topic/how confident you are with the topic. Always leave 1 week prior to exams for leeway/time to go over sample/past papers/revise stuff you don't know very well/last minute cram. I usually start thinking about making my revision schedule well in advance or else if you do one too late, you'll realize you have too little weeks left and too many topics. To avoid that, maybe think about your revision schedule when you come back from your last holiday before exams.
2) Find a study buddy! If you live with other medics, then that's sorted. If you don't, try finding a study buddy who has the same sort of revising method as you. It's a great way to make sure you don't miss out any topics and also a great way to test each other's knowledge. Make sure this study buddy won't be a distraction though or else you won't accomplish much!
3) Rest! I cannot stress enough how important it is to get enough rest during your revision weeks. No point of pulling all-nighters when your brain can't even function anymore. Nothing will get absorbed. Your body will tell you when it is time to take a break (usually when you find yourself reading the same page over and over again and nothing is going in). Try and get a good nights sleep every day. Pretty basic stuff, but it is so easy to forget to just rest.
4) Use cue cards for memorizing things. Some people don't like cue cards, which is fair enough. In medicine we have to learn a lot of names that aren't even related to the condition such as drug names/some medical syndromes. Once you write it down, you can put it to the side. Also great for the last minute cram a day or two before exams.
5) Start early. At the same time I'm not saying start revising 10 weeks before exams. Obviously this is down to personal preference. I think I started too early for this year's exam, but it's not something I regret. It was extremely tiring and boring though. At the same time, last year I started too late and regretted it and it was extremely stressful. Because I started a bit too early (or maybe even perfect timing), I could sacrifice a day or two to take a break or to spend a few extra days on a topic such as Paediatrics. I originally allocated 10 days for Paediatrics, but actually ended up taking 2 weeks to go through all of Paediatrics, but because I started revising early, I was able to give up a few days and shift my other dates around for my other topics.
6) Use revision books to AID knowledge, not gain knowledge. There are some books called Crash Course or At a Glance, which are really good books which gives you a quick glance at a topic. These are good books to help you look up stuff quickly or to double check info, but these are books you should not base your revision around as it misses out fundamental/basic knowledge that you will get from a proper textbook/lectures.
To be honest, I think the key things for revision is to be organized, good time management, rest lots, and try not to stress out too much. Exams are extremely stressful and your anxiety levels go through the roof. Everyone will be feeling the same so don't think you're the odd one out. On top of revising, you might still have to go into placement as some unis only give you 1 week of revision (where nothing is timetabled), so you'll need to be able to balance going to placement and revising. If you aren't organized, your revision will get quite messy. At the same time, don't start skiving placements so you can revise because at the same time, you can learn/revise while on placement. Sometimes really useful tutorial sessions will be held and you can learn/revise during those sessions. To be honest, this whole revision business sounds a lot harder than it really is. You'll know what to do when it comes to revision.
Hope this helps!
What I just described is the ideal way...but realistically, the chances of that happening is quite slim, unless you're quire organized and on top of everything. For me, that method got tossed out 2 weeks into my course. What actually happens is that you take notes during your lectures/print out your lecture slides. If you're having a good week and have some spare time, your notes will go into a binder so your room stays relatively neat and that you will be able to find your notes. If your university only does 1 year-end exam, like mine, on average, medics begin studying between 4-6 weeks prior to exams. You would think that's ridiculously too far in advance, but the sheer amount of material you learn in one year...it just as ridiculous. I personally need 6 weeks to go through a whole year worth of material, but do keep in mind...I don't really look at my notes again until my 6 week revision period. So here I will list some tips on how to get on top of your revision period:
1) Make a revision schedule. Try and figure out how many days/weeks you will need to go over a topic (eg. 1 week for Paediatrics, 5 days for O&G). How much time to dedicate to each topic will depend on how well you know a topic/how confident you are with the topic. Always leave 1 week prior to exams for leeway/time to go over sample/past papers/revise stuff you don't know very well/last minute cram. I usually start thinking about making my revision schedule well in advance or else if you do one too late, you'll realize you have too little weeks left and too many topics. To avoid that, maybe think about your revision schedule when you come back from your last holiday before exams.
2) Find a study buddy! If you live with other medics, then that's sorted. If you don't, try finding a study buddy who has the same sort of revising method as you. It's a great way to make sure you don't miss out any topics and also a great way to test each other's knowledge. Make sure this study buddy won't be a distraction though or else you won't accomplish much!
3) Rest! I cannot stress enough how important it is to get enough rest during your revision weeks. No point of pulling all-nighters when your brain can't even function anymore. Nothing will get absorbed. Your body will tell you when it is time to take a break (usually when you find yourself reading the same page over and over again and nothing is going in). Try and get a good nights sleep every day. Pretty basic stuff, but it is so easy to forget to just rest.
4) Use cue cards for memorizing things. Some people don't like cue cards, which is fair enough. In medicine we have to learn a lot of names that aren't even related to the condition such as drug names/some medical syndromes. Once you write it down, you can put it to the side. Also great for the last minute cram a day or two before exams.
5) Start early. At the same time I'm not saying start revising 10 weeks before exams. Obviously this is down to personal preference. I think I started too early for this year's exam, but it's not something I regret. It was extremely tiring and boring though. At the same time, last year I started too late and regretted it and it was extremely stressful. Because I started a bit too early (or maybe even perfect timing), I could sacrifice a day or two to take a break or to spend a few extra days on a topic such as Paediatrics. I originally allocated 10 days for Paediatrics, but actually ended up taking 2 weeks to go through all of Paediatrics, but because I started revising early, I was able to give up a few days and shift my other dates around for my other topics.
6) Use revision books to AID knowledge, not gain knowledge. There are some books called Crash Course or At a Glance, which are really good books which gives you a quick glance at a topic. These are good books to help you look up stuff quickly or to double check info, but these are books you should not base your revision around as it misses out fundamental/basic knowledge that you will get from a proper textbook/lectures.
To be honest, I think the key things for revision is to be organized, good time management, rest lots, and try not to stress out too much. Exams are extremely stressful and your anxiety levels go through the roof. Everyone will be feeling the same so don't think you're the odd one out. On top of revising, you might still have to go into placement as some unis only give you 1 week of revision (where nothing is timetabled), so you'll need to be able to balance going to placement and revising. If you aren't organized, your revision will get quite messy. At the same time, don't start skiving placements so you can revise because at the same time, you can learn/revise while on placement. Sometimes really useful tutorial sessions will be held and you can learn/revise during those sessions. To be honest, this whole revision business sounds a lot harder than it really is. You'll know what to do when it comes to revision.
Hope this helps!
Wednesday, December 19, 2012
I'm baaaaack!
Well it's certainly been awhile since my last post. Apologies. I've been revising for my exams. Finished exams so I suddenly have a lot of free time. Quite weird. I've technically been studying for over 6 weeks for this exam which felt a lot longer as it just kept dragging on and on. It didn't help that the other years have already taken their exams/have left for winter holiday already. It's gutting when people are away back at home or on vacation and you're stuck in your room/library revising all day, every day.
Today I got my results from my exam and good news: PASSED! Managed to jump over another hurdle. Next hurdle: Finals. Scary! To be honest these exams meant a lot to me. I wasn't very happy with my performance in last year's exams and promised myself that I will never make the same mistake and study harder and work harder. I pretty much declared this year as a "comeback" year. I promised myself to go into placements and actively learn. So today when I went to get my results, I was very nervous. I was confident I had passed, but there's always that little bit of doubt in the back of your mind. The relief when I saw my results. Phew. I think I can officially say that this has been a successful comeback year. I have regained my motivation for Medicine and during the 2nd half of this year, I have regained a lot of confidence. I got to say - it's been a good year (despite the highs and lows).
Along with my results, I have received my schedule and placements for next year. Starting off in A&E, so it will be a very quick and hectic start! Should be very interesting though. Now that exams are over and that I've gotten my results - I can finally relax. Get back to normality. Do what I enjoy and meet up with friends. It was a tough exam period and I cannot wait to go back home. See my school friends. See my parents. Celebrating Christmas and New Year with the family. It will be nice. It will probably be my last proper winter holiday as next year I will be revising for finals as my final exams are after winter holidays. I will definitely have to make use and enjoy this winter holiday as much as I can this year. It's been a very tough road. Scarier thought: after next year's winter holiday, I will be working as a proper doctor in a hospital somewhere during winter holidays! Wow. It's getting close!
One step closer to being a doctor!
Anyways Merry Christmas to everyone and good luck with interviews!
Today I got my results from my exam and good news: PASSED! Managed to jump over another hurdle. Next hurdle: Finals. Scary! To be honest these exams meant a lot to me. I wasn't very happy with my performance in last year's exams and promised myself that I will never make the same mistake and study harder and work harder. I pretty much declared this year as a "comeback" year. I promised myself to go into placements and actively learn. So today when I went to get my results, I was very nervous. I was confident I had passed, but there's always that little bit of doubt in the back of your mind. The relief when I saw my results. Phew. I think I can officially say that this has been a successful comeback year. I have regained my motivation for Medicine and during the 2nd half of this year, I have regained a lot of confidence. I got to say - it's been a good year (despite the highs and lows).
Along with my results, I have received my schedule and placements for next year. Starting off in A&E, so it will be a very quick and hectic start! Should be very interesting though. Now that exams are over and that I've gotten my results - I can finally relax. Get back to normality. Do what I enjoy and meet up with friends. It was a tough exam period and I cannot wait to go back home. See my school friends. See my parents. Celebrating Christmas and New Year with the family. It will be nice. It will probably be my last proper winter holiday as next year I will be revising for finals as my final exams are after winter holidays. I will definitely have to make use and enjoy this winter holiday as much as I can this year. It's been a very tough road. Scarier thought: after next year's winter holiday, I will be working as a proper doctor in a hospital somewhere during winter holidays! Wow. It's getting close!
One step closer to being a doctor!
Anyways Merry Christmas to everyone and good luck with interviews!
Tuesday, November 20, 2012
Something for you to think about...
To make up for my last short post - I'll give you guys something to think/reflect about.
So you meet a 55 year old male patient on the neurology ward who was admitted with severe unilateral headaches in the front which radiates to the back of the head with no associated neck stiffness. As you talk to the patient you notice he's fairly relaxed and quite talkative. He tells you how he first presented to his GP 4 weeks ago who didn't explain much and sent him for a CT/MRI scan on his head, then proceeded to send him for Chest X-rays...eventually getting a pelvic MRI scan. The patient says: "I have no idea why I had to go through all these scans. Bit pointless in my opinion. It's just a headache...any ideas doc?" You know all these events had happened over the last 4 weeks and this patient has seen several doctors and you start to wonder why no one has told this man why all these investigations were done. Eventually you find out that the patient is aware that there is a "lump" in the back of his brain and that he's being scheduled to get a biopsy. After saying this, the patient still seems very relaxed and seemingly unaware of what is going on...actually he ends up telling you that he actually doesn't have a clue what's going on.
After the nice conversation you've had with the patient, you go look in his medical notes. You read the report from the scans which clearly says: "Query metastasis to the brain". You know that the GP/other doctors had sent this patient for several different investigations is to locate the primary cancer - which the patient is completely unaware of. Next imaging report: "Primary glioma". All brain tumours are technically malignant. Then you think: does this patient know he's possibly got brain cancer? No one knows how severe it is as a biopsy hasn't been done.
So here's something for you to think about. As a medic or soon to be medic: would you rather know about everything? Know exactly WHY the scans are being done and what are the results. Reasons behind all the investigations. All the plans from the doctors and suspicions/differentials. Then you look at it from another point. If this patient knew about all of the reasons and all the prior suspicions that the doctors had, would he still be as relaxed and calm about his "headache"? So is it actually better to not know that much?
Personally I think there's a fine line between knowing too much and knowing too little. As a patient, I would want as much info as I can as I'm a medic - I want to know things. If I didn't have any medical background, I think I wouldn't want to know anything. Live life in denial and in the unknown I guess? At least I won't be busy stressing myself out. These things can be emotionally difficult and cancer is such a sensitive topic. I would think the general population wouldn't want to know all the reasoning. It's tough. I think every person has a different view on this. Something for you to think about/reflect about.
So you meet a 55 year old male patient on the neurology ward who was admitted with severe unilateral headaches in the front which radiates to the back of the head with no associated neck stiffness. As you talk to the patient you notice he's fairly relaxed and quite talkative. He tells you how he first presented to his GP 4 weeks ago who didn't explain much and sent him for a CT/MRI scan on his head, then proceeded to send him for Chest X-rays...eventually getting a pelvic MRI scan. The patient says: "I have no idea why I had to go through all these scans. Bit pointless in my opinion. It's just a headache...any ideas doc?" You know all these events had happened over the last 4 weeks and this patient has seen several doctors and you start to wonder why no one has told this man why all these investigations were done. Eventually you find out that the patient is aware that there is a "lump" in the back of his brain and that he's being scheduled to get a biopsy. After saying this, the patient still seems very relaxed and seemingly unaware of what is going on...actually he ends up telling you that he actually doesn't have a clue what's going on.
After the nice conversation you've had with the patient, you go look in his medical notes. You read the report from the scans which clearly says: "Query metastasis to the brain". You know that the GP/other doctors had sent this patient for several different investigations is to locate the primary cancer - which the patient is completely unaware of. Next imaging report: "Primary glioma". All brain tumours are technically malignant. Then you think: does this patient know he's possibly got brain cancer? No one knows how severe it is as a biopsy hasn't been done.
So here's something for you to think about. As a medic or soon to be medic: would you rather know about everything? Know exactly WHY the scans are being done and what are the results. Reasons behind all the investigations. All the plans from the doctors and suspicions/differentials. Then you look at it from another point. If this patient knew about all of the reasons and all the prior suspicions that the doctors had, would he still be as relaxed and calm about his "headache"? So is it actually better to not know that much?
Personally I think there's a fine line between knowing too much and knowing too little. As a patient, I would want as much info as I can as I'm a medic - I want to know things. If I didn't have any medical background, I think I wouldn't want to know anything. Live life in denial and in the unknown I guess? At least I won't be busy stressing myself out. These things can be emotionally difficult and cancer is such a sensitive topic. I would think the general population wouldn't want to know all the reasoning. It's tough. I think every person has a different view on this. Something for you to think about/reflect about.
Friday, November 2, 2012
Another Step Forward.
I think a bit back I said I was working on an Orthopaedic project (since May). Today I had the chance to present my project in front of a group of orthopaedic surgeons across the region. It's nice to finally present something that you've been working so hard on, but I would be lying if I said I wasn't nervous. I was fairly confident a week ago when I was preparing my powerpoint though. My run-through with my supervisor went really well, but this was presenting in front of someone who I know. Presenting in front of a group of orthopaedic consultants is a whole other ball game. What I was most worried about were the questions at the end.
One thing about me is that I don't like over-rehearsing/practising my presentations as I like to improvise. I like to give relaxed presentations that can go any direction depending on how I feel as it shows confidence in your presentation/project. I know my project very...very well so this was a route I know I wanted to take, but a risky one as I haven't presented in over 2 years and certainly not in front of a group of consultants. But because I didn't want to make a fool out of myself, I thought it was a good idea to practice a bit more than usual so I rehearsed once a day starting on Monday. The one rule I have for myself is to never use cue cards or notes and this was definitely not going to change for this presentation. When I showed up at the meeting, I think the lead was a bit surprised by the fact all I had was my powerpoint and no notes/cue cards to run through while I wait for my turn. To be fair, I wanted to look like I was confident and at ease about my presentation, but actually I was completely bricking it inside. The night before I was "choking". Was confident until the night before and everything just fell apart. I was stuttering when I was running through and forgetting to talk about certain things as my slides contain very little info as I like to expand on my points.
Anyways it got to my turn and I told myself that one of my strong points are doing presentations and this is not anything different. I introduced my powerpoint and I went through my powerpoint like it was second nature. It was almost like I wasn't even consciously doing it. It felt really good! Then the dreaded part: question time. Surprisingly, the first question wasn't even a question. A consultant took the time to complement me so I was really chuffed about it. It definitely made me feel proud of myself and especially when I was the only medical student presenting amongst a bunch of registrars. At least it was some sort of confirmation that I didn't make myself look like a complete idiot, but the bail out sentence was always ready: "Sorry I am just only a medical student." The questions asked weren't too bad and it actually started a discussion amongst the audience about the thing I studied.
After doing this presentation it gave me an idea to make a post of tips for making presentations:
One thing about me is that I don't like over-rehearsing/practising my presentations as I like to improvise. I like to give relaxed presentations that can go any direction depending on how I feel as it shows confidence in your presentation/project. I know my project very...very well so this was a route I know I wanted to take, but a risky one as I haven't presented in over 2 years and certainly not in front of a group of consultants. But because I didn't want to make a fool out of myself, I thought it was a good idea to practice a bit more than usual so I rehearsed once a day starting on Monday. The one rule I have for myself is to never use cue cards or notes and this was definitely not going to change for this presentation. When I showed up at the meeting, I think the lead was a bit surprised by the fact all I had was my powerpoint and no notes/cue cards to run through while I wait for my turn. To be fair, I wanted to look like I was confident and at ease about my presentation, but actually I was completely bricking it inside. The night before I was "choking". Was confident until the night before and everything just fell apart. I was stuttering when I was running through and forgetting to talk about certain things as my slides contain very little info as I like to expand on my points.
Anyways it got to my turn and I told myself that one of my strong points are doing presentations and this is not anything different. I introduced my powerpoint and I went through my powerpoint like it was second nature. It was almost like I wasn't even consciously doing it. It felt really good! Then the dreaded part: question time. Surprisingly, the first question wasn't even a question. A consultant took the time to complement me so I was really chuffed about it. It definitely made me feel proud of myself and especially when I was the only medical student presenting amongst a bunch of registrars. At least it was some sort of confirmation that I didn't make myself look like a complete idiot, but the bail out sentence was always ready: "Sorry I am just only a medical student." The questions asked weren't too bad and it actually started a discussion amongst the audience about the thing I studied.
After doing this presentation it gave me an idea to make a post of tips for making presentations:
- Keep your powerpoint short and simple - maximum 4-5 points per slide - use these as cues for yourself and expand on these points
- Use images to make your slides/presentation look more interesting
- My personal rule is about 30-60 seconds per slide. 10 minute presentations = 10-15 slides. Any more slides, you could potentially end up speaking too quickly
- Practice your powerpoint without any cue cards or notes from day 1 - if you don't get into the habit of using cue cards...then you'll never need to rely on them
- If you're really unsure about your presentation, find a friend to practice in front of and ask he/she to give you feedback
- If you're nervous at the time of your presentation, pause for a second at the end of each slide to allow yourself to gather your thoughts for the next slide. The audience will think you're giving them time to read your slide so use the opportunity to calm yourself and gather yourself.
- Introduction is key - also an easy way to calm yourself as you'll never forget your own name!
- Always end your presentation with a summary slide as it's a nice way to round off the presentation
- Body language! Be aware of how you stand and what you're doing with your hands. If sitting, don't fidget/swivel in your chair. Standing and don't know what to do with your hands? Clasp them in front of you or try to use your hands to point to relevant images on your slide. Practice makes perfect for this. Avoid closed body positions such as crossing your arms across your chest and leaning against the wall. Don't want to look bored of your own presentation!
- Look around the room when talking. Don't have to make eye contact, but remember there's more than one person there so involve the room by looking around.
- And SMILE! Don't want to look grumpy about your own presentation!
Wednesday, October 10, 2012
Psychiatry - Final Week
This placement went by QUICK! I think it was the fact that the placement wasn't too bad and that I was quite busy doing my other work - time has just flown by. To be honest, I haven't seen too many exciting things as I had hoped to have seen. There's always a lot of misconceptions about each specialty and I think psychiatry is no different. Before I started the placement I was a bit unsure what to expect. I was a bit scared as on our first day we were each given a personal "alarm" which we would put on our belt loops. In addition to those alarms, when we entered the ward, we got another alarm which has tracking on it as well. You can't help but think that psychiatry might not be the safest specialty. We were also taught a lot about risk assessment when interviewing a patient. I remember we got a tutorial on where to sit and what to look out for in a room. We were told to always look out for objects that can be easily thrown and to sit near the door but not with our backs towards the door so if we need to escape we can just go out without turning around.
Okay yes, there are some "dangerous" patients who are known to be quite aggressive, but I never really felt "in danger" while on the wards or in clinic. I guess the only time I felt a bit "iffy" was today in clinic. The final patient I saw on my psychiatry attachment is known to have a very short temper and when he snaps - he snaps in a big way (throw objects, get violent, etc.). As the consultation went on, I could tell the patient was starting to get agitated and worst bit - I was sat furthest from the door and the patient was sat between the door and I (so much for remembering about risk assessment). To be honest - the clinic room wasn't appropriately arranged so there wasn't much one could do other than hope for the best. The consultation came to an end and for no reason the patient just "lost it". He lashed out but thankfully he didn't throw anything and instead stormed out the door and slammed it with a considerable amount of force. You could actually hear him leave the clinic as he was slamming every door along the way. I expected it to happen but it wasn't a nice situation to be caught in knowing there isn't really anywhere to go other than curling up into a ball.
Other than that incident - all the patients I have seen are all quite "alright". Despite some having a history of violence/aggression, these patients all seemed fairly cooperative. We are told of the ones who we shouldn't go speak to as they aren't cooperative but the "okay" ones are fairly normal. Of my 6 weeks in psychiatry, there hasn't been any major incidences. I'm sure more incidences/violence occur in A&E than in psychiatry. I think the one thing about psychiatry is the need for patience. Some of the patients are great historians...some are terrible and will not admit to anything/are not cooperative. With new patients - the clerking can take up to 1 hour and most of these inpatients don't have the patience to speak to you for an hour. I personally don't even have the patience to ask questions for an hour/listen to their history for an hour. I find it very time consuming. The number of times I have nearly fallen asleep during a consultation has been ridiculous. I drift off not because it is boring, but it's the fact that sitting and listening to a history for an hour is very difficult. Again with this attachment, there wasn't much I could do other than observe, but the good thing I had over GP was that when in the hospital - I can actually wander around and am not constrained to one building/area. Psychiatry is definitely different and I have definitely learned a lot since it is a new topic. I'm fairly certain it isn't something I can do, but it is quite interesting as you see a range of people and personalities.
Unfortunately I don't really get a break between this placement and the next other than a 3 day weekend. My next placement will be in Care of Old People - specifically Orthogeriatrics. Talk about luck. I'm actually really looking forward to it as I'll get to see and deal with something I'm interested in and maybe I can sneak off and see a few surgeries as well. I also know the team in the department - so I don't need to endure the whole awkward introduction/getting used to the ward/staff. It will be a short placement but I think it will be one that will pick my motivation back up and get me going again just in time for exams. Eek!
Okay yes, there are some "dangerous" patients who are known to be quite aggressive, but I never really felt "in danger" while on the wards or in clinic. I guess the only time I felt a bit "iffy" was today in clinic. The final patient I saw on my psychiatry attachment is known to have a very short temper and when he snaps - he snaps in a big way (throw objects, get violent, etc.). As the consultation went on, I could tell the patient was starting to get agitated and worst bit - I was sat furthest from the door and the patient was sat between the door and I (so much for remembering about risk assessment). To be honest - the clinic room wasn't appropriately arranged so there wasn't much one could do other than hope for the best. The consultation came to an end and for no reason the patient just "lost it". He lashed out but thankfully he didn't throw anything and instead stormed out the door and slammed it with a considerable amount of force. You could actually hear him leave the clinic as he was slamming every door along the way. I expected it to happen but it wasn't a nice situation to be caught in knowing there isn't really anywhere to go other than curling up into a ball.
Other than that incident - all the patients I have seen are all quite "alright". Despite some having a history of violence/aggression, these patients all seemed fairly cooperative. We are told of the ones who we shouldn't go speak to as they aren't cooperative but the "okay" ones are fairly normal. Of my 6 weeks in psychiatry, there hasn't been any major incidences. I'm sure more incidences/violence occur in A&E than in psychiatry. I think the one thing about psychiatry is the need for patience. Some of the patients are great historians...some are terrible and will not admit to anything/are not cooperative. With new patients - the clerking can take up to 1 hour and most of these inpatients don't have the patience to speak to you for an hour. I personally don't even have the patience to ask questions for an hour/listen to their history for an hour. I find it very time consuming. The number of times I have nearly fallen asleep during a consultation has been ridiculous. I drift off not because it is boring, but it's the fact that sitting and listening to a history for an hour is very difficult. Again with this attachment, there wasn't much I could do other than observe, but the good thing I had over GP was that when in the hospital - I can actually wander around and am not constrained to one building/area. Psychiatry is definitely different and I have definitely learned a lot since it is a new topic. I'm fairly certain it isn't something I can do, but it is quite interesting as you see a range of people and personalities.
Unfortunately I don't really get a break between this placement and the next other than a 3 day weekend. My next placement will be in Care of Old People - specifically Orthogeriatrics. Talk about luck. I'm actually really looking forward to it as I'll get to see and deal with something I'm interested in and maybe I can sneak off and see a few surgeries as well. I also know the team in the department - so I don't need to endure the whole awkward introduction/getting used to the ward/staff. It will be a short placement but I think it will be one that will pick my motivation back up and get me going again just in time for exams. Eek!
Sunday, September 16, 2012
That Time of the Year...Again.
So Freshers Week is literally right around the corner. You're sitting in front of your computer/packing/feeling excited and nervous/etc. A million questions race through your mind: What's medical school going to be like? Am I going to make any friends? What is Freshers like? Will I be able to cope? Will I get homesick?
I am probably considered an "oldie" at university now since I am now in 4th year. Most people who started university with me in the UK have all graduated now...most are working as well...and I'm still in school. I've been through 3 fresher weeks now - I think I can safely say that I'm fairly confident about what goes on in Freshers and what students are usually concerned about. Let's crack a few FAQs.
What is medical school going to be like?
Medical school is going to be challenging, physically and mentally tough, tiring, and most importantly - FUN. At the end of the day - we are medics. We work hard and party hard, BUT it is essential to maintain a good balance between the two. Don't want to work too hard to the point you burn out within first year, but at the same time not party so hard you end up flunking the year. In the first few weeks of school, it will mainly be a lot of introductory lectures. Unfortunately, your first few weeks will probably be a bit of a shock. First 2 weeks - you'll still be either hungover or on cloud 9 as you are still coming to terms that you are in medical school. Then week 3 comes around and so on...you're in lectures from 9am-5pm. You want to be seeing patients and learning clinical things, etc. Here's the truth - everyone has to take baby steps first so you'll probably spend quite a bit of time learning the basics. The science of medicine more than anything.
How do I make friends?
I cannot stress the importance of getting out there. Don't just stay in your accommodation. Go out and socialize! I do understand drinking/alcohol culture is not everyone's "cup of tea", but not all socials need to be at a pub/bar/club. In your first week (Freshers Week) there will be a lot of fairs. There will be a medical freshers fair, union freshers fair, sports fair, etc. Go to the fairs and join some societies! Remember all the freshers that attend these fairs will also be looking for friends. Thinking back, in the first few weeks of university was quite overwhelming. Every one seems a bit too friendly. You get so many numbers and emails from people you only say "Hi" to. Great place to start is at your first medical lecture. Go meet your classmates! You'll be stuck with them for the next 5-6ish years...so it's not a bad idea to start getting to know them. If you are a shy person, just think about it - everyone is looking to make friends. To be entirely honest - I used to be quite shy and the week before starting medical school - I was pretty nervous. I didn't know if I will be able to make friends. I'm not exactly the best person to initiate conversations. I can actually be quite quiet and can happily stand in the corner and watch the world pass by. Seeing how I'm in a new country, new school, etc - I knew I have to step out of my bubble and really try hard to make the first move and meet as many people as I can. Not sure what to say? Here's a start: "Hi! My name is _______. So where are you from? Liking *the university/city* so far? How are you finding it?"
Do I have to party every single day to make friends?
No. I did not go party every night. I think I went out twice (?) during Freshers week. BUT a great way to get to know your flatmates is probably to hang out with them, but know your limits. Sometimes you feel really pressured to go out, but if you aren't comfortable going out - then don't go! Just tell your friends you're going to take it easy for the night and need to finish unpacking. It isn't a crime to take it easy and most people should understand. However, I do HIGHLY recommend going to the Medic Freshers Party. I've been to the union party and the medics party 3 years in a row during Freshers week. The Medics' Party is a lot better. Plus it gives you another chance to meet more of your classmates and probably upper years such as people like me who don't want to give up on Fresher parties! I still fondly remember my first year medics freshers party. The people who I met at the party are still my great friends 3 years later. All I can say about these parties is just to enjoy yourself. Let loose. You're a fresher only once - just go for it! You're away from home. You're officially a medical student! I think these are good enough reasons to celebrate!
I got the welcome pack and everything seems really confusing and overwhelming! What to do?!
Just relax. I have always found the welcome packs overwhelming and exciting. Things start to feel real when you read through the welcome pack. I still remember reading mine and going: "wow...I am going to university. I'm going to be a medical student in a few days. There is a lot of stuff to know...crap." Essentially what schools tend to do is try to cram as much info in a welcome pack as they possibly can. It isn't a bad idea to give it a read before you start university, but you don't have to know everything in it. Introductory lectures/induction will probably cover most of it. How I've always seen things is to just "go with the flow". Just remember if you are feeling scared/nervous - there will probably be quite a lot of other people feeling the same thing. You're not the only one on the boat.
All in all - in a way Freshers week is overhyped. Keep your expectations low, and you won't be disappointed. How much you will enjoy Freshers Week is solely down to you. You control your life so you go out as much as you need to. But like I've said earlier: you're only a Fresher once so enjoy your time. Celebrate your week. You deserve it. You got into medical school - which was certainly not an easy task. Just think how far you have come to get here. It's also a fantastic time to get to know lots of people. Go join societies and get to know people from other courses. You are at university for 5-6 years so it is important to make the first good step. Relax and just go with the flow! Be excited. It will be a very fun 5+ years of university. It will go by quickly so enjoy it.
Good luck and enjoy your Freshers week. Also congratulations for getting into medical school.
Monday, September 3, 2012
Penultimate Year.
"Hi, my name is - and I am a 4th year student doctor."
How time flies. I still remember when I first step foot onto the wards in first year and introduced myself as a first year medical student - it was almost like yesterday! Now, I unwillingly have to introduce myself as a 4th year. I quite liked introducing myself as a 3rd year to patients and to doctors/nurses. I feel like we get a bit more sympathy and leeway. As a 3rd year, we can always pull the: "Sorry it's my first year of clinical.", when we make a mistake. As a 4th year - expectations are higher and mistakes will be looked down on. I feel like 4th year is the "real deal". People expect you to know your place in the hospital and know what you are doing. Questions won't be as well appreciated and you will be much more independent. It's actually quite frightening! As a 4th year - people who know that your course is 5 years will know that as a 4th year, you'll be in your penultimate year and pull the: "You'll be graduating in a year or so - come on, you should know better!"
So I'm starting psychiatry and will on the specialty for 6 weeks. We just had a week of lectures on psychiatry and it seems pretty interesting. It's also nice to learn something completely new as well. The past lectures we've had were more of a refresher and a bit more clinical, but wasn't completely new. We have never learned about psych so it was good.
Had my induction at the psychiatric hospital and it seems promising. It seems really organized and we've got a binder full of info. We've also got schedules for our next 6 weeks. Something so simple is well appreciated as that means I can plan my life. It's a shame other placements can't give our schedules that far in advance. Got a fairly easy week - mainly at clinics. Bit nervous as psych is so unfamiliar and new. Also scared about being quizzed. Yikes. Got to do some reading asap!
How time flies. I still remember when I first step foot onto the wards in first year and introduced myself as a first year medical student - it was almost like yesterday! Now, I unwillingly have to introduce myself as a 4th year. I quite liked introducing myself as a 3rd year to patients and to doctors/nurses. I feel like we get a bit more sympathy and leeway. As a 3rd year, we can always pull the: "Sorry it's my first year of clinical.", when we make a mistake. As a 4th year - expectations are higher and mistakes will be looked down on. I feel like 4th year is the "real deal". People expect you to know your place in the hospital and know what you are doing. Questions won't be as well appreciated and you will be much more independent. It's actually quite frightening! As a 4th year - people who know that your course is 5 years will know that as a 4th year, you'll be in your penultimate year and pull the: "You'll be graduating in a year or so - come on, you should know better!"
So I'm starting psychiatry and will on the specialty for 6 weeks. We just had a week of lectures on psychiatry and it seems pretty interesting. It's also nice to learn something completely new as well. The past lectures we've had were more of a refresher and a bit more clinical, but wasn't completely new. We have never learned about psych so it was good.
Had my induction at the psychiatric hospital and it seems promising. It seems really organized and we've got a binder full of info. We've also got schedules for our next 6 weeks. Something so simple is well appreciated as that means I can plan my life. It's a shame other placements can't give our schedules that far in advance. Got a fairly easy week - mainly at clinics. Bit nervous as psych is so unfamiliar and new. Also scared about being quizzed. Yikes. Got to do some reading asap!
Sunday, August 12, 2012
Request: The Future.
There was a request from one of the readers here asking:
Now I may be determined and ambitious, but I'm not going to shoot myself in the foot. Always have a back-up plan. Things can go wrong. Life can throw a curve-ball at you. Rules can change. Who knows. The future is unknown and the most you can do is to be ready. Yes I have my mind set to stay in the UK, but I am still planning to take the Canadian MCCEE so if push comes to shove and I have to go back to Canada, I can. Nothing worse than ending up jobless and stuck in that awkward grey area.
I know quite a few international students wondering about taking the USMLE. (Note: I am not trying to start an argument/debate with this topic - just a personal opinion. Sorry in advance if anyone takes this persona/finds it offensive...) Who doesn't want to live the "American Dream". So why am I not taking it? Because I am not seeking for the "American Dream". To be very blunt - I do not care for working in the US. Some people see it as a great opportunity to make some good money. Some people just like the environment more. How I see it - if you are looking for the "American Dream", I'm sorry to break it to you, but in today's economy - there isn't much of an "American Dream" anymore unless you become a very famous doctor. The US is a very competitive place. Remember not only do you have to take a sickeningly hard exam, but you also have to score well in it. There's no point in just scraping a pass - you have to have a competitive score to get a desirable job in the US. I personally have my mind set on a specialty and it is a very competitive specialty. If I wanted to go the US, I would actually have to ace the USMLE. I don't want to end up working in some small southern town in the states in the middle of nowhere. The UK schools aren't geared to take the USMLE. UK medical students are geared to become practising doctors...not to take a US registry exam. That means students who want to take the USMLE, have to spend a lot of extra time to study for the USMLE alongside with their UK course work/exams. It is a very tough thing to juggle and you really have to be determined to go to the US and be committed to do well. So do your research.
Having said that, those who are determined to go to the US and have their eyes set on the prize - will probably do well in the USMLE. These people would probably take the exam seriously and study hard for it. Some might not really care what specialty they want to go into. These people will probably get a job in a desirable location. I'm sure I wrote a post about priorities before. Personal preferences and priorities - what is important to you, may not be as important to the person sat next to you. To make your priorities work, you will have to make sacrifices. At the moment, my #1 priority is to get into my desired specialty. This will probably require me to make quite a few sacrifices as it is a competitive field. The most likely thing I will have to sacrifice is: location. Someone else who wants to do the same specialty may see location as a huge priority. He or she may rather stay in London than do specialty X or he/she may not mind doing specialty Y in order to stay in London. It is all down to you.
All in all, the future is a personal thing. Everyone has his/her own path. No one path is the same. Know your priorities and stick with them. Don't let someone else alter your priorities or talk you out or into things. It is your life at the end of the day.
"What are you planning to do after medical school? It would be great to get some insight to what Canadian medics plan to do after their studies in the UK."To be honest, the future can always change directions and I know I will have to be prepared for anything that life throws at me. My first choice is to stay in the UK and do my specialty training here as I know the system, and I have gotten to know quite a lot of doctors who can give me advice for the future. I will try my hardest to stay in the UK, but laws do change. Hopefully the law won't change to prevent international students who study in a UK medical school from practising in the UK. In my eyes, I have spent 5 years in the UK. Moving isn't easy. The last thing I want to do is moving back and forth between countries. When I set my mind to something, I like to stay on that track and I am a very determined and ambitious person. In a way some people see it as stubborn, but I set goals for a reason - it is something for me to look forward to and to work towards to. I used to be quite a high level athlete and giving up is not an option. I do not like to stray away from the goal and when I do, I do get disappointed. I set high standards for myself and yes I know staying in the UK will not be easy, but I have set my mind to it. I have moved my life over to the UK and I personally don't see much of a future for me in Canada.
Now I may be determined and ambitious, but I'm not going to shoot myself in the foot. Always have a back-up plan. Things can go wrong. Life can throw a curve-ball at you. Rules can change. Who knows. The future is unknown and the most you can do is to be ready. Yes I have my mind set to stay in the UK, but I am still planning to take the Canadian MCCEE so if push comes to shove and I have to go back to Canada, I can. Nothing worse than ending up jobless and stuck in that awkward grey area.
I know quite a few international students wondering about taking the USMLE. (Note: I am not trying to start an argument/debate with this topic - just a personal opinion. Sorry in advance if anyone takes this persona/finds it offensive...) Who doesn't want to live the "American Dream". So why am I not taking it? Because I am not seeking for the "American Dream". To be very blunt - I do not care for working in the US. Some people see it as a great opportunity to make some good money. Some people just like the environment more. How I see it - if you are looking for the "American Dream", I'm sorry to break it to you, but in today's economy - there isn't much of an "American Dream" anymore unless you become a very famous doctor. The US is a very competitive place. Remember not only do you have to take a sickeningly hard exam, but you also have to score well in it. There's no point in just scraping a pass - you have to have a competitive score to get a desirable job in the US. I personally have my mind set on a specialty and it is a very competitive specialty. If I wanted to go the US, I would actually have to ace the USMLE. I don't want to end up working in some small southern town in the states in the middle of nowhere. The UK schools aren't geared to take the USMLE. UK medical students are geared to become practising doctors...not to take a US registry exam. That means students who want to take the USMLE, have to spend a lot of extra time to study for the USMLE alongside with their UK course work/exams. It is a very tough thing to juggle and you really have to be determined to go to the US and be committed to do well. So do your research.
Having said that, those who are determined to go to the US and have their eyes set on the prize - will probably do well in the USMLE. These people would probably take the exam seriously and study hard for it. Some might not really care what specialty they want to go into. These people will probably get a job in a desirable location. I'm sure I wrote a post about priorities before. Personal preferences and priorities - what is important to you, may not be as important to the person sat next to you. To make your priorities work, you will have to make sacrifices. At the moment, my #1 priority is to get into my desired specialty. This will probably require me to make quite a few sacrifices as it is a competitive field. The most likely thing I will have to sacrifice is: location. Someone else who wants to do the same specialty may see location as a huge priority. He or she may rather stay in London than do specialty X or he/she may not mind doing specialty Y in order to stay in London. It is all down to you.
All in all, the future is a personal thing. Everyone has his/her own path. No one path is the same. Know your priorities and stick with them. Don't let someone else alter your priorities or talk you out or into things. It is your life at the end of the day.
Wednesday, August 1, 2012
End of GP Placement.
Oh how much I looked forward to typing the title to this post. It could have easily been the least brain stimulating placement I have yet to have. Not only that, I couldn't go make myself useful elsewhere unlike being in the hospital. Looking back on the last 6 weeks, it was definitely a struggle and a challenge. It was mentally draining as it was just so much harder to get the motivation to work. After throwing my arms in the air when stepping out the door of the practice...I realized I have another GP placement next year. Joy. BUT, I know it'll be more useful as I'll have my own surgery and get to see my own patients. This placement literally has redefined work experience. It was 20 days, 10 hours/day of work experience.
Also in other news - crisis averted with all the deadlines as you would remember from my "Walls Closing In" post.
1 report - completed and submitted.
1 audit report - completed awaiting for submission.
1 audit poster - 90% complete.
1 audit abstract - completed and awaiting for submission.
Cannot feel any more satisfied and proud of myself managing to get everything done in time. I think it has been a long time since I was really sure I was not going to make the deadlines. Miracles do happen. Actually it's more like: Efficient...and very late and long nights...
Oddly enough, in my final week of GP placement, I saw the most interesting case. It was a case of a man with an end-stage disease and the GP needed to start the palliative care pathway with him. This man is quite young (40 years old). Initially when I heard about his medical history, I did not know how old is he. In my mind I imagined him to be an elderly man. Surprisingly when I went to go meet the patient, he looked frail and skinny, but young. What really struck me was that he also has two very young children (ages 8 and 3). Unfortunately, the patient has not really told his children what is wrong with him. They are aware that their father is ill, but do not know the extent of his illness. With his condition, no one really knows how many more years he will live. His condition has been progressively getting worse and the GP told the patient and his wife that there would be one day where he does a nose dive and his health severely deteriorates. We discussed the various options for support and care. In my mind I knew the GP was trying to find the right moment to bring up the "Do Not Attempt to Resuscitate" (DNAR). Eventually we had to talk about it and only until you come onto the topic you then come to realize that the patient is still in denial. To be fair, he has a young family and he himself is quite young. Worst bit is that there is no cause for his condition - as what doctors like to call it: "Idiopathic". He was adamant that he wants to be resuscitated when it comes to the end of the line despite the GP fully informing him about the benefits and harm of resuscitation. As we were talking about his palliative care plan, his children were happily running outside - no clue what is going on in the room. It was definitely a very "grim" consultation. Before leaving, the GP advised the patient to find some support for his end-stage disease and to have someone help him to explain his condition to his children as they will have to know at some point. The GP was right that it is better for him to talk to his children while he is still well and still able to versus down the road he might not be well enough to explain - leaving his children a bit puzzled.
In all fairness - my experience in GP has not been the best, but the GPs who I have worked with are all really nice people and some are great at teaching. Guess it just wasn't my "cup of tea". Had a good feedback session with my supervisor though and I suggested giving students a bit more responsibilities and letting us see our own patients. Hopefully they'll take my feedback on board as I really think it'll improve the student's experience. All in all though, 7 weeks...that was painful.
Psychiatry up next...don't really know what to expect...actually I have no clue what to expect. At least it is hospital based (in a more familiar environment). I'm sure it'll be interesting seeing these sort of patients. Hopefully it'll be better than my GP placement and get back to the happy-go-lucky medical student.
Also in other news - crisis averted with all the deadlines as you would remember from my "Walls Closing In" post.
1 report - completed and submitted.
1 audit report - completed awaiting for submission.
1 audit poster - 90% complete.
1 audit abstract - completed and awaiting for submission.
Cannot feel any more satisfied and proud of myself managing to get everything done in time. I think it has been a long time since I was really sure I was not going to make the deadlines. Miracles do happen. Actually it's more like: Efficient...and very late and long nights...
Oddly enough, in my final week of GP placement, I saw the most interesting case. It was a case of a man with an end-stage disease and the GP needed to start the palliative care pathway with him. This man is quite young (40 years old). Initially when I heard about his medical history, I did not know how old is he. In my mind I imagined him to be an elderly man. Surprisingly when I went to go meet the patient, he looked frail and skinny, but young. What really struck me was that he also has two very young children (ages 8 and 3). Unfortunately, the patient has not really told his children what is wrong with him. They are aware that their father is ill, but do not know the extent of his illness. With his condition, no one really knows how many more years he will live. His condition has been progressively getting worse and the GP told the patient and his wife that there would be one day where he does a nose dive and his health severely deteriorates. We discussed the various options for support and care. In my mind I knew the GP was trying to find the right moment to bring up the "Do Not Attempt to Resuscitate" (DNAR). Eventually we had to talk about it and only until you come onto the topic you then come to realize that the patient is still in denial. To be fair, he has a young family and he himself is quite young. Worst bit is that there is no cause for his condition - as what doctors like to call it: "Idiopathic". He was adamant that he wants to be resuscitated when it comes to the end of the line despite the GP fully informing him about the benefits and harm of resuscitation. As we were talking about his palliative care plan, his children were happily running outside - no clue what is going on in the room. It was definitely a very "grim" consultation. Before leaving, the GP advised the patient to find some support for his end-stage disease and to have someone help him to explain his condition to his children as they will have to know at some point. The GP was right that it is better for him to talk to his children while he is still well and still able to versus down the road he might not be well enough to explain - leaving his children a bit puzzled.
In all fairness - my experience in GP has not been the best, but the GPs who I have worked with are all really nice people and some are great at teaching. Guess it just wasn't my "cup of tea". Had a good feedback session with my supervisor though and I suggested giving students a bit more responsibilities and letting us see our own patients. Hopefully they'll take my feedback on board as I really think it'll improve the student's experience. All in all though, 7 weeks...that was painful.
Psychiatry up next...don't really know what to expect...actually I have no clue what to expect. At least it is hospital based (in a more familiar environment). I'm sure it'll be interesting seeing these sort of patients. Hopefully it'll be better than my GP placement and get back to the happy-go-lucky medical student.
Wednesday, July 4, 2012
Unreasonable.
One of my biggest pet peeves is when someone wrecks my lunch breaks for no reason. I don't mind missing my lunch because I am in theatre or doing something productive. Actually I don't mind if I'm in clinic and I have to delay my lunch...but what really drives me mental is when someone makes me MISS my lunch when it really didn't need to be missed.
I don't know if I am just being unreasonable or uncooperative, but essentially here's the story:
One week ago I gave notice that I have to attend a compulsory observation session at a clinic which is quite far away. I asked the secretary who does up my schedules if it will be possible for me to leave slightly earlier so I have some travel time and a time for me to eat my lunch. I was told by the secretary that it will be okay and she has left a note for the GP who I will be following in the morning.
Fast forward to today. I made sure I arrived early and kindly asked the GP if I could leave at 11am so I could go to my session at 12:30pm. Clinic usually ends at 11:30am so it wasn't like I'm asking to get off 2 hours early. It was simply just leaving 30 minutes early which is equivalent to seeing 2-3 patients. Despite seeing the note left for the GP about me leaving early, I was then given a fairly rude look and essentially was told why I can't leave after clinic (11:30am ish). Still maintaining my composure, I told the GP that I need to go home and drop off my car and then make my way to the other clinic (which has no parking hence I need to take the bus), and that I would like to have a bit of time to have some lunch as well. The drive home probably takes about 20-30 minutes depending on traffic, then another 30 minutes to travel to the other clinic. That would leave me about 30 minutes lunch break...which isn't unreasonably long. I explained this to the GP and she essentially didn't even listen and proceeded to interrupt me. She went on how I can leave at 11:30am and have my lunch on the go while traveling to the other clinic. I was obviously fuming as I do not understand what is the importance of me staying for an extra 30 minutes. Either way I just sit there and day dream as I don't do anything in clinic. I just sit and listen...and try to stay awake. I think the most annoying bit was the rude attitude the GP gave me first thing when I asked to leave early almost giving me the vibe that she's the "know it all - who are you to leave early" attitude. Hate it when people get all arrogant like that. I asked for permission a week in advance and again I'm only leaving 30 minutes early.
What also drove me mental was in the last 30 minutes of clinic....one patient needed a sick note/letter and another patient needed a wound to be checked for possible infection. Wow...that was surely useful....I couldn't help but give the GP a look of: "You seriously kept me an extra 30 minutes to see these things?!" Once the clinic was done all you could see behind me was a cloud of dust. Raced home and raced back out to clinic. No lunch. No snack. Didn't even have time to drop off my car keys. By the time I got to the other clinic...I felt like I was going to faint. I was starving and I had a smaller breakfast than usual as I thought I would be having an earlier lunch.
I mean I think the GP was being highly unreasonable and very inflexible especially when I had a valid reason and a reason which was something the medical school required me to attend. I wouldn't even care if I had to miss my lunch because an operation overran and we had to skip lunch so we will stay on time plus the consultant starves with you. I swear this GP did not help me with my experience with this placement so far. To most, if not all of you, you probably think this is such a small thing...why the heck is it bothering me so much. My tolerance for this placement is getting very thin and I am starting to really lose motivation in even putting in effort.
I don't know if I am just being unreasonable or uncooperative, but essentially here's the story:
One week ago I gave notice that I have to attend a compulsory observation session at a clinic which is quite far away. I asked the secretary who does up my schedules if it will be possible for me to leave slightly earlier so I have some travel time and a time for me to eat my lunch. I was told by the secretary that it will be okay and she has left a note for the GP who I will be following in the morning.
Fast forward to today. I made sure I arrived early and kindly asked the GP if I could leave at 11am so I could go to my session at 12:30pm. Clinic usually ends at 11:30am so it wasn't like I'm asking to get off 2 hours early. It was simply just leaving 30 minutes early which is equivalent to seeing 2-3 patients. Despite seeing the note left for the GP about me leaving early, I was then given a fairly rude look and essentially was told why I can't leave after clinic (11:30am ish). Still maintaining my composure, I told the GP that I need to go home and drop off my car and then make my way to the other clinic (which has no parking hence I need to take the bus), and that I would like to have a bit of time to have some lunch as well. The drive home probably takes about 20-30 minutes depending on traffic, then another 30 minutes to travel to the other clinic. That would leave me about 30 minutes lunch break...which isn't unreasonably long. I explained this to the GP and she essentially didn't even listen and proceeded to interrupt me. She went on how I can leave at 11:30am and have my lunch on the go while traveling to the other clinic. I was obviously fuming as I do not understand what is the importance of me staying for an extra 30 minutes. Either way I just sit there and day dream as I don't do anything in clinic. I just sit and listen...and try to stay awake. I think the most annoying bit was the rude attitude the GP gave me first thing when I asked to leave early almost giving me the vibe that she's the "know it all - who are you to leave early" attitude. Hate it when people get all arrogant like that. I asked for permission a week in advance and again I'm only leaving 30 minutes early.
What also drove me mental was in the last 30 minutes of clinic....one patient needed a sick note/letter and another patient needed a wound to be checked for possible infection. Wow...that was surely useful....I couldn't help but give the GP a look of: "You seriously kept me an extra 30 minutes to see these things?!" Once the clinic was done all you could see behind me was a cloud of dust. Raced home and raced back out to clinic. No lunch. No snack. Didn't even have time to drop off my car keys. By the time I got to the other clinic...I felt like I was going to faint. I was starving and I had a smaller breakfast than usual as I thought I would be having an earlier lunch.
I mean I think the GP was being highly unreasonable and very inflexible especially when I had a valid reason and a reason which was something the medical school required me to attend. I wouldn't even care if I had to miss my lunch because an operation overran and we had to skip lunch so we will stay on time plus the consultant starves with you. I swear this GP did not help me with my experience with this placement so far. To most, if not all of you, you probably think this is such a small thing...why the heck is it bothering me so much. My tolerance for this placement is getting very thin and I am starting to really lose motivation in even putting in effort.
Saturday, June 30, 2012
Dull.
If I could describe my GP placement with one word I would use the word: "Dull". Dull might even be an understatement. I have caught myself so many times zoning out during consultations. Again my frustrations are growing as I still cannot do anything in clinic. The most I can do is maybe do manual blood pressures. I guess the only thing I can take away so far from GP is the difficulty of immigrants. My practice sees a lot of immigrants and most of these people can't speak English. You realize that it is very difficult to get a patient history and even more difficult when you have to talk to your patient through an interpreter.
We had one patient who was from Slovakia and could not speak very much English. It was requested that an interpreter come, but he/she did not show up so the patient attempted to tell us her problem in broken English. Unfortunately, her problem was a mental health related problem so patient history is really important and there was no way we will get what is the problem as her English was not cutting it. We resorted to using the phone interpreter. I swear those things are not user friendly. The interpreters aren't that great and it is really awkward having a phone in between the patient and you and the phone is on speakerphone so it is quite difficult to hear what the interpreter is saying. Even weirder is that you lose a lot of rapport with the patient as both of you are trying to talk into a phone. Very confusing stuff. After 45+ minutes (when it should've been 10 minutes), the GP gave up. It got far too complicated and too difficult to get a proper patient history. I felt like we wasted a lot of time and it obviously makes the clinic run quite behind. We asked the patient to bring an interpreter next time and you just can't help but feel a bit annoyed that you wasted 45 minutes only to get nothing accomplished. The next few patients weren't too pleased either as clinic got quite delayed. When one patient sees that you spend 30+ minutes with one patient, they think they have the right to have 30 minutes as well and it's hard to cut people short and to keep them on topic about their medical problem/presenting complaint. When you're running behind, the last thing you want to hear about is what the patient did on the weekend.
I have no problems admitting that GPs are extremely patient people and their job is certainly not easy. I just feel like I would have a lot of difficulty maintaining my composure during consultations especially when it gets quite frustrating. I do consider myself quite patient, but I guess not patient enough for GP and probably the main reason why I'm having a difficult time enjoying this placement. Worst bit is that I still have another 5 weeks to go. Thankfully I am only in 3 days/week so my weeks won't be too long. I'll take it that I have 15 more practice days. That doesn't sound too bad...I guess....
We had one patient who was from Slovakia and could not speak very much English. It was requested that an interpreter come, but he/she did not show up so the patient attempted to tell us her problem in broken English. Unfortunately, her problem was a mental health related problem so patient history is really important and there was no way we will get what is the problem as her English was not cutting it. We resorted to using the phone interpreter. I swear those things are not user friendly. The interpreters aren't that great and it is really awkward having a phone in between the patient and you and the phone is on speakerphone so it is quite difficult to hear what the interpreter is saying. Even weirder is that you lose a lot of rapport with the patient as both of you are trying to talk into a phone. Very confusing stuff. After 45+ minutes (when it should've been 10 minutes), the GP gave up. It got far too complicated and too difficult to get a proper patient history. I felt like we wasted a lot of time and it obviously makes the clinic run quite behind. We asked the patient to bring an interpreter next time and you just can't help but feel a bit annoyed that you wasted 45 minutes only to get nothing accomplished. The next few patients weren't too pleased either as clinic got quite delayed. When one patient sees that you spend 30+ minutes with one patient, they think they have the right to have 30 minutes as well and it's hard to cut people short and to keep them on topic about their medical problem/presenting complaint. When you're running behind, the last thing you want to hear about is what the patient did on the weekend.
I have no problems admitting that GPs are extremely patient people and their job is certainly not easy. I just feel like I would have a lot of difficulty maintaining my composure during consultations especially when it gets quite frustrating. I do consider myself quite patient, but I guess not patient enough for GP and probably the main reason why I'm having a difficult time enjoying this placement. Worst bit is that I still have another 5 weeks to go. Thankfully I am only in 3 days/week so my weeks won't be too long. I'll take it that I have 15 more practice days. That doesn't sound too bad...I guess....
Friday, June 22, 2012
1 down, 6 More Weeks to Go.
What a shock to the brain. I've tried my best to prepare myself for my next attachment in General Practice....and actually had very little expectations. My main fear prior to starting my attachment was the prospect of just sitting in the corner of a clinic from 9-5pm and not really do anything practical/talk to any patients. I have never had a rotation in GP before so I am obviously out of my element. I have always been in a hospital and there are a lot of advantages of being in a hospital such as if you don't find your attachment particularly interesting/useful - you can always go to another ward/department and there will surely be someone who will be willing to teach. The problem with GP is that you are stuck in the same building and there is no where to run. I am a type of medical student who likes to venture off to find more interesting things if I find myself getting very bored. There is a sense of "freedom" in a hospital as you aren't bound to a single area for the whole day. It is seen to be acceptable for us to roam to other wards to learn about different things while we are in the hospital so no one would really notice you not being on your assigned ward (unless there is scheduled teaching). In terms of GP, it is VERY obvious if I do not turn up as I am the only student in the practice and the GPs who I am attached to can see on their own schedules that they should have me, the student, in clinic with them. Very difficult to escape.
So I had a short week...had 2 days of lecture and 2 days on placement + 1 day off. Despite only being in the GP practice for only 2 days...it still has managed to knock my motivation completely over. My last attachment in orthopaedics probably was the highlight of my degree and my motivation to work was at an all-time high. I could wake up for early morning meetings. I rarely found it boring. Just everything clicked. I was truly happy. I was hoping all the happiness and motivation I managed to build up in my orthopaedics attachment will get me through GP. Wrong. In 1 week....my motivation level is at an all-time low. I am not interested in doing anything. Can't wake up in the morning. Don't feel like doing any work. Do not feel like participating. According to my friends, I am in a horrible mood. I am actually really low at the moment. On my first day I walked in with a very open mind and told myself it will be a good change as I'll get to see various different type of conditions and get to relax a bit more.
I will certainly not dispute that GPs see a lot of different things, and actually props to them for being such patient people. Some of the patients who come through the doors really....erm....there are no words to describe it. GPs are given 10 minutes per patient...but some patients come through the door expecting to get 30 minutes and talk about everything and anything. I can obviously tell in between patients that GPs get frustrated and they have to put on a mask whenever another patient comes through the door. As a student (who is sitting in a corner), it's just painful. If the GP finds it frustrating and boring to constantly have to reassure and listen to life stories...think about the poor student sitting in the corner who can't do anything but sit and watch. There is only so much I can learn by sitting and listening. I learned from my last placement that you won't learn anything until someone pushes you into the deep end of the pool. I was very hesitant in my first week of orthopaedics to go see new patients on my own as I had never done that before...but very quickly I found it very useful and eventually became quite good with taking patient histories. I don't think you can learn communication skills by just observing. It is something you have to learn by experience and I think that by making your student sit in the corner and listen is not very productive/a good way for he/she to learn.
I personally think that medical students can actually be very useful if used correctly. At the moment I feel like an old piece of furniture which isn't being used. I literally just sit there and watch. I don't even get to interact with the patient. I just try my best to not fall asleep and smile. I don't want to look not interested in what GPs do so I have to put on a face. I was so bored in my morning clinic today that I was desperate enough to offer to get things for the GP or make him a cup of coffee/tea, but nope...was told everything is fine and to just sit there. I haven't been so frustrated with a placement in a long time. I mean paediatrics wasn't my most favourite placement....but at least I was in a hospital where I was given the freedom to walk around and go to other wards...go see other things. I feel trapped at the moment. How am I going to survive next week. I don't get how I'll stay sane by the end of this attachment. All I want to do now is just sleep the day away. Props to people who want to be a GP...don't think I have the patience/tolerance to be one. Need to desperately find a way this weekend to pick myself back up or else I won't be able to bring myself in to the practice on Monday.
So I had a short week...had 2 days of lecture and 2 days on placement + 1 day off. Despite only being in the GP practice for only 2 days...it still has managed to knock my motivation completely over. My last attachment in orthopaedics probably was the highlight of my degree and my motivation to work was at an all-time high. I could wake up for early morning meetings. I rarely found it boring. Just everything clicked. I was truly happy. I was hoping all the happiness and motivation I managed to build up in my orthopaedics attachment will get me through GP. Wrong. In 1 week....my motivation level is at an all-time low. I am not interested in doing anything. Can't wake up in the morning. Don't feel like doing any work. Do not feel like participating. According to my friends, I am in a horrible mood. I am actually really low at the moment. On my first day I walked in with a very open mind and told myself it will be a good change as I'll get to see various different type of conditions and get to relax a bit more.
I will certainly not dispute that GPs see a lot of different things, and actually props to them for being such patient people. Some of the patients who come through the doors really....erm....there are no words to describe it. GPs are given 10 minutes per patient...but some patients come through the door expecting to get 30 minutes and talk about everything and anything. I can obviously tell in between patients that GPs get frustrated and they have to put on a mask whenever another patient comes through the door. As a student (who is sitting in a corner), it's just painful. If the GP finds it frustrating and boring to constantly have to reassure and listen to life stories...think about the poor student sitting in the corner who can't do anything but sit and watch. There is only so much I can learn by sitting and listening. I learned from my last placement that you won't learn anything until someone pushes you into the deep end of the pool. I was very hesitant in my first week of orthopaedics to go see new patients on my own as I had never done that before...but very quickly I found it very useful and eventually became quite good with taking patient histories. I don't think you can learn communication skills by just observing. It is something you have to learn by experience and I think that by making your student sit in the corner and listen is not very productive/a good way for he/she to learn.
I personally think that medical students can actually be very useful if used correctly. At the moment I feel like an old piece of furniture which isn't being used. I literally just sit there and watch. I don't even get to interact with the patient. I just try my best to not fall asleep and smile. I don't want to look not interested in what GPs do so I have to put on a face. I was so bored in my morning clinic today that I was desperate enough to offer to get things for the GP or make him a cup of coffee/tea, but nope...was told everything is fine and to just sit there. I haven't been so frustrated with a placement in a long time. I mean paediatrics wasn't my most favourite placement....but at least I was in a hospital where I was given the freedom to walk around and go to other wards...go see other things. I feel trapped at the moment. How am I going to survive next week. I don't get how I'll stay sane by the end of this attachment. All I want to do now is just sleep the day away. Props to people who want to be a GP...don't think I have the patience/tolerance to be one. Need to desperately find a way this weekend to pick myself back up or else I won't be able to bring myself in to the practice on Monday.
Thursday, June 14, 2012
Difficulty of Going Backwards.
So I've had a week of lectures...which to be fair weren't too
intense. They weren't 9-5 lectures so I can't really complain. Ever
since January, I feel like I have made leaps and bounds in terms of
progression in clinical experience. In paediatrics, I hardly did any
clinical skills and was in a small group for my placement. I had a
partner with me for all clinics and was never really on my own. Didn't
really even see patients on my own either. Then we get to Obs and
Gynae...slowly venturing out a bit and being a bit more independent.
Still in a small group on my placement, BUT I didn't have a partner to
go with to clinic/theatre. I was actually scared to be on my own as I
have never really been to clinic on my own and you get all these
thoughts of: "Ahh no one to bail me out when the consultant asks me a
question." I actually really enjoyed going to clinics on my own as you
get to chat with the consultant more and it isn't as daunting for
patients to have two students watching/sitting in. I definitely started
becoming more independent on placements and started being more proactive
in guiding my learning.
Then my last placement in orthopaedics. It was the first time I ever attended a placement on my own. I have always been in a small group. Funny enough my first concern was: "Who the heck is going to eat lunch with me?!" I am definitely not a fan of eating on my own as it is painfully boring. I like to talk during my lunch as I eat quite quickly so talking helps me slow down. I can easily scoff down lunch in 5-10 minutes and I end up taking extremely short lunch breaks. Luckily, due to my half-days I was able to go home to eat so I didn't have to sit in a cafeteria eating on my own and staring off into space. When I did have to eat lunch at the hospital I was usually with my consultant/registrar so we all ate together. But yeah my independence was really tested in this placement as everything I did was all "me". No one to fall back on. No one to rely on. No one to catch your mistakes...other than the consultant. Went to see new patients on my own and do full examinations on my own..then presented to my supervisor. If you had asked me to do that in my paeds placement...I wouldn't be confident enough to do it. I guess that's one thing with being dropped in the deep end. Got to learn quick and deal with it quickly. To be honest it did help that my supervisor is probably one of the nicest people I have ever met so I knew if I made a mistake I wouldn't get a full blown telling off/humiliation. It was also nice that I actually got to do things during my placement such as see patients, do examinations, assist in surgery, etc.
Now...sitting in lectures on a very hard plastic seat (even the clinic chairs are more comfy) in a small tutorial room...painful. I was talking to my friends and they kept saying it was nice to have a relaxed week of just sitting around and doing nothing but listen. I actually struggled this week. I may not be the hardest working medical student...but I hate sitting around. Especially with my last 2 placements where I was actually being productive and learning loads on placement...I am actually a bit sick of sitting in lectures and listening to one person talk about the same subject for 2-3 hours. Also got my induction pack for my next placement (GP) and the first thing I read: "Patients should not be seen by medical students who are on their own. Medical students will be supervised at ALL times." I'm totally looking forward to GP now...so excited that I'm bouncing off the walls (sarcasm). I really really hope that the package is a bit outdated and my GP will let me go see patients on my own and do some examinations. It's weird getting so much independence and responsibilities...and suddenly being stripped from all of it and back to holding hands. If this is the case...wow this is going to be a shock to the system.
Then my last placement in orthopaedics. It was the first time I ever attended a placement on my own. I have always been in a small group. Funny enough my first concern was: "Who the heck is going to eat lunch with me?!" I am definitely not a fan of eating on my own as it is painfully boring. I like to talk during my lunch as I eat quite quickly so talking helps me slow down. I can easily scoff down lunch in 5-10 minutes and I end up taking extremely short lunch breaks. Luckily, due to my half-days I was able to go home to eat so I didn't have to sit in a cafeteria eating on my own and staring off into space. When I did have to eat lunch at the hospital I was usually with my consultant/registrar so we all ate together. But yeah my independence was really tested in this placement as everything I did was all "me". No one to fall back on. No one to rely on. No one to catch your mistakes...other than the consultant. Went to see new patients on my own and do full examinations on my own..then presented to my supervisor. If you had asked me to do that in my paeds placement...I wouldn't be confident enough to do it. I guess that's one thing with being dropped in the deep end. Got to learn quick and deal with it quickly. To be honest it did help that my supervisor is probably one of the nicest people I have ever met so I knew if I made a mistake I wouldn't get a full blown telling off/humiliation. It was also nice that I actually got to do things during my placement such as see patients, do examinations, assist in surgery, etc.
Now...sitting in lectures on a very hard plastic seat (even the clinic chairs are more comfy) in a small tutorial room...painful. I was talking to my friends and they kept saying it was nice to have a relaxed week of just sitting around and doing nothing but listen. I actually struggled this week. I may not be the hardest working medical student...but I hate sitting around. Especially with my last 2 placements where I was actually being productive and learning loads on placement...I am actually a bit sick of sitting in lectures and listening to one person talk about the same subject for 2-3 hours. Also got my induction pack for my next placement (GP) and the first thing I read: "Patients should not be seen by medical students who are on their own. Medical students will be supervised at ALL times." I'm totally looking forward to GP now...so excited that I'm bouncing off the walls (sarcasm). I really really hope that the package is a bit outdated and my GP will let me go see patients on my own and do some examinations. It's weird getting so much independence and responsibilities...and suddenly being stripped from all of it and back to holding hands. If this is the case...wow this is going to be a shock to the system.
Saturday, March 24, 2012
The Grind.
Clinic here. Clinic there. What a brutal week. I don't mind clinics...but I do mind them when I have 2 clinics per day from 9-5pm. I have now grown to fear Antenatal Clinics. It is essentially an overbooked clinic where you talk to high risk pregnant ladies and just following up on their pregnancy. It's nice as you spend about 10-15 minutes with each lady; however, after 5 pregnant women...it gets very boring.
Not only did I have Antenatal Clinics, but I also had to attend Gynae Clinics, which I admit are a bit more exciting/interesting. Gynae Clinic is where patients come in with problems downstairs. This could include menorrhagia, dymenorrhoea, discharge, etc. Because I was with my supervisor, Mr R, I was able to carry out a few examinations and after being taught how to use a Cusco Speculum in theatre, I was finally able to try it out on a patient who is awake. I gotta admit...I was extremely nervous as I obviously don't want to cause any pain and the Cusco can easily cause pain. I managed to find the cervix in the first go and I felt a sense of pride come over me and Mr R was complimenting on my technique. It definitely filled me with confidence and to be honest...inserting the Cusco wasn't that difficult. I don't know why I was pissing my pants about it. I also really appreciate patients being so tolerant with students. I mean if I needed to get my downstairs checked up...the last thing I want in clinic with me is a medical student...and no way the student will be going near my bits. I mean these patients who allow us to practice our skills really need to be more appreciated. It's one thing to practice on a plastic mannequin but being able to practice on a real patient is a whole new ball game and it really helps build confidence. It also helps when your supervisor is keen to allow you to practice skills and perform examinations. Overall I enjoyed my clinic with Mr R as he was also in a good mood and we finished clinic on time (RARE!). Learned loads, got to do examinations + Cusco, and had a lot of good banter and many good laughs.
Unfortunately, I cannot say that I had as much fun with the rest of my clinics. Note to self: READ UP before attending special interest clinics. I literally got wiped all over the floor by another consultant when I went to Colposcopy and Gestational Diabetes Clinic on Tuesday. Because I had an evening meeting, I did not have time to read up on the clinic and I wrongly assumed that the consultant I was going to have wouldn't quiz me like Mr R does. To my demise...this consultant LOVES quizzing and I got my butt kicked. It was so embarrassing. I have never felt so dumb either. I kept blanking out and my heart was racing with every question. Worst bit is that I know the answers to the questions...or more like I SHOULD know the answers but I couldn't spit it out as I had not done any revision. Definitely taught me a good lesson and ever since Tuesday I did some reading prior to clinics especially clinics with consultants I haven't met yet.
On top of all the clinics this week...hands down...I have never worked so hard on placement...ever. I was putting in so much extra time. Usually we are expected to be in 9-5pm on a standard day. Monday...technically didn't have to go in until 10:30am for a tutorial. I went in at 9am to take a full patient history for my case study report. Tuesday: 9am clinic...went in at 8am to get a different patient history as the patient history on Monday wasn't good enough for my case study (ended up not seeing any patients as there was a ward round going on). Then had clinic in the afternoon which did not end until 5pm. Went to the ward to see if there are any more interesting patients...didn't leave until 6pm. Wednesday: 9am start for clinic...but stayed until 6pm...when I could've went home at 3:30pm (clinic finished very early) - was chasing after some patient notes I had requested for as I forgot to copy down info. Thursday: 9am start (clinic). Gave up my lunch hour to go read up the patient notes that I had requested for. Then had teaching from 2pm-3pm. Went to clinic...which didn't end until 5:30pm. Friday: FINALLY a normal day - 9pm-5pm.
Worst bit about this case study I was chasing around for a whole week - I ended up writing up on the first patient history I took Monday morning. Most annoying bit: of ALL the patients I could've picked, I picked a patient who was under the care of my supervisor (who is also marking my essay). I didn't want to do up a report on my supervisor's patient as he would know the patient history well so I definitely have to write accurately. This unfortunate coincidence doesn't end there. I thought I could get away with this patient case study as my supervisor had no idea which patient I am writing up, but also this patient presented with a fairly common problem (urinary retention post-op total abdo hysterectomy) so it could easily be anyone. Because the patient was discharged later in the afternoon on Monday and I needed to look at the notes, I requested for the notes to return to the ward so I can read through them. They arrived on Thursday, but were delivered to my supervisor's secretary. No problem right? Wrong...the secretary shares the same office as my supervisor, but luckily my supervisor was called to cover a clinic for another consultant for a few minutes. Perfect - quickly ran to fetch the notes, except the secretary forbid me from leaving the office with the notes. I knew my supervisor had just left his office as his computer was still on (screensaver wasn't up yet), and his chair was still warm. I predicted that my supervisor would be back in 30 minutes so I quickly went through the patient notes.
Unfortunately...my supervisor returned in 10 minutes and found me lounging on his chair and working at his desk and I had moved all his stuff to the side to give myself some room to write. Doh! I quickly stood up and moved over to finish up copying out important info about the patient's operation. My supervisor got curious as why the heck was I in his office, and who's notes was I looking up. He knew I have been working on my case report...and obviously his curiosity took over and he was trying to see the patient name. I kept my hand over the patient label on each page; however, in the 2 seconds I bent over to pick up my pen, which I dropped, my cheeky supervisor took the notes and found out which patient I was writing about. I was obviously a bit annoyed as now my supervisor definitely knows who I am writing about, but now also knows what I will be writing about in my report. He promptly refreshed his memory by flipping through the notes while I stood next to him giving off a dumb face. Guess I really have to do a good job on my essay now that my supervisor knows I'm writing up about his patient and the fact he remembers the patient as well. Great. Bonus bit: my essay is due in 3 days...2 weeks earlier than everyone else. What a tiring week. Hopefully all this hard work will pay off in the end. Next week: Labour Week. Going to be VERY tiring. Long shifts. Lots of waiting around. Yikes.
Not only did I have Antenatal Clinics, but I also had to attend Gynae Clinics, which I admit are a bit more exciting/interesting. Gynae Clinic is where patients come in with problems downstairs. This could include menorrhagia, dymenorrhoea, discharge, etc. Because I was with my supervisor, Mr R, I was able to carry out a few examinations and after being taught how to use a Cusco Speculum in theatre, I was finally able to try it out on a patient who is awake. I gotta admit...I was extremely nervous as I obviously don't want to cause any pain and the Cusco can easily cause pain. I managed to find the cervix in the first go and I felt a sense of pride come over me and Mr R was complimenting on my technique. It definitely filled me with confidence and to be honest...inserting the Cusco wasn't that difficult. I don't know why I was pissing my pants about it. I also really appreciate patients being so tolerant with students. I mean if I needed to get my downstairs checked up...the last thing I want in clinic with me is a medical student...and no way the student will be going near my bits. I mean these patients who allow us to practice our skills really need to be more appreciated. It's one thing to practice on a plastic mannequin but being able to practice on a real patient is a whole new ball game and it really helps build confidence. It also helps when your supervisor is keen to allow you to practice skills and perform examinations. Overall I enjoyed my clinic with Mr R as he was also in a good mood and we finished clinic on time (RARE!). Learned loads, got to do examinations + Cusco, and had a lot of good banter and many good laughs.
Unfortunately, I cannot say that I had as much fun with the rest of my clinics. Note to self: READ UP before attending special interest clinics. I literally got wiped all over the floor by another consultant when I went to Colposcopy and Gestational Diabetes Clinic on Tuesday. Because I had an evening meeting, I did not have time to read up on the clinic and I wrongly assumed that the consultant I was going to have wouldn't quiz me like Mr R does. To my demise...this consultant LOVES quizzing and I got my butt kicked. It was so embarrassing. I have never felt so dumb either. I kept blanking out and my heart was racing with every question. Worst bit is that I know the answers to the questions...or more like I SHOULD know the answers but I couldn't spit it out as I had not done any revision. Definitely taught me a good lesson and ever since Tuesday I did some reading prior to clinics especially clinics with consultants I haven't met yet.
On top of all the clinics this week...hands down...I have never worked so hard on placement...ever. I was putting in so much extra time. Usually we are expected to be in 9-5pm on a standard day. Monday...technically didn't have to go in until 10:30am for a tutorial. I went in at 9am to take a full patient history for my case study report. Tuesday: 9am clinic...went in at 8am to get a different patient history as the patient history on Monday wasn't good enough for my case study (ended up not seeing any patients as there was a ward round going on). Then had clinic in the afternoon which did not end until 5pm. Went to the ward to see if there are any more interesting patients...didn't leave until 6pm. Wednesday: 9am start for clinic...but stayed until 6pm...when I could've went home at 3:30pm (clinic finished very early) - was chasing after some patient notes I had requested for as I forgot to copy down info. Thursday: 9am start (clinic). Gave up my lunch hour to go read up the patient notes that I had requested for. Then had teaching from 2pm-3pm. Went to clinic...which didn't end until 5:30pm. Friday: FINALLY a normal day - 9pm-5pm.
Worst bit about this case study I was chasing around for a whole week - I ended up writing up on the first patient history I took Monday morning. Most annoying bit: of ALL the patients I could've picked, I picked a patient who was under the care of my supervisor (who is also marking my essay). I didn't want to do up a report on my supervisor's patient as he would know the patient history well so I definitely have to write accurately. This unfortunate coincidence doesn't end there. I thought I could get away with this patient case study as my supervisor had no idea which patient I am writing up, but also this patient presented with a fairly common problem (urinary retention post-op total abdo hysterectomy) so it could easily be anyone. Because the patient was discharged later in the afternoon on Monday and I needed to look at the notes, I requested for the notes to return to the ward so I can read through them. They arrived on Thursday, but were delivered to my supervisor's secretary. No problem right? Wrong...the secretary shares the same office as my supervisor, but luckily my supervisor was called to cover a clinic for another consultant for a few minutes. Perfect - quickly ran to fetch the notes, except the secretary forbid me from leaving the office with the notes. I knew my supervisor had just left his office as his computer was still on (screensaver wasn't up yet), and his chair was still warm. I predicted that my supervisor would be back in 30 minutes so I quickly went through the patient notes.
Unfortunately...my supervisor returned in 10 minutes and found me lounging on his chair and working at his desk and I had moved all his stuff to the side to give myself some room to write. Doh! I quickly stood up and moved over to finish up copying out important info about the patient's operation. My supervisor got curious as why the heck was I in his office, and who's notes was I looking up. He knew I have been working on my case report...and obviously his curiosity took over and he was trying to see the patient name. I kept my hand over the patient label on each page; however, in the 2 seconds I bent over to pick up my pen, which I dropped, my cheeky supervisor took the notes and found out which patient I was writing about. I was obviously a bit annoyed as now my supervisor definitely knows who I am writing about, but now also knows what I will be writing about in my report. He promptly refreshed his memory by flipping through the notes while I stood next to him giving off a dumb face. Guess I really have to do a good job on my essay now that my supervisor knows I'm writing up about his patient and the fact he remembers the patient as well. Great. Bonus bit: my essay is due in 3 days...2 weeks earlier than everyone else. What a tiring week. Hopefully all this hard work will pay off in the end. Next week: Labour Week. Going to be VERY tiring. Long shifts. Lots of waiting around. Yikes.
Saturday, March 10, 2012
Obs&Gynae - Initial Thoughts
So I have completed my first week of placement for Obstetrics and Gynaecology. Initial impressions? Fairly interesting. It's nice to see adult patients again. When I took my first patient history on this attachment, it was weird being able to speak directly to the patient and receiving specific information. Also in Obstetrics (pregnant women), you can't really call these people 'patients' as most of them are healthy and essentially are only in hospital to give birth. It's quite a nice change of environment from seeing ill children. In Gynaecology, one has to be quite professional as this specialty deals with quite sensitive things. You have to ask personal questions and you really need to gain the trust of your patients in order to get such personal/sensitive information. Again a huge contrast from Paediatrics as I have to put on a "fun" attitude when approaching children; however, with gynaecological patients, I have to be composed and essentially act professionally. It is a nice change and I haven't found the transition too difficult...yet. We'll see in the next few weeks.
Again I am in a peripheral hospital, but this hospital isn't actually that far away. For me, it is actually closer than the central hospital so I'm not complaining. It's great to be in a hospital which has a good reputation for teaching. They pride themselves in teaching and on day 1 it was very noticeable. The supervisor and secretary was very organized and were expecting us. We felt very welcomed and we received our schedule for the next 6 weeks! I was not expecting a schedule as in my previous attachment everything was done ad hoc and we received little guidance. Huge difference for this attachment and it was definitely a change I welcomed. It was nice knowing what you will be doing in the next few weeks and I could actually plan my life as I will know when I will be free and I can prepare ahead of time for clinics/teaching.
On top of that, I have come to realize how patient some people are. I went onto the wards to help out and was given the task of clerking in 2 new patients. These 2 patients have not seen anyone yet, so I was excited to go talk to them. The first patient I saw was having severe pain and to my surprise, she had been waiting to be seen for 4.5 hours! Talk about patience! I would've left ages ago and I found it quite ridiculous someone in so much pain has been waiting for so long! After taking the patient history, I realized this patient was in a lot of pain and a doctor had to see her soon. In addition to that, the patient was not impressed with the care so far (not surprised) so I quickly went to go get a senior doctor. It was found that she had surgery a week ago and the stitches were infected and some of it has come away. This patient was promptly admitted to the ward and was finally given stronger pain killers and a surgeon was called to review the case.
Then I went to go talk to my next patient...who actually arrived earlier than the last patient I saw. She had been waiting for 5 hours and I felt really bad for her. She had come to A+E the day before and due to the long wait she left and decided to come to the ward the next day. Because the ward was fairly busy, no one has really seen her and again I was the first person to see her. This could of easily been the longest history I had ever taken. After introducing myself I asked the standard question: "What brings you to hospital today?". This patient went on and on with a very extensive history of her presenting complaint and I was overwhelmed with information. She did not stop talking for a good 10-15 minutes and I was completely lost. I slowly had to work my way back through her history to get a more clear idea what was wrong and this clerking felt like it took ages. It didn't help that this lady's first language was not English so I had to word my questions differently and I had to try and figure out some of her medical conditions as she didn't know the names. It was the few times I actually struggled taking a patient history and this is the first time where there was a bit of a language barrier between the patient and I. It was a good challenge and it was new experience. It definitely taught me to be patient and to take things one by one. Luckily the patient was patient with me as we worked our way through the problem and her history and after 40 minutes I finally got through the history. Mind you...it usually takes me 10-15 minutes to get a full patient history. After presenting the history to a doctor I had to leave so unfortunately I could not follow up with the patient. When I came in the next day she wasn't on the ward list so I assume she didn't need to be admitted to hospital, which I guess is good news.
All in all...interesting week. It was an introductory week so it was quite light and I took things slowly as I found my bearings around the hospital. Next week is my theatre week so lots of surgeries! I can't wait!
Again I am in a peripheral hospital, but this hospital isn't actually that far away. For me, it is actually closer than the central hospital so I'm not complaining. It's great to be in a hospital which has a good reputation for teaching. They pride themselves in teaching and on day 1 it was very noticeable. The supervisor and secretary was very organized and were expecting us. We felt very welcomed and we received our schedule for the next 6 weeks! I was not expecting a schedule as in my previous attachment everything was done ad hoc and we received little guidance. Huge difference for this attachment and it was definitely a change I welcomed. It was nice knowing what you will be doing in the next few weeks and I could actually plan my life as I will know when I will be free and I can prepare ahead of time for clinics/teaching.
On top of that, I have come to realize how patient some people are. I went onto the wards to help out and was given the task of clerking in 2 new patients. These 2 patients have not seen anyone yet, so I was excited to go talk to them. The first patient I saw was having severe pain and to my surprise, she had been waiting to be seen for 4.5 hours! Talk about patience! I would've left ages ago and I found it quite ridiculous someone in so much pain has been waiting for so long! After taking the patient history, I realized this patient was in a lot of pain and a doctor had to see her soon. In addition to that, the patient was not impressed with the care so far (not surprised) so I quickly went to go get a senior doctor. It was found that she had surgery a week ago and the stitches were infected and some of it has come away. This patient was promptly admitted to the ward and was finally given stronger pain killers and a surgeon was called to review the case.
Then I went to go talk to my next patient...who actually arrived earlier than the last patient I saw. She had been waiting for 5 hours and I felt really bad for her. She had come to A+E the day before and due to the long wait she left and decided to come to the ward the next day. Because the ward was fairly busy, no one has really seen her and again I was the first person to see her. This could of easily been the longest history I had ever taken. After introducing myself I asked the standard question: "What brings you to hospital today?". This patient went on and on with a very extensive history of her presenting complaint and I was overwhelmed with information. She did not stop talking for a good 10-15 minutes and I was completely lost. I slowly had to work my way back through her history to get a more clear idea what was wrong and this clerking felt like it took ages. It didn't help that this lady's first language was not English so I had to word my questions differently and I had to try and figure out some of her medical conditions as she didn't know the names. It was the few times I actually struggled taking a patient history and this is the first time where there was a bit of a language barrier between the patient and I. It was a good challenge and it was new experience. It definitely taught me to be patient and to take things one by one. Luckily the patient was patient with me as we worked our way through the problem and her history and after 40 minutes I finally got through the history. Mind you...it usually takes me 10-15 minutes to get a full patient history. After presenting the history to a doctor I had to leave so unfortunately I could not follow up with the patient. When I came in the next day she wasn't on the ward list so I assume she didn't need to be admitted to hospital, which I guess is good news.
All in all...interesting week. It was an introductory week so it was quite light and I took things slowly as I found my bearings around the hospital. Next week is my theatre week so lots of surgeries! I can't wait!
Friday, December 16, 2011
Brain Torture.
As some of you know, I had exams about a week ago. Had 2 written papers and 1 practical (OSCE). It could easily be the hardest exam I have ever endured. I was mentally drained after each exam - I had never struggled so much in an exam. Our year had our exams re-written to a new format so we were going into the exam blind as we were told 3 days before our exam that the specimen papers that were put online are not representative of what we will be examined on. Instilling so much confidence into us (sarcasm). So pretty much we were all pooping ourselves prior to exams as we have no idea what to expect. We didn't even know what to study or how to study for this exam so the general consensus was "We are so screwed." It didn't help that we were told that the previous year 1 in 5 students had failed (20%). The scare tactics had been brutal and was pretty much messing with our confidence (quite unprofessional of the director to be honest). We were also told that the director was going to fail 20% of the year again so everyone was extremely scared. Horrible way to go into an exam.
Anyways the first paper I had was multiple choice and I swear once I finished the exam it felt like someone had continuously kicked my brain. I couldn't even think straight afterwards. The exam was 1.5 hours and the exam we took was definitely for a 2 hour time limit. I had BARELY just finished the exam. I was on my last question with only 10 minutes to spare. Didn't even get time to check. Mind you I'm not a slow exam taker...for the last 2 years I have finished my multiple choice papers in 30 minutes and the last two years my exam had 90 question and a 2 hour time limit. This year we had 60 questions with a 1.5 hour time limit. Each question was a massive paragraph to read. It was really frustrating as it takes just a minute to read the question. You seriously start to wonder if anyone had checked the exam paper and tried doing it to make sure it is possible to finish the paper in 1.5 hours. I had several friends who couldn't even finish this paper. Most people only did about 40ish questions out of 60. What a way to start the exam week.
Next day was the OSCE practical exam. 12 stations. 6 patient histories. 6 physical examinations. I was fairly confident going into this as I feel that I'm strong at doing practicals. Anyways the exam was 2 hours and it was so hectic and a lot more difficult than I had expected it to be. Should've known if I had based it on the previous day's exam. The instructions that were given in each station were long and very confusing. It would be like "Please do _____ examination on the patient BUT do not do _____, ______, _____, and _______; BUT remember to assess _______." Mind you the time you take to read the instructions is part of the time you're supposed to perform the physical examination so the longer you take to read, the less time you have to do the physical examination. You're already nervous and anxious, so when seeing such unclear instructions your brain gets all jumbled up. Personally I thought I did okay in the OSCE. Did however watch one examiner fail me in a patient history station for no reason. Everyone else in my circuit was complaining about the same examiner as he was giving everyone just half marks and was being very stingy/strict. Quit frustrating.
Final day was modified essay question paper. Obviously every one was petrified of this exam as based on how the last 2 days went - this exam will be ridiculously hard. Also because a lot of people couldn't finish the first paper, a lot of people were relying on this final paper to pull their mark up. This year we have to pass our written papers overall and pass the OSCE individually. For the first time in 2.5 years, people were studying prior to the exam. Usually we would all be standing around and being really relaxed. The air was so tense, it was ridiculous. My heart was thumping and I saw people being sick right before the exam. The nerves were through the roof. Got to the exam...and oh....my....goodness. We were asked really rare conditions which were probably mentioned in 1 slide of a random lecture. Again more people got up to be sick in the toilet. One girl passed out in the final 10 minutes of the exam. Some people threw the paper on the floor and just left in disgust. What an exam.
"Time is up. Can everyone please stop writing and close their papers."
I have never heard such a quiet exam hall after the exam. No one was celebrating as it was our last exam. No one was cheering. Every one looked shocked/disappointed/upset. People left the exam building in record time. The mood was quite solemn. No one was in the mood to do anything. Had lunch with friends and most of my friends had lost their appetite. To be honest, when I finished that last exam, it was the very first time I said to myself: "I am going to fail." I was already thinking how I was going to tell my parents. I was so convinced I had failed it was eating me up inside.
Medicine is not easy. Again confirming my belief you have to be mentally strong to study Medicine. It is mentally and physically grueling. You have to be determined. There will be several up and downs as I have faced in this new phase. Probably the worst 6 months of medical school I have ever endured. It was like going through Medicine Boot Camp. Medics certainly do have a crazy life. It is never a straight line. Never take it for granted you're in medicine - anything can happen.
Anyways the first paper I had was multiple choice and I swear once I finished the exam it felt like someone had continuously kicked my brain. I couldn't even think straight afterwards. The exam was 1.5 hours and the exam we took was definitely for a 2 hour time limit. I had BARELY just finished the exam. I was on my last question with only 10 minutes to spare. Didn't even get time to check. Mind you I'm not a slow exam taker...for the last 2 years I have finished my multiple choice papers in 30 minutes and the last two years my exam had 90 question and a 2 hour time limit. This year we had 60 questions with a 1.5 hour time limit. Each question was a massive paragraph to read. It was really frustrating as it takes just a minute to read the question. You seriously start to wonder if anyone had checked the exam paper and tried doing it to make sure it is possible to finish the paper in 1.5 hours. I had several friends who couldn't even finish this paper. Most people only did about 40ish questions out of 60. What a way to start the exam week.
Next day was the OSCE practical exam. 12 stations. 6 patient histories. 6 physical examinations. I was fairly confident going into this as I feel that I'm strong at doing practicals. Anyways the exam was 2 hours and it was so hectic and a lot more difficult than I had expected it to be. Should've known if I had based it on the previous day's exam. The instructions that were given in each station were long and very confusing. It would be like "Please do _____ examination on the patient BUT do not do _____, ______, _____, and _______; BUT remember to assess _______." Mind you the time you take to read the instructions is part of the time you're supposed to perform the physical examination so the longer you take to read, the less time you have to do the physical examination. You're already nervous and anxious, so when seeing such unclear instructions your brain gets all jumbled up. Personally I thought I did okay in the OSCE. Did however watch one examiner fail me in a patient history station for no reason. Everyone else in my circuit was complaining about the same examiner as he was giving everyone just half marks and was being very stingy/strict. Quit frustrating.
Final day was modified essay question paper. Obviously every one was petrified of this exam as based on how the last 2 days went - this exam will be ridiculously hard. Also because a lot of people couldn't finish the first paper, a lot of people were relying on this final paper to pull their mark up. This year we have to pass our written papers overall and pass the OSCE individually. For the first time in 2.5 years, people were studying prior to the exam. Usually we would all be standing around and being really relaxed. The air was so tense, it was ridiculous. My heart was thumping and I saw people being sick right before the exam. The nerves were through the roof. Got to the exam...and oh....my....goodness. We were asked really rare conditions which were probably mentioned in 1 slide of a random lecture. Again more people got up to be sick in the toilet. One girl passed out in the final 10 minutes of the exam. Some people threw the paper on the floor and just left in disgust. What an exam.
"Time is up. Can everyone please stop writing and close their papers."
I have never heard such a quiet exam hall after the exam. No one was celebrating as it was our last exam. No one was cheering. Every one looked shocked/disappointed/upset. People left the exam building in record time. The mood was quite solemn. No one was in the mood to do anything. Had lunch with friends and most of my friends had lost their appetite. To be honest, when I finished that last exam, it was the very first time I said to myself: "I am going to fail." I was already thinking how I was going to tell my parents. I was so convinced I had failed it was eating me up inside.
Medicine is not easy. Again confirming my belief you have to be mentally strong to study Medicine. It is mentally and physically grueling. You have to be determined. There will be several up and downs as I have faced in this new phase. Probably the worst 6 months of medical school I have ever endured. It was like going through Medicine Boot Camp. Medics certainly do have a crazy life. It is never a straight line. Never take it for granted you're in medicine - anything can happen.
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