Sorry for the lack of updates. The weird thing with this rotation is that I'm running through all the other specialities: ENT, Ophthalmology, Urology, Haematology, Dermatology, and Oncology. I only get either 1 or 2 weeks in each specialty. You can imagine I only get a quick glimpse of everything and so far nothing interesting has happened.
Because I am now on Urology and have got 2 weeks here, I thought it would be worth doing a bit of an update. So we were inducted into the specialty on the Monday and were pretty much scared stiff. The urology department at our hospital is an academic department as well so they have academic ward rounds and really encourage full participation from students. You will probably wonder: "So what's wrong with that? That's great isn't it?" Well yes, that's great as we get loads of teaching, but that means we got to work twice as hard as we are expected to do presentations. I don't mind working hard, it's just our presentations have to be a case study on an inaptient. With how our schedules are, we don't have much time on the wards as we are timetabled to be in clinics/theatre. We were also told that consultants expect us all to be prepared for clinics/theatre and expect us to do our reading beforehand.
Biggest heart sinker? On theatre days we are expected to go to Theatre Admissions Unit (TAU) at 7:30am to get a brief patient history for all the patients on the list and be prepared to tell the surgeon all about the patient in theatre. Don't get me wrong, I love going to theatre, I just don't enjoy this horrifically early wake-up. I've been quite lucky with not needing to go to TAU in prior placements as the consultants I have been placed with don't require me to go to TAU and talk to the patient ahead of time so I usually get to theatre at around 8:30am. Anyways so Tuesday was my theatre day and I was placed with the academic lead for Urology (perfect...). Being a bit scared, I obviously head to TAU at 7:30am and talked to the 2 patients who were on the theatre list. As I was finishing up the consultant shows up and was actually quite surprised to see me in TAU. I was then promptly quizzed about the 2 patients and about their procedures. Luckily I did a bit of reading before I saw the consultant so everything was fresh in my mind. Think I impressed him as I got the nod of approval and the brief grilling seized.
At theatre, I met with the registrar and was warned I will probably get a full grilling on anatomy and should do some reading while the consultant isn't around. Read up on the prostate and bladder, which wasn't too difficult. I've always remembered the general rule for surgery is to know the blood supply, lymph drainage, and nerve supply for that organ, and you'll be alright. 30 minutes into a cystectomy, the consultant asked me for the blood, lymph, and nerve supply for the bladder. Check. Check. And check. The greatest bit was when he looked over to me in awe and proceeded to go quiet until lunch time. Just going to dust my shoulders off now. Now here comes a curve-ball, I was then shown a muscle and was asked what it was. Thankfully due to my "love" for orthopaedics and hip/knee anatomy, I immediately recognized the muscle as the psoas. Then another dead pan from the consultant who then went quiet again. Then he asked about the path of the Obturator nerve and what it innervates. Easy as I've been quizzed on that before by an orthopaedic consultant for fun not too long ago. As I finished my answer, the consultant put his scissors down and remarked that he'll sign me off for the next 2 weeks. He seemed really impressed and well I obviously felt good for once and not like a complete idiot. I was quite lucky with the questions though as usually it is a hit or miss. Was a fairly good day!
Rest of the week was fairly...dull. Went to a haematuria/cystoscopy clinic and did a bit of ward work, where I found myself being the cannula/bloods monkey again. Was nice being able to put cannulas in again as it has been awhile since I've put one in and I was worried I would lose the skill, but looking at my 100% in one go rate on the ward, think I'm still alright! All in all - okay week. Not very stimulating. Not very interesting. Escaped presentation - think it was partly due to my "good play" in theatre. Hopefully next week will go just as well!
Showing posts with label morning. Show all posts
Showing posts with label morning. Show all posts
Friday, May 3, 2013
Tuesday, March 27, 2012
O&G Labour Week Part 1.
I'm only 2 days in to my labour week and I'm already struggling. I'm supposed to be in for midwives handover at 7am every day. Day 1 - alarm clock for 5:45am...next thing I knew I woke up again and it was 6:30am. Didn't get to the hospital til 7:10am...by the time I got changed into scrubs for labour ward...it was like 7:20am. Day 2 - alarm clock for 5:45am...actually got up this time. Arrived at the hospital at 6:55am and traffic wasn't bad. I actually tried really hard to make it to handover...ran to get changed. By the time I got out...I had apparently missed handover already and the midwives said I should aim to arrive for 6:50am tomorrow. In my head I was like "6:50am?! Yeaaahhh right." Dreading it already. Also I have been sooo tired. I would sometimes catch myself dozing off in the ward because I start so early in the morning...but still get off at 5ish pm. Brutal. And when I get home...I hardly have the energy to eat and all I want to do is sleep. So unproductive.
Pretty exciting first day though. Saw 2 normal vaginal deliveries. Also assisted as a first assistant on 2 caesarean sections (aka I got to scrub in and actually do proper surgical stuff...not just hang around and watch - just the consultant surgeon, me, and a scrub nurse - what a dream). Also witnessed an emergency caesarean section as the baby was stuck. When the emergency button was pressed it was like a TV show. It was crazy. Loads of people ran in within 5 seconds of the buzzer going off and everyone knew what they were doing. Anaesthetist was already making his way to theatre and some of the theatre staff darted to theatre to prep. About 8 of us were racing the bed down to theatre. It was really surreal. Obviously there was a sense or urgency. The mother had to be put under general anaesthetic (most caesareans is under spinal so the mother stays awake and just can't feel anything down below). Staff was frantically prepping the theatre with the equipment...it was just organized chaos. I was so scared to get in the way so I just crammed myself into a tiny corner of the room. I obviously couldn't scrub in as it was an emergency and the registrar had turned up. Eventually we managed to get the baby out and I finally got to see the link between the paediatricians and obstetricians. The paeds team was already waiting for us ready for the baby and for any resuscitation as it was a complicated birth. Baby came out floppy and wasn't crying/breathing. It was a very tense moment as we handed the baby over to the paeds team. Unfortunately I'm with the obstetrics team so I couldn't go watch the paeds team work their magic. Finally after a few tense minutes we heard the baby cry and you could see the relief on some of the staffs' faces. I'm sure it was pretty scary for the mother herself as one minute she was just about to give birth but the baby got stuck..the next minute she's asleep. Also the father is left waiting outside of theatre after seeing a bunch of people wheel off his wife. Pretty scary situation for the family in general I would think. I couldn't say I had as much fun in the afternoon though. Immensely boring after a frantic morning. But the morning certainly made my day though.
Day 2 - quiet morning. Waited til 9am for elective caesarean sections. Again was really lucky and got asked to scrub in and help out...but not to the certain extent of a first assistant. Still makes a huge difference when you're scrubbed in. I even got to transfer the newborn to the crib after we pulled him out. It was really cool. After the sections...again went quiet again. Saw 1 normal delivery and that was it. Next thing to knock off my list: Instrumental Delivery (eg. using Forceps or Ventouse Suction). Really need to get that signed off tomorrow.
Labour week to be continued.......(if I'm still alive by the end of it)
Pretty exciting first day though. Saw 2 normal vaginal deliveries. Also assisted as a first assistant on 2 caesarean sections (aka I got to scrub in and actually do proper surgical stuff...not just hang around and watch - just the consultant surgeon, me, and a scrub nurse - what a dream). Also witnessed an emergency caesarean section as the baby was stuck. When the emergency button was pressed it was like a TV show. It was crazy. Loads of people ran in within 5 seconds of the buzzer going off and everyone knew what they were doing. Anaesthetist was already making his way to theatre and some of the theatre staff darted to theatre to prep. About 8 of us were racing the bed down to theatre. It was really surreal. Obviously there was a sense or urgency. The mother had to be put under general anaesthetic (most caesareans is under spinal so the mother stays awake and just can't feel anything down below). Staff was frantically prepping the theatre with the equipment...it was just organized chaos. I was so scared to get in the way so I just crammed myself into a tiny corner of the room. I obviously couldn't scrub in as it was an emergency and the registrar had turned up. Eventually we managed to get the baby out and I finally got to see the link between the paediatricians and obstetricians. The paeds team was already waiting for us ready for the baby and for any resuscitation as it was a complicated birth. Baby came out floppy and wasn't crying/breathing. It was a very tense moment as we handed the baby over to the paeds team. Unfortunately I'm with the obstetrics team so I couldn't go watch the paeds team work their magic. Finally after a few tense minutes we heard the baby cry and you could see the relief on some of the staffs' faces. I'm sure it was pretty scary for the mother herself as one minute she was just about to give birth but the baby got stuck..the next minute she's asleep. Also the father is left waiting outside of theatre after seeing a bunch of people wheel off his wife. Pretty scary situation for the family in general I would think. I couldn't say I had as much fun in the afternoon though. Immensely boring after a frantic morning. But the morning certainly made my day though.
Day 2 - quiet morning. Waited til 9am for elective caesarean sections. Again was really lucky and got asked to scrub in and help out...but not to the certain extent of a first assistant. Still makes a huge difference when you're scrubbed in. I even got to transfer the newborn to the crib after we pulled him out. It was really cool. After the sections...again went quiet again. Saw 1 normal delivery and that was it. Next thing to knock off my list: Instrumental Delivery (eg. using Forceps or Ventouse Suction). Really need to get that signed off tomorrow.
Labour week to be continued.......(if I'm still alive by the end of it)
Friday, February 17, 2012
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."
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."
Saturday, October 29, 2011
End of Placement 3.
What a placement. It actually went by a lot faster than I thought it would as I hated my first week of placements. In the end, it wasn't too bad. Definitely found out colorectal surgery is not for me. I can never seem to orientate myself in theatre especially during laparoscopic procedures. Everything looks the same! Just bowels here and there. Clinics were alright - completely understand why consultants hate it though. It's usually the same old things - over and over again. Only been to 2.5 clinics - and to be fair - it was starting to get repetitive and boring. I must admit, I am a bit embarrassed by the fact that I only turned up to ward rounds ONCE in the entire 4 weeks of placement. Oops. 7:30am ward rounds are too early - Note to self: don't get admitted as a patient to a hospital with 7:30am ward rounds - no wonder most of the patients we saw on ward round were cranky. You're ill/in pain and you're tired - 7:30 am a team of 5+ doctors (have seen teams of 10) crowd around your bed - doctor takes a feel/ask a few questions and then disappear. As a patient, that would really tick me off, but then again I'm not the most cheerful person in the morning.
What else have I learned on this placement? As previously mentioned in an earlier post - common sense takes you a long way. Oh and some consultants are actually human and love to talk about other stuff other than medicine. And again especially at busy hospitals - medical students are probably the least important things in the hospital - be prepared to get ignored/no one caring about you. That's reality and you just have to be proactive and be responsible for your own learning.
Next placement will be in endocrinology. Don't know what to expect; however, I don't even think I will have time to go into placement as exams are around the corner (December). Need to really study and start focusing. Can't tell you how stressed I am - it's mental. Like most students - I hate revising. The only thing that keeps me going is the future. I keep telling myself that once these exams are over I can slack off again and it'll be a year before my next exam. Can't wait as we just had our year-end exams in May - so it's only been 6ish months. The thought of 2nd year exams/revision still scares me - it was tough/a nightmare. At least this year's December exam will be more clinical (what I like) and not as science based. Still a bit lost as to what to study. Just hoping the best and hoping that I'm studying the right material as this year - we've hardly had any guidance. Eep.
What else have I learned on this placement? As previously mentioned in an earlier post - common sense takes you a long way. Oh and some consultants are actually human and love to talk about other stuff other than medicine. And again especially at busy hospitals - medical students are probably the least important things in the hospital - be prepared to get ignored/no one caring about you. That's reality and you just have to be proactive and be responsible for your own learning.
Next placement will be in endocrinology. Don't know what to expect; however, I don't even think I will have time to go into placement as exams are around the corner (December). Need to really study and start focusing. Can't tell you how stressed I am - it's mental. Like most students - I hate revising. The only thing that keeps me going is the future. I keep telling myself that once these exams are over I can slack off again and it'll be a year before my next exam. Can't wait as we just had our year-end exams in May - so it's only been 6ish months. The thought of 2nd year exams/revision still scares me - it was tough/a nightmare. At least this year's December exam will be more clinical (what I like) and not as science based. Still a bit lost as to what to study. Just hoping the best and hoping that I'm studying the right material as this year - we've hardly had any guidance. Eep.
Saturday, October 8, 2011
Placement 3 - Week 1
Can't believe it's already my third placement. Time flies. Actually I lied...this week was pretty slow. So I'm back in the local teaching hospital so I don't have to drive like 40-50 minutes to the peripheral hospital anymore. But day 1 of my placement was probably the worst experience I have had on placement...ever. First I found out I was placed in General Surgery....AGAIN. Found out I was in colorectal surgery...joy. I mean general surgery is interesting, but I'm a bit tired of it as I want to see other specialties. First year I had 2 surgical placements both in General Surgery. First placement of this year was General Surgery. Now...general surgery...again. I feel like I know loads about the GI system...and nothing about other systems.
Met my consultant in the afternoon...and only to be told I couldn't join him in endoscopy as I was in a group of 3 and only 2 people can stay in the room. My two other partners are quite keen...and jumped on the opportunity before I even started moving my slow Canadian mouth. I was a bit bummed out as it is our first time meeting the consultant and I kinda missed out on the first meeting. But then again I got to go home early as there wasn't anything else for me to do in the hospital. Also got to suck in the last of the amazing heatwave/get some colour back into me. Got home and hoped that the next day will be MUCH better as I felt like I accomplished nothing. Also felt that the nurses and doctors weren't as nice as the ones in the peripheral hospitals. Everyone seemed busy and us medical students just blended into the background/environment. It was a weird feeling. It was a bit unsettling. Kind of like: this is reality. I must've had too high of expectations as I did have a great time in the peripheral hospital as I got loads of teaching and everyone was so friendly (and the hospital wasn't as busy). It finally struck - us medical students are no one. We are of no importance as there are more important things for doctors and nurses to care about. It is a big hospital and it is very very busy. Depressing start to be honest.
Tuesday - I was determined to make my placement better as I will be on this placement for 4 weeks. I have a strong interest in Orthopaedics so I decided to go to theatre with my friend who is placed in Orthopaedics. Went in really early and I was quite content. I definitely felt less anxious and tense about the placement. I started to relax and was enjoying being in theatre. We were quizzed on the ankle and I knew how to answer the question as I know my MSK anatomy quite well. I got a sudden boost of confidence and my day was looking to be a good day. In the afternoon I went to meet my consultant to go to a really busy clinic...I think we had about 20+ patients. It was also my first time properly meeting my consultant. Managed to see a lot of PRs and unfortunately a lot of patients who have/had colorectal cancer. It seems like the surgery for colorectal cancer is quite effective especially if the cancer is a T1 cancer (early cancer). Also learned about the different surgical procedures for colorectal cancer such as the TAEMS procedure which is apparently quite new and the major surgery which is an anterior resection. After 4 hours...and getting the impression that our consultant doesn't particularly find his job that interesting...my partner and I finally got dismissed from clinic as our consultant noticed that we were quite bored and it was also getting late. I mean my consultant seems like a really great guy. Very chill and relaxed and doesn't really care about us. Not caring about us is sometimes good...sometimes bad. He does teach a bit, but he wouldn't breathe down your neck about going to placement from 7:30am to 5pm (I do have friends who are forced to go in every day 7:30am to 5pm).
Took a day-off on Wednesday as my other 2 partner wanted to go to theatre. Thursday...can't really remember what I did....hmmm. What did I do on Thursday?! I know I went in...so I assume I was on the wards talking to patients...I guess Thursday is my new mystery. Old age...can't even remember what I did 2 days ago. Friday....first time I went in for ward round, which was at 7:30am. I think a little bit of me died when I woke up at 6:00am to get ready. It was pitch black outside. Got to the ward to meet up with the team and was trying to stay awake. My consultant came in...did probably the fastest ward round I have experienced. It took less than an hour. Met the new registrar and he did some teaching with us and watched us do patient histories and abdominal examinations. Examined a patient with an incisional hernia. It was really interesting and I really enjoyed the teaching. It was a nice change. So I guess I ended the week on a high note. Oh and I think my consultant has came to a conclusion I'm a lazy bugger. Apparently he was on ward rounds which I didn't go to on Wednesday morning. Maybe that's why I got a surprised look from him on Friday morning. Anyways bring on a really busy next week.
Met my consultant in the afternoon...and only to be told I couldn't join him in endoscopy as I was in a group of 3 and only 2 people can stay in the room. My two other partners are quite keen...and jumped on the opportunity before I even started moving my slow Canadian mouth. I was a bit bummed out as it is our first time meeting the consultant and I kinda missed out on the first meeting. But then again I got to go home early as there wasn't anything else for me to do in the hospital. Also got to suck in the last of the amazing heatwave/get some colour back into me. Got home and hoped that the next day will be MUCH better as I felt like I accomplished nothing. Also felt that the nurses and doctors weren't as nice as the ones in the peripheral hospitals. Everyone seemed busy and us medical students just blended into the background/environment. It was a weird feeling. It was a bit unsettling. Kind of like: this is reality. I must've had too high of expectations as I did have a great time in the peripheral hospital as I got loads of teaching and everyone was so friendly (and the hospital wasn't as busy). It finally struck - us medical students are no one. We are of no importance as there are more important things for doctors and nurses to care about. It is a big hospital and it is very very busy. Depressing start to be honest.
Tuesday - I was determined to make my placement better as I will be on this placement for 4 weeks. I have a strong interest in Orthopaedics so I decided to go to theatre with my friend who is placed in Orthopaedics. Went in really early and I was quite content. I definitely felt less anxious and tense about the placement. I started to relax and was enjoying being in theatre. We were quizzed on the ankle and I knew how to answer the question as I know my MSK anatomy quite well. I got a sudden boost of confidence and my day was looking to be a good day. In the afternoon I went to meet my consultant to go to a really busy clinic...I think we had about 20+ patients. It was also my first time properly meeting my consultant. Managed to see a lot of PRs and unfortunately a lot of patients who have/had colorectal cancer. It seems like the surgery for colorectal cancer is quite effective especially if the cancer is a T1 cancer (early cancer). Also learned about the different surgical procedures for colorectal cancer such as the TAEMS procedure which is apparently quite new and the major surgery which is an anterior resection. After 4 hours...and getting the impression that our consultant doesn't particularly find his job that interesting...my partner and I finally got dismissed from clinic as our consultant noticed that we were quite bored and it was also getting late. I mean my consultant seems like a really great guy. Very chill and relaxed and doesn't really care about us. Not caring about us is sometimes good...sometimes bad. He does teach a bit, but he wouldn't breathe down your neck about going to placement from 7:30am to 5pm (I do have friends who are forced to go in every day 7:30am to 5pm).
Took a day-off on Wednesday as my other 2 partner wanted to go to theatre. Thursday...can't really remember what I did....hmmm. What did I do on Thursday?! I know I went in...so I assume I was on the wards talking to patients...I guess Thursday is my new mystery. Old age...can't even remember what I did 2 days ago. Friday....first time I went in for ward round, which was at 7:30am. I think a little bit of me died when I woke up at 6:00am to get ready. It was pitch black outside. Got to the ward to meet up with the team and was trying to stay awake. My consultant came in...did probably the fastest ward round I have experienced. It took less than an hour. Met the new registrar and he did some teaching with us and watched us do patient histories and abdominal examinations. Examined a patient with an incisional hernia. It was really interesting and I really enjoyed the teaching. It was a nice change. So I guess I ended the week on a high note. Oh and I think my consultant has came to a conclusion I'm a lazy bugger. Apparently he was on ward rounds which I didn't go to on Wednesday morning. Maybe that's why I got a surprised look from him on Friday morning. Anyways bring on a really busy next week.
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