Start of Clinical Years.

Finally got some free time to make a post. First want to thank those who are still following me on my blog as I really do appreciate it.

So I finished my 3 exams (MEQ, Multi-Station, and EMQ) on May 5. 3 torturous days as predicted. To be honest - The MEQ and EMQ exams weren't too bad as I adapted a new way of studying which is better suited for those two exams; however, I neglected the method needed for Multi-Station exam. Consequently, I did suffer a bit in my Multi-Station exam. It was horrible. I didn't exactly start at a great station either. I knew how to do the questions in my first station but the next 4 stations shattered my confidence. I did not study the things asked and it was a horrible feeling. With every station I lost more and more confidence and was starting to think pretty negatively. At one point I even asked myself if it was possible to get 0% on the exam. It was grim. After 2 hours of absolute shattered confidence and the horrible sinking feeling - I was hoping like no tomorrow that the EMQ would be much better. Thankfully - EMQ was quite okay and I didn't have too many difficulties with it.

Fast forward to May 19. Results day. My university requires us to go into the medical school to get our results so the journey to the school was long and nerve-racking. I don't think I have been so nervous before. To my relief I had passed and cue celebration. We still haven't received the breakdown marks of our 3 papers, and I'm looking forward to see how I did in the multi-station paper. Last year it was my best paper of the 3...I don't think that is the case this year. Who knows - maybe I've got some pretty amazing guessing skills.

Just the other day I got my first clinical year schedule and it looks really crammed and hectic but after looking at it again - it isn't too bad. The major downside of starting clinical years...is the lack of holidays. I guess they're trying to prepare us for the future? From what I've heard from upper years - this is the time when it hits you - you'll be a doctor in 3 years and it is quite a frightening thought. I swear the last 2 years FLEW by. Freshers week felt like it was only a few months ago.

Anyways just wanted to do a quick update and hopefully my next post will be soon. :)

5 days.

5 more days until my year end exam. I must admit - I have never worked so hard before - even my friends agree. In return, the level of stress is immense. There are days of ups and downs. Days where my confidence is sky high and days where I start doubting myself. With every low point I have faced and on the verge of giving up - I refuse. I have never given up on anything and I am certainly not going to give up now. 5 more days. It is almost over. I can't wait as I know it'll be all worth it in the end. I found a great speech from a commercial titled: "You vs. Them" It definitely keeps me going. The video is below if you want to listen to it.

Whether or not you win this thing, you’ve got to decide how you’re gonna walk out of here when it’s all said & done because the game is going to go on. And there’s only one rule you’re going to need to know about:

There are no second chances.

There is only this moment and the next moment. Every one of those moments is a test that you get to take one time – and only one time.

So, if you see an opening – tear into it! If you get a shot at victory, make damn sure you take it! Seize that moment. That moment is a crossroad where everything you want will collide with everything standing in your way.

You’ve got momentum at your back. Fear and doubt are thundering like a freight train straight at you. And all you’ve got, the only difference between making history and being history, the only thing – THE ONLY THING – you can count on at any given moment is YOU.

It’s You versus Them.
You versus No.
You versus Can’t.
It’s You versus Next Year. Last Year. Statistics. Excuses.
You versus History.
You versus The Odds.
You versus 2nd Place.

The clock is ticking – let’s see what you’ve got.

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!

That's It?

After some good banter after our critical analysis presentation for our SSC research attachment, we were told by our supervisor that we essentially will not go back in/see him until the LAST day of our attachment which is in 2.5 weeks. In the meantime we are supposed to do our final task: data analysis. I am absolutely ____ing my pants about this as I do not know anything about stats. Doh! This is definitely going to be a REALLY tough task and thank goodness we have 2.5 weeks to figure it out. At the same time when I found out we will not be going in for 2.5 weeks you would assume that I would be doing a victory dance the minute I left the building. Wrong. I was actually really bummed out. I hate to admit it, but I have THOROUGHLY enjoyed this attachment and I am having a really good time! I think it is because I have an amazing supervisor coupled with amazing group members as we get along extremely well. Once you get into med school and make medic friends you tend to talk about medicine with each other, but with my group members - we all play sports and we are quite athletic and to be honest - we NEVER talk about medicine when we are around each other. We actually have something interesting to talk about and it is quite nice. Such small things can make quite a big difference.

As well, we were promised at the beginning...okay not promised...more like notified that we will probably get to go to the gait lab to try out the equipment and test out what the volunteers will be going through in the trial. Because our supervisor has to leave for conferences and stuff, we apparently will not be going in. I was really excited about going to the gait lab and now seeing that we won't go in until the last day - we obviously will not be getting the opportunity to try out the machines. Boooooo. Super bummed.

So essentially our last day of attachment is 2.5 weeks away and that means we have already been at this attachment for 3 weeks now. It definitely does not feel like 3 weeks and I know earlier I was whining about doing a research attachment, but I loved it. I think the main reason is because of the tiny little things like a great supervisor and a great group really made things a lot more enjoyable. On top of that, my attachment is very clinical based and it was nice not being in a lab all day (actually we never went to the lab) and the hours were quite "slack". Definitely a good balance. Go in just enough to get a feel for the attachment, but at the same time we get enough free time to get some revision done for exams. When I looked at my calendar and looked at the last day of our attachment I said: "That's it?" Before embarking on this attachment I would NEVER think I would be saying this as I thought by the end of this I would be sick of the attachment and hate the attachment. I am soooooooooooooo wrong and I am happy to admit that it was wrong of me to have such a close-minded view of this attachment prior. Can't believe that this is it. Today was my last proper day of being at the attachment. The final session will be a quick presentation and then getting feedback. Wow. Time flies. Scary stuff.

Agitated Patient.

As some of you know - I am currently on my 6 week SSC Research Attachment. Today I was lucky enough to go to clinic with my supervisor to get some clinical experience. It was quite a straight forward day. 6 patients - all mainly with osteoporosis. However, one patient does stick out. She is fairly young to be having osteoporosis and the minute she walked in there was a sense of tension. I quickly noticed that she seemed fairly annoyed/agitated. It seemed like she was forced to come and was absolutely not interested about going to clinic.

I have followed/gone to clinics several times and have seen some patients and I luckily have not come across an "agitated" patient before. All the ones I have met are quite nice and did not fuss much about going to clinic.

First question asked to the patient: "Do you know why you're here today?"

Patient: "NO."

Immediately there was a bit of an awkward silence and in your head you're already saying: "This is going to be an interesting one..." Throughout the consultation it almost seemed like the patient was not listening at all and just did not care. At one point I thought she was going to get aggressive and thump my supervisor with her bag! It was such an uncomfortable environment. Throughout the consultation there were no bad news and everything was good - my supervisor and I were smiling and thinking that the patient would be glad to hear the good news and would smile...well she still looked "pissed". My supervisor tried to inform the patient about her treatment options and that everything will be fine and that it is essentially up to her if she wants to follow with the treatment. At no point was he rude or confronting. He was actually REALLY nice and patient. He took his time to explain to her about things and the treatment.

Anyways after a bit, the consultation was done and the patient left - obviously still agitated and annoyed. She was apparently moaning to the nurses about the treatment and all that and was being a bit uncooperative. No joke I had a sigh of relief when she left as it was really uncomfortable. It didn't help that the office was TINY.

Definitely a neat experience and I will definitely encounter some patients who do not want to be in the hospital or at the clinic and will be a bit uncooperative. It was a good learning experience and it is something I will keep in mind. I felt that my supervisor handled it very well and calmly. Thought I'd mention this as I thought it was something different and made clinic a bit more interesting.

Tidbit for International Students.

Today I received my Student BMJ in the mail and while reading the front page articles on the newspaper - I managed to walk into a door. You may ask: "What's so interesting?"

Well there is an article called: "BMA rejects 'unjust' limits on training for non-EEA medics". A summary of this article is literally about the unfair treatment towards international students especially those studying medicine. I was shocked to see that us international students' tuition fee contribute £100m annually! WHAT! That's a HUGE number. Technically we should get equal rights on getting specialty training and with the new immigration rule of removing the Tier 1 Visa it will essentially be impossible to get specialty training in England. So in the last post I said that recruiters don't care if you are international and they are happy to accept them. THE annoying part is the VISA and that Tier 1 visas is our post-study work route for specialty training, which they want to junk.

It was shown in studies that International graduates are not stealing away jobs from local students so they don't see why they should make an international student's life so difficult. I don't know if you guys have been around the hospitals a lot but I have noticed a lot of consultants aren't actually local British people. I've talked to a few consultants who are from India and we have had a few internationals who lectured us - and they appear to be quite skilled (well they are consultants). Unfortunately with the junking of Tier 1 and if these consultants have not declared citizenship...wouldn't they be in danger of being kicked out from the country?! That to me sounds quite shocking that the UK would want to kick out highly skilled people...especially extremely skilled consultants. It was also mentioned that it is unfair towards those medical students who are currently studying medicine and suddenly changing the immigration rule on us midway through our degree. If some of us knew about these immigration restrictions and not being able to do a specialty...some of us may have not chosen to come to study in England as essentially it appears to be a flipping dead end after foundation year 2.

Now with the NHS reform and the ridiculous suggestions...I do not know what is the UK government trying to accomplish. I feel that the UK heavily relies on immigrants for jobs and it is a shame that they believe that internationals are getting in the way of locals. While providing £100m annually from tuition fees in total and the NHS is spending a couple hundred thousand pounds to train each medical student (including internationals) I reckon the smart thing to do is to not shoo us away. If the UK is going to make working in the UK as a doctor and an international so difficult and almost impossible, just simply stop international students from applying to universities! With every article I read about the immigration rules and how it'll affect us, the less UK appears to be welcoming. Hopefully by the time I graduate the UK government gets their heads checked and really take a deep thought about the consequences of these immigration rules will do the economy and the work force. I feel that internationals play a vital role in the UK as a whole. Really is a shame if these immigration rules completely bar off internationals. Multiculturism is good to have and especially coming from one of the more successful multicultural countries (Canada) - I truly feel that immigrants are not as welcomed anymore in the UK.

Local students may argue with me on this, but really what a shame.

Surgical Careers Open Day.

On Saturday (26/02) I went to Liverpool Medical School to attend their Surgical Careers Open Day and I must say it had the most depressing start ever! We had an ENT surgeon do a brief introduction about being a surgeon and the mood of the entire room just shot down through the floor. Essentially his view was in order to become a surgeon you MUST do a BMedSci and get lots of publications. And even if you do those things you won't get into your surgical specialty. I understand surgery is quite competitive but we all attend the surgical open day because we are excited about it honestly there is a less harsher way of putting reality into context. Instead of scaring our pants off and being a black cloud...how about just introduce the steps and the possible downfalls that could happen along the way...instead of just hammering on about how difficult it is and that we can mess up our career if we don't show any sort of progress while doing a masters degree if we don't get into CST. Wayyyyy to start the morning off. Essentially from what I can tell the mood was grim.

We had talks from an ENT surgeon, paediatric surgeon, plastic surgeon, orthopaedic surgeon, and a transplant surgeon. Most interesting/well done presentation was done by the Orthopaedic surgeon as it was short and concise. It gave us a good overview of the career and what it involves. After the talk I talked to the Orthopaedic surgeon to ask him about his view on BMedSci and how recruiting works if you're an international student.

What I gather from our short conversation was that if you are not interested in doing a BMedSci do not force yourself into doing one. If you're interested - good do one! And there was a bit of a mention how some people are doing it just for the sake of getting brownie points for their application forms and what matters most is your pure interest in the specialty. He also mentioned about making your CV stand out. If you had to take all your friends' CV and compare it with yours - yours should stand out if you want to make it into surgery.

Now with international students it seems like we are not discriminated anymore for specialty selection. Once we have registered after foundation year (if that will even happen in the future) we will be placed on the same level as local students as we have gone through the UK medical education system. The tough part is just getting your Visa. I was pretty glad to find out that we will be treated like the local students as that evens the playing field a bit more. Shame nothing has really been released about the new immigration scheme as that will be the biggest obstacle.

Overall the careers day was alright. It wasn't anything special. Came home pretty much shattered due to the early wake up to catch the train to Liverpool. It was nice talking to the Orthopaedic surgeon though. :)