Walls Closing In.

Yes this is another s*** hitting the fan post.

1 report on screening programs.
1 audit report.
1 audit poster.
1 audit abstract.

The beauty of finding out that instead of having 2 full three-day weekends to work on all these things....you actually have 3 full free days to work.

16 days left until deadline.

Calling for lots of coffee. A lot of creative power. And very little sleep. I refuse to let GP be the one placement that becomes the hurdle of my medical degree.

I knew I was going to regret bumming around. Grrrr.

Help!

Progress.

I was watching Junior Doctors earlier on and listened to the FY1 doctors saying how they feel more like a real doctor as they have responsibilities and they get to do procedures. I sat on my couch thinking about my last placement on paediatrics. Thinking about it...comparing to my placements just only half a year ago when I first stepped onto the wards as a student doctor, I have seen myself progress. My last placement in paediatrics, I was clerking in patients and presenting the patient history and examination findings to senior doctors. I am probably one of the first "medical" person on the ward to properly sit down and ask them about what has brought them to hospital. I get the honour of seeing these patients prior to the doctors on the ward. While on my placement, I guess I didn't really appreciate this properly as I just took on the responsibility to clerk the patients in, but never realized that I could be one of the first people to see the patient on the ward. I also have to make sure my patient histories are accurate and that my examination is accurate as when I present the history to a senior doctor, it is now expected for me to have a differential diagnosis, possible investigations, and management. Only half a year ago, I was stepping on the consultant's heels going around on ward rounds and just watching. I didn't really get to do very much. If there is something interesting on physical examination that the consultant sees/hears, then he/she would let us take a look/listen. Now...I am the one telling the senior doctor about hearing something and I have to be confident about it. It is actually quite frightening. There were times where I heard crackles at the base of the chest, but I would sometimes doubt myself as they are fairly faint crackles. However, when I present the patient to a senior doctor I have to be sure about these crackles and now I get to write into the patient's notes about any examination findings. It's pretty crazy how much I have progressed from half a year ago.

Also 2 weeks ago the first year medical students got their quick taster of hospital placements and for once I wasn't the most newbie medical student around. There were people more "new"/fresh than me. It was a weird feeling. Then you start noticing that they really don't have a clue how to take patient histories.  And then you think to yourself...about 2 years ago...I was just as clueless. It's weird thinking how much you learn in such a short period of time. Now the structure of patient histories come naturally and you don't really have to think about it. You just ask the questions and go with the flow. I still remember in first year constantly trying to remember what questions to ask...what is important to ask...what the structure is to take a patient history. In first year before I saw a patient, I always wrote on my paper:

PC (presenting complaint)

HPC (history of presenting complaint)

PMH (past medical history)

DH (drug history) - ALLERGIES?

SH (social history)

FMH (family medical history)

This structure is now engraved into my head...and it's only been 2 years! I also taught these freshers how to take a pain history. It's weird that they don't know SOCRATES. SOCRATES is my saving grace. You can never go wrong with it!

Site (where is the pain exactly?)

Onset (when did the pain first come on?)

Character (what does the pain feel like? can you describe it to me?)

Radiation (does this pain go elsewhere?)

Associations (are there any other symptoms that you noticed?)

Timing (does this pain come on at certain times? does it come and go? is it constant?)

Exacerbating/Alleviation (what makes the pain better? what makes it worse?)

Severity (on a scale from 1 to 10 - 1 being not very painful and 10 being the worst pain you have ever felt, what score would you give your pain?)

I found it very confusing to actually see these medical students taking me seriously and genuinely absorbing what I was saying. I'm not much older than them...one of my students was actually older than me! Also when I walked by a few of the first year students and quickly said "Hi!" to them as I walked by, I heard them whispering: "Whoa an older medical student said hi!" I still remembered when an older medical student said "Hi" to me while I was in the hospital...I felt quite happy as I felt like I was noticed and not ignored....more like I actually existed!

Crazy how 2 years make such a big difference, yet thinking about it...it hasn't been too long ago. Speaking of which...this month actually marked the halfway point of my career! Halfway to being a doctor! Scary!

Close Call.

If you have read my previous post on exams...you would have noticed that this exam was very difficult and I was fairly convinced I had failed. From last day of exams to results...I had 7 days to ponder and scare myself/reassure myself. Easily the most anxious 7 days of my life. First day post exam - I swear I was brain dead. I couldn't do anything properly. At the same time - I was in a bit of a depressed state of mind. Also found it very difficult to sleep. Mind you, I'm not the type that worries about stuff. I literally am a happy-go-lucky/care-free person. I rarely worry about things.  Thank goodness I got to go to London for the weekend to watch a concert, which allowed me to get my mind off of exams and just to relax.

Results day - woke up at 8am...pretty much tossed around in bed for the next 4 hours as results aren't released until 2pm. Worst bit is that I have to go to the medical school to go see my results as for no reason the school does not post them online.

"Results are out...it ain't pretty." - the text message I received from my friend at 2:10pm. When I read the message, I felt my heart drop. As I got closer to the medical school, I could feel my heart racing. I then saw classmates standing outside the school. Some crying. Some cheering. Some looked in shock. I really didn't know what to expect. The short walk from the entrance to the notice board where our results are posted was probably the longest walk ever. Next comes the difficult bit. Finding your student number in a list of 280 other numbers. "Should I check the fail list first? Or just try to find my number in the pass list?" My gut went with looking through the pass list first. Thank goodness our numbers are in numerical order this year. Page after page....I finally found my number. I passed my exam! Then curiosity won me over and I took a look at the fail list. I was in shock. The phase director had failed 20% of the year (50+ students). Wow. She actually kept her word about it. I was disgusted by the number of students she had decided to fail. Ridiculous. As time passed, more of my friends came in to check their results as word had spread about results being out. One by one I saw students come through. Saw a couple people crying as they had failed their exams. Thinking about it - we were all top of the class students. Failure...is probably something we have never really experienced before, so for those who failed their medical exams it probably came as a shock. By the way - usually only 10-15 people fail their exams. In our last two years, my year had set the highest passing rate. The academic department was proud of our year. In 6 months, we went from the highest passing rate, to the highest failing rate. Obviously there is something wrong with the exam and not us.

Unfortunately a few of my close friends had failed their exams. I know a few people getting kicked out from the course from failing more than 3 times in the course. A couple of people had failed and had such a bad experience from these last 6 months, will be quitting medicine. It's really a shame that one phase director can put so many people off from medicine and possibly even change the future of so many students.  Lots of students had lost a lot of confidence because of these exams. These exams disgust me especially knowing the school had screwed up badly with these exams. Pass mark for our exams are usually at around 47-50%. This year our pass mark was around 40%. OBVIOUSLY something wrong with the exam if your pass mark is that low. I surely hope the school does something to resolve this as I think this is unacceptable. Yes I am angry at the school. Yes I am annoyed. Yes I know I passed, but knowing the pass mark was that low - I feel like I didn't pass my exam as it was not a fair exam and not a fair way to examine the knowledge I had gained in the last 6 months.

What I had experienced from these exams, I am a bit hesitant on even recommending the school to prospective students. It's really a shame how poorly this has been handled. Hopefully the school will regain my confidence in them in the new year.