The Grind.

Clinic here. Clinic there. What a brutal week. I don't mind clinics...but I do mind them when I have 2 clinics per day from 9-5pm. I have now grown to fear Antenatal Clinics. It is essentially an overbooked clinic where you talk to high risk pregnant ladies and just following up on their pregnancy. It's nice as you spend about 10-15 minutes with each lady; however, after 5 pregnant women...it gets very boring.

Not only did I have Antenatal Clinics, but I also had to attend Gynae Clinics, which I admit are a bit more exciting/interesting. Gynae Clinic is where patients come in with problems downstairs. This could include menorrhagia, dymenorrhoea, discharge, etc. Because I was with my supervisor, Mr R, I was able to carry out a few examinations and after being taught how to use a Cusco Speculum in theatre, I was finally able to try it out on a patient who is awake. I gotta admit...I was extremely nervous as I obviously don't want to cause any pain and the Cusco can easily cause pain. I managed to find the cervix in the first go and I felt a sense of pride come over me and Mr R was complimenting on my technique. It definitely filled me with confidence and to be honest...inserting the Cusco wasn't that difficult. I don't know why I was pissing my pants about it. I also really appreciate patients being so tolerant with students. I mean if I needed to get my downstairs checked up...the last thing I want in clinic with me is a medical student...and no way the student will be going near my bits. I mean these patients who allow us to practice our skills really need to be more appreciated. It's one thing to practice on a plastic mannequin but being able to practice on a real patient is a whole new ball game and it really helps build confidence. It also helps when your supervisor is keen to allow you to practice skills and perform examinations. Overall I enjoyed my clinic with Mr R as he was also in a good mood and we finished clinic on time (RARE!). Learned loads, got to do examinations + Cusco, and had a lot of good banter and many good laughs.

Unfortunately, I cannot say that I had as much fun with the rest of my clinics. Note to self: READ UP before attending special interest clinics. I literally got wiped all over the floor by another consultant when I went to Colposcopy and Gestational Diabetes Clinic on Tuesday. Because I had an evening meeting, I did not have time to read up on the clinic and I wrongly assumed that the consultant I was going to have wouldn't quiz me like Mr R does. To my demise...this consultant LOVES quizzing and I got my butt kicked. It was so embarrassing. I have never felt so dumb either. I kept blanking out and my heart was racing with every question. Worst bit is that I know the answers to the questions...or more like I SHOULD know the answers but I couldn't spit it out as I had not done any revision. Definitely taught me a good lesson and ever since Tuesday I did some reading prior to clinics especially clinics with consultants I haven't met yet.

On top of all the clinics this week...hands down...I have never worked so hard on placement...ever.  I was putting in so much extra time. Usually we are expected to be in 9-5pm on a standard day.  Monday...technically didn't have to go in until 10:30am for a tutorial. I went in at 9am to take a full patient history for my case study report. Tuesday: 9am clinic...went in at 8am to get a different patient history as the patient history on Monday wasn't good enough for my case study (ended up not seeing any patients as there was a ward round going on). Then had clinic in the afternoon which did not end until 5pm. Went to the ward to see if there are any more interesting patients...didn't leave until 6pm. Wednesday: 9am start for clinic...but stayed until 6pm...when I could've went home at 3:30pm (clinic finished very early) - was chasing after some patient notes I had requested for as I forgot to copy down info. Thursday: 9am start (clinic). Gave up my lunch hour to go read up the patient notes that I had requested for. Then had teaching from 2pm-3pm. Went to clinic...which didn't end until 5:30pm. Friday: FINALLY a normal day - 9pm-5pm.

Worst bit about this case study I was chasing around for a whole week - I ended up writing up on the first patient history I took Monday morning. Most annoying bit: of ALL the patients I could've picked, I picked a patient who was under the care of my supervisor (who is also marking my essay). I didn't want to do up a report on my supervisor's patient as he would know the patient history well so I definitely have to write accurately. This unfortunate coincidence doesn't end there. I thought I could get away with this patient case study as my supervisor had no idea which patient I am writing up, but also this patient presented with a fairly common problem (urinary retention post-op total abdo hysterectomy) so it could easily be anyone. Because the patient was discharged later in the afternoon on Monday and I needed to look at the notes, I requested for the notes to return to the ward so I can read through them. They arrived on Thursday, but were delivered to my supervisor's secretary. No problem right? Wrong...the secretary shares the same office as my supervisor, but luckily my supervisor was called to cover a clinic for another consultant for a few minutes. Perfect - quickly ran to fetch the notes, except the secretary forbid me from leaving the office with the notes. I knew my supervisor had just left his office as his computer was still on (screensaver wasn't up yet), and his chair was still warm. I predicted that my supervisor would be back in 30 minutes so I quickly went through the patient notes.

Unfortunately...my supervisor returned in 10 minutes and found me lounging on his chair and working at his desk and I had moved all his stuff to the side to give myself some room to write. Doh! I quickly stood up and moved over to finish up copying out important info about the patient's operation. My supervisor got curious as why the heck was I in his office, and who's notes was I looking up. He knew I have been working on my case report...and obviously his curiosity took over and he was trying to see the patient name. I kept my hand over the patient label on each page; however, in the 2 seconds I bent over to pick up my pen, which I dropped, my cheeky supervisor took the notes and found out which patient I was writing about. I was obviously a bit annoyed as now my supervisor definitely knows who I am writing about, but now also knows what I will be writing about in my report. He promptly refreshed his memory by flipping through the notes while I stood next to him giving off a dumb face. Guess I really have to do a good job on my essay now that my supervisor knows I'm writing up about his patient and the fact he remembers the patient as well. Great. Bonus bit: my essay is due in 3 days...2 weeks earlier than everyone else. What a tiring week. Hopefully all this hard work will pay off in the end. Next week: Labour Week. Going to be VERY tiring. Long shifts. Lots of waiting around. Yikes.

Sh!t Hitting the Fan.

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

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