Post #100 - A Look Back.

Post #100 for this blog. I obviously want to make a special post and let's take a trip back to the beginning of this blog.

August 6, 2009 - my first blog post. It was a big day for me as it was the day I received an unconditional offer from my university to study Medicine in the UK. Looking back, coming to study in the UK was a huge decision and definitely a path of a lot of unknowns. A new country. A new culture. A new chapter. Little did I know what a roller coaster ride it would be for the next 2.5 years. I faced many challenges (and still facing challenges) and have grown up a lot in the last 2.5 years. University was a new chapter to my life. Saw and learned so many new things. It has so far been the best few years of my life. I can easily say that Freshers week will always be a highlight as it was quite an experience getting to know so many new people in such a short amount of time. I've been in the same school for half my life so making new friends is something "new" and I was extremely nervous. Kind of laughing at myself now for being so nervous/scared as there was nothing to be scared about. Every one is on the same boat in terms of friends and people are just so friendly. A tip for those who will be starting this coming September: be EXCITED. There is nothing to be afraid of and don't let anything hold you back. Enjoy your time as a Fresher as it will blow by in a blink of an eye. 

When I first started this blog I was really unsure whether I will even be able to keep up with it. Slowly I've noticed that people are reading it and it really motivated me to keep posting. Whilst scrolling through my archives...I have noticed quite a change in frequency of posts. I think it's a fairly good representation of excitement through my years in medical school. Obviously if there is something exciting, I would post about it. Here's reality: the first 2 years of medical school is a bit of a shock. I think a lot of us come into medical school thinking like we would be like the TV show ER...or House and we would be immersed in doing clinical procedures and running around. WRONG. Well in my case I was stuck in a lecture theatre for 2 years learning about the basic sciences, which isn't the most exciting thing. It is obvious there were a lot of up and downs in the last 2 years. I lost sight of the final prize (becoming a doctor) several times throughout the last 2 years. You get to a certain point where you're like "get me on the wards!" and then there will be times where you ask yourself: "Why in the world am I studying Medicine?" Medical school is full of obstacles and it is emotionally, mentally, and physically tough. There are so many times where you're on the floor and you really need to dig deep to pick yourself back up. I realized this is a degree that you have to be committed to because there are times where you truly do question your desires of being a doctor. Then at last - I reached clinical years. 2 grueling years of being cooped up in a lecture theatre and finally I am able to do some practical things and talk to patients. But hold up...with my school we are quite lucky to have a bit of clinical experience in the first 2 years.

March 15, 2010 - first hospital attachment. It was a short clinical attachment and really just a taste test of what I'll be doing in the future. Only a few months ago I saw first year medical students starting with their first clinical attachment like I did back in 2010. Seeing these freshers really put things into perspective of how far you have come along. (And for once it was nice not being at the bottom of the ladder at the hospital). It really gave me a flashback to what it was like when I started my first clinical attachment. Patient histories were a struggle...I was not good at them at all. Hardly knew any medical sciences so I didn't really understand anything and tried my best to keep up. Couldn't do any clinical skills. Essentially just shadowed the doctors and tried to not get in the way. Went to observe a few surgeries and standing on a pedestal trying to peer over the consultant's shoulder. However, I do remember how much I enjoyed watching surgeries. It just clicked. Fast forward to 2012. Patient histories - easy. Interacting with patients - easy. Medical knowledge - growing every day. Clinical skills - taking bloods, inserting cannulas, inserting catheters...just the other day I put in an endotracheal tube on my own (supervised by the anaesthetist). Surgery - observe? Heck I'm scrubbing in now and even helping close up at the end! Medical school is a long and painful process...but when you take the time to stop and think back to when you started...you see how far you have come.

February 8, 2011 - immigration laws changing. I believe this is the first proper post where I've discussed in detail about being an international student and things we have to think about. From then on, I have dedicated 2 other posts (Tidbit for International Students and Life of an International Student) to give a bit more insight about the life of an INTERNATIONAL medical student. To be honest, being an international student isn't that much more different than a local British student. We go through the same course. We get treated the same. We learn the same things. We see the same things. The only difference is our accents, and our passports...and the fact we have to worry about Visas and immigration laws. But other than that, being an international student hasn't been that hard of a transition that I had initially thought. Before I started medical school, my biggest fear was the fact I was an international student and it might be a bit harder for me to make friends or get used to the culture. Again during Freshers week...everyone was just so friendly...I didn't feel different. I didn't feel that much of an outsider. There were a few times in the last 2.5 years where it was frustrating to be an international student due to the lack of support from the medical school, but you learn to manage. As an international student, you make a lot of sacrifice. You leave your family behind. You leave home behind (which can be thousands of miles away). You pay higher fees. But hey hopefully it will be worth it. Hopefully this is something I will not regret. At the end of the day...hopefully this will be all worth it. Homesickness is a huge thing for international students and a lot of my friends do struggle with this...including me. Every time this happens I just have to take a break and tell myself it will be worth it and think about all the obstacles I have already been through and how far I have come. What makes me wake up every morning is the end prospect from studying medicine. I am grateful to be in such a great field and the experiences I have had so far have been amazing. The future with immigration and working in the UK - not a straight path and one with many bumps, but the fact I have made so many sacrifices just gives me so much more motivation and determination to make it work. Work hard and hopefully have a bit of luck on my side when it comes to jobs.

August 7, 2009 - first tip post. Not exactly one of my best tip post, but hey we all got to start somewhere. Obviously this blog was to keep a track of my crazy life of being a medical student, but also to give some tips to future medical applicants. I try my best and over the last 2 years I have posted quite a few tip posts here and there. Applying to medical school is no easy process and I wished I got some tips. My school back in Canada was not very good with helping out students with applying abroad as they are not very familiar with the process. It was a difficult process as I had to do a lot of stuff myself and call up universities in the middle of the night (my time due to the time difference) to get some more information. Hopefully with my tip posts I am able to help future applicants with the process. Obviously I applied 3ish years ago so UKCAT info and tips are a bit off, but I'm sure the interview process is still the same. Now I'm trying to focus on giving tips on surviving medical school. Little tricks I have learned here and there. I remember my very first medical school lecture, one of my professors told all of us: "Life is not fair." And it is so true and particularly true with medical school. So here is a tip to all of you: Life is not fair. You cannot have your way with everything...unfortunately, BUT what you can do is make the best of every experience no matter how undesirable it is. There is always something to learn. Stay humble and treat those around you with the same respect you would expect in return. You will meet a lot of people throughout medical school and treat everyone well as you never know, you might see he or she again in the future. Consultants on placements - treat them with as much respect as you can as who knows, he or she may just be your future employer in a few years. Don't do anything you will regret, even outside of school hours as things can come back and bite you on the ass. Unfortunately as a medical student - we got to grow up very fast. We start medical school at around 18 or 19 years old...you will see patients of all ages and they expect professional behaviour despite your age. Also grow some thick skin - consultants can be very unforgiving. Do your best to not take it personal. At the end of the day their criticisms are for your own good.

June 2, 2012 - post #100. It has been quite a journey and I expect more ups and downs in the next 2 years. Being a doctor is starting to get real. Now going through my specialty placements, I'm starting to do more and more on placements. This post has made me look back and realize how much I have grown emotionally and mentally. Thank you to all you readers out there and keeping me going on this blog. I really appreciate it. Happy reading!

End of Week 2.

Wow this week went by really quickly. One more week and then summer holiday!

So last week wasn't the most productive, so this week I wanted to make sure I get lots of patient histories and examinations done, as well as find a patient for my SSC project. This week I have managed to do about five patient histories and managed to do at least two physical examinations on 3 of the 5 patients. Again today (Friday), was my most productive day. Started bright and early and went to go see a patient my partner and I had taken a history from yesterday. The patient was going to be discharged today so we quickly did all the physical examinations we needed to do for our SSC project. Our SSC project requires us to find a patient where we do a full case history and all physical examinations (Cardio, Respiratory, GI, GALS, and CNS). This patient was extremely nice. I mean he was not feeling well and was quite frail. My partner and I expected him to say "no" when we asked for permission to take a history and examine him, but to our surprise he quickly said "yes" with a big smile on his face!

We first asked why he was admitted into hospital and listening to his history made me feel quite sad. This patient lives on his own and is almost at the grand age of 90 and he had collapsed on his floor at night. Because no one lived with him, no one knew he had collapsed and unfortunately he could not get up off the floor. He spent the entire night on the cold floor and because he had not answered his phone, his son had gotten worried about him and went to see if he was alright. The way the patient described his ordeal made it sound painful and you just feel really bad for the patient. He looked very upset and distressed about collapsing and told us that the pain he had from falling was immense. Whilst talking to the patient, we realized he was quite short of breath and had a constant and productive cough; therefore, we thought we should give the patient a break and would come back and examine him the next day (Friday).

So today we went to see the patient and the nurses told us not to bother the patient because they had just finished ward rounds and had prodded him quite a bit. He also looked quite tired as well and did not look very comfortable. We were then told he was going to be discharged later in the afternoon, so after popping to another ward to join a ward round we went back to the patient and asked if it was alright to do a quick full examination on him. Again, we were expecting to hear a "no" and a "leave me alone!" as he did look quite annoyed; however, he looked at us and promptly smiled and told us that he'll be more than happy to let us examine him. Because the patient looked quite tired, we tried to do our examination as quick as possible to minimize the amount of "prodding" we had to do. At the end we thanked our patient again and he gave us a firm handshake and wished us good luck with our career. He said it with so much sincerity and kindness it definitely brightened up my day. If I was in the patient's position I definitely would not let two medical students poke around and bother me if I was not feeling well. What a kind man and I got to say, my partner and I had learned a lot from this patient as he had an extensive history and was an immense pleasure to talk to.

Also now being my 2nd week of venturing the hospital, I realized that the staff in the ward I am placed in are starting to recognize me and it was nice to see them saying "Hi" to me. Makes me feel like I am not invisible and that the staff do remember there's a medical student wandering around. I even had a lovely chat with one of the nurses as well and finally felt welcomed. Worst part is that next week is my last week and I feel like I am starting to get the hang of being in my ward and getting to know people. The turnover is so quick as each placement only lasts 3 weeks for us (total of 4 placements). Can't believe that next week is my last week! I feel like I've still got lots of stuff to do. I still have to be assessed on doing a patient history and a physical examination by a doctor. As well, I need to find another patient for my second SSC project with some sort of ethics and law background to it, such as discussing patient confidentiality, DNR forms, etc. Not only do we have to do that, but also we need to find our consultant. We haven't seen him since Monday in theatre as he is away for the rest of this week. He said he'll be back next Monday and my partner and I will have to chain him down (as he can vanish into thin air in a blink of an eye) and hopefully arrange a meeting with him on Wednesday morning as he will be free. I will definitely make the most of my final week and I still haven't been in clinic so I'm going to try really hard to go to one next week. It should be good. And then...I'll be HOME! Haven't been back since winter holiday and I'm starting to get really homesick.

Anyways sorry for the long post. Will update next week if I have time!

International vs. Local Debate.

So the other day I had quite an interesting debate with my fellow medical friends. Mind you this debate involved a mix of international and local medical students. With immigration laws changing and making an international student's life even harder, it leads to the question of how are international students studying at a UK medical school affected? Let me give you a quick overview as to what is the proposed change that COULD affect international medics. The government is planning to scrap the Post Study Work Scheme (Tier 1 visas). This apparently does not affect Foundation Year jobs, but apparently does affect international medics wanting to pursue a specialty in the NHS.

Not sure how true is this but someone please do correct me if this is not correct: all posts for specialties will be first filled by local students. Any postings with room left behind will be then filled with international students. In my eyes that sounds a bit unfair but my local friends have made a valid point that us "internationals" are stealing jobs away from the locals. However, what I do not understand is that it is such a shame that an international student who got an equal education to the local students at a UK university still has to be classified as an international. Obviously a bit biased here, but I would think it would be a lot more fair that when ALL medical students graduate (including internationals), everyone should be placed on an equal playing field. Received the same education, hence, should receive equal opportunity for specialty placements? Either way, quite a few internationals do end up leaving UK and return back home to work, but I feel that those who are left behind should be regarded equally and just as suitable for specialty postings. Again I'm not sure how true this is about locals getting more priority than internationals when competing for specialty posts, but I do get both sides of the story.

Next point which could be a bit controversial. Some locals I have spoken to are quite against universities accepting international students in general! Obviously baffled by this comment I do admit I did take it a bit personal even though I know I should not as it is just a fun debate. Anyways again I see why locals find internationals a bit of a nuisance. However, I feel that international students bring a lot of diversity to the UK. I know recently David Cameron said that "Multiculturism [in the UK] has failed", and with these changing immigration laws, studying in the UK doesn't seem as welcoming for international students as it is quite the challenge to get a job after your studies. I think without international students UK would lose its diversity and possibly higher education being less renowned. A major factor for me to come to the UK was for its renowned education system and that its top notch. Who knows down the line immigration is cut down so much that internationals just don't want to go to the UK as there are no job prospects, I think it could put a bit of a dent in the UK higher education's reputation. As well there was this whole other point about international fees vs. local fees which turned out quite heated but not really worth mentioning on the blog. I guess I may have poked a few too many buttons when I said that I like the system in the US where both local and international students pay the SAME fees. I think again it puts people on a more leveled playing field. Then another debate of being able to afford higher education, etc etc.

Where I stand is in the middle. International students bring a lot to the universities and certainly to the medical schools, however, it does threaten local students as we can take up posts that should be for local students. But I don't think it is fair to make it so difficult for a competent graduate (especially a medical student) to stay in the UK. As well, if international students are placed on a leveled playing field with local students when fighting for posts, I think it would create really good competition. Medical school shouldn't be a cruise along the river. It should be like back in school where you compete and do your absolute best to get into the universities you want to go to and study medicine! I feel that now there is hardly any competition and I think we need just a bit more. Competition can create more competent/excellent doctors as everyone will feel the need to work hard, take on extracurricular activities, etc.

What do you guys think about the changing immigration laws which could possibly put off possibly amazing future medical students? How do you think it will affect the UK/NHS? What is your view on the whole International vs. Local Student? Should there be more competition at medical school? Please post your comments below. :)