Doh!

Interesting and short week of paediatrics. Had Monday off as I was in for 9-5 lectures. Tuesday..can't remember what happened...obviously nothing exciting as I would remember. I was on-call again on Wednesday so I was in the hospital from 8:45am - 9pm. It was also my SHO's last day and to be honest I think he was really great. Probably the few doctors that really made us medical students feel very welcomed and a part of the team. He's also really good at teaching too. Really smart dude. As a medical student, the biggest worry is being left out from the team. It's already nerve-racking to step into an unfamiliar environment and have no clue what you're supposed to do, so when a doctor welcomes you and teaches - you feel much more at ease and it really makes a huge difference to your experience at the hospital.  It was also nice that he could remember our names and it really helps with making us feel welcomed. Great thing about this SHO is that I understood him. I knew when to bother him and when not to. And it seems like he too knew what I was like. Seriously, some of you may think I'm really hard working, but I am definitely not the hardest working student to have graced medical school. In fact, I'm quite lazy (blushes). It was interesting how my SHO could tell that there are times where I don't want to do anything and he lets me be. It was like we were on the same page so it was good we had this mutual understanding.

Took quite a few "tea breaks" during my on-call so I got to talk about life as a doctor with the SHO as the ward wasn't too busy either. It was eye-opening. But the conversation soon led to a massive "DOH!" moment. Out of no where I was asked: "You don't like Paediatrics very much do you..or this attachment in general right?" I was actually left speechless. My face was probably a mix of a dead pan with a "DOH" moment. Secretly inside...I haven't really been enjoying this placement very much as in general I'm not very interested in Medicine. I really miss going to theatres and watching surgeries as I find it much more interesting and exciting. I have tried my best to put on an enthusiastic/keen face during this placement, BUT apparently it is fairly obvious I don't really like paediatrics. Another interesting bit is that the SHO could tell what I wanted to do in the future. Haven't told him what I was interested in and he randomly was like: "You're definitely going to do surgery. It's written all over you." And for some of the followers of this blog, you probably know I want to do Orthopaedic Surgery in the future so it was nice that people can see I want to do surgery. On top of that, the day after, another doctor went up to me and was like "You don't like Paeds very much do you. It's like written all over your face." Cue another "Doh!" moment. I even asked if it was that obvious and everyone around me was like "Yes." Soooo....it probably means my supervisor/consultant can also tell I'm not really enjoying the attachment. Honestly though, I'm not HATING it, but I don't love it either. I'm quite indifferent about it and I do realize I'm quite awkward around kids as I don't know what to do with them. Guess it's something I have to work on...and I am trying quite hard though...guess that's what matters.

Next week there will be new SHOs starting on the job and meaning starting back at square one with trying to get on with the new doctors. Life is always full of changes and you just have to keep adapting. Also being a medical student you constantly have to remind yourself that you're at the bottom of the ladder and you really have to work hard to get noticed. Note to self: Stop making it so obvious that I don't like kids.

The Key is to be Proactive

Have been in placements for about 10 weeks now and I have had many ups and downs as you have read in my previous posts. After looking back at my placements, I've realized that my best experiences had been when I am being proactive. Being active in learning and stepping out from my consultant's shadow. In my first placement in the summer, I put a lot of effort into taking patient histories and doing loads of physical examinations (cardio, resp, and abdo). 2nd placement...did a lot of ward rounds - definitely seen a lot. For comparison sake - first placement I took about 10 patient histories and have done 4 cardiac exams, 3 respiratory exams, and 3 abdo exams. 2nd placement: 1 patient history, 1 shortened peripheral nerve exam. Poor showing in the 2nd placement. Yesterday, I did a group revision session on cardiac, resp, and abdo examinations. I knew how to do those examinations quite well and knew what I was looking for and can easily explain positive findings. The minute we got into neuro and musculoskeletal (MSK) exams...I died a little inside. I didn't know what was going on. Okay well MSK was easy to follow as I'm quite familiar with joints and those tests...but neuro was painful. I obviously didn't know how to do these exams as well as the cardio, resp, and abdo exams and it just felt horrible how lopsided my learning has been. Thinking back - it was because I was really proactive in my first placement. I had put a lot of effort into seeing patients and doing examinations. These last 2 placements - I've been...how should we put it...lazy.

You might ask: why suddenly the realization? Yesterday I was in clinic in the afternoon and my consultant told me to go take patient histories of the new patients in clinic and to come back and present the histories to him. While presenting, my consultant would ask questions dealing with the presenting complaint and about the differential diagnosis. It really made me think and be on the ball. When I didn't know something - he would teach me what to look for in a history and I realized: "I'm actually learning and remembering this." Once clinic was over - I actually had a good time. I felt independent and a lot more confident in my history taking skills as I got to present my histories and then got quizzed on it. I also realized that I was quite rough with my history taking with my first patient but by the time I saw my 3rd patient - it was easy and straight forward. It was a great feeling and a great confidence boost.

Now I'm sitting about - pondering - actually no...stressing about exams (OSCE + 2 written papers in December). There's no way I can pull off taking good histories and performing examinations without practice. I need to be proactive and do what I did in my first placement. Make a schedule and follow it. Be involved and just take a step away from my consultant and tell him that I need to practice. There isn't much point following him - I've got a good idea what the specialty is about already. I need to see more physical signs and conditions to start seeing patterns and recognizing things quicker. 4 more weeks of placements - I need to get back on the wards and talk to patients!