So exams are in 3 weeks. Truthfully, I'm not as nervous about these exams as I was last year. Last year was a disaster. It was horrible. Actually those exams last year could be deemed scarring. Worst experience ever. I have been constantly telling myself that nothing can be worse than last year's exam. This year, it is fairly obvious what we need to know for our exams and it has been clearly laid out for us. I think what's making revision difficult is that we still need to go to placements. We only get 1 week of revision. Consultants expect us to be on the wards 9am - 5pm and by the time you get home, you're exhausted. On average, you're looking at around about 3 hours of revision time. I am finding it quite difficult to juggle and obviously have to adapt my revision style to my placement schedule. I am quite used to staying up quite late to revise as I work best at night. On top of that, I am on my Neurology placement, which is an examinable topic for our exams, so I'm trying to learn and revise while on placement. Swear my brain feels like it can explode as I'm trying to do so much all at the same time.
The neurology ward in general has been interesting. We have got various different cases ranging from stroke to epilepsy to multiple sclerosis. If I had this placement at any other time in the year, I would enjoy it a lot as there are so many examination signs to see and the patient histories are really educational. As I've mentioned above, the brain is focused on revising so any time I catch a break, I am heading to the library or a quiet room to revise instead of spending time on the wards. Because we don't have OSCEs this year, I'm not too bothered about seeing signs, but it is certainly affecting the experience I am having on the placement. It is quite annoying as I find neurology quite fascinating...and challenging, but certainly something that does not bore me. It makes you think and it makes you think laterally as well. Anyways I'm going to keep this post short as I have to hit the books. Exam season is tough. I cannot wait for this to be over and bring on the new year.
Work hard. Play harder.
Showing posts with label obstacle. Show all posts
Showing posts with label obstacle. Show all posts
Saturday, November 17, 2012
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.
Sunday, July 8, 2012
A Mask.
This isn't a new revelation, but one that has occurred to me more during my GP placement.
I have come to realize that doctors need to put on a mask most of the time as patients come to doctors for various kinds of problems. No matter how annoyed you are about a patient or how fed up you are with your clinic, you cannot let it show. There are tons of patients out there who visit the GP 2-4x a month and I'm sure as the GP you can get frustrated/annoyed with the patient especially when they are coming in for insignificant things. It is definitely difficult as patients expect the doctor to be professional and empathetic, but it is extremely difficult to show this when the patient themselves aren't coming in with the right intentions. I have sat in clinics where the patient is very rude and overly demanding. And as a doctor, you can't do anything about their rudeness, other than still treat them respectfully and try your best to listen. Definitely need a high tolerance level when dealing with "troublesome" patients. On the contrary, there are certainly very nice patients (usually tend to be the elderly). They are usually very respectful and always apologizing about wasting your time. These are the patients who are worth treating and you can't help but be a bit more empathetic, despite knowing that you're supposed to treat all patients with empathy and care.
However, masks are not just for GPs. As I have mentioned earlier, I have encountered it in my other placements. You would think surgeons wouldn't need to put on a mask as often, as they have a bit less patient contact. Unfortunately, surgeons have just as much face time with patients; however, the reasons of putting on a mask may be different. After a surgery and you have to break some bad news/complications about the surgery, you have to be able to put on a confident face and an appropriate mask. There isn't as much time for you to gather yourself after the operation. GPs or physicians in general would get results/bad news ahead of time so they will be ready and have time to think about how they will break the news. It is definitely a tough job as you don't want to show that much emotion when talking to patients especially after a tough case/surgery.
With clinics, you could enjoy the company of one of the patients and be laughing about something, but you have to be able to quickly return back to neutral before seeing your next patient. It can work the other way around as for one particular case, we were giving our condolences to a patient as her father had just passed away the day before and she was telling us about his death. Definitely an emotional/sad moment where you have to again put on a mask and empathize and comfort the patient. Easily within 2 minutes between patients, you have to regain your composure and be ready for the next patient as he or she can come in with anything. You certainly can't let things affect you and as well for doctors, you have to be good with moving on. You can't dwell on one particular case.
There has been arguments that doctors should not bring their outside emotions to work. Despite having a horrible morning, people argue that you shouldn't bring that grumpiness into the work place. I personally agree with that point as it isn't fair to your patients and your colleagues. I have met a few GPs who said that it is important to bring your emotions to work as you will seem more genuine. I don't mind bringing in a good mood to work, but I certainly wouldn't want to bring in grumpiness to the work place as you can easily affect your patients and colleagues. No one wants to see a grumpy doctor. In my eyes, I think my emotions should not affect my work, so even in that sense, you will have to put on a mask before coming to work especially when you're having a bad day. People argue as a doctor you should be genuine, but for me it is far more advantageous if I put on a mask for work and sort out my issues/problems when I go home/leave work.
What are your thoughts about putting on a mask for work or bringing your emotions to work?
Post your comments below!
I have come to realize that doctors need to put on a mask most of the time as patients come to doctors for various kinds of problems. No matter how annoyed you are about a patient or how fed up you are with your clinic, you cannot let it show. There are tons of patients out there who visit the GP 2-4x a month and I'm sure as the GP you can get frustrated/annoyed with the patient especially when they are coming in for insignificant things. It is definitely difficult as patients expect the doctor to be professional and empathetic, but it is extremely difficult to show this when the patient themselves aren't coming in with the right intentions. I have sat in clinics where the patient is very rude and overly demanding. And as a doctor, you can't do anything about their rudeness, other than still treat them respectfully and try your best to listen. Definitely need a high tolerance level when dealing with "troublesome" patients. On the contrary, there are certainly very nice patients (usually tend to be the elderly). They are usually very respectful and always apologizing about wasting your time. These are the patients who are worth treating and you can't help but be a bit more empathetic, despite knowing that you're supposed to treat all patients with empathy and care.
However, masks are not just for GPs. As I have mentioned earlier, I have encountered it in my other placements. You would think surgeons wouldn't need to put on a mask as often, as they have a bit less patient contact. Unfortunately, surgeons have just as much face time with patients; however, the reasons of putting on a mask may be different. After a surgery and you have to break some bad news/complications about the surgery, you have to be able to put on a confident face and an appropriate mask. There isn't as much time for you to gather yourself after the operation. GPs or physicians in general would get results/bad news ahead of time so they will be ready and have time to think about how they will break the news. It is definitely a tough job as you don't want to show that much emotion when talking to patients especially after a tough case/surgery.
With clinics, you could enjoy the company of one of the patients and be laughing about something, but you have to be able to quickly return back to neutral before seeing your next patient. It can work the other way around as for one particular case, we were giving our condolences to a patient as her father had just passed away the day before and she was telling us about his death. Definitely an emotional/sad moment where you have to again put on a mask and empathize and comfort the patient. Easily within 2 minutes between patients, you have to regain your composure and be ready for the next patient as he or she can come in with anything. You certainly can't let things affect you and as well for doctors, you have to be good with moving on. You can't dwell on one particular case.
There has been arguments that doctors should not bring their outside emotions to work. Despite having a horrible morning, people argue that you shouldn't bring that grumpiness into the work place. I personally agree with that point as it isn't fair to your patients and your colleagues. I have met a few GPs who said that it is important to bring your emotions to work as you will seem more genuine. I don't mind bringing in a good mood to work, but I certainly wouldn't want to bring in grumpiness to the work place as you can easily affect your patients and colleagues. No one wants to see a grumpy doctor. In my eyes, I think my emotions should not affect my work, so even in that sense, you will have to put on a mask before coming to work especially when you're having a bad day. People argue as a doctor you should be genuine, but for me it is far more advantageous if I put on a mask for work and sort out my issues/problems when I go home/leave work.
What are your thoughts about putting on a mask for work or bringing your emotions to work?
Post your comments below!
Thursday, October 27, 2011
In Memory of...
Sorry everyone, but this is going to be a solemn post so if you're not into reading something depressing please read another post - will be making another post either tonight or later in the week which will be a bit more cheerful.
Anyways...I've been a medical student for almost three years now - been around the hospitals a fair bit. Have seen happy things, have seen sad things. Have seen births, have seen deaths. Can one environment contain any more contrasting emotions? One family is in tears of joy; another family is in tears of sorrow as they have lost someone close. I myself have witnessed these events as a medical student. I smile with those who celebrate/are in joy; and I try to comfort those who are in a tough time. To be fair, deaths in the hospital has yet to make me lose any sleep or never really bothered me as I know everyone on the healthcare team has tried their best to save a person's life or at least have tried to make it as comfortable as possible.
When I first came to university - we were told in our first week that we will experience many personal obstacles. We are at the age where drastic things happen in our lives - some good, some bad. One of these "bad" things is death. Me being the typical fresher who didn't really pay attention in the lecture just brushed it off. Most of us tend to think: "Meh this won't happen to us."
October 24, 2011, I received the news that a friend of mine had passed away. I have never met this friend face to face, but we had shared many life stories and experiences. He was a guy I could talk to and have a nice laugh with, but because he lived in another country - I never had the chance to meet him. In terms of how I met this person? Well 4 years ago I purchased a custom item from him that required a lot of communication as we were in different countries - so I couldn't just walk into his factory and tell him what I want done. Anyways we would have periods where we would talk every single day - like loads, and then go through weeks where we wouldn't talk at all as this man was very busy with his business. Few weeks later - he would contact me again and we would talk about random things/he would check up on the product he made for me and whether I'm still happy with it. When I heard the tragic news - I was shocked. To be honest - I didn't know what to feel. It was mixed. Shocked, sad, empty...essentially confused. It was weird because I never met this man face to face, but yet cared about him. He was a very kind man. I still remember just last year he sent me a surprise Christmas present and I was planning to surprise him this year with a Christmas present. I had not been in contact with him for the whole summer as I did not want to bother him as he said he was very busy. Thinking back, I wish I had checked up on him.
Unfortunately this made me realize that death can occur in anyone's life. Like it or not, it's a fact. You can brush it off as much as you want, but it is something we will all have to face in our life. Take care of your friends, keep in touch with love ones, and if you know you don't talk to a friend that much - make sure you make every sentence count. You don't want to regret not telling someone something as anything can happen in this world. I wish I had told my friend how great of a friend he was to me and how much I enjoy his product. Hopefully he could decipher that from our conversations but I just wish I had told him plain and simple and thank him for his advice and lovely chats. If I could have done anything differently, I wish I had just contacted my friend despite knowing he was busy - just to make sure everything is alright.
But to those who are still reading - seriously, cherish your friends and loved ones. Death is a topic we all want to avoid and never want to think about, but it can happen to anyone. Because once you're in university and especially when we are all travelling away from home/friends, make an effort to keep in touch. Check up on your friends once in awhile. Be there for them. Support them. Don't hide things away and make sure they know you're there for them.
RIP buddy, you know who you are. Thank you for the great memories and the fantastic product. I will miss you.
Anyways...I've been a medical student for almost three years now - been around the hospitals a fair bit. Have seen happy things, have seen sad things. Have seen births, have seen deaths. Can one environment contain any more contrasting emotions? One family is in tears of joy; another family is in tears of sorrow as they have lost someone close. I myself have witnessed these events as a medical student. I smile with those who celebrate/are in joy; and I try to comfort those who are in a tough time. To be fair, deaths in the hospital has yet to make me lose any sleep or never really bothered me as I know everyone on the healthcare team has tried their best to save a person's life or at least have tried to make it as comfortable as possible.
When I first came to university - we were told in our first week that we will experience many personal obstacles. We are at the age where drastic things happen in our lives - some good, some bad. One of these "bad" things is death. Me being the typical fresher who didn't really pay attention in the lecture just brushed it off. Most of us tend to think: "Meh this won't happen to us."
October 24, 2011, I received the news that a friend of mine had passed away. I have never met this friend face to face, but we had shared many life stories and experiences. He was a guy I could talk to and have a nice laugh with, but because he lived in another country - I never had the chance to meet him. In terms of how I met this person? Well 4 years ago I purchased a custom item from him that required a lot of communication as we were in different countries - so I couldn't just walk into his factory and tell him what I want done. Anyways we would have periods where we would talk every single day - like loads, and then go through weeks where we wouldn't talk at all as this man was very busy with his business. Few weeks later - he would contact me again and we would talk about random things/he would check up on the product he made for me and whether I'm still happy with it. When I heard the tragic news - I was shocked. To be honest - I didn't know what to feel. It was mixed. Shocked, sad, empty...essentially confused. It was weird because I never met this man face to face, but yet cared about him. He was a very kind man. I still remember just last year he sent me a surprise Christmas present and I was planning to surprise him this year with a Christmas present. I had not been in contact with him for the whole summer as I did not want to bother him as he said he was very busy. Thinking back, I wish I had checked up on him.
Unfortunately this made me realize that death can occur in anyone's life. Like it or not, it's a fact. You can brush it off as much as you want, but it is something we will all have to face in our life. Take care of your friends, keep in touch with love ones, and if you know you don't talk to a friend that much - make sure you make every sentence count. You don't want to regret not telling someone something as anything can happen in this world. I wish I had told my friend how great of a friend he was to me and how much I enjoy his product. Hopefully he could decipher that from our conversations but I just wish I had told him plain and simple and thank him for his advice and lovely chats. If I could have done anything differently, I wish I had just contacted my friend despite knowing he was busy - just to make sure everything is alright.
But to those who are still reading - seriously, cherish your friends and loved ones. Death is a topic we all want to avoid and never want to think about, but it can happen to anyone. Because once you're in university and especially when we are all travelling away from home/friends, make an effort to keep in touch. Check up on your friends once in awhile. Be there for them. Support them. Don't hide things away and make sure they know you're there for them.
RIP buddy, you know who you are. Thank you for the great memories and the fantastic product. I will miss you.
Wednesday, September 7, 2011
Reality.
So I've been back for just over a week now and have started lectures. These lectures have literally made me question why I am studying Medicine. It has been a horrible week. 9am - 5pm lectures. I can fly back to Canada in that time period! I do not know what is going on with my medical school...but 9-5 lectures do not work. No one can concentrate for that long. I really have to admit it was tough. Not only was it tough, but I was dealing with jet lag so my days felt like weeks. I actually thought time had stopped as my days were going by so slowly.
All these lectures actually made me lose focus of my ultimate goal: to be a doctor. I was struggling to find my footing and was not motivated at all. I mean I have definitely found my footing again after having a good rest during the weekend. Yesterday I had Diabetes Teaching which was more interactive and practical. Definitely lifted my spirits and gave me a bit of motivation. I'm sure once placements come around again I will be inspired and motivated again.
After talking to a few good friends, I feel a bit better. One of my friends pointed out that I never give up in anything I do and giving up Medicine is not an option. And you know what, she is right. I never give up and I am not prepared to give up now. I'm halfway through my degree and it can only get better. Just need to put my head down and power through these lectures and assignments. I had a passion for medicine and when I really think about it - I still have a passion for it. There were some sparkles of hope today during our practical session and tomorrow I will be seeing diabetic patients. I am actually excited so I know my passion for medicine is still with me. Just need to get through 3 more days of lectures and I'll be back on the wards. I will be examined on my clinical skills soon so I'll be able to do some clinical skills on the wards. I just need to be patient and keep going.
You know while writing this post, it made me think. This is what medicine is about. Fighting adversity. Overcoming challenges. Pick yourself up and keep moving. On the wards - you will face challenges. You will have to make difficult decisions. There will always be ups and downs throughout your career and you have to learn how to deal with them. These days have been long and will only get longer when I become a doctor. Time to get used to it. This is reality.
All these lectures actually made me lose focus of my ultimate goal: to be a doctor. I was struggling to find my footing and was not motivated at all. I mean I have definitely found my footing again after having a good rest during the weekend. Yesterday I had Diabetes Teaching which was more interactive and practical. Definitely lifted my spirits and gave me a bit of motivation. I'm sure once placements come around again I will be inspired and motivated again.
After talking to a few good friends, I feel a bit better. One of my friends pointed out that I never give up in anything I do and giving up Medicine is not an option. And you know what, she is right. I never give up and I am not prepared to give up now. I'm halfway through my degree and it can only get better. Just need to put my head down and power through these lectures and assignments. I had a passion for medicine and when I really think about it - I still have a passion for it. There were some sparkles of hope today during our practical session and tomorrow I will be seeing diabetic patients. I am actually excited so I know my passion for medicine is still with me. Just need to get through 3 more days of lectures and I'll be back on the wards. I will be examined on my clinical skills soon so I'll be able to do some clinical skills on the wards. I just need to be patient and keep going.
You know while writing this post, it made me think. This is what medicine is about. Fighting adversity. Overcoming challenges. Pick yourself up and keep moving. On the wards - you will face challenges. You will have to make difficult decisions. There will always be ups and downs throughout your career and you have to learn how to deal with them. These days have been long and will only get longer when I become a doctor. Time to get used to it. This is reality.
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