All 56 entries tagged Joanne
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June 11, 2018
I’ve now moved onto the second part of my Assistantship placement, after 4 weeks in A&E, I’m now on a general medical ward working with the haematology team. Working on a general medical ward is very different to A&E. Most medical wards have their own routine of ward rounds followed by various jobs. On a medical ward it’s also important to be proactive about planning for discharges. This is important to ensure beds are available in the hospital and to ensure patients get home quicker and in a safe and organised way. The FY1 is very important to this, as its usually their responsibility to write the discharge letters. This can be a tedious task but if it’s not done on time it can cause huge delays! Learning about managing jobs like these is something we didn’t cover in medical school, which is why we have our assistantship block to learn about these vital tasks and to find out what the FY1 has to do on a daily basis.
I’ve also had the opportunity to attend the twice weekly FY1 teaching. This has been interesting to see what sort of topics are covered and at what level. Once a week FY1s take turns to present sort presentations to each other on various topics, focusing on the role of the FY1 in recognising and managing those conditions. In the other teaching sessions, a consultant will give a talk focusing on common presentations within their specialty, again focusing on what is expected of an FY1 in those situations. I’ve been pleasantly surprised that the level of knowledge hasn’t been that different from finals, but there is more focus on local services and referrals processes. It’s often the FY1 sorting out tests or organising referrals to different services so it’s important they know who to contact in lots of different situations!
As well as spending lots of time in hospital during assistantship I also got the opportunity to attend the Warwick Medical Education Conference, an annual 1-day conference organised by the Medical school. Members of staff from the university and the local hospitals present their latest research and educational projects, and students also get the opportunity to present work they have done in medical education. Some students in 2ndyear presented the work they had done with peer teaching between students with non-science backgrounds which was interesting and I took the opportunity to present some of the work I did at the start of 3rd year (the SSC2 research block) when I conducted a questionnaire asking students about their career ambitions. My presentation went well and was early in the morning so I could relax and enjoy the rest of the day. It was interesting to hear about educational initiatives being trialled here at Warwick. I hope medical education and teaching is something I can be part of as an FY1, teaching medical students and as I become more senior teaching junior colleagues. I think teaching is a great way to bring variety to your medical career and to keep you excited and interested in your job in amongst all the shift work!
Speaking of shift work, I’ve shadowed the FY1s on some of their medical on call shifts, long shifts that take place 9am-9.30pm. These shifts are very hard work but this week I’m also going to go on some night shifts, I may be mad doing these voluntarily but I don’t my first night shift to be on my first job where I am responsible for patient care. Doing some night shifts during assistantship I can see what it’s like working at night in the hospital and what it’s like trying to work at 3am, while still being supervised in everything I do! Wish me luck!
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!
May 21, 2018
It’s been a pretty hectic few months, finals followed quickly by our Elective. When we arrived back from elective we went straight into the last part of our medical degree, the Assistantship. This is an 8-week block where we shadow the current Foundation year 1 doctors closely, so we are ready to start our jobs as FY1s in August!
Our assistantship started with 2 days of lectures at the medical school covering various topics about life as an FY1 doctor, including some top tips from current FY1s. How to stay on top of the dreaded Eportfolio and how to survive a night shift were topics I found especially helpful, if slightly scary to think about! The assistantship is split into 2 4-week blocks, with students covering a medical ward and then a non-medical ward such as surgery or psychiatry depending on what placements are available. For students staying in the local area one of their 4-week bocks will be on the ward they are due to start on in august, so they will have lots of opportunity to learn how their new ward works and soak up all the wisdom they can from the FY1 currently doing their future job!
For my assistantship I have started on A&E and then I move onto a Haematology Ward for the last 4 weeks, both at Warwick Hospital. Starting on A&E has been a great experience. The FY1 I am shadowing has been so welcoming and friendly and is full of helpful tips on how to survive FY1. In A&E I have been able to clerk patients as they arrive so have had lots of practice with my histories and examinations. If any patients need bloods taken or a cannula inserted the nurses have been sending them to us so we have lots of opportunities to practice. I’m getting better but still struggle with some patients, fortunately they seem to be the ones that even my seniors find difficult so at least I know it’s not just me! Getting confident with these clinical procedures is something I really want to do during my assistantship, if I can do the basics well as an FY1 the rest of my day will be much easier!
The FY1 I am shadowing also has some shifts as medical on calls, during the week this means covering either the acute medical ward or the ambulatory unit but on the evenings and weekends this means being part of the on-call team that covers the whole hospital out of hours. Having joined them on a few of these shifts, the amount of responsibility can be a bit overwhelming but that’s why you are part of a team. I must remember that just because I’m the FY1 doesn’t mean it’s just me-I can ask lots of people for help!
I’m looking forward to the rest of my A&E placement and then moving onto the Haematology ward. My first job is on a medical ward so it will be good to learn how a normal medical ward works differently from the fast pace of A&E.
May 11, 2018
Over 4 months ago I had just finished my final specialist clinical placement and was embarking on the epic task of finals revision. The first week of my Christmas holiday was spent trapped in my study, I was allowed out only for tea and bathroom breaks! This was a bit of miserable start to my holidays but it meant that I could take a whole week off over Christmas and enjoy spending time with my family. Our first exam was in the middle of February so before that we had 6 weeks of our revision block, Advanced clinical cases. All the local hospitals organised revision seminars for us, we had practice OSCE days (clinical skills like cannulation and wound care) and you could go on the wards to practice your history and examinations. Going into hospital was a welcome break from my study, and when exams were finally over in the first week of March I could finally breathe a sigh of relief!
It’s a strange feeling when you finish exams, you feel great, but almost immediately the worry about results sets in. Despite the horror that was the last few months of revision and how hard the last 4 years have been, it was all worth it as I passed! On the day of results, I had a quick celebratory cup of coffee with my friends and then instead of heading to the pub I had to sort myself out for my elective as I was flying 2 days later! I hadn’t wanted to jinx my results and think too much about elective so this meant that I had a lot to do! So less than 48 hours after getting my results I was on a plane to Addis Ababa, the capital of Ethiopia, for 6 whole weeks!
I enjoyed my elective so much, it was been a totally unique experience and one I certainly won’t forget. I’m interested in psychiatry and academic medicine so for my elective I had organised a small research project focusing on the mental health of mothers and the long term consequences for their children. I also spent some time in the local psychiatry clinics and made the most of my spare time and explore Ethiopia! I really enjoyed working on my project, it was totally different to any research I’ve ever done before and certainly made me think about how much of an impact mental illness can have on an entire family, not just on an individual. I’m still in the process of writing it up for publication, so fingers crossed! Gaining clinical experience in Ethiopia was very eye opening, there are only 70 psychiatrists in the entire country and culturally mental illness isn’t well understood, with most patients, even those with psychosis, been taken to religious sites seeking a cure for spirit possession or the “evil eye” before coming to the attention of a medical doctor.
I didn’t go all the way to Ethiopia to just sit on my laptop or in a dusty outpatient department so I made the most of my free time exploring Ethiopia. I stayed with a wonderful host family who cooked beautiful traditional Ethiopian food for me and I was invited to join them for their Easter celebrations, which involved the sacrifice of two very plump chickens to mark the end of fasting-this bit was tricky for me to enjoy as I’m vegetarian! I saw hippos in the Rift Valley lakes, fed monkeys from my hand, visited several UNESCO world heritage sites and enjoyed the most fabulous coffee in the whole world (Ethiopia is where coffee was originally grown and brewed!).
I arrived back from my elective yesterday yet it feels like I only just got my exam results. My elective supervisor kept introducing me to people as the newly qualified doctor, which felt very strange, but I suppose that’s what I am…almost. For the next two months I will be on my “Assistantship”, where I shadow the FY1 doctors closely and make sure I know what I’m doing before I am let loose on the wards in August! I haven’t taken any blood or inserted a cannula for about 6 months so wish me luck!
January 03, 2018
After what feels like the longest year that most of us can remember, we are finally done with our last block of the Specialist Clinical Placements. It’s hard to believe that from now on, it’s all going to be revision and clinical apprenticeships (presuming finals success…). I’m glad that we ended with the Psychiatry block, however, as it allowed us to focus on an area of medicine that we don’t see very much of outside of psychiatry, and hopefully having this block so late will keep the information fresh for our upcoming exams.
Our last week of Psychiatry involved more time spent in an acute-ward setting, and enabled us to see far more presentations of common psychiatric conditions, including Emotionally Unstable Personality Disorder, severe Generalised Anxiety Disorder and many other fascinating presentations. We were also able to see another assessment under the Mental Health Act, something which is taken very seriously (for obvious reasons) and is very thorough and complete. I’m glad that so much effort is put in place to safeguard patients who might not be in a safe mental state to manage their own mental-health conditions, and it’s good that the process is so robust and observed so closely. There really is a lot of legal scrutiny for the process of detaining patients in hospital, and every professional I have worked with has agreed that this is entirely appropriate.
Looking back on 2017, it’s really amazing to think of how much ground we have actually covered; there is so much that I didn’t know at the start of the year but have picked up throughout the course of the year through many different means: we’ve had large-group teaching, small-group teaching, one-on-one teaching, ward-based exposure and of course loads of self-study. My notes, however, are a complete horror show and I could easily spend the majority of the next two months just reorganising and getting everything into shape! But of course we don’t have time for that right now. It’s all about accessing, revising and hopefully committing to memory all of the information that we’ve learned over the past three-and-a-half years. The task is daunting, but I think we’ve climbed steeper hills (first year, I’m looking at you). My main goal for the first day of revision is to at least get everything on one disk drive!
Now that we are done with our last Specialist Clinical Placement, most of our cohort are now off on Christmas break – which will be nice, but of course we will have the additional spectre of upcoming final exams looming over our heads. I’m looking forward to leaving the UK for a couple of weeks – Coventry is lovely, but I think I need a change of scenery to keep from going mad – and hopefully some slightly warmer weather and creature comforts will be the perfect environment to start my revision.