Still Alive! Happy New Year!

Wow these last 2 months have been a whirlwind hence I haven't had time to make a post (apologies!). Essentially just wanted to check-in and wish everyone a Happy New Year. 2013 for me has been a whistle-stop tour. I've made many accomplishments and is certainly another memorable year. Some highlights:

• Presenting a poster at a national conference
• Meeting new people
• Going back home for my elective 
• Commencing another research project (fairly large one too)!
• Applying for my first proper job!
• Learning more skills (medical and surgical)
• Being happy :)

This year had blown by and it has essentially been a year where I had to gain even more confidence especially knowing next year, I will be given responsibilities (no more fooling around!). This second half of the year was just hectic. The minute I came back from elective, it was just non-stop meeting deadlines and never-ending work. Even now I'm supposed to be busy as I've got my first set of final exams in a few days (cruel). I despise revising through the holidays...it's very depressing. 

Anyways better get back to revising. I'll hopefully get some free time soon and be able to write an entry about the job application process and what that was like. 

Wishing you all a Happy New Year. I know for sure it'll be a big and very important year for me. Bring on 2014!

A Mask.

This isn't a new revelation, but one that has occurred to me more during my GP placement.

I have come to realize that doctors need to put on a mask most of the time as patients come to doctors for various kinds of problems. No matter how annoyed you are about a patient or how fed up you are with your clinic, you cannot let it show. There are tons of patients out there who visit the GP 2-4x a month and I'm sure as the GP you can get frustrated/annoyed with the patient especially when they are coming in for insignificant things.  It is definitely difficult as patients expect the doctor to be professional and empathetic, but it is extremely difficult to show this when the patient themselves aren't coming in with the right intentions. I have sat in clinics where the patient is very rude and overly demanding. And as a doctor, you can't do anything about their rudeness, other than still treat them respectfully and try your best to listen. Definitely need a high tolerance level when dealing with "troublesome" patients. On the contrary, there are certainly very nice patients (usually tend to be the elderly). They are usually very respectful and always apologizing about wasting your time. These are the patients who are worth treating and you can't help but be a bit more empathetic, despite knowing that you're supposed to treat all patients with empathy and care.

However, masks are not just for GPs. As I have mentioned earlier, I have encountered it in my other placements. You would think surgeons wouldn't need to put on a mask as often, as they have a bit less patient contact. Unfortunately, surgeons have just as much face time with patients; however, the reasons of putting on a mask may be different. After a surgery and you have to break some bad news/complications about the surgery, you have to be able to put on a confident face and an appropriate mask. There isn't as much time for you to gather yourself after the operation. GPs or physicians in general would get results/bad news ahead of time so they will be ready and have time to think about how they will break the news. It is definitely a tough job as you don't want to show that much emotion when talking to patients especially after a tough case/surgery.

With clinics, you could enjoy the company of one of the patients and be laughing about something, but you have to be able to quickly return back to neutral before seeing your next patient. It can work the other way around as for one particular case, we were giving our condolences to a patient as her father had just passed away the day before and she was telling us about his death. Definitely an emotional/sad moment where you have to again put on a mask and empathize and comfort the patient. Easily within 2 minutes between patients, you have to regain your composure and be ready for the next patient as he or she can come in with anything. You certainly can't let things affect you and as well for doctors, you have to be good with moving on. You can't dwell on one particular case.

There has been arguments that doctors should not bring their outside emotions to work. Despite having a horrible morning, people argue that you shouldn't bring that grumpiness into the work place. I personally agree with that point as it isn't fair to your patients and your colleagues. I have met a few GPs who said that it is important to bring your emotions to work as you will seem more genuine. I don't mind bringing in a good mood to work, but I certainly wouldn't want to bring in grumpiness to the work place as you can easily affect your patients and colleagues. No one wants to see a grumpy doctor. In my eyes, I think my emotions should not affect my work, so even in that sense, you will have to put on a mask before coming to work especially when you're having a bad day. People argue as a doctor you should be genuine, but for me it is far more advantageous if I put on a mask for work and sort out my issues/problems when I go home/leave work.

What are your thoughts about putting on a mask for work or bringing your emotions to work?

Post your comments below!

Dull.

If I could describe my GP placement with one word I would use the word: "Dull". Dull might even be an understatement. I have caught myself so many times zoning out during consultations. Again my frustrations are growing as I still cannot do anything in clinic. The most I can do is maybe do manual blood pressures. I guess the only thing I can take away so far from GP is the difficulty of immigrants. My practice sees a lot of immigrants and most of these people can't speak English.  You realize that it is very difficult to get a patient history and even more difficult when you have to talk to your patient through an interpreter.

We had one patient who was from Slovakia and could not speak very much English.  It was requested that an interpreter come, but he/she did not show up so the patient attempted to tell us her problem in broken English. Unfortunately, her problem was a mental health related problem so patient history is really important and there was no way we will get what is the problem as her English was not cutting it. We resorted to using the phone interpreter. I swear those things are not user friendly.  The interpreters aren't that great and it is really awkward having a phone in between the patient and you and the phone is on speakerphone so it is quite difficult to hear what the interpreter is saying.  Even weirder is that you lose a lot of rapport with the patient as both of you are trying to talk into a phone. Very confusing stuff.  After 45+ minutes (when it should've been 10 minutes), the GP gave up. It got far too complicated and too difficult to get a proper patient history. I felt like we wasted a lot of time and it obviously makes the clinic run quite behind. We asked the patient to bring an interpreter next time and you just can't help but feel a bit annoyed that you wasted 45 minutes only to get nothing accomplished.  The next few patients weren't too pleased either as clinic got quite delayed. When one patient sees that you spend 30+ minutes with one patient, they think they have the right to have 30 minutes as well and it's hard to cut people short and to keep them on topic about their medical problem/presenting complaint.  When you're running behind, the last thing you want to hear about is what the patient did on the weekend.

I have no problems admitting that GPs are extremely patient people and their job is certainly not easy.  I just feel like I would have a lot of difficulty maintaining my composure during consultations especially when it gets quite frustrating.  I do consider myself quite patient, but I guess not patient enough for GP and probably the main reason why I'm having a difficult time enjoying this placement.  Worst bit is that I still have another 5 weeks to go. Thankfully I am only in 3 days/week so my weeks won't be too long. I'll take it that I have 15 more practice days.  That doesn't sound too bad...I guess....

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.

A New Decade, Another Chapter.

Welcome 2011. 2010 has been very memorable, but sadly went by too quickly. After some thought, I realized that entering this decade could possibly mean a new chapter in my life. I realized in a few months I will be completing my second year of medicine and with a bit of luck and good studying I will be entering into my third year or essentially entering into my clinical years of medicine! To me, this seems to be a huge step and from what I have heard, when entering your clinical years it will probably be the first proper time where you get the slap in the face that you will be a doctor. Just thinking about it makes me nervous and excited.

This also means that my medical sciences portion of my course will be coming to a close meaning I've learned about the basics/general idea of almost everything in the body. Quite daunting. To be honest, judging how fast 2010 went by, I have a feeling my medical school years will be going by quite quickly. Just the other day I was thinking about the 2010 Winter Olympics and how much I enjoyed watching the Canada vs. USA ice hockey gold medal game. Then it occurred to me that the next time I'll be watching an Olympic ice hockey game (IF I have time) will be months before graduating from medical school in 2014. Crazy crazy crazy. This next decade of 2011-2020 I can guarantee will be a decade of highs and lows, firsts and lasts, challenges and accomplishments. When this decade comes to a close at 2020 HOPEFULLY I will be specializing in what I enjoy in a place I enjoy. A lot will be happening in this decade and hopefully I will be able to accomplish my goals and dreams. There will be a lot of transition and change: from medical student, to a junior doctor, to picking my specialty and so on. That's a lot of transitioning/change in one decade and I'm pretty sure it'll be a decade to remember.

Cheers to a new year and of course a new decade of new challenges, accomplishments, and happiness.