Shocker - I'm back! Most of you probably thought I fell off the planet or medical school had simply killed me. Actually what had happened is that after my placements in May I had left for my medical elective for 2 months. I went back to Canada to do my medical elective in..........you guessed it: Orthopaedics. It was tough - and that's putting it lightly. I have not worked as hard as I had during my medical elective than any of my last 4 years at medical school. So once I got back I was seriously burnt out while my friends were burnt from their lovely sun filled elective in the beautiful/tropic parts of the world such as: Thailand, Vietnam, Fiji...I am feeling my blood pressure go up again. To put it in even more simple terms - I was miserable during my elective and very jealous of my friends who had a tropical and fun-filled elective to discover themselves.
Why was my elective so tough?
Well North American medical school will always have its stereotype to uphold. My mornings started at 6:30 am and my day didn't end until 6pm and that's me sneaking off early. Despite being a visiting elective student I was expected to still do 24 hour on-calls. Yes there were a few days especially in the first 2 weeks where I wanted to go and hide in a corner and cry. I've never been told off so much in medical school as much as I had during my first 4 week rotation. Apologies I have to leave out details as it will make me very easily identifiable if I start specifying EXACTLY what sub-specialty I was doing. I remember telling my parents several times I would quit. I nearly walked out of clinic many times. I walked out of the operating room once after being unfairly treated. This elective definitely pushed my limits to the max. When I reached my 2nd rotation of 4 weeks - I was back in my comfort zone. Let's say the first 4 weeks was a very steep learning curve and one I hope to never go through again. Looking back at it, I'm glad I got my ass-whipped as not only did I never work so hard before, but I have never learnt so much before in such a short amount of time. I had to gain A LOT of self-confidence and was pushed to the deep end of the pool during my elective and I'm glad the consultant pushed me that hard. I would have never learned...but with that, I sacrificed the enjoyment of the elective. I guess it's a fine balance.
When I returned to the UK I was just so burnt out. I didn't get much of a summer holiday. I was back to placements and well let's just say placement seemed extremely SLOW compared to Canada. I had a hard time adjusting back and consultants thought I was overly too proactive. It's a very different system here in the UK. In Canada I felt like I had to fight for my learning opportunities and I learned by falling flat on my face a million times. In the UK, we are spoon-fed our learning opportunities. There isn't a huge competition atmosphere in the UK. I was with other medical students in Canada and I found myself fighting to get to scrub in and fighting to see patients. As a student in the UK I feel like sometimes we take it for granted the amount of learning opportunities we get. Anyways there isn't much to talk about my elective. If I had to sum it up in one sentence it would go like this: Worked my ass off, but came out more mature and wiser and perhaps a hell lot more worn out. To be honest I still don't know what to think of my elective. Don't get me wrong, I was lucky to have got an elective in Canada in a major city in a very popular specialty, so I don't regret it at all.
Hopefully I'll start updating a bit more, however, final exams are coming up so I am a lot busier than usual now. Currently doing my General Practice rotation so who knows maybe I'll find time. Sorry again for the lack of updates...just had a rough few months.
Showing posts with label tired. Show all posts
Showing posts with label tired. Show all posts
Sunday, September 15, 2013
Saturday, March 9, 2013
A&E Night Shifts.
Many apologies for the lack of updates...A&E is proving to be a lot busier than first thought. My first week was a bit shaky as I started off with a week of night shifts. I really did not know what to expect. I made sure I sorted out my sleeping schedule and got plenty of sleep right before my shift. No matter how many placements I go on, the first day will always be slightly awkward. Literally stood around for a good hour by the doctor's desk waiting for a friendly doctor to say hi and welcome my group and I. Nope. Eventually we stopped a doctor and was quickly told: "Get stuck in! There is the box of the patient notes. Take a history and stalk the box and see which doctor picks up the patient you saw." Was quite perplexed and shrugged and just "got stuck in". Eventually attached myself to a doctor and found myself with a list of jobs, which included putting cannulas in and taking bloods. Just coming off from Anaesthetics proved useful, as I was still confident in putting in cannulas and was popping them in with ease. Though not having another pair of hands to help like we do in the anaesthetics room in theatre was proving to be quite tricky (and messy). Eventually it got to about 4am, and you notice yourself starting to lapse in concentration. I was definitely starting to miss veins and needed to "fish around" before getting into a vein when inserting a cannula. What's really annoying is that no matter how late I eat my dinner, I will get hungry at 4am. Luckily the doctors were really chilled and are always prepared. The registrar brings food for the team on night shifts so when A&E was calming down, we all sat around and snacked. Thankfully my first night wasn't too busy and the doctors told us to leave at around 5:30am. It was eerily quiet when leaving the hospital. And the roads were even quieter.
Anyways the next few days of nights progressively got quieter and quieter which was quite "abnormal". Just my luck. Didn't manage to see as many patients and didn't get to feel that useful/productive. At least the nights treated me well! Then I had to start my weekend night shifts. Saturday night...should be interesting! Swear the first 5 patients I saw had "intoxicated +++" written at the top of their notes. It was actually very frustrating to try and get histories out from them or their friends. What was a bit shocking was that there were students coming in from other cities to experience the night life here and end up getting completely plastered (and ending up in A&E). I personally would never go to a foreign city and get absolutely plastered. I guess I would be a bit more "aware" in a foreign city as the last place I want to end up in is in A&E. But of course, everyone has their own version of "fun" and I'm just a boring...old...medical student. Other than the non-stop flow of "intoxicated +++" people, it was a fairly uneventful night. Didn't really get to do very much either.
All in all, night shifts weren't actually that bad! But I do think I got off quite lightly as my friends who were on night shifts said they saw a few cardiac arrests and a few trauma cases. Oh well.
I'll try and make a few more posts this weekend. Need to catch up! Apologies again!
Anyways the next few days of nights progressively got quieter and quieter which was quite "abnormal". Just my luck. Didn't manage to see as many patients and didn't get to feel that useful/productive. At least the nights treated me well! Then I had to start my weekend night shifts. Saturday night...should be interesting! Swear the first 5 patients I saw had "intoxicated +++" written at the top of their notes. It was actually very frustrating to try and get histories out from them or their friends. What was a bit shocking was that there were students coming in from other cities to experience the night life here and end up getting completely plastered (and ending up in A&E). I personally would never go to a foreign city and get absolutely plastered. I guess I would be a bit more "aware" in a foreign city as the last place I want to end up in is in A&E. But of course, everyone has their own version of "fun" and I'm just a boring...old...medical student. Other than the non-stop flow of "intoxicated +++" people, it was a fairly uneventful night. Didn't really get to do very much either.
All in all, night shifts weren't actually that bad! But I do think I got off quite lightly as my friends who were on night shifts said they saw a few cardiac arrests and a few trauma cases. Oh well.
I'll try and make a few more posts this weekend. Need to catch up! Apologies again!
Thursday, May 31, 2012
What a Day.
So like I said in my last post, my placement is coming to an end and because my supervisor is really good with slowly giving me more responsibilities as the weeks go by, this week has been a lot of fun. My last placement, Obs and Gynae, could easily be the highlight of my medical school in terms of all-round great placement. Yesterday could have EASILY been the highlight day of my degree so far and by the looks of it - this placement will probably become the best placement of my degree.
Anyways yesterday was theatre day and was expecting to have 3 patients on the theatre list but I was actually disappointed in the morning to find out that one of the patients were cancelled so we only had two patients on the list. It was also going to be my last orthopaedic theatre list for this placement so I was a bit bummed out that we were most likely going to finish early. First patient was a simple straight forward one man job so I didn't scrub in and just observed. Afterwards we had a good break prior to the next and final patient for the day. Had some good banter with my supervisor and then I went to go see the patient in the anaesthetic room. It was a bit weird as the anaesthetist had quite a bit of difficulty putting in an epidural and other things just weren't going right/straight forward. The anaesthetist and I had a bit of a chat and we agreed that we have a feeling this surgery is going to be FAR from straightforward. Anyways after the patient was put to sleep my supervisor came in and told me that I will be scrubbing in and will be a first assistant. My eyes lit up. Last few weeks, I was scrubbed in, but I was more of an observer who did a bit of suction here and there, but nothing really special/that helpful.
Brief summary of patient: 1st stage revision of total hip replacement. Reason: Infection
11.10 - first incision made
I am still a bit new to orthopaedic surgery, but I have seen a few now and I knew immediately that something wasn't right. Immediately after the first incision, the patient was bleeding a lot more than usual. As we went deeper, it was obvious that the bleeding is only going to get worse and by the time we got to the muscle layers...it was like the flood gates were opened. The patient was bleeding from all sides of the opening and it was difficult to find where the bleeding is coming from. I tried my best to keep up with the suction so we can identify where the bleed is coming from, but we couldn't find a specific source. At least we knew it wasn't an artery as the blood is darker in colour. Anyways it was just a big mess in there and slowly it became obvious that this surgery is going to take a lot longer than predicted. The anaesthetist was struggling to keep the patient's stats normal and eventually had to call in for blood. We took a break during the surgery to try and get the patient to clot by packing the wound with swabs and putting pressure. After a bit, we hoped the swabs did the trick and started removing the swabs (which also gave the anaesthetist time to catch up with the fluids) and 5 seconds after removing the swabs...the blood just came pouring out.
12.30 - removing the femoral stem component
This wasn't too hard and everything came out very easily as the bone was dead and very weak. The cement and the component came out without much difficulty...luckily. Then we had to remove the acetabular cup which proved very challenging...to the point we had to get creative. Anyways after a lot of creativity and trial and error we did get the cup out. Again the bleeding was still really bad and it was so hard to keep up with the suction and to keep the view clear. There were times where we were sloshing around blindly trying to feel for the anatomy instead of visualizing as it was far too difficult. At this point I was starting to lose track of time as I was completely focused on my job of suctioning and holding tissue out of the way, etc. As time went I could tell we were taking awhile as my feet were starting to hurt. My hands were starting to cramp up due to the gloves. My back was starting to stiffen up. Oh and I had to use the toilet...but guess what: too bad.
14.30 - making antibiotic cement beads
Essentially we leave these beads inside the patient to allow the antibiotics to work and to kill off the infection in the local area. After the patient has healed from this surgery...these beads will be taken out in the 2nd stage revision and a new joint would be put in.
14.50 - patient starting to really deteriorate
While we are operating...it is difficult to hear what is going on outside of the operating area as we are in a "tent" area with plastic walls, but you could hear the anaesthetist making a lot of calls for extra help. People were starting to come in and you know something isn't right.
15.00 - closing up the wound
We started closing up the wound and then I heard my supervisor tell the scrub nurse: "vicryl to the student as well please". I was a bit confused as to why my supervisor and I both each had sutures as usually only one person would close up while the other person uses the scissors to cut the stitch (which is usually my job). My supervisor told me to start on the bottom end of the wound and he went off and started closing up the top portion of the wound. Last time I sutured, my supervisor watched me and guided me. This being my 3rd (?) time suturing on a real person...no one is watching. Worst bit: I was also shaking like a leaf. No I wasn't nervous/scared...it was because the last time I ate was at 8.00am and was obviously starving. Anyways managed to close up the bottom of the wound and then proceeded to help my supervisor with cutting and pushing the skin closer together so he can close up properly. Other than the shaking...I didn't struggled with the knots or anything. It actually went fine and my supervisor said my sutures looked fine as well. Proud moment. Thank goodness for masks as I was probably smiling like an idiot.
15.30 - put dressing on the wound (which was leaking out with blood still) and clean up
As we took down the drapes and everything you really notice that the patient isn't doing well as hiding in the back were 4 other people helping the anaesthetist and the floor was covered with empty blood bags. At one point the patient's haemoglobin count dropped to 6 (normal is 12). Apparently the patient had no clotting factors as well and we suspected the patient had DIC (disseminated intravascular coagulation) as the patient was bleeding from the cannula sites and from her nose. By the end of surgery it was calculated that the patient had lost up to 10 litres of blood. Normal human has about 5 litres of blood. It wasn't good and the patient was obviously in a critical state. There was a student nurse watching the surgery so I went over to go talk to her. She initially thought I was also a surgeon and hadn't realized I was a medical student. I was a bit shocked as I thought it would be obvious as I'm the "clumsy" medical student that probably looked lost and clueless during the surgery. The student nurse quickly disagreed and said that she was amazed how it looked like I knew what I was doing and what needed to be done. She thought I was constantly on the same page with the consultant and I didn't need much direction. It was weird hearing that as I always though I looked like a clueless idiot when scrubbed in. Even the other theatre staff gave me a pat on the back and told me I did a good job. Definitely put a huge smile on my face and the surgery felt good. I really enjoyed it and it was exciting. The surgery was also definitely challenging so it was an interesting case for me.
Anyways first time being a first assistant for orthopaedic surgery and a good way to end my last theatre list for this placement. The patient ended up getting transferred to ICU, but she managed to recover so all was good. Definitely a very tiring day. By the time I got home it was around 1800 and I still had not eaten, but guess what...it was fine and I think it is something I have to get used to. My supervisor also hadn't eaten as well and he doesn't complain as I'm sure skipping lunch is a usual thing for him. What a day.
Anyways yesterday was theatre day and was expecting to have 3 patients on the theatre list but I was actually disappointed in the morning to find out that one of the patients were cancelled so we only had two patients on the list. It was also going to be my last orthopaedic theatre list for this placement so I was a bit bummed out that we were most likely going to finish early. First patient was a simple straight forward one man job so I didn't scrub in and just observed. Afterwards we had a good break prior to the next and final patient for the day. Had some good banter with my supervisor and then I went to go see the patient in the anaesthetic room. It was a bit weird as the anaesthetist had quite a bit of difficulty putting in an epidural and other things just weren't going right/straight forward. The anaesthetist and I had a bit of a chat and we agreed that we have a feeling this surgery is going to be FAR from straightforward. Anyways after the patient was put to sleep my supervisor came in and told me that I will be scrubbing in and will be a first assistant. My eyes lit up. Last few weeks, I was scrubbed in, but I was more of an observer who did a bit of suction here and there, but nothing really special/that helpful.
Brief summary of patient: 1st stage revision of total hip replacement. Reason: Infection
11.10 - first incision made
I am still a bit new to orthopaedic surgery, but I have seen a few now and I knew immediately that something wasn't right. Immediately after the first incision, the patient was bleeding a lot more than usual. As we went deeper, it was obvious that the bleeding is only going to get worse and by the time we got to the muscle layers...it was like the flood gates were opened. The patient was bleeding from all sides of the opening and it was difficult to find where the bleeding is coming from. I tried my best to keep up with the suction so we can identify where the bleed is coming from, but we couldn't find a specific source. At least we knew it wasn't an artery as the blood is darker in colour. Anyways it was just a big mess in there and slowly it became obvious that this surgery is going to take a lot longer than predicted. The anaesthetist was struggling to keep the patient's stats normal and eventually had to call in for blood. We took a break during the surgery to try and get the patient to clot by packing the wound with swabs and putting pressure. After a bit, we hoped the swabs did the trick and started removing the swabs (which also gave the anaesthetist time to catch up with the fluids) and 5 seconds after removing the swabs...the blood just came pouring out.
12.30 - removing the femoral stem component
This wasn't too hard and everything came out very easily as the bone was dead and very weak. The cement and the component came out without much difficulty...luckily. Then we had to remove the acetabular cup which proved very challenging...to the point we had to get creative. Anyways after a lot of creativity and trial and error we did get the cup out. Again the bleeding was still really bad and it was so hard to keep up with the suction and to keep the view clear. There were times where we were sloshing around blindly trying to feel for the anatomy instead of visualizing as it was far too difficult. At this point I was starting to lose track of time as I was completely focused on my job of suctioning and holding tissue out of the way, etc. As time went I could tell we were taking awhile as my feet were starting to hurt. My hands were starting to cramp up due to the gloves. My back was starting to stiffen up. Oh and I had to use the toilet...but guess what: too bad.
14.30 - making antibiotic cement beads
Essentially we leave these beads inside the patient to allow the antibiotics to work and to kill off the infection in the local area. After the patient has healed from this surgery...these beads will be taken out in the 2nd stage revision and a new joint would be put in.
14.50 - patient starting to really deteriorate
While we are operating...it is difficult to hear what is going on outside of the operating area as we are in a "tent" area with plastic walls, but you could hear the anaesthetist making a lot of calls for extra help. People were starting to come in and you know something isn't right.
15.00 - closing up the wound
We started closing up the wound and then I heard my supervisor tell the scrub nurse: "vicryl to the student as well please". I was a bit confused as to why my supervisor and I both each had sutures as usually only one person would close up while the other person uses the scissors to cut the stitch (which is usually my job). My supervisor told me to start on the bottom end of the wound and he went off and started closing up the top portion of the wound. Last time I sutured, my supervisor watched me and guided me. This being my 3rd (?) time suturing on a real person...no one is watching. Worst bit: I was also shaking like a leaf. No I wasn't nervous/scared...it was because the last time I ate was at 8.00am and was obviously starving. Anyways managed to close up the bottom of the wound and then proceeded to help my supervisor with cutting and pushing the skin closer together so he can close up properly. Other than the shaking...I didn't struggled with the knots or anything. It actually went fine and my supervisor said my sutures looked fine as well. Proud moment. Thank goodness for masks as I was probably smiling like an idiot.
15.30 - put dressing on the wound (which was leaking out with blood still) and clean up
As we took down the drapes and everything you really notice that the patient isn't doing well as hiding in the back were 4 other people helping the anaesthetist and the floor was covered with empty blood bags. At one point the patient's haemoglobin count dropped to 6 (normal is 12). Apparently the patient had no clotting factors as well and we suspected the patient had DIC (disseminated intravascular coagulation) as the patient was bleeding from the cannula sites and from her nose. By the end of surgery it was calculated that the patient had lost up to 10 litres of blood. Normal human has about 5 litres of blood. It wasn't good and the patient was obviously in a critical state. There was a student nurse watching the surgery so I went over to go talk to her. She initially thought I was also a surgeon and hadn't realized I was a medical student. I was a bit shocked as I thought it would be obvious as I'm the "clumsy" medical student that probably looked lost and clueless during the surgery. The student nurse quickly disagreed and said that she was amazed how it looked like I knew what I was doing and what needed to be done. She thought I was constantly on the same page with the consultant and I didn't need much direction. It was weird hearing that as I always though I looked like a clueless idiot when scrubbed in. Even the other theatre staff gave me a pat on the back and told me I did a good job. Definitely put a huge smile on my face and the surgery felt good. I really enjoyed it and it was exciting. The surgery was also definitely challenging so it was an interesting case for me.
Anyways first time being a first assistant for orthopaedic surgery and a good way to end my last theatre list for this placement. The patient ended up getting transferred to ICU, but she managed to recover so all was good. Definitely a very tiring day. By the time I got home it was around 1800 and I still had not eaten, but guess what...it was fine and I think it is something I have to get used to. My supervisor also hadn't eaten as well and he doesn't complain as I'm sure skipping lunch is a usual thing for him. What a day.
Monday, February 27, 2012
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!
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!
Sunday, February 12, 2012
Planning Ahead.
I would like to think I am fairly good at planning ahead. I am quite a simple person and fairly straight forward, but few know that I actually think quite a bit about the future. Being an international student, you have to think about the future. We try our best to not think about the future as anything can happen, but we also have to be ready for anything unexpected. My biggest advice to international students (no matter how confident you are about staying in the UK) is to have a backup plan. What happens if the UK government decide to throw us a curve ball and change the immigration/Visa rules? What happen if you suddenly have to return home due to family issues? And if you're not planning on staying in the UK, you really got to plan when to take the registry exams such as USMLE. It pains me when I see international students not having a single clue what they'll be doing in a few years time. Unfortunately it isn't a straight path for international students, let it be staying in the UK or going back home. Either way it won't be easy and you will have to make sacrifices. Anyways enough with the grim outlook for international students. It isn't all that bad to be honest. It's just that you have to constantly remind yourself you are an international student and it isn't a simple straight path. There will be many obstacles to cross and many walls to climb. It isn't easy, but hopefully it'll be all worth it in the end.
Anyways enough with the weird banter paragraph above. Maybe I should put the beer away. Haha. If you guys read my last post carefully, I did not talk about Friday. No I didn't have lectures...and no I did not go into placement. Then you must assume I was skiving. No I wasn't skiving either...well I wouldn't consider it skiving because I was actually doing something productive. I had a meeting with an Orthopaedic consultant at the central hospital to discuss about my Student Selected Component (SSC) project for this coming May. The last time I met the consultant, I fell asleep in the chair and he had to wake me up...great first impression. Luckily it didn't really affect him as he was willing to see me again. He was actually quite keen to be my supervisor for my SSC and to mentor me. This time prior to meeting him, I made sure I was not going to fall asleep. I heard him come out from his office so I made sure I didn't look like I was dozing off...to be honest I was zoning out as all I did was stare at the wall. I had to wait for awhile as I was 30 minutes early for the meeting as I messed up on my travel timing so I was quite tired. Went into the office to discuss what I will be doing for my 6 week SSC project. We did a lot of brainstorming and came up with quite a few ideas. Either this consultant is smart or was prepared to discuss about my SSC as he was rapid firing ideas at me. Unfortunately, I kept zoning out as to be fair...I did not understand half the things he mentioned. He was talking about the different type of implants used in Orthopaedics, and obviously I have never heard of the brands. He talked to me like I knew all the brands so you could imagine I was very lost. When I get lost...I zone out. It's a horrible trait I have. As he went on, he realized he should write down what I will be doing. He set out a bunch of aims and wanted me to expand on it and give it a think. He filled up half a page with notes on the aims of my project (looking at implants). I quickly put the paper away in my bag without looking at the paper.
And then I perked up as the consultant mentioned that during my project he wants to do some clinical things with me. I told him that I got to observe a few trauma surgeries and paeds orthopaedic surgeries over the last few weeks. He ended up throwing a curve-ball at me and told me that it is good that I'm making the effort and be keen to go see these things, BUT the difference is that when I follow him I will be scrubbing in and actually assisting. Oh man, I got so excited it was ridiculous. I immediately sat up straight and couldn't stop smiling. Scrubbing in and assisting = music to my ears. Finally I get the chance to get my hands in and do something that I am interested in. He also went on how I will be able to do some stitching (heart sank a bit as the last time I learned stitching was a year ago). Now, I was very excited about my SSC and the consultant surely knows how to make a student happy.
After the meeting I quickly went home and took out the paper that he wrote on. To my demise, I could not make out half the things he wrote. I regretted zoning out and I should've remembered doctors do not write legibly. Took me ages to decipher what the consultant wrote. In the end, I figured out most of the things he wrote as I vaguely remembered the stuff he was talking about and managed to crack on with expanding on his notes. Note to self: Do NOT zone out while a consultant is talking to you. You'll regret it as you won't be able to read half the things he wrote down. Imagine if I couldn't decipher what he wrote...the embarrassment I would have to go through as I would have to email him and tell him I can't read what he wrote when I should have been paying attention during the meeting.
Anyways I'm super stoked about my SSC in May! One more meeting and a bit of paperwork before my SSC will be official. Cannot wait.
Anyways enough with the weird banter paragraph above. Maybe I should put the beer away. Haha. If you guys read my last post carefully, I did not talk about Friday. No I didn't have lectures...and no I did not go into placement. Then you must assume I was skiving. No I wasn't skiving either...well I wouldn't consider it skiving because I was actually doing something productive. I had a meeting with an Orthopaedic consultant at the central hospital to discuss about my Student Selected Component (SSC) project for this coming May. The last time I met the consultant, I fell asleep in the chair and he had to wake me up...great first impression. Luckily it didn't really affect him as he was willing to see me again. He was actually quite keen to be my supervisor for my SSC and to mentor me. This time prior to meeting him, I made sure I was not going to fall asleep. I heard him come out from his office so I made sure I didn't look like I was dozing off...to be honest I was zoning out as all I did was stare at the wall. I had to wait for awhile as I was 30 minutes early for the meeting as I messed up on my travel timing so I was quite tired. Went into the office to discuss what I will be doing for my 6 week SSC project. We did a lot of brainstorming and came up with quite a few ideas. Either this consultant is smart or was prepared to discuss about my SSC as he was rapid firing ideas at me. Unfortunately, I kept zoning out as to be fair...I did not understand half the things he mentioned. He was talking about the different type of implants used in Orthopaedics, and obviously I have never heard of the brands. He talked to me like I knew all the brands so you could imagine I was very lost. When I get lost...I zone out. It's a horrible trait I have. As he went on, he realized he should write down what I will be doing. He set out a bunch of aims and wanted me to expand on it and give it a think. He filled up half a page with notes on the aims of my project (looking at implants). I quickly put the paper away in my bag without looking at the paper.
And then I perked up as the consultant mentioned that during my project he wants to do some clinical things with me. I told him that I got to observe a few trauma surgeries and paeds orthopaedic surgeries over the last few weeks. He ended up throwing a curve-ball at me and told me that it is good that I'm making the effort and be keen to go see these things, BUT the difference is that when I follow him I will be scrubbing in and actually assisting. Oh man, I got so excited it was ridiculous. I immediately sat up straight and couldn't stop smiling. Scrubbing in and assisting = music to my ears. Finally I get the chance to get my hands in and do something that I am interested in. He also went on how I will be able to do some stitching (heart sank a bit as the last time I learned stitching was a year ago). Now, I was very excited about my SSC and the consultant surely knows how to make a student happy.
After the meeting I quickly went home and took out the paper that he wrote on. To my demise, I could not make out half the things he wrote. I regretted zoning out and I should've remembered doctors do not write legibly. Took me ages to decipher what the consultant wrote. In the end, I figured out most of the things he wrote as I vaguely remembered the stuff he was talking about and managed to crack on with expanding on his notes. Note to self: Do NOT zone out while a consultant is talking to you. You'll regret it as you won't be able to read half the things he wrote down. Imagine if I couldn't decipher what he wrote...the embarrassment I would have to go through as I would have to email him and tell him I can't read what he wrote when I should have been paying attention during the meeting.
Anyways I'm super stoked about my SSC in May! One more meeting and a bit of paperwork before my SSC will be official. Cannot wait.
Friday, February 10, 2012
Lack of Sleep.
5 weeks in! 2 more weeks to go. This has got to me the toughest week in terms of waking up. Every morning I am waking up at 6:30am to get ready, but it doesn't help that there isn't much to motivate me to get up. I think the only thing that is making me wake up on time is the fact that I have to drive other people to the hospital so they kinda rely on me. I also think that being 5 weeks in, there isn't much else to see. Most of the patients we see have acute illnesses as most of the special illnesses get referred to a bigger hospital.
I was on-call on Wednesday and the best bit is that the doctors on the ward can tell when I am on-call as I'm never on the ward when I am on-call. I try to go to clinics to try and make the time go by faster. As usual...Wednesday - I escaped the ward. I went to the Children's Orthopaedic Clinic for the entire morning. It was a lot more interesting than I expected it to be. I saw a lot of different cases. I was even able to sympathize with some of the patients. Met a girl who is hypermobile, which was affecting her participation in sports. The consultant was doing a physical examination on the range of movement of her joints and on doing internal rotation of the hip, the consultant asked me if it was normal. I knew my leg could turn that far so I said: "normal". I have never seen such a confused face. "That is NOT normal. LOOK how far it goes!" Feeling a bit dumb/embarrassed I covered my back side by saying: "Oh sorry didn't notice how far it went *blushes*"
Once the patient left, the consultant questioned why I thought the range of movement was normal as it was apparently fairly abnormal. Then I proceeded to tell him that I am hypermobile as well. Then I found out he isn't very good with hypermobility. The consultant looked quite uncomfortable and didn't want to see me showing my "flexibility". I was quite surprised about his reaction, but thinking about it....it is fairly gross. Fingers shouldn't bend so far back and such. Haha. Hypermobility is a great party trick by the way. Just thought I would throw that out there.
Anyways clinic took quite long, but we had a lot of patients. What I enjoyed the most about the clinic is that we did not see two of the same case. Every single patient had a different problem and it really kept me awake and interested. For the first time at a clinic, I did not find myself bored. I was constantly engaged and I found each case interesting. Probably could be one of the best clinics that I have ever been to. Long, but interesting.
At some point the clinic had to end and I had to return to the ward. On the way back, I stopped for a lunch break. When I returned to the ward I was told there was another clinic happening in 30 minutes. Obviously I pounced on that opportunity and I disappeared from the ward for another 4 hours. By the time I got back to the ward, I only had 4 more hours left of my on-call to do. Luckily when I got back, the ward started to get busy and I got to clerk in a few patients. Most of them were diarrhoea and vomiting problems, so it wasn't too exciting. It was better than sitting around doing nothing. But because the ward started to get busy, I didn't get to leave til 9:30pm. I had quite a bit of work to do when I got home and didn't get to sleep early. Worst part, I had to get up at 6:30am the next morning again. Thursday was brutal. For the entire day I was falling asleep whenever I sat down. We also had lunchtime teaching from the registrar and I accidentally fell asleep. I felt really bad as I didn't mean to fall asleep as it wasn't boring. I was just so tired I couldn't keep my eyes open. Now I think the registrar hates me. She wouldn't talk to me afterwards and it was kinda awkward on the ward. Hopefully she'll forget about it after the weekend. And hopefully I can catch up on my sleep.
I was on-call on Wednesday and the best bit is that the doctors on the ward can tell when I am on-call as I'm never on the ward when I am on-call. I try to go to clinics to try and make the time go by faster. As usual...Wednesday - I escaped the ward. I went to the Children's Orthopaedic Clinic for the entire morning. It was a lot more interesting than I expected it to be. I saw a lot of different cases. I was even able to sympathize with some of the patients. Met a girl who is hypermobile, which was affecting her participation in sports. The consultant was doing a physical examination on the range of movement of her joints and on doing internal rotation of the hip, the consultant asked me if it was normal. I knew my leg could turn that far so I said: "normal". I have never seen such a confused face. "That is NOT normal. LOOK how far it goes!" Feeling a bit dumb/embarrassed I covered my back side by saying: "Oh sorry didn't notice how far it went *blushes*"
Once the patient left, the consultant questioned why I thought the range of movement was normal as it was apparently fairly abnormal. Then I proceeded to tell him that I am hypermobile as well. Then I found out he isn't very good with hypermobility. The consultant looked quite uncomfortable and didn't want to see me showing my "flexibility". I was quite surprised about his reaction, but thinking about it....it is fairly gross. Fingers shouldn't bend so far back and such. Haha. Hypermobility is a great party trick by the way. Just thought I would throw that out there.
Anyways clinic took quite long, but we had a lot of patients. What I enjoyed the most about the clinic is that we did not see two of the same case. Every single patient had a different problem and it really kept me awake and interested. For the first time at a clinic, I did not find myself bored. I was constantly engaged and I found each case interesting. Probably could be one of the best clinics that I have ever been to. Long, but interesting.
At some point the clinic had to end and I had to return to the ward. On the way back, I stopped for a lunch break. When I returned to the ward I was told there was another clinic happening in 30 minutes. Obviously I pounced on that opportunity and I disappeared from the ward for another 4 hours. By the time I got back to the ward, I only had 4 more hours left of my on-call to do. Luckily when I got back, the ward started to get busy and I got to clerk in a few patients. Most of them were diarrhoea and vomiting problems, so it wasn't too exciting. It was better than sitting around doing nothing. But because the ward started to get busy, I didn't get to leave til 9:30pm. I had quite a bit of work to do when I got home and didn't get to sleep early. Worst part, I had to get up at 6:30am the next morning again. Thursday was brutal. For the entire day I was falling asleep whenever I sat down. We also had lunchtime teaching from the registrar and I accidentally fell asleep. I felt really bad as I didn't mean to fall asleep as it wasn't boring. I was just so tired I couldn't keep my eyes open. Now I think the registrar hates me. She wouldn't talk to me afterwards and it was kinda awkward on the ward. Hopefully she'll forget about it after the weekend. And hopefully I can catch up on my sleep.
Friday, January 20, 2012
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.
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.
Sunday, January 15, 2012
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....
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....
Monday, October 12, 2009
FRESHERS WEEK - SEPT 25, 2009
Luckily our first lecture of the day was at 1pm so most of us could get over/recover slightly from any hangovers. When I got to the lecture theater, half the class was holding a water bottle which I found pretty hilarious. Schedule for the day was just:
1:00pm - 2:00pm : Summing Up Introductory Activity
Pretty easy day to be honest. Anyways by 1:15pm our lecturer still hasn't showed up and people started to get bored. People started throwing paper planes and paper balls around the room. It was quite the scene. Things flying from side to side, from back to front. By 1:40pm a MedSoc rep. noticed that our lecturer was still not here and contacted the med school that there are 250 students are impatiently waiting for their lecture. So at around 1:50pm our lecturer shows up and everyone was really bummed out for obvious reasons. The lecturer was pretty considerate and just rushed through the conclusion of our task and went over the answer. The diagnosis for our case study ended up being H1N1/Swine flu and the differential diagnosis was just the common flu. Lecture ended at like 2:10pm which was REALLY fast. We all ran off pretty fast back to our flats.
After the lecture I quickly went over the student union to check our the Sports Activity Fair. There was SO MANY PEOPLE! By the time I finished my late lunch (after lecture) and got INTO the sports fair, the stands were starting to pack up. I didn't get to see much and was interested in signing up for some stuff but sadly they were all done for the day and took away their sign-up sheets.
Oh forgot to mention: I could hear the beginning of freshers flu flying around the class (oh no!). Nice short post as I didn't do anything interesting and just went home and took a nap.
Tip of the day: Load up on vitamin C during freshers week if you want to avoid freshers flu. No guarantees though. Oh and party really hard during freshers week because you won't be able to party as hard during actual uni time...too much work. Oh and if you really want to go sign up for stuff at a fair and you know you'll be in a rush after your lecture to go to the fair...just go before. It makes life much easier.
Side note: Hopefully most of you have already submitted your UCAS application for medical school by now or putting in the final touches to your personal statement. Good luck!
1:00pm - 2:00pm : Summing Up Introductory Activity
Pretty easy day to be honest. Anyways by 1:15pm our lecturer still hasn't showed up and people started to get bored. People started throwing paper planes and paper balls around the room. It was quite the scene. Things flying from side to side, from back to front. By 1:40pm a MedSoc rep. noticed that our lecturer was still not here and contacted the med school that there are 250 students are impatiently waiting for their lecture. So at around 1:50pm our lecturer shows up and everyone was really bummed out for obvious reasons. The lecturer was pretty considerate and just rushed through the conclusion of our task and went over the answer. The diagnosis for our case study ended up being H1N1/Swine flu and the differential diagnosis was just the common flu. Lecture ended at like 2:10pm which was REALLY fast. We all ran off pretty fast back to our flats.
After the lecture I quickly went over the student union to check our the Sports Activity Fair. There was SO MANY PEOPLE! By the time I finished my late lunch (after lecture) and got INTO the sports fair, the stands were starting to pack up. I didn't get to see much and was interested in signing up for some stuff but sadly they were all done for the day and took away their sign-up sheets.
Oh forgot to mention: I could hear the beginning of freshers flu flying around the class (oh no!). Nice short post as I didn't do anything interesting and just went home and took a nap.
Tip of the day: Load up on vitamin C during freshers week if you want to avoid freshers flu. No guarantees though. Oh and party really hard during freshers week because you won't be able to party as hard during actual uni time...too much work. Oh and if you really want to go sign up for stuff at a fair and you know you'll be in a rush after your lecture to go to the fair...just go before. It makes life much easier.
Side note: Hopefully most of you have already submitted your UCAS application for medical school by now or putting in the final touches to your personal statement. Good luck!
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