To be fair, every placement has a "slow" week. Mine is usually the first week...somehow out of my 4 week placement, I managed to have another slow week. Last week, I spent most of my time checking out the intensive care unit and the high dependency unit. I'll just say in my opinion, it is probably the "less exciting" part of the job. Lots of ward rounds! I really don't know what to take away from this week. Having said that, I did manage to get a lot of physiology teaching from a consultant anaesthetist. It was actually a really good refresher. The way he taught was based on quizzing (which I hate, but love at the same time). I was picked on most of the time as I was the only medical student and that the knowledge should be "fresher" in my mind. It made me realize that I actually haven't really forgotten about physiology. From the quizzing/grilling, I realized that I just lack confidence in my answers and should just be brave and say what I think the answer is. It's a shame that it takes massive pushing and pressure for me to get an answer out. Guess it's one thing I need to learn and obviously shows I need to hit the books a bit harder to build some confidence in my knowledge. The foundation knowledge is definitely there and I just need to "go for it".
Thankfully to end the week, I got to go back to theatre and was placed with a really good anaesthetist who let me do a lot of skills. I was putting in all the cannulas, holding the oxygen mask, and inserting LMAs. It felt really good. In the first week, despite being very determined to get some hands on, I was quite scared and nervous performing these skills. Now, I'm on it the minute the patient comes to the anaesthetic room. Gloves on. Equipment ready. Ready to go! It also showed me that with practice, you'll get better at the skills. I had to cannulate a tricky patient. I missed the vein on entry, but managed to salvage it and got the cannula in without needing to try in a different spot. Added bonus was that the consultant complimented me on it, so it was a definite boost to my confidence level! Thinking back to the last 2 weeks and seeing my placement come to an end - I think I've made leaps and bounds in terms of clinical skills. I built a lot of confidence in my clinical skills and in general feel just a bit more competent. My day in theatre really showed me how far I have come from the beginning of placement and I think I have accomplished what I have set out to do - to improve on my clinical skills.
I do realize that my posts have been fairly short...as to be honest - there's not much to really talk about. I don't get to speak to as many patients as most are asleep. This placement was mainly refreshing my pharmacological and physiology knowledge and improving on my clinical skills.
Sorry for the boring read! I promise the end of this week's post will be more interesting!
Showing posts with label ward round. Show all posts
Showing posts with label ward round. Show all posts
Monday, February 11, 2013
Thursday, April 5, 2012
O&G Ward Week.
You can hardly call this my "Ward Week" as I probably spent more time in clinics than on the ward. This week also marks my last timetabled week of my placement and I have been seriously trying my best to enjoy every day of it as there is a bit more flexibility with my week.
Spent Monday morning in Gynae clinic. I managed to see a lot of prolapses such as cystoceles (proplapse of the bladder). Luckily the consultant has gotten to know me as I've been in a few of his clinics with him so I got to do a vaginal examination on almost every patient. It was interesting to feel a prolapse as it is definitely very different and then feel the difference when a shelf/pessary is inserted as a temporary treatment for the prolapse. Patients with cystoceles tend to classically present with a "dragging" feeling down below which becomes quite uncomfortable as the day progresses. There is also a "heavy" feeling, which again gets worse as the day progresses especially when stood up for a long time. Some of these patients also present with urinary symptoms such as urinary frequency and hesitancy. I think by coincidence these patients also present with some form of urinary incontinence as well. Usually elderly women would not be offered a surgical repair where stitches will be placed to reinforce the anterior wall of the vagina (where the bladder prolapses through) as these patients are usually unsuitable to go under anaesthesia. By the looks of it, most of the women are fine with the pessary and it seems to sort out their problems quite well.
Then I wandered onto the wards with one main goal in my mind: Take as many gynae patient histories as possible. Why so keen? This is because my assessment is taking place the following day. Essentially we are required to take a full patient history with an assessor sitting alongside. This assessment either makes or breaks me. If I fail, I would obviously have to resit the assessment which would go down on my records that I had 1 failed attempt. If I fail the second time, then I will have to repeat the entire 7 week placement all over again. I mean I'm having a good time on this placement, but if you asked me to do another 7 weeks, it might be a bit of an overkill. Anyways I took about 4 patient histories in the afternoon and had a good time talking to patients. It's nice to see patients enjoying talking to me as I guess for them it is better than sitting in silence and day dreaming as the hospital is pretty boring in general.
So I had my assessment...and oddly enough...I wasn't too nervous for it. Actually I was so calm it was worrying. I was struggling to take the assessment seriously as before I went in to take the patient history I was chatting away with my colleagues (well I did the talking...they just listened as they all looked very nervous). I kept telling myself to take this assessment seriously but I struggled. I was fairly annoyed with myself, but at the same time - if I'm in a good mood I tend to take better patient histories and form much better rapport with the patients, which is key for the assessment. Luckily, my patient wasn't too complicated (vaginal hysterectomy and anterior wall repair). I finished my history quite quickly and I thought I did quite well. Didn't have any difficulties whatsoever. Huge contrast from my last placement (paediatrics) assessment. In my last placement I was properly pooping myself prior to my assessment and I was dead scared. I was much more confident for this gynae assessment - night and day in terms of confidence between my last placement assessment and this one. My assessor had no difficulties in passing me and even gave me an "above average" mark which I was quite chuffed about. I was quite proud of myself as I was only expecting a "meets expectation" as my supervisor is known to be quite strict with marking.
Since my next assessment isn't until next week, I knew I can relax for a bit and return to enjoying my placement. Oddly enough I thought I was going to be quite bored on the wards as there isn't much a medical student can do on the wards, but I was actually quite productive on the wards. The doctors were all really welcoming and actually allowed me to write in the medical notes and sign off on them (of course the doctors reviewed and counter-signed my notes). I also got to clerk in a few patients, which is always interesting. It's weird seeing how seriously some of the patients treat me. I mean at the end of the day I'm just a medical student, but these patients really take everything I say seriously and show a lot of respect. It's quite nice to not be treated as a joke and it definitely makes me feel much more responsible.
Because my next assessment is on obstetrics and I haven't had much exposure to it on the wards, I decided to spend my day on the obstetrics ward and practice my obstetrics examination skills. And jeez....I suck at obstetrics examination. I swear I cannot feel a thing. In our assessment I'm supposed to be able to tell the position of the baby, the engagement of the head, the lie, etc. I feel like my hands are dead stubborn as I swear the bum of the baby feels the same as the head! Yes I know one side is flat and the other is round like a ball, but at the same time I'm too scared to palpate deeply in fear of hurting the mother. I definitely need to get more confident in doing this examination or else I will fail my final assessment. Not looking good. I thought I could get away with just a full day of practice, but I definitely need to go back to the obstetrics ward next week to examine more pregnant women. I think I did leave a good impression with the midwives as they seemed keen to have me around and that I am welcomed to come back next week to practice some more.
1 more week until holiday...well not even. Technically only 2.5 more days of placement left as I have a half day next Thursday (and Monday is a bank holiday and I get Friday off). Can't believe it's already been 7 weeks. I can still remember my very first lecture for O&G like it was just yesterday. This placement seriously went by way too fast...and I'm having such a good time. Argh.
Spent Monday morning in Gynae clinic. I managed to see a lot of prolapses such as cystoceles (proplapse of the bladder). Luckily the consultant has gotten to know me as I've been in a few of his clinics with him so I got to do a vaginal examination on almost every patient. It was interesting to feel a prolapse as it is definitely very different and then feel the difference when a shelf/pessary is inserted as a temporary treatment for the prolapse. Patients with cystoceles tend to classically present with a "dragging" feeling down below which becomes quite uncomfortable as the day progresses. There is also a "heavy" feeling, which again gets worse as the day progresses especially when stood up for a long time. Some of these patients also present with urinary symptoms such as urinary frequency and hesitancy. I think by coincidence these patients also present with some form of urinary incontinence as well. Usually elderly women would not be offered a surgical repair where stitches will be placed to reinforce the anterior wall of the vagina (where the bladder prolapses through) as these patients are usually unsuitable to go under anaesthesia. By the looks of it, most of the women are fine with the pessary and it seems to sort out their problems quite well.
Then I wandered onto the wards with one main goal in my mind: Take as many gynae patient histories as possible. Why so keen? This is because my assessment is taking place the following day. Essentially we are required to take a full patient history with an assessor sitting alongside. This assessment either makes or breaks me. If I fail, I would obviously have to resit the assessment which would go down on my records that I had 1 failed attempt. If I fail the second time, then I will have to repeat the entire 7 week placement all over again. I mean I'm having a good time on this placement, but if you asked me to do another 7 weeks, it might be a bit of an overkill. Anyways I took about 4 patient histories in the afternoon and had a good time talking to patients. It's nice to see patients enjoying talking to me as I guess for them it is better than sitting in silence and day dreaming as the hospital is pretty boring in general.
So I had my assessment...and oddly enough...I wasn't too nervous for it. Actually I was so calm it was worrying. I was struggling to take the assessment seriously as before I went in to take the patient history I was chatting away with my colleagues (well I did the talking...they just listened as they all looked very nervous). I kept telling myself to take this assessment seriously but I struggled. I was fairly annoyed with myself, but at the same time - if I'm in a good mood I tend to take better patient histories and form much better rapport with the patients, which is key for the assessment. Luckily, my patient wasn't too complicated (vaginal hysterectomy and anterior wall repair). I finished my history quite quickly and I thought I did quite well. Didn't have any difficulties whatsoever. Huge contrast from my last placement (paediatrics) assessment. In my last placement I was properly pooping myself prior to my assessment and I was dead scared. I was much more confident for this gynae assessment - night and day in terms of confidence between my last placement assessment and this one. My assessor had no difficulties in passing me and even gave me an "above average" mark which I was quite chuffed about. I was quite proud of myself as I was only expecting a "meets expectation" as my supervisor is known to be quite strict with marking.
Since my next assessment isn't until next week, I knew I can relax for a bit and return to enjoying my placement. Oddly enough I thought I was going to be quite bored on the wards as there isn't much a medical student can do on the wards, but I was actually quite productive on the wards. The doctors were all really welcoming and actually allowed me to write in the medical notes and sign off on them (of course the doctors reviewed and counter-signed my notes). I also got to clerk in a few patients, which is always interesting. It's weird seeing how seriously some of the patients treat me. I mean at the end of the day I'm just a medical student, but these patients really take everything I say seriously and show a lot of respect. It's quite nice to not be treated as a joke and it definitely makes me feel much more responsible.
Because my next assessment is on obstetrics and I haven't had much exposure to it on the wards, I decided to spend my day on the obstetrics ward and practice my obstetrics examination skills. And jeez....I suck at obstetrics examination. I swear I cannot feel a thing. In our assessment I'm supposed to be able to tell the position of the baby, the engagement of the head, the lie, etc. I feel like my hands are dead stubborn as I swear the bum of the baby feels the same as the head! Yes I know one side is flat and the other is round like a ball, but at the same time I'm too scared to palpate deeply in fear of hurting the mother. I definitely need to get more confident in doing this examination or else I will fail my final assessment. Not looking good. I thought I could get away with just a full day of practice, but I definitely need to go back to the obstetrics ward next week to examine more pregnant women. I think I did leave a good impression with the midwives as they seemed keen to have me around and that I am welcomed to come back next week to practice some more.
1 more week until holiday...well not even. Technically only 2.5 more days of placement left as I have a half day next Thursday (and Monday is a bank holiday and I get Friday off). Can't believe it's already been 7 weeks. I can still remember my very first lecture for O&G like it was just yesterday. This placement seriously went by way too fast...and I'm having such a good time. Argh.
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....
Tuesday, November 1, 2011
Late Again!
I left my flat really early today to make sure I would show up on time to meet my new consultant. Obviously turning up on time is going to be my new enemy for this placement. Despite leaving my flat much earlier, I still ended up being 5 minutes late and the new consultant started his ward round right at 9am. I can't wait until the roads are reopened so I don't have to deal with the nightmare traffic I had to endure for these 2 days. However, I was quite lucky as this new consultant is really nice. He assumed I was late because I had some teaching earlier and was running a bit late. He greeted me and introduced himself and made sure I felt part of the team. It was definitely a nice thing for him to do and I do admit I felt bad for being late.
Anyways saw a new patient today who was moved from another ward. Found myself sympathizing with this patient as he had a metastatic tumour in his brain. He had undergone chemotherapy and radiotherapy, but is now placed for palliative care as it is an advanced tumour. Met the family today and you see the family trying to be strong and keep their chin up, but in the end the wife broke down. Felt quite useless as a student as no matter what you say - it isn't going to change the situation.
What confuses me the most about this placement is that I am placed in Endocrinology but majority of the patients don't have an endocrine related illness. Most of the patients I've seen have chest infections/pneumonia. It's quite weird. I only saw 1 patient today who had an endocrine related illness (Cushing's). I guess endocrinology is quite flexible? Will definitely have to ask one of the SHOs or FY1/2 doctors about this.
Anyways saw a new patient today who was moved from another ward. Found myself sympathizing with this patient as he had a metastatic tumour in his brain. He had undergone chemotherapy and radiotherapy, but is now placed for palliative care as it is an advanced tumour. Met the family today and you see the family trying to be strong and keep their chin up, but in the end the wife broke down. Felt quite useless as a student as no matter what you say - it isn't going to change the situation.
What confuses me the most about this placement is that I am placed in Endocrinology but majority of the patients don't have an endocrine related illness. Most of the patients I've seen have chest infections/pneumonia. It's quite weird. I only saw 1 patient today who had an endocrine related illness (Cushing's). I guess endocrinology is quite flexible? Will definitely have to ask one of the SHOs or FY1/2 doctors about this.
Monday, October 31, 2011
Final Placement of the Year!
So today was Day 1 of my final placement of 2011. I'm only on this placement for 3 weeks so yay, but that also means...EXAMS are coming up. Been revising for the last 2 weeks and it's bringing good ol' memories of how much I hate revising. It's tedious, tiring, and stressful. Oh and I have to juggle it with placements as well. Luckily I've been placed in a fairly slack placement (Endocrinology) so hopefully I won't have to be too committed.
Met my consultant today and I always believe in first impressions. If you want to impress:
Saw quite a lot of patients - all seemed pretty ill. I also noticed a trend that most of the patients are quite confused. We had one patient who told us that her husband had passed away 30 minutes earlier, and seemed quite depressed. However, when asked what date it is she thought it was the 10th of October, 2009! She didn't know where she was either and didn't know what our consultant was (expected answer = doctor, she had no clue!). She is a new patient and the consultant wasn't sure whether the news of her husband's passing was whether she was confused or it really did happen. At this point my partner and I left the patient and stepped to one side as our consultant talked to a nurse about the patient's story. Unfortunately it was quite noisy and we couldn't hear what the nurse had told our consultant. I guess it is now just a mystery to us. Anyways our ward round lasted 2.5 hours (which isn't too bad as I've been on 4 hour ward rounds). At the end we were told that today was our consultant's last day and another consultant will be taking over for the month. But because our consultant isn't actually leaving the hospital he now has more time to teach so he offered to teach us this week on anything we would like. It was great news as endocrinology is quite complex and it would be great revision for exams. However, that also means I will have to go in tomorrow morning to meet the new consultant as he will be the one to sign us off for the placement. I wasn't planning to go in so I could stay home to revise - guess that won't be happening. Who knows, this consultant might be really nice and good at teaching, so I guess there is something to look forward to! Cross my fingers that this new consultant won't be stern/serious/intimidating. Some of the doctors on the ward knows of this consultant and they say he is quite nice. Hopefully they were being honest. Bring on tomorrow!
Met my consultant today and I always believe in first impressions. If you want to impress:
- Dress well
- Show up early
- Be keen
- Read up on the specialty
Saw quite a lot of patients - all seemed pretty ill. I also noticed a trend that most of the patients are quite confused. We had one patient who told us that her husband had passed away 30 minutes earlier, and seemed quite depressed. However, when asked what date it is she thought it was the 10th of October, 2009! She didn't know where she was either and didn't know what our consultant was (expected answer = doctor, she had no clue!). She is a new patient and the consultant wasn't sure whether the news of her husband's passing was whether she was confused or it really did happen. At this point my partner and I left the patient and stepped to one side as our consultant talked to a nurse about the patient's story. Unfortunately it was quite noisy and we couldn't hear what the nurse had told our consultant. I guess it is now just a mystery to us. Anyways our ward round lasted 2.5 hours (which isn't too bad as I've been on 4 hour ward rounds). At the end we were told that today was our consultant's last day and another consultant will be taking over for the month. But because our consultant isn't actually leaving the hospital he now has more time to teach so he offered to teach us this week on anything we would like. It was great news as endocrinology is quite complex and it would be great revision for exams. However, that also means I will have to go in tomorrow morning to meet the new consultant as he will be the one to sign us off for the placement. I wasn't planning to go in so I could stay home to revise - guess that won't be happening. Who knows, this consultant might be really nice and good at teaching, so I guess there is something to look forward to! Cross my fingers that this new consultant won't be stern/serious/intimidating. Some of the doctors on the ward knows of this consultant and they say he is quite nice. Hopefully they were being honest. Bring on tomorrow!
Saturday, October 8, 2011
Placement 3 - Week 1
Can't believe it's already my third placement. Time flies. Actually I lied...this week was pretty slow. So I'm back in the local teaching hospital so I don't have to drive like 40-50 minutes to the peripheral hospital anymore. But day 1 of my placement was probably the worst experience I have had on placement...ever. First I found out I was placed in General Surgery....AGAIN. Found out I was in colorectal surgery...joy. I mean general surgery is interesting, but I'm a bit tired of it as I want to see other specialties. First year I had 2 surgical placements both in General Surgery. First placement of this year was General Surgery. Now...general surgery...again. I feel like I know loads about the GI system...and nothing about other systems.
Met my consultant in the afternoon...and only to be told I couldn't join him in endoscopy as I was in a group of 3 and only 2 people can stay in the room. My two other partners are quite keen...and jumped on the opportunity before I even started moving my slow Canadian mouth. I was a bit bummed out as it is our first time meeting the consultant and I kinda missed out on the first meeting. But then again I got to go home early as there wasn't anything else for me to do in the hospital. Also got to suck in the last of the amazing heatwave/get some colour back into me. Got home and hoped that the next day will be MUCH better as I felt like I accomplished nothing. Also felt that the nurses and doctors weren't as nice as the ones in the peripheral hospitals. Everyone seemed busy and us medical students just blended into the background/environment. It was a weird feeling. It was a bit unsettling. Kind of like: this is reality. I must've had too high of expectations as I did have a great time in the peripheral hospital as I got loads of teaching and everyone was so friendly (and the hospital wasn't as busy). It finally struck - us medical students are no one. We are of no importance as there are more important things for doctors and nurses to care about. It is a big hospital and it is very very busy. Depressing start to be honest.
Tuesday - I was determined to make my placement better as I will be on this placement for 4 weeks. I have a strong interest in Orthopaedics so I decided to go to theatre with my friend who is placed in Orthopaedics. Went in really early and I was quite content. I definitely felt less anxious and tense about the placement. I started to relax and was enjoying being in theatre. We were quizzed on the ankle and I knew how to answer the question as I know my MSK anatomy quite well. I got a sudden boost of confidence and my day was looking to be a good day. In the afternoon I went to meet my consultant to go to a really busy clinic...I think we had about 20+ patients. It was also my first time properly meeting my consultant. Managed to see a lot of PRs and unfortunately a lot of patients who have/had colorectal cancer. It seems like the surgery for colorectal cancer is quite effective especially if the cancer is a T1 cancer (early cancer). Also learned about the different surgical procedures for colorectal cancer such as the TAEMS procedure which is apparently quite new and the major surgery which is an anterior resection. After 4 hours...and getting the impression that our consultant doesn't particularly find his job that interesting...my partner and I finally got dismissed from clinic as our consultant noticed that we were quite bored and it was also getting late. I mean my consultant seems like a really great guy. Very chill and relaxed and doesn't really care about us. Not caring about us is sometimes good...sometimes bad. He does teach a bit, but he wouldn't breathe down your neck about going to placement from 7:30am to 5pm (I do have friends who are forced to go in every day 7:30am to 5pm).
Took a day-off on Wednesday as my other 2 partner wanted to go to theatre. Thursday...can't really remember what I did....hmmm. What did I do on Thursday?! I know I went in...so I assume I was on the wards talking to patients...I guess Thursday is my new mystery. Old age...can't even remember what I did 2 days ago. Friday....first time I went in for ward round, which was at 7:30am. I think a little bit of me died when I woke up at 6:00am to get ready. It was pitch black outside. Got to the ward to meet up with the team and was trying to stay awake. My consultant came in...did probably the fastest ward round I have experienced. It took less than an hour. Met the new registrar and he did some teaching with us and watched us do patient histories and abdominal examinations. Examined a patient with an incisional hernia. It was really interesting and I really enjoyed the teaching. It was a nice change. So I guess I ended the week on a high note. Oh and I think my consultant has came to a conclusion I'm a lazy bugger. Apparently he was on ward rounds which I didn't go to on Wednesday morning. Maybe that's why I got a surprised look from him on Friday morning. Anyways bring on a really busy next week.
Met my consultant in the afternoon...and only to be told I couldn't join him in endoscopy as I was in a group of 3 and only 2 people can stay in the room. My two other partners are quite keen...and jumped on the opportunity before I even started moving my slow Canadian mouth. I was a bit bummed out as it is our first time meeting the consultant and I kinda missed out on the first meeting. But then again I got to go home early as there wasn't anything else for me to do in the hospital. Also got to suck in the last of the amazing heatwave/get some colour back into me. Got home and hoped that the next day will be MUCH better as I felt like I accomplished nothing. Also felt that the nurses and doctors weren't as nice as the ones in the peripheral hospitals. Everyone seemed busy and us medical students just blended into the background/environment. It was a weird feeling. It was a bit unsettling. Kind of like: this is reality. I must've had too high of expectations as I did have a great time in the peripheral hospital as I got loads of teaching and everyone was so friendly (and the hospital wasn't as busy). It finally struck - us medical students are no one. We are of no importance as there are more important things for doctors and nurses to care about. It is a big hospital and it is very very busy. Depressing start to be honest.
Tuesday - I was determined to make my placement better as I will be on this placement for 4 weeks. I have a strong interest in Orthopaedics so I decided to go to theatre with my friend who is placed in Orthopaedics. Went in really early and I was quite content. I definitely felt less anxious and tense about the placement. I started to relax and was enjoying being in theatre. We were quizzed on the ankle and I knew how to answer the question as I know my MSK anatomy quite well. I got a sudden boost of confidence and my day was looking to be a good day. In the afternoon I went to meet my consultant to go to a really busy clinic...I think we had about 20+ patients. It was also my first time properly meeting my consultant. Managed to see a lot of PRs and unfortunately a lot of patients who have/had colorectal cancer. It seems like the surgery for colorectal cancer is quite effective especially if the cancer is a T1 cancer (early cancer). Also learned about the different surgical procedures for colorectal cancer such as the TAEMS procedure which is apparently quite new and the major surgery which is an anterior resection. After 4 hours...and getting the impression that our consultant doesn't particularly find his job that interesting...my partner and I finally got dismissed from clinic as our consultant noticed that we were quite bored and it was also getting late. I mean my consultant seems like a really great guy. Very chill and relaxed and doesn't really care about us. Not caring about us is sometimes good...sometimes bad. He does teach a bit, but he wouldn't breathe down your neck about going to placement from 7:30am to 5pm (I do have friends who are forced to go in every day 7:30am to 5pm).
Took a day-off on Wednesday as my other 2 partner wanted to go to theatre. Thursday...can't really remember what I did....hmmm. What did I do on Thursday?! I know I went in...so I assume I was on the wards talking to patients...I guess Thursday is my new mystery. Old age...can't even remember what I did 2 days ago. Friday....first time I went in for ward round, which was at 7:30am. I think a little bit of me died when I woke up at 6:00am to get ready. It was pitch black outside. Got to the ward to meet up with the team and was trying to stay awake. My consultant came in...did probably the fastest ward round I have experienced. It took less than an hour. Met the new registrar and he did some teaching with us and watched us do patient histories and abdominal examinations. Examined a patient with an incisional hernia. It was really interesting and I really enjoyed the teaching. It was a nice change. So I guess I ended the week on a high note. Oh and I think my consultant has came to a conclusion I'm a lazy bugger. Apparently he was on ward rounds which I didn't go to on Wednesday morning. Maybe that's why I got a surprised look from him on Friday morning. Anyways bring on a really busy next week.
Thursday, September 29, 2011
End of Placement 2.
...where did my 3 weeks go?!
Seriously. These last 3 weeks actually blew by. Crazy. Couldn't believe that today was my last day on my placement in the peripheral hospital. Next week I will be back in the local teaching hospitals so I guess YAY no more 45-50 minute drives! Thinking back - I quite enjoyed my placement in the peripheral hospital. There were only 20 medical students at the hospital so the doctors were all really keen to teach and the staff were all very friendly. If only the hospital wasn't so far away. I've been hearing stories how the local teaching hospitals are absolutely packed with students; hence, patients are pretty annoyed with us and the consultants don't have time to teach.
Anyways this week has been really good. Did the standard ward rounds and finished up my first essay assignment that I handed in today. Got loads of teaching from Dr Y so that was really good. Saw some pretty interesting physical signs this week. Saw really marked dyskinesia in a patient with Parkinsons Disease. Today we saw a really interesting case. Patient presented to hospital with left sided weakness as well as facial weakness. This patient had a previous history of stroke. On examination, it was found that the patient had heminiopia and reduced corneal reflex in both eyes. Patient could not show her teeth/smile and could not open her mouth very wide. Arms and legs were not that weak. Both limbs seemed fairly normal and there were no changes in sensation except in the face. So what do you think she has?
Well she was just admitted so investigations have to be done, but it is suspected that she has bilateral facial palsy which is apparently quite difficult to make out. In general her face was emotionless which lead us to think that she may have bilateral facial palsy, and both corneal reflexes were reduced. The team didn't think this is a stroke but probably a pathology in the brain.
I personally thought this case was quite fascinating. It was different and it definitely makes you think. Thought I would share this case with you all.
Found out my next placement will be in General Surgery..........................AGAIN. General Surgery is great, but I have had enough. I'm so sick of it. I've done general surgery in my 2 weeks of placements in first year and then general surgery for my first placement this year. I want to see something else NOT GI related...PLEASE. I'm really interested in surgery and it's just so frustrating to be constantly placed in the same specialty. I really want to see the other surgical specialties and it's annoying how the medical school doesn't take into consideration your previous placements and what specialties you have been on. Pretty sure the school will come up with something like "Life isn't fair." But come on.
But yeah all in all - great placement out in a peripheral hospital. Definitely the complete opposite to my initial impression and have learned not to listen to other students as these students said that the hospital I was just placed in was hostile and unfriendly. Complete opposite and my experience has been fantastic. Really enjoyed it and have learned so much. Hopefully this continues in my next placement.
Seriously. These last 3 weeks actually blew by. Crazy. Couldn't believe that today was my last day on my placement in the peripheral hospital. Next week I will be back in the local teaching hospitals so I guess YAY no more 45-50 minute drives! Thinking back - I quite enjoyed my placement in the peripheral hospital. There were only 20 medical students at the hospital so the doctors were all really keen to teach and the staff were all very friendly. If only the hospital wasn't so far away. I've been hearing stories how the local teaching hospitals are absolutely packed with students; hence, patients are pretty annoyed with us and the consultants don't have time to teach.
Anyways this week has been really good. Did the standard ward rounds and finished up my first essay assignment that I handed in today. Got loads of teaching from Dr Y so that was really good. Saw some pretty interesting physical signs this week. Saw really marked dyskinesia in a patient with Parkinsons Disease. Today we saw a really interesting case. Patient presented to hospital with left sided weakness as well as facial weakness. This patient had a previous history of stroke. On examination, it was found that the patient had heminiopia and reduced corneal reflex in both eyes. Patient could not show her teeth/smile and could not open her mouth very wide. Arms and legs were not that weak. Both limbs seemed fairly normal and there were no changes in sensation except in the face. So what do you think she has?
Well she was just admitted so investigations have to be done, but it is suspected that she has bilateral facial palsy which is apparently quite difficult to make out. In general her face was emotionless which lead us to think that she may have bilateral facial palsy, and both corneal reflexes were reduced. The team didn't think this is a stroke but probably a pathology in the brain.
I personally thought this case was quite fascinating. It was different and it definitely makes you think. Thought I would share this case with you all.
Found out my next placement will be in General Surgery..........................AGAIN. General Surgery is great, but I have had enough. I'm so sick of it. I've done general surgery in my 2 weeks of placements in first year and then general surgery for my first placement this year. I want to see something else NOT GI related...PLEASE. I'm really interested in surgery and it's just so frustrating to be constantly placed in the same specialty. I really want to see the other surgical specialties and it's annoying how the medical school doesn't take into consideration your previous placements and what specialties you have been on. Pretty sure the school will come up with something like "Life isn't fair." But come on.
But yeah all in all - great placement out in a peripheral hospital. Definitely the complete opposite to my initial impression and have learned not to listen to other students as these students said that the hospital I was just placed in was hostile and unfriendly. Complete opposite and my experience has been fantastic. Really enjoyed it and have learned so much. Hopefully this continues in my next placement.
Saturday, September 24, 2011
Placement 2 - End of Week 2
Holy smokes what a crazy week. To be honest though there isn't much to talk about placement as I only went in 3 out of the 5 days. Well actually more like 2/5. On Monday I had my clinical skills assessment so I spent the whole day pooping myself and practising before my assessment. I was so nervous it was kind of ridiculous. I was nervous because I felt that I haven't had enough practice yet and there's just so much to think about whilst doing a clinical skill.
So it was finally my turn to do the assessment and thank goodness the assessors were REALLY nice. It was really informal and they told me that they don't expect me to be a pro at it and will guide me through each skill. Essentially I was tested on hand washing (easy), vital signs (BP, temperature, pulse, SpO2), venepuncture, cannulation, drug mixing, and finally setting up an IV drug. I didn't mind doing any of those EXCEPT for drug mixing and setting up an IV. I haven't done either of those skills since last year and I didn't get a chance to practice either of those skills prior to my assessment. I nearly started sweating bullets while doing those two skills but thankfully everything came back to me and I managed to pass all my clinical skills. That means I can officially do all of these clinical skills on real patients in the hospital as long as I am supervised.
Tuesday - standard - ward round and clinic. Clinic was really interesting. Saw 2 patients which some interesting case histories. Ward round...was a pain. Dr B was doing ward rounds which meant another grilling session. Also what I have realized is that he is PAINFULLY slow at doing ward rounds. Dr Y takes 3 hours to do a ward round....Dr B takes 4.5 hours and has the same amount of patients to go through. Anyways while Dr B was finishing writing notes in the patient's notes, my partner and I talked about the patient and the physical signs that we saw. Out of no where, Dr B turns around and snaps at us. He told us off for talking and said that if we keep getting distracted/aren't interested we can go to the library and do something else. My partner and I were like "....what?" We were confused because we were talking about the patient and what we saw, so we weren't distracted and obviously we are interested; hence why we were talking about the patient. Obviously Dr B was a bit grumpy today. The way he snapped at us really bugged us as it was uncalled for. So my partner and I had two choices: a) Piss him off more and just leave and go follow Dr Y or b) Bombard Dr B with loads of questions to show him we are interested and obviously to annoy him as much as possible. We chose to go with plan B and cue the waterfall of questions. We literally asked him about EVERYTHING. We looked at a patient's drug chart and asked Dr B about why he would prescribe these medications and why not alternatives. We started asking about the mechanisms of different drugs. I'm pretty sure Dr B got the idea that my partner and I were doing this on purpose and Dr B blazed through the rest of ward round. I guess that's one way of getting things done fast.
Wednesday - I didn't go to placement as I was helping out at the Medic's Fresher's Fair, which was quite tiring. Started setting up quite early and then had to wait for the fair to finish as I also have to help put away stuff. It was really nice meeting the new medics. Then I had an age crisis as some of these freshers look really young. I mean I saw some who barely even look 16 years old! It was crazy. We also got to showcase the Fresher's Video that we made. It turned out quite well and I think (hope) that the freshers enjoyed it.
Thursday was the usual, BUT Thursday night was the night of Medic's Fresher's Fever! I was really excited for it as there was going to be a hot tub and sand at the venue. In the end - I must say this was the best Fresher's Fever I have experienced. It had a really good vibe and for once all the Fresher's stayed til the end! The last two Fresher Fevers I went to, people left 2 hours into the party and essentially used the event as a pre-drink before going to another club. This time - people stayed all the way until the venue closed. I was so glad I got Friday off as there was no way I would've been able to go to placement. I got to get Friday off as there was another freshers event that I had to help out at: Buddy Scheme. That didn't start until 3pm....and I thought I would definitely be able to wake up for that. I ended up waking up at like 2:15pm and was literally running around my flat trying to get ready to get my butt out of the door. But yeah this week has been quite interesting. Highlight of the week must be Fresher's Fever. Yeah yeah I know I'm getting too old for it, but seriously it was amazing. Definitely a memorable night.
So it was finally my turn to do the assessment and thank goodness the assessors were REALLY nice. It was really informal and they told me that they don't expect me to be a pro at it and will guide me through each skill. Essentially I was tested on hand washing (easy), vital signs (BP, temperature, pulse, SpO2), venepuncture, cannulation, drug mixing, and finally setting up an IV drug. I didn't mind doing any of those EXCEPT for drug mixing and setting up an IV. I haven't done either of those skills since last year and I didn't get a chance to practice either of those skills prior to my assessment. I nearly started sweating bullets while doing those two skills but thankfully everything came back to me and I managed to pass all my clinical skills. That means I can officially do all of these clinical skills on real patients in the hospital as long as I am supervised.
Tuesday - standard - ward round and clinic. Clinic was really interesting. Saw 2 patients which some interesting case histories. Ward round...was a pain. Dr B was doing ward rounds which meant another grilling session. Also what I have realized is that he is PAINFULLY slow at doing ward rounds. Dr Y takes 3 hours to do a ward round....Dr B takes 4.5 hours and has the same amount of patients to go through. Anyways while Dr B was finishing writing notes in the patient's notes, my partner and I talked about the patient and the physical signs that we saw. Out of no where, Dr B turns around and snaps at us. He told us off for talking and said that if we keep getting distracted/aren't interested we can go to the library and do something else. My partner and I were like "....what?" We were confused because we were talking about the patient and what we saw, so we weren't distracted and obviously we are interested; hence why we were talking about the patient. Obviously Dr B was a bit grumpy today. The way he snapped at us really bugged us as it was uncalled for. So my partner and I had two choices: a) Piss him off more and just leave and go follow Dr Y or b) Bombard Dr B with loads of questions to show him we are interested and obviously to annoy him as much as possible. We chose to go with plan B and cue the waterfall of questions. We literally asked him about EVERYTHING. We looked at a patient's drug chart and asked Dr B about why he would prescribe these medications and why not alternatives. We started asking about the mechanisms of different drugs. I'm pretty sure Dr B got the idea that my partner and I were doing this on purpose and Dr B blazed through the rest of ward round. I guess that's one way of getting things done fast.
Wednesday - I didn't go to placement as I was helping out at the Medic's Fresher's Fair, which was quite tiring. Started setting up quite early and then had to wait for the fair to finish as I also have to help put away stuff. It was really nice meeting the new medics. Then I had an age crisis as some of these freshers look really young. I mean I saw some who barely even look 16 years old! It was crazy. We also got to showcase the Fresher's Video that we made. It turned out quite well and I think (hope) that the freshers enjoyed it.
Thursday was the usual, BUT Thursday night was the night of Medic's Fresher's Fever! I was really excited for it as there was going to be a hot tub and sand at the venue. In the end - I must say this was the best Fresher's Fever I have experienced. It had a really good vibe and for once all the Fresher's stayed til the end! The last two Fresher Fevers I went to, people left 2 hours into the party and essentially used the event as a pre-drink before going to another club. This time - people stayed all the way until the venue closed. I was so glad I got Friday off as there was no way I would've been able to go to placement. I got to get Friday off as there was another freshers event that I had to help out at: Buddy Scheme. That didn't start until 3pm....and I thought I would definitely be able to wake up for that. I ended up waking up at like 2:15pm and was literally running around my flat trying to get ready to get my butt out of the door. But yeah this week has been quite interesting. Highlight of the week must be Fresher's Fever. Yeah yeah I know I'm getting too old for it, but seriously it was amazing. Definitely a memorable night.
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