All entries for Wednesday 30 May 2018
May 30, 2018
I’m now 4 weeks into assistantship and have finished the first part of my placement. I have been in A&E at Warwick Hospital for the last 4 weeks and now I’m moving onto the Haematology Ward. I can’t believe how fast assistantship is going, 8 weeks seemed like a long time at the start, but now I’m halfway though I’m getting more excited but also increasingly nervous about finishing.
I’ve really enjoyed my time on A&E. I have an A&E job as my last rotation of foundation year 1 so it’s been a good experience to see what’s expected of the FY1 Doctor. I’ve gained a lot more confidence in my clinical procedures as well as my histories and examinations in A&E. I have picked up some good tips about note writing which will be invaluable to me going onto a medical ward where you write a lot of notes for ward rounds. Part of the A&E FY1s responsibilities also include medical on calls. Every few weeks instead of being on your normal base ward you head to the acute medical ward for handover from the night shift medical team.The day team then split themselves between the ambulatory unit and the acute medical ward. These shifts are quite intense as they are ward based 9-5 and then from 5-9.30pm the day team are responsible for providing medical cover to the whole hospital for the evening until they handover to the night team.
While these on call shifts are very busy, they have been great learning opportunities. Many of the patients from A&E who need admission move onto the acute medical ward unless they need specific treatment by a speciality team or will be in hospital for longer than 2-3 days, this means I got the chance to follow up lots of the patients I had clerked in A&E which was interesting. I also got experience of completing more ward based tasks such as chasing blood tests and scan results. For one patient I was the person liaising with another hospital where they were receiving treatment for a long-term condition which was a bit scary! I was also involved more with relatives, explaining to them the treatment plans and talking about discharges. You spend so much time as a medical student observing, it’s been enjoyable in assistantship to be doing more and feeling like I’m contributing to the ward team.
The downside to having a bit more purpose and looking like you might know what you’re doing is that nurses on the ward come up to you and ask you about patients, medical students in lower year groups ask you if any of the patients on the ward are good for practice histories and examinations. At the moment I can still say “Sorry, I’m not a doctor, I’m just a medical student”. I can’t use that excuse for much longer though which is equally exciting and terrifying!
Now that we’re done with finals, elective is over and most of the difficult assessments are behind us, our cohort members are able to relax a tiny bit and enjoy the final tasks of medical school: trailing F1 doctors, getting stuck into teams in the hospitals, and learning the practicalities of how doctors actually do their jobs on the wards. This is the Assistantship phase, in which we learn what it takes to be a junior doctor, and prepare properly for our role in two short months! It’s hard to believe that we’re so close to finishing now.
The medical-school admin team try to match up students who are staying locally for their foundation years with the team that they will do their first rotation with. This way they can get to know the actual team and wards they’ll be based on when they start. It seems such a nice way to ease into the world of working on the wards and relatively stress-free. Those of us who aren’t staying around, however, are unfortunately not so blessed. I am planning to go to a hospital in the Southwest of England and therefore my experience on Assistantship, like the majority of the cohort, is sadly more generic. It’s absolutely fine, however, and every bit as useful as I would expect.
However, I think I have been lucky with Assistantship in some respects: two of my rotations in my first year of the Foundation Programme are respiratory medicine and upper-gastrointestinal surgery, and these are the two areas where I have been placed for Assistantship. This means that I will have some idea of what to expect next year and what F1s are expected to do in these roles. Although each trust is different (this is stressed a lot), some things will be common between all hospitals in the UK. I imagine this includes things like the types of procedures that are carried out in surgery, the demographics (roughly), the types of conditions that are present on respiratory wards, the general treatments and so on.
Outside of Assistantship, I still try to teach students in younger years when I can for a couple of reasons. First, I honestly believe that nobody should be in competition with one another in medical school – we are all here to help one another out, because if we become better doctors, then our patients are the ones that win. Second, I have certainly attended more than my fair share of peer-support sessions over the years and the least I can do is repay the favour in kind. A few weeks ago, I taught some second-year students at a weekend (people give up their weekends to be taught – amazing dedication!) and, I have to be honest, I’m quite glad that that part of my life is behind me. Although medical school has been fun, there are some parts that I’m quite happy not to repeat! Now I’m looking forward to the future, and enjoying the last parts of the journey along the way.