End of GP Placement.

Oh how much I looked forward to typing the title to this post. It could have easily been the least brain stimulating placement I have yet to have. Not only that, I couldn't go make myself useful elsewhere unlike being in the hospital. Looking back on the last 6 weeks, it was definitely a struggle and a challenge. It was mentally draining as it was just so much harder to get the motivation to work. After throwing my arms in the air when stepping out the door of the practice...I realized I have another GP placement next year. Joy. BUT, I know it'll be more useful as I'll have my own surgery and get to see my own patients. This placement literally has redefined work experience. It was 20 days, 10 hours/day of work experience.

Also in other news - crisis averted with all the deadlines as you would remember from my "Walls Closing In" post.

1 report - completed and submitted.
1 audit report - completed awaiting for submission.
1 audit poster - 90% complete.
1 audit abstract - completed and awaiting for submission.

Cannot feel any more satisfied and proud of myself managing to get everything done in time. I think it has been a long time since I was really sure I was not going to make the deadlines.  Miracles do happen. Actually it's more like: Efficient...and very late and long nights...

Oddly enough, in my final week of GP placement, I saw the most interesting case. It was a case of a man with an end-stage disease and the GP needed to start the palliative care pathway with him. This man is quite young (40 years old). Initially when I heard about his medical history, I did not know how old is he. In my mind I imagined him to be an elderly man. Surprisingly when I went to go meet the patient, he looked frail and skinny, but young. What really struck me was that he also has two very young children (ages 8 and 3). Unfortunately, the patient has not really told his children what is wrong with him. They are aware that their father is ill, but do not know the extent of his illness. With his condition, no one really knows how many more years he will live. His condition has been progressively getting worse and the GP told the patient and his wife that there would be one day where he does a nose dive and his health severely deteriorates. We discussed the various options for support and care. In my mind I knew the GP was trying to find the right moment to bring up the "Do Not Attempt to Resuscitate" (DNAR). Eventually we had to talk about it and only until you come onto the topic you then come to realize that the patient is still in denial. To be fair, he has a young family and he himself is quite young. Worst bit is that there is no cause for his condition - as what doctors like to call it: "Idiopathic". He was adamant that he wants to be resuscitated when it comes to the end of the line despite the GP fully informing him about the benefits and harm of resuscitation. As we were talking about his palliative care plan, his children were happily running outside - no clue what is going on in the room. It was definitely a very "grim" consultation. Before leaving, the GP advised the patient to find some support for his end-stage disease and to have someone help him to explain his condition to his children as they will have to know at some point. The GP was right that it is better for him to talk to his children while he is still well and still able to versus down the road he might not be well enough to explain - leaving his children a bit puzzled.

In all fairness - my experience in GP has not been the best, but the GPs who I have worked with are all really nice people and some are great at teaching. Guess it just wasn't my "cup of tea". Had a good feedback session with my supervisor though and I suggested giving students a bit more responsibilities and letting us see our own patients. Hopefully they'll take my feedback on board as I really think it'll improve the student's experience. All in all though, 7 weeks...that was painful.

Psychiatry up next...don't really know what to expect...actually I have no clue what to expect. At least it is hospital based (in a more familiar environment). I'm sure it'll be interesting seeing these sort of patients. Hopefully it'll be better than my GP placement and get back to the happy-go-lucky medical student.

The End of Another Placement.

Seriously cannot believe it has been 6 weeks. It literally blew by. I didn't think it would as I wasn't particularly busy and I had quite a few day offs as well (bank holidays, etc). My friends said that you cannot find a happier medical student on placement than me. I will admit, the placement started off quite slow...but once it got going...I truly truly truly did not want it to end. It's the first specialty where I could see myself work in as a career. Before starting, I was a bit hesitant as ever since I knew I wanted to do medicine, I wanted to do orthopaedics. I had very high hopes for it. Obviously I was very excited to start the placement, but there was a bit of doubt in the back of my mind. These 6 weeks could either make or break this specialty for me. I was actually scared that I will end up not liking orthopaedics...and actually hating it.

Luckily, orthopaedic surgery is just like how I imagined it to be. I was genuinely happy. It's the first placement where I enjoyed everything about the specialty. I enjoyed the surgeries. I enjoyed being on the ward (which was minimal to be fair). And I can't believe I am saying this but I enjoyed clinic. Everything clicked for me. I never struggled waking up to go to this placement. I had 8am meetings to go to (where I had to wake up at 6am) and I never struggled. If this was any other specialty and was told to go to an 8am meeting...I can guarantee you I would struggle and would probably turn up late or maybe even miss it. I was actually motivated to work hard in this placement. I didn't work hard because my supervisor was strict/I was scared of him...I actually worked hard because I enjoyed the specialty. I felt no pressure to work hard...actually my supervisor kept telling me to take it easy and made it very free. It was all down to me. There were times where I wished I was in more.

This was probably the most flexible and easy going placement I have had this year, but this is easily the one placement where I have learned the most. I had lots of fun, but also learned a lot of useful things. I am so lucky to have a supervisor who is really good with teaching and letting me progress. You all probably remember me having great praises for my last O&G placement and that it has set a very high bar. This orthopaedic placement just blew through that bar. I mean I knew it was going to be hard to have more fun and more responsibilities than my last placement, but wow this placement was fantastic. I have nothing but good things to say. I got to scrub in. I assisted in surgery. I learned how to suture and help close up. I saw patients in clinic on my own and got to examine them. I got to start and finish an audit project. I really could not ask for more. I don't even think I could do much more.

Today started out like any other day. Early meeting and then to morning clinic. Usual banter in the meeting...lots of good laughs and teasing. I took up my usual spot at the back of the room against the cabinet. Then off to clinic. Busy clinic as usual. Saw new patients on my own. Did the usual. I'm sure no one knew it was my last day because everything was going like it was just another day of my placement. Patient by patient...the note pile got smaller and smaller. Clinic was coming to an end. Next thing I knew my supervisor was signing my feedback form off. Had a bit of a chat about the placement and then a solid handshake. To be honest it was tough to leave. I wasn't sick of the placement yet. Just wasn't ready for it to end already. Every day when we finish and before I leave, I always crack a: "When am I seeing you next?" It was weird not to say that as I was heading for the door. I didn't even know what to say as I left. I think all I kept saying was "thank you" as I dragged my feet out the door. Even now...I'm absolutely gutted this placement is over. Feels like someone shot me out from cloud 9. Next week is going to be tough. Back to lectures. Back to reality. Then on to GP and being cooped up in a clinic from 9-5. No surgeries. Not in a hospital environment. Going to be out of my element. Hurts just to think about it. Should be a crime to enjoy a placement so much.  Genuinely loved this placement. Entered placement as one of the happiest medical student you can find to probably the most gutted one at the moment. What a contrast. Just shows you how much I enjoyed this placement.