Expectations.

Everyone has his or her own expectations for certain things. In my case: I had my own expectations for this placement (Obs & Gynae). Before I even started this new year and embarked on my specialty placements, I had already made up my mind about some of the specialties. And I have once again been proven wrong and again shouldn't be making judgments before even starting a specialty. You would think I would learn by now not to judge so early. Before I started O&G I constantly told myself that it is going to be my worst placement ever and I will truly hate it. I was not looking forward to it. I even marked it on my calendar as: "Ugh." To make things short, I had extremely low expectations for O&G. And you know what, sometimes I like being proven wrong. Don't get me wrong I have respect for the specialty, it just never clicked with me. You get this whole: "Awkwardddd women's health...it's going to be weeeirdddd!". I think in general anything that deals with bits downstairs is a whole taboo subject.

So I went back to my archives and read up on my blog post that I typed up before starting the specialty:

"My next placement is Obstetric and Gynaecology. I'm actually really scared for this as I don't really know what to expect as well. Should be interesting as I'll definitely be able to go to theatre (YES!); however, it'll be dealing with quite a sensitive subject so I'll definitely need to change from being playful in Paeds to professional for this specialty. Hopefully I'll be able to compose myself and try to enjoy this specialty as much as I can. First I'll need to go to a week of lectures before commencing my placement. I much rather having lectures first before going to placement as at least I'll have some basic knowledge prior to going to the hospital so I won't look like an idiot in front of the doctors. I also hope I'll have a really nice/easy going/chill supervisor. My last supervisor on paediatrics was very easy-going, which made the placement much more enjoyable. Crossing my fingers that I'll be just as lucky this time with Obs+Gyn. Another 7 weeks of Obs+Gyn and then Easter Holiday! I can't wait for holiday. To be honest...I kinda need one now!"

I really can't blame myself for being scared as it is a sensitive subject, but in terms of changing my behaviour from playful to professional was something I was a bit unsure about as I'm naturally a "happy-go-lucky" so I was a bit nervous for that change. Thinking back through the last few weeks, I haven't had so much fun on placement. Even more fun than my paediatric placement. Yes I have to be professional and build a good rapport with patients to talk about more sensitive things, but I realized that if I'm having a good time, the rapport comes naturally and you as a person become a bit more easier to approach and get along with. In paeds I was told that it was "written all over me" that I was not enjoying my placement. For this placement, yes I went in knowing I'll hate it, but I really wanted to make sure that I didn't make it obvious that I'm not enjoying the attachment. Because I went in with such low expectations I was open for anything and had little expectations. This actually helped me be a bit more welcome to anything and I think a lot of the staff and my supervisor could see that. I was even told by the nurses that some of the patients thought I was a "breath of fresh air" as I was always smiling on the wards and just enjoying my time. A patient told me that most of the staff look bored, but I look interested and just trying to have fun. Because in my last placement in paeds I looked super bored, it was probably the main reason it took me a bit longer to get to know the staff and interact with the patients.

And I can't really call it luck anymore with getting a nice/easy going/chill supervisor. I've said it before, but at the end of the day, a consultant/supervisor is a person as well. Yes they too have expectations for me and I try to meet their expectations, but because they are also people, you can certainly have some good banter with them. I got to know my supervisor and probably saw my supervisor the most out of the rest of my group so I guess he got to know me better than the others. Definitely made the attachment more enjoyable as I could feel that my supervisor genuinely cared about my learning and it's also nice to get to know your supervisor as it'll keep my blood pressure and heart rate from shooting through the roof whenever I see him. In some placements I would purposely avoid my supervisor just to avoid getting told off/being quizzed. For this placement, I didn't mind bumping into my supervisor on the ward or even in the corridors. I think we also had a "mutual understanding". He knew what my personality is like and what sort of student I am so he didn't form unrealistic expectations for me so that put me at ease and allowed me to feel comfortable in the hospital.  Again it is a two-way process. I know when my supervisor didn't want to see me and I guess I'm fairly good at telling when I can be cracking jokes. I guess it is a skill I definitely cherish as like I said I'm a "happy-go-lucky" and a bit of a prankster/joker who is quite cheeky as well...so I definitely need to know where to draw my line with each person.

All in all, I think this attachment has worked out really well and essentially exceeded my expectations. I have definitely gained a heck lot more respect for the specialty and it has definitely changed my view on the specialty. It really ain't that bad at the end of the day. The doctors are also pretty cool people as well so it was good. The hospital was great as well and was really good at making sure medical students are learning and interacting. Following a doctor around is one thing, but being able to assist and do things is a whole other ball game that makes your attachment so much better. This could be the very last time I'll be doing O&G for the rest of my career, but hey if I do get a rotation in it in the future, I won't mind doing it again. Hate to say this, but this is easily the best placement I have ever had so far. Who would've thought I would be saying this 7 weeks later. I wish all my placements can be this good. Now I'm scared about my future attachments as this placement has set the bar so high. How can I go back to just following a doctor around? How can I go back to standing in theatre not scrubbed in and peering over the surgeon's shoulder? Will I get along with my next supervisor how I got along with my supervisor now? What are my expectations for my next placements now?

Thank you for proving me wrong and giving me the best 7 weeks of my medical degree. What a placement. Damn. Can't believe it is over. The one time I am dreading for the end of a placement. I guess one good thing about this is that I finally get a much needed 3 week holiday.

Side note: Will be on holiday for the next 3 weeks and I, most likely, will not be posting as I really need a break. Sorry! 

End of Paediatrics.

7 weeks have passed which means I am done with my paediatrics placement! To be honest, it actually went by really fast. I got to admit that the first few weeks went by really slowly...to the point I was dreading the placement. Luckily, the placement started to blow by as I got to know the doctors and nurses on the ward and in general felt more welcomed.  I think 7 weeks was plenty of time for a taster of the specialty so my impression of paediatrics? Not for me. But I won't 100% remove it from my potential list of specialties as I find the surgical side of paediatrics fairly interesting. On my last day of paeds I had a lecture about paediatric orthopaedics, and to be fair...it seems quite interesting. These surgeons see a lot of different conditions ranging from pathological to congenital conditions. Definitely something I wouldn't mind considering in the future.

Also another reason to celebrate about the end of the placement is that I have passed my placement based assessment!!! I was really nervous for it, but it went really well. Did a full patient history on a boy with pneumonia and did a cardiovascular and respiratory examination on him.  I also got a lot of feedback from my supervisor, which was good as I'm constantly trying to improve and do better. I also managed to finish all my essays and reflective writing all in time along with my log book! Really stressful weekend, but everything came together in the end. I was really chuffed with it and after Monday (where everything was due including my assessment), I felt like the world was off my shoulders. I felt so much more at ease and just felt a sense of relaxation. I can finally enjoy the placement again and just take it easy for the last few days on my placement. On top of that, end of paediatrics = end of driving a long way to placement. My next placement is only a 15 minute drive (which is closer than the central hospital from where I live), so I'm excited for that. I no longer have to wake up at a ridiculous time to drive. I've also heard fantastic reviews about the next hospital I will be going to as they like to pride themselves in teaching medical students.

My next placement is Obstetric and Gynaecology. I'm actually really scared for this as I don't really know what to expect as well. Should be interesting as I'll definitely be able to go to theatre (YES!); however, it'll be dealing with quite a sensitive subject so I'll definitely need to change from being playful in Paeds to professional for this specialty. Hopefully I'll be able to compose myself and try to enjoy this specialty as much as I can. First I'll need to go to a week of lectures before commencing my placement. I much rather having lectures first before going to placement as at least I'll have some basic knowledge prior to going to the hospital so I won't look like an idiot in front of the doctors. I also hope I'll have a really nice/easy going/chill supervisor. My last supervisor on paediatrics was very easy-going, which made the placement much more enjoyable. Crossing my fingers that I'll be just as lucky this time with Obs+Gyn. Another 7 weeks of Obs+Gyn and then Easter Holiday! I can't wait for holiday. To be honest...I kinda need one now!

Sh!t Hitting the Fan.

Oh wow...it is quite rare for me to leave work to the last minute. I should be panicking, but I'm not...well not just yet. I have 2 essays and 1 reflective writing to hand in on Monday. One of my essays is a case report, which I have finished...but it is still pretty rough. The other essay is an evidence based medicine essay, which requires me digging through a bunch of literature...haven't started that whatsoever. Reflective writing...I hope it doesn't take long as I haven't done that either, but I usually only take 10-15 minutes to do up reflective pieces. As you can tell...I'm not too shabby at reflecting (which I do believe is a very important part of the degree - can't improve if you can't reflect on your performance/day). It doesn't end there - I've got a summative assessment on Monday where I will be watched by a consultant in taking a full patient history and perform two systems examination (could be either Cardiovascular, Respiratory, GI, Peripheral Nervous System, Cranial Nerves, or Developmental examination). Afterwards I will be asked a few questions about the patient history such as differential diagnosis, management, investigations, pathophysiology, etc. Anything goes as long as it is relevant to the patient's condition. Will also be asked to present my findings on physical examinations. Ack. I mean taking a patient history and doing examinations is just a matter of practising which I think I've done enough of. I'm just worried about the questions my consultant will ask me.

This week has been fairly uneventful. I was only in for 3 days as I had a lot of meetings to attend. Because of all my meetings, I haven't been able to do an "on-call" from 9am-9pm, which means I have to do 2 on-calls in my final week of Paediatrics. Fun. Essentially I spent this week completing my log book in terms of getting my clinical skills signed off and getting a registrar to do my formative assessment for 3 systems examinations in preparation for my summative assessment for next Monday.  I also found this week incredibly hard to wake up. Every morning I was struggling to wake up. Thank goodness 1 more week of Paediatrics and travelling a long way to the peripheral hospital. Next placement is Obs+Gynaecology and the drive there is about 15 minutes so I won't have to wake up as early. PHEW. To be honest I'm quite sick of my placement now. 7 weeks is too long and I haven't really been having a great time either so that doesn't help with my experience. I'm usually bored and I generally feel quite unproductive. To be fair though, I still learned a lot especially on how to interact with children. Still something I'm struggling with, but if I compared myself to the first week of placement, I have definitely grown as a person and have learned some new skills. It'd be unfair for me to write this placement off as it has been very useful. Just not my "cup of tea". Can't love every placement. There will always be up and downs, but medical school is all about exploring specialties and learning about everything. As a medical student, you need to learn how to adapt and essentially "just get on with it". My basketball coach from high school always told me: "If you don't like it, too bad. Make the most of it. If not, just suck it up and keep going."

Long day - On-call.

So it is week 2 of my paediatric placement. Now I'm getting to know the doctors on the ward much better and they seem more keen to teach us. Even if they see something vaguely interesting, he or she will come and tell us to take a look. I was on-call on Wednesday and what a long day. Got in at 8:45am and didn't get home until 10pm. I was intending to leave at 8pm as I do have to drive back home as I do not stay in the hospital accommodation.  Day started off with a ward round (usual). Saw a few interesting patients, but nothing really out of the ordinary. Managed to see a Stevens-Johnson Syndrome. To be honest...it looks pretty horrible. Essentially Stevens Johnson is where you get really red eyes and blisters all around your mouth and oral mucosa. You can also get blisters elsewhere in your body...including your genitalia........yeah. Anyways it doesn't look pleasant and obviously the patient was in quite a bit of discomfort as he could not really eat any solid food. Then went to clinic after lunch where we saw pretty general stuff. Ear infections, constipation, diarrhoea, etc. Got to play with a few of the kids that came in/working on my "playing with children" skill.

I don't have any younger siblings so I personally am not really used to playing with young children. I am still quite apprehensive about playing with kids as I don't really know what to do with them. I mean I think I'm good at making faces as so far I have been able to make the kids laugh by making faces. In terms of toys....I try and just pick up whatever  I see and hand it to them...which they quickly put to the side/throw it to the side. Had a few quizzical looks from babies...which is quite adorable...and pretty funny. Sometimes they just look so confused even you get confused yourself! So clinic lasted for about 3 hours and I did get my bum grilled to a burnt toast by the consultant. Non-stop questions. I asked my consultant a question and he proceeded to ask my question back to me! I'm sure I gave him several blank looks. I'm alright with being put on the spot to answer questions, but it still gets my heart rate up. Luckily the consultant is very relaxed and nice so I knew he only asked to help me learn instead of trying to make me feel dumb....not like any consultant would have that sort of intention (sarcasm). Nice thing about being quizzed is that you do remember things much better. I did learn quite a few things.

Then the ward went dead. There was nothing to do. I literally was wandering around in circles looking for patients to talk to or something to do, but most of the patients I saw in the morning have been discharged. I sat around at the nurse's/doctor's station and swiveled in my chair. Then my registrar who is on-call with me...started getting several bleeps. Literally 5 patients walked in at the same time right after dinner. So I got to work clerking the patients in and helping the registrar out with some stuff. Did learn how to take blood from a baby. A pretty pain-staking process. You essentially prick the heel of the baby with a device and you let the blood drip out and catch it in the bottle....you can imagine this can take awhile depending on how fast the blood drips out/how cooperative the baby is.

As earlier stated...I was planning to leave at 8pm, but because suddenly all the patients decided to show up at the same time...I ended up getting held back. I didn't want to leave midway through clerking so I told myself I can leave after clerking and presenting the cases to the registrar. At around 9pm I was finally finished and made my way home. Got home...showered...and then passed out on my bed. And up again next day for 9am. As you can guess....I had a lot of difficulty waking up. Plus the prospect of needing to drive for about an hour was not helping. Either way....thankfully this week kind of picked up and I am starting to get much more teaching from the doctors and I'm starting to get along with the doctors. Starting to feel like I'm a part of the team. It's a nice feeling.

Paediatrics - Week 1

Wow this week was LONG. First started the week with a whole day of introductory lectures from 9-5. Then on Tuesday it was the start of our placement and the start of long drives early in the morning. Got to the peripheral hospital and the minute I stepped into the Children's Unit, I knew something wasn't right. In first year I had a placement in Paediatrics and you could hear children screaming/crying from outside in the hallway. This time...it was dead quiet. There were no doctors to be seen. We met in the doctor's room and soon all the doctors arrived and did a handover. The reason for the quietness of the ward? We only had 3 patients on the ward and another patient was coming in later in the day. I mean the doctors are all really nice though. All of them are also really keen in teaching as well. They did mention that the lack of patients is common so we do have to be proactive.

We are expected to do 7 on-calls in our entire attachment (7 weeks). So it would make out to be 1 on-call per week. I did my on-call on Friday which meant I was in from 9am-10pm. What a long day. However, I managed to clerk in several patients and I was definitely learning. Also in the middle of the week I got to do baby checks. This is where the doctor would check over a newborn baby making sure he/she is healthy and ready to go home. Some of the babies were so cute; however, after all the baby checks, I feared crying babies. Every time I hear a baby cry, I flinch a bit. Also the funny bit is that almost every baby we checked, the baby decided to leave a present for us in his/her nappy. Lovely. Guess that's what you get in paediatrics. Cute babies and stinky diapers.

Paediatrics is definitely interesting, but the lack of patients in our hospital is really taking a toll on me as I do find myself standing around doing nothing. I also find myself getting bored quite often. Unfortunately there isn't much to talk about for this week. It has been overall quite dull. Not a lot of banter either on the ward. Guess not every placement will be fun. Hopefully next up will pick up. I mean at least I'm starting to get to know the doctors quite well and they are very welcoming. 6 more weeks. Yay....

Clinical Specialty Placements

So tomorrow I will be starting clinical specialty placements. I will be on Paediatrics for 6 weeks. I am kind of nervous for it as I don't know what to expect. I was placed in Paediatric Surgery in first year (which by the way is still my most memorable and fun time I have had on placement), but  I was only on the attachment for 1 week. I'm pretty sure it'll be a completely different ball game as obviously the consultants will expect much more knowledge. I have been placed in a peripheral hospital so hello to 1 hour drives each way. Should be interesting...hopefully the weather holds up to make my drive less stressful.

To best honest, I am alright with kids. I don't LOVE kids so I'm not uber excited to be surrounded by them. But who knows, in first year I was really inspired by my first attachment and saw some really interesting things. At one point I was thinking about maybe even specializing in Paediatric Surgery. Hopefully this will be a good experience and I will be able to learn loads as the hospital is much smaller so the doctors will have more time to teach.

9 am introductory lectures tomorrow until 4pm, then on Tuesday I'll be going to the peripheral hospital. Really hoping this will be a good attachment. More updates will come in the week!