Well I'm back to "work". Had a week of ENT...which has been fairly uneventful. Went to a few adult and children ear/head/neck clinics. The clinics actually run quite quickly, but I'm not sure if it is because the surgeons are efficient or the cases in general are more simple. Think it is the former. Anyways it has been a fairly frustrating placement. Because it is half-term, a lot of the consultants are away so a lot of clinics/theatre lists are cancelled. Obviously being a medical student, we don't get told about the schedule changes, so we don't find out until we get to clinic/theatre. Just one of those skills you need as a student: Adaptation. Need to be able to think on your feet and figure out what are you going to do with your time. I found myself running between hospitals quite a bit - I guess it's a good workout! Absolute pain though.
To be entirely honest - my impression of ENT surgeons before I started the placement was: "a bunch of arrogant surgeons". I am so glad I was proven wrong. They were all really nice and are really keen to teach. Don't know where did I get that impression from. Then again most impressions/stereotypes are no longer accurate. One thing I will admit is that the surgeries that ENT surgeons do are remarkable and beautiful. So delicate and intricate, but it works! I assisted in a myringoplasty and laryngectomy. Just amazing. Myringoplasty is where a perforation in the ear drum is replaced by a graft which you get from the fascia lying over the skull. Everything is done under a microscope. Admittedly my eyes were hurting after, but it was quite a beautiful surgery. They work in such a small space and still manage to do it with a lot of precision. Also watching them place a graft over the perforation and finding ways to support the graft while it heals with the rest of the ear drum...just can't describe it in words. Whoever thought up of these surgeries - genius. On the other hand - laryngectomy - massive incision requiring neck dissection. Saw so much great anatomy. Also got to scrub in and close up in the end (after hours of retracting). This surgery showed me why some people absolutely dread surgery. Never understood it until that day. My hands were cramping so much that I couldn't feel them anymore at one point. Guess my reward in the end was closing up. Suturing will always make a keen medical student's (interested in surgery) day better. Got to learn a new type of suturing technique, which is quite challenging. Took a few goes for me to get a hang of it, but eventually I managed to get a hang of it and I don't think I did too bad. Got it checked over, and got the nod of approval. Was quite satisfied with myself!
The thing I noticed in my very short 1 week stint in ENT was that you see a lot of cancers in adults and a lot of ear infection/tonsillitis in children clinics. Such contrasting conditions. Overall the attachment was too short...but in a way I was relieved that it was over because it was so disorganized. I was really fed up with running around looking for the right clinics and going between hospitals to go to a different theatre list. Then the consultant wouldn't be expecting a student and you have to explain, etc etc. Life of a medical student!
Showing posts with label first impression. Show all posts
Showing posts with label first impression. Show all posts
Friday, April 12, 2013
Saturday, March 17, 2012
O&G Theatre Week
So far so good! I'm enjoying this placement 100% more than my paediatrics placement. I feel much more comfortable and it's a nice feeling to be looked after. Yes it is annoying that someone is keeping a hawk eye on your progress and your work, BUT at least someone cares. In my last placement I felt like I could get away with anything and there wasn't enough motivation/pressure for me to work hard. I'm working much harder in this placement and I am learning loads. This week was my theatre week and as you probably know - I'm a bit biased towards surgeries as I really enjoy surgery. If you tell me to stand in theatre from 9-5 and watch surgery all day...I will happily do that - no complaints. If you tell me to stand in the ward from 9-5...I'm pretty sure I won't be as happy about that. I don't know what draws me to surgery so much. It's just nice being able to fix things immediately right there and then.
Anyways all in all the week had its highs and lows. Monday and Thursday were my two highlight days of the week. Oddly enough these two days were the two days where I had theatre sessions with my supervisor (Mr R). Right before joining Mr R for theatre, I was told by his registrar that he enjoys quizzing his students in theatre. I found it quite weird as when I was in clinic with Mr R, he didn't seem to be the "quizzing" type of consultant. Before surgery even started, I was grilled about common gynaecological problems. Luckily the questions weren't too challenging and Mr R seemed fairly impressed with my knowledge. I was just lucky that I had clinic prior to theatre which covered the conditions that Mr R quizzed me about. Phew. After the grilling, Mr R invited me to scrub in and to assist in the surgery! I was obviously very excited and it was nice being right at the table and I got to actually assist. I felt a part of the team and I felt like I was helping out. Unfortunately, this gave Mr R the opportunity to quiz me on the pelvic anatomy (which was VERY rusty). My lack of knowledge in the pelvic anatomy was not exactly impressive and I was promptly told to review my anatomy. Oops. Other than that I was able to get my hands in and I learned quite a lot as I did not get a female cadaver dissection specimen during my 2nd year so it was nice to be able to actually see the organs. I was also lucky to help out in a total hysterectomy as it was an open surgery so I got to see the organs more clearly. As the days went by I realized this was the only open surgery I will be watching as the rest of the surgeries I saw were laparoscopic surgeries. Pretty lucky to be honest. When surgery finished I had a good time and had some good banter going on during the surgery. Got to know my supervisor and the registrar better. No joke I really felt welcomed and I didn't feel so much like a medical student. I didn't feel like a joke in the theatre. People were taking me seriously and the nurses were all very friendly to me and I got along with everyone. Definitely a good start.
Tuesday I was with a different consultant for surgery and then realized to appreciate my supervisor as this consultant did not teach me at all. We were performing laparoscopic excisions of endometriosis and these were fairly complicated surgeries in general so the consultant was busy concentrating and I felt forgotten. I casually stood at the the back of the team as I was not offered to scrub in so I just observed. It was horrendously boring and I was getting fairly restless. After a fairly boring/dull Tuesday morning I went to look back at my schedule and realized I have the same consultant that I had in the morning on Thursday. I did a bit of snooping around and found out Mr R had a day theatre list Thursday morning so I decided to make amendments to my schedule and decided to follow Mr R. You would think why would I want to follow Mr R as he loves quizzing and it's quite a lot of pressure as this is my supervisor who will be assessing me at the end of my placement. After following a different consultant on Tuesday, I realized that despite all the quizzing, I learned a lot more with Mr R and in general had a lot more fun in theatre. Yes it's nice not needing to use your brain, but because I'm interested in surgery I rather get quizzed and learn things. On top of that Mr R lets me scrub in and help out so it really makes my experience a whole lot better. I guess it's a give and take situation.
Unfortunately I caught Mr R on a bad day on Wednesday and managed to "anger" him as I didn't know I was scheduled in for an audit in the afternoon as it wasn't on my schedule. Because I had my schedule in advance I decided to arrange a few meetings on that day in the afternoon as I assumed I had a half day. I had to explain to Mr R why I cannot attend the audit and he was not impressed whatsoever. I was properly pooping myself as we have been getting along and he's been pretty chill. I didn't think he would care that much about me missing an audit. I obviously felt really bad on Wednesday so I knew I had to redeem myself on Thursday. Wednesday night I decided to dust off my anatomy text books and revised my pelvic anatomy very well and read up on various gynaecological conditions. I also found out that Mr R consents his patients at 8am on Thursday prior to starting theatre so I decided to head in early and join him in his consent clinic. Let's just say he was pleasantly surprised that I was there so early and I managed to get consent from all the patients for the list in order to allow me to do examinations while she is under general anaesthesia. When in theatre I was promptly grilled on common gynaecological problems and because I had done my revision I was able to answer his questions with ease. To be honest...it was extremely satisfying. On the first patient I was told to put on a pair of gloves and to quickly do a vaginal examination. I was a bit disappointed I wasn't asked to scrub in, but I assumed Mr R was still annoyed with me from the previous day. Fair enough. I was essentially ignored for the rest of the procedure and then I guess Mr R remembered about me and then quizzed me on the pelvic anatomy. Again having revised anatomy the night before, I named all the parts with ease and Mr R was very impressed. He gave me the nod of approval and again I got that sense of satisfaction. It felt really good. Had a bit of banter in between patients and because I had "passed his test", I earned the right to scrub in for the rest of the list. It was amazing. I got to move the uterus into position for the procedures and the quizzing stopped. Yes it may sound daft "maneuvering the uterus"...big deal right? But something that small can make a huge difference to your experience in theatre. Yes I was doing a pretty dull job, but I knew I was making it easier for Mr R to perform the procedure with his registrar. I was then taught how to properly do a vaginal examination and was also taught how to do a speculum examination. I think this was the first time where Mr R took the time to teach and explain things thoroughly. Usually Mr R briefly explains things and is usually quite vague, but this time he was detailed and was really patient with me. He made sure I got a hang of it and made me do all of this with all the patients in the list. By the last patient I was doing the examinations with ease and was getting good at maneuvering the uterus. Haha. Was in a VERY good mood for the rest of the day. I was really proud of myself and it was nice getting praised by my supervisor. He seemed very impressed and I felt like I redeemed myself from the previous day's mishap. What a day.
At the same time I was a bit sad that it was my last proper theatre session for the rest of the placement. I will miss it a lot. My whole of next week are clinics and I'm not a huge fan of them. Will be a hard change and I'm sure I will be craving to go back into theatre. It was a shame I only got 2 sessions with Mr R in theatre as I learned so much. And with his quizzing, I realized I remember things much better. I guess in the end he ain't that bad of a teacher. I guess first impressions aren't always that accurate.
Anyways all in all the week had its highs and lows. Monday and Thursday were my two highlight days of the week. Oddly enough these two days were the two days where I had theatre sessions with my supervisor (Mr R). Right before joining Mr R for theatre, I was told by his registrar that he enjoys quizzing his students in theatre. I found it quite weird as when I was in clinic with Mr R, he didn't seem to be the "quizzing" type of consultant. Before surgery even started, I was grilled about common gynaecological problems. Luckily the questions weren't too challenging and Mr R seemed fairly impressed with my knowledge. I was just lucky that I had clinic prior to theatre which covered the conditions that Mr R quizzed me about. Phew. After the grilling, Mr R invited me to scrub in and to assist in the surgery! I was obviously very excited and it was nice being right at the table and I got to actually assist. I felt a part of the team and I felt like I was helping out. Unfortunately, this gave Mr R the opportunity to quiz me on the pelvic anatomy (which was VERY rusty). My lack of knowledge in the pelvic anatomy was not exactly impressive and I was promptly told to review my anatomy. Oops. Other than that I was able to get my hands in and I learned quite a lot as I did not get a female cadaver dissection specimen during my 2nd year so it was nice to be able to actually see the organs. I was also lucky to help out in a total hysterectomy as it was an open surgery so I got to see the organs more clearly. As the days went by I realized this was the only open surgery I will be watching as the rest of the surgeries I saw were laparoscopic surgeries. Pretty lucky to be honest. When surgery finished I had a good time and had some good banter going on during the surgery. Got to know my supervisor and the registrar better. No joke I really felt welcomed and I didn't feel so much like a medical student. I didn't feel like a joke in the theatre. People were taking me seriously and the nurses were all very friendly to me and I got along with everyone. Definitely a good start.
Tuesday I was with a different consultant for surgery and then realized to appreciate my supervisor as this consultant did not teach me at all. We were performing laparoscopic excisions of endometriosis and these were fairly complicated surgeries in general so the consultant was busy concentrating and I felt forgotten. I casually stood at the the back of the team as I was not offered to scrub in so I just observed. It was horrendously boring and I was getting fairly restless. After a fairly boring/dull Tuesday morning I went to look back at my schedule and realized I have the same consultant that I had in the morning on Thursday. I did a bit of snooping around and found out Mr R had a day theatre list Thursday morning so I decided to make amendments to my schedule and decided to follow Mr R. You would think why would I want to follow Mr R as he loves quizzing and it's quite a lot of pressure as this is my supervisor who will be assessing me at the end of my placement. After following a different consultant on Tuesday, I realized that despite all the quizzing, I learned a lot more with Mr R and in general had a lot more fun in theatre. Yes it's nice not needing to use your brain, but because I'm interested in surgery I rather get quizzed and learn things. On top of that Mr R lets me scrub in and help out so it really makes my experience a whole lot better. I guess it's a give and take situation.
Unfortunately I caught Mr R on a bad day on Wednesday and managed to "anger" him as I didn't know I was scheduled in for an audit in the afternoon as it wasn't on my schedule. Because I had my schedule in advance I decided to arrange a few meetings on that day in the afternoon as I assumed I had a half day. I had to explain to Mr R why I cannot attend the audit and he was not impressed whatsoever. I was properly pooping myself as we have been getting along and he's been pretty chill. I didn't think he would care that much about me missing an audit. I obviously felt really bad on Wednesday so I knew I had to redeem myself on Thursday. Wednesday night I decided to dust off my anatomy text books and revised my pelvic anatomy very well and read up on various gynaecological conditions. I also found out that Mr R consents his patients at 8am on Thursday prior to starting theatre so I decided to head in early and join him in his consent clinic. Let's just say he was pleasantly surprised that I was there so early and I managed to get consent from all the patients for the list in order to allow me to do examinations while she is under general anaesthesia. When in theatre I was promptly grilled on common gynaecological problems and because I had done my revision I was able to answer his questions with ease. To be honest...it was extremely satisfying. On the first patient I was told to put on a pair of gloves and to quickly do a vaginal examination. I was a bit disappointed I wasn't asked to scrub in, but I assumed Mr R was still annoyed with me from the previous day. Fair enough. I was essentially ignored for the rest of the procedure and then I guess Mr R remembered about me and then quizzed me on the pelvic anatomy. Again having revised anatomy the night before, I named all the parts with ease and Mr R was very impressed. He gave me the nod of approval and again I got that sense of satisfaction. It felt really good. Had a bit of banter in between patients and because I had "passed his test", I earned the right to scrub in for the rest of the list. It was amazing. I got to move the uterus into position for the procedures and the quizzing stopped. Yes it may sound daft "maneuvering the uterus"...big deal right? But something that small can make a huge difference to your experience in theatre. Yes I was doing a pretty dull job, but I knew I was making it easier for Mr R to perform the procedure with his registrar. I was then taught how to properly do a vaginal examination and was also taught how to do a speculum examination. I think this was the first time where Mr R took the time to teach and explain things thoroughly. Usually Mr R briefly explains things and is usually quite vague, but this time he was detailed and was really patient with me. He made sure I got a hang of it and made me do all of this with all the patients in the list. By the last patient I was doing the examinations with ease and was getting good at maneuvering the uterus. Haha. Was in a VERY good mood for the rest of the day. I was really proud of myself and it was nice getting praised by my supervisor. He seemed very impressed and I felt like I redeemed myself from the previous day's mishap. What a day.
At the same time I was a bit sad that it was my last proper theatre session for the rest of the placement. I will miss it a lot. My whole of next week are clinics and I'm not a huge fan of them. Will be a hard change and I'm sure I will be craving to go back into theatre. It was a shame I only got 2 sessions with Mr R in theatre as I learned so much. And with his quizzing, I realized I remember things much better. I guess in the end he ain't that bad of a teacher. I guess first impressions aren't always that accurate.
Monday, October 31, 2011
Final Placement of the Year!
So today was Day 1 of my final placement of 2011. I'm only on this placement for 3 weeks so yay, but that also means...EXAMS are coming up. Been revising for the last 2 weeks and it's bringing good ol' memories of how much I hate revising. It's tedious, tiring, and stressful. Oh and I have to juggle it with placements as well. Luckily I've been placed in a fairly slack placement (Endocrinology) so hopefully I won't have to be too committed.
Met my consultant today and I always believe in first impressions. If you want to impress:
Saw quite a lot of patients - all seemed pretty ill. I also noticed a trend that most of the patients are quite confused. We had one patient who told us that her husband had passed away 30 minutes earlier, and seemed quite depressed. However, when asked what date it is she thought it was the 10th of October, 2009! She didn't know where she was either and didn't know what our consultant was (expected answer = doctor, she had no clue!). She is a new patient and the consultant wasn't sure whether the news of her husband's passing was whether she was confused or it really did happen. At this point my partner and I left the patient and stepped to one side as our consultant talked to a nurse about the patient's story. Unfortunately it was quite noisy and we couldn't hear what the nurse had told our consultant. I guess it is now just a mystery to us. Anyways our ward round lasted 2.5 hours (which isn't too bad as I've been on 4 hour ward rounds). At the end we were told that today was our consultant's last day and another consultant will be taking over for the month. But because our consultant isn't actually leaving the hospital he now has more time to teach so he offered to teach us this week on anything we would like. It was great news as endocrinology is quite complex and it would be great revision for exams. However, that also means I will have to go in tomorrow morning to meet the new consultant as he will be the one to sign us off for the placement. I wasn't planning to go in so I could stay home to revise - guess that won't be happening. Who knows, this consultant might be really nice and good at teaching, so I guess there is something to look forward to! Cross my fingers that this new consultant won't be stern/serious/intimidating. Some of the doctors on the ward knows of this consultant and they say he is quite nice. Hopefully they were being honest. Bring on tomorrow!
Met my consultant today and I always believe in first impressions. If you want to impress:
- Dress well
- Show up early
- Be keen
- Read up on the specialty
Saw quite a lot of patients - all seemed pretty ill. I also noticed a trend that most of the patients are quite confused. We had one patient who told us that her husband had passed away 30 minutes earlier, and seemed quite depressed. However, when asked what date it is she thought it was the 10th of October, 2009! She didn't know where she was either and didn't know what our consultant was (expected answer = doctor, she had no clue!). She is a new patient and the consultant wasn't sure whether the news of her husband's passing was whether she was confused or it really did happen. At this point my partner and I left the patient and stepped to one side as our consultant talked to a nurse about the patient's story. Unfortunately it was quite noisy and we couldn't hear what the nurse had told our consultant. I guess it is now just a mystery to us. Anyways our ward round lasted 2.5 hours (which isn't too bad as I've been on 4 hour ward rounds). At the end we were told that today was our consultant's last day and another consultant will be taking over for the month. But because our consultant isn't actually leaving the hospital he now has more time to teach so he offered to teach us this week on anything we would like. It was great news as endocrinology is quite complex and it would be great revision for exams. However, that also means I will have to go in tomorrow morning to meet the new consultant as he will be the one to sign us off for the placement. I wasn't planning to go in so I could stay home to revise - guess that won't be happening. Who knows, this consultant might be really nice and good at teaching, so I guess there is something to look forward to! Cross my fingers that this new consultant won't be stern/serious/intimidating. Some of the doctors on the ward knows of this consultant and they say he is quite nice. Hopefully they were being honest. Bring on tomorrow!
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