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.

End of Week 3.

Sorry for the late update. Literally left for Canada the day after the end of my first placement, so I haven't had time to update.

Anyways. This was my final week on my first placement. I realized that the patient I was originally going to use for my SSC project/essay does not fit the criteria for the essay. Therefore, I was out hunting for another SSC patient. Decided to take a stroll to the Coronary Care Unit to see if there are any straight forward patients. We met a patient who was quite talkative and in general well enough to talk to us. He had an MI and was waiting for a bypass surgery. This time I made sure we got every single bit of info we need for this essay and all in all it was a really straight forward patient history. Did cardio, respiratory, and abdominal physical examinations. The patient was really friendly and actually didn't want us to leave because he was so bored. Kinda feel bad for some of the patients as they really do look like they are bored out of their mind. Some of them don't even get patients so you really do sympathize.

Actually before we went SSC patient hunting (on Monday) we went to theatre to look for our consultant. We literally stood there for 1.5 hour as our consultant was late and we didn't want to risk missing him so we turned up quite early. Finally caught our consultant racing through the corridor and asked to meet him on Wednesday so we could get our proformas signed off. I swear those 1.5 hours were horrendous as nurses kept asking if we were alright and if we needed anything. Swear we nearly blended into the background.

So come Wednesday, our consultant had clinic so we went to meet him at his clinic...only to find out he isn't there yet and will be an hour late. Great. I decided to talk to the SHO and nurses about bariatric surgery as I was thinking of writing up about it for my 2nd SSC essay on ethics and law. Had a really really good conversation going and I learned quite a lot. It's all down to personal opinion and it is definitely an interesting topic. So an hour later, consultant turns up...only to be in a bad-ish mood and completely ignored my partner and I. We waited til the end of his clinic to talk to him. So we gave him our proformas for him to assess how we did in placement. He took our sheets, quickly glimpse and it, and just circled "Satisfactory" for each section. My partner and I were panicking and our consultant returned the sheets to us without leaving feedback. In general it is expected for us to get an overall mark of "Good" in placement or else the medical school may think we didn't show up to placement. So out of desperation we asked if we can show him what we have been doing on placement as he hasn't watched us therefore couldn't really mark us properly. We were hoping after showing him our work he would raise our grade. He told us to meet him in between surgery on Thursday at 12:30pm.

We get there at 12pm...he apparently finished his first surgery early and had an early lunch break so he could get on with his second surgery. So we stood in for one of his surgeries which was expected to be only 2 hours. Not bad right? Wrong...midway through surgery we had a complication and the surgery ended up taking 4.5 hours. My legs were not happy with me. I think at one point I lost feeling in my quads. After surgery, our consultant was obviously annoyed, but still managed to meet us. We gave him a new proforma and he was like "Didn't I sign something like this yesterday?". We pretty much told him it's a different sheet and it requires written feedback. Somehow he fell for it and before marking us we showed him all our patient histories we took over the 3 weeks. Despite all the effort...he still gave us "Satisfactory" but in the feedback he put down that it was difficult to mark us and was sure we were "good/excellent" students but he didn't get the opportunity to watch us in the wards. At least we got some sort of reason. But to be honest, we now understand why he gave us a "Satisfactory".

So on Friday, we actually had nothing to do and it was our last day. Went in at like 10pm and my partner and I decided to get assessed on our history and examination skills. I think I did alright in it, but was told that my smiling was unprofessional. Still confused about it because if I was a patient I wouldn't want to be greeted by a doctor looking like he/she doesn't give a crap and is in a bad mood. Anyways everyone has their own opinions but it was one feedback point that I will keep in the back of my mind but definitely won't change the way I greet patients. It's not like I excessively smile and laugh/be inappropriate with my facial expression. Just want to treat the patients like a person. It was a weird one to get my head around, and still kinda bothers me. Oh well. After the assessment, we managed to leave at like 12pm and returned our lockers and bleeps. Only if I could relax the minute I got home. It was more like "need to pack. need to pack. need to pack." I don't think I sat down at all for the rest of the day as I was running all over the place trying to get things done and running some final errands before I left.

All in all my first placement as a student doctor has been enjoyable and I definitely learned loads. When I return to placements at the end of September, I will be able to take bloods and do injections/perform invasive procedures, so I'm really looking forward to that. Shame I have 2 weeks of 9-5 lectures prior to my 2nd placements. Yuck.

But finally a week into holiday I've had my chance to sleep in and relax. Now getting to writing up my first SSC essay. The brain hardly wants to work though.

Anyways sorry again for the late update. Hope everyone is enjoying their holiday! Freshers week is getting closer! :D

5 Weeks.

Well okay not exactly 5 weeks but close enough. Anyone care to take a guess 5 weeks until what?

If you said exams...you are CORRECT! It has come to that time of the year that every medical student dreads - EXAMS. Well for my university...not sure about others...passing the year 100% relies on 3 exam papers which are done 3 days in a row. Stressful much?! I dread it so much. It can easily be the 3 worst days in my life. No matter how much you study you will not know everything on the paper. Unlike back in school - you study...you go to the exam...you know everything - easy. Medicine? Study like no end...think you've covered everything...get to exam day and first page of the exam - BAM - you have no bleeping clue about the question. It is BOUND to happen. Now as a 2nd year medical student we have to also know last year's material so technically we will be examined on 2 years worth of knowledge. Not like one year isn't hard enough eh?

I have started studying since end of February...now I am about 3/4 way through the material. Now thinking back...I don't think I remember really anything from what I studied in February (which was all of last year's material). Great. Oh and NEVER look at a specimen paper in the middle of revision just because you got curious or whatever. With no doubt you will most likely scare the crap out of yourself as you'll see questions in there that you have no clue about and then cue panic attack/major stress. I made that mistake a few days ago...and I nearly cracked, but I haven't actually studied the section that the question was aimed for, but still - it was not a pleasant feeling.

The only nice thing about only having 3 papers is that we can get it all done with in 3 days. Nice and short - just extremely torturous. At least now having already taken an exam last year, I know now what to expect in this year's exam and will be more prepared. Last year, I had absolutely no clue what the exam would be like. Armed with experience I think I am a bit more confident this year than I was last year. One major difference is that I started studying MUCH earlier than I did last year so I won't be rushing through revision and causing unnecessary stress.

5 weeks...jeez. I'm really scared. Haha. Instead of losing an hour sleep can we possibly increase the days to about 30 hours just until exam time? It would be very useful. Oh and to make matters worse, the SSC attachment I have been talking about...well my final report (2500 words) is due in a few days. Great...time to wave goodbye to good quality sleep and hello long hours of studying through the night!