All 42 entries tagged Joanne

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July 31, 2017

Perks of the job…

Being a graduate entry medical student is pretty tough, hours are long and the work never really ends so feelings of guilt are always present, having said that studying medicine is a real privilege and there are some excellent perks…you just have to know where to look for them! One of the perks of being a medical student is the opportunity to go to conferences. There are always bursaries and prizes available for medical students to attend conferences. At the start of third year all students must complete a research project and lots of my colleagues have been able to present their work at conferences. Some around the UK, to exotic places like Newcastle, and others have gone a bit further afield to present at conferences in Canada! Presenting an oral or poster presentation at a conference not only looks great on your CV but is a great opportunity to network with other students and doctors who share your interests.

This year I’ve had the chance to present my work on a medical education course for students at a regional medical education conference. This was not only great practice at delivering oral presentations but I got to meet lots of people interested in medical education. Many of the attendees were clinicians who also worked in medical education, I was able to quiz them about their jobs and how they got into their roles over coffee. I was also able to get to know senior members of the medical school better and understand what it’s like to work in management roles within a large medical school. The most recent conference I had the opportunity to attend was the International Congress for the Royal College of Psychiatrists which took place in Edinburgh. Although I wasn’t presenting at this conference I was able to attend fully funded as I had successfully applied for a fellowship from the RCPSYCH that supports students interested in psychiatry for 3 years, and as part of this you can go to the annual conference for the duration of your award! Being able to attend such a large conference was really exciting but also quite daunting. I took the opportunity to attend sessions on topics that I’m particularly interested in such as perinatal mental health, getting into research and improving medical education and recruitment to psychiatry. In between sessions I met lots of other medical students as well as psychiatry trainees in a special refreshment area reserved for Students and Trainees- a very friendly and welcoming place to enjoy the free conference food!  I was introduced to the Chair of the Psychiatry Trainees committee and learnt about opportunities to get involved in this in the future. I also made contacts with people in Warwickshire who I could get additional clinical experience with in sub specialities like Forensic psychiatry.

I’m looking forward to attending the conference again in the future and been able to present some of my work that my fellowship is supporting me with as part of my elective project. The medical student elective is another major perk of medicine-6 weeks to go and experience medicine in any part of the world! Our elective takes place after final exams in March/April and I’m hoping to go to Ethiopia and conduct a research project in perinatal mental health. We had to submit our proposals for approval last week so fingers crossed it will all be approved and I’ll be off to Africa! Medicine isn’t all that bad after all!

Joanne


July 21, 2017

Scrubbed up…

It’s now Specialist placement 5, the last block of year 3, and for me it’s my care of the surgical patient block. Despite all those years watching Grey’s Anatomy I’m not particularly interested in surgery and have spent most of my time in theatres so far thinking about lunch or how much my feet hurt! At the start of the surgical block I was definitely less than enthused and thinking more about my upcoming holiday in august than the anatomy of the abdominal wall, but I must say I have been pleasantly surprised!

I’m based at George Elliot, which is a small district hospital. Over the 6 weeks we rotate round 3 different surgical specialities: Urology, Colorectal and Breast Surgery. I’ve been with urology for my first 2 weeks, learning about different types of disease that can affect the prostate, bladder or kidneys that may require surgical intervention rather than medical intervention from the nephrologists. Clinics in urology are really varied; there is some overlap with gynaecology in women suffering from incontinence due to pelvic floor damage and there are lots of patients referred through the fast track system for worrying symptoms such as blood in the urine. Learning about the different investigations for these patients was something we covered last year but this year there is more focus on learning about the surgical management options, and how you decide which is best. Being able to get scrubbed up in surgeries means you can get much closer to the action and see the anatomical structures, and really appreciate the complexity of some of the operations. One operation to remove a patients kidney that had a tumour, lasted 6 hours, watching the surgeons avoid major blood vessels and control bleeding as they dissected the large tumour was fascinating. In contrast, another operation I observed was to remove a bladder tumour, which took less than half an hour-but to the patient these are both major, life saving operations.

As well as spending time in clinic and in theatres with the surgeons and anaesthetists we have also spent time with the junior members of the team while they are on call. The surgical senior house officer (not an FY1 but not a registrar yet) carries a bleep and sees all new patients that come into A&E or are referred by GP’s who may need to see a surgeon. This was a great opportunity for my clinical partner and I to take the history, examine the patient, come up with our differential diagnosis and decide what investigations we would want. The SHO was brilliant and gave us really useful feedback and helped us understand things we might have missed and importantly asked us to justify our investigations, something we have to do in our exams!

So 2 weeks in and I fairly sure I still won’t ever be a surgeon but so far I’ve learnt lots, which is always good with the prospect of 4th year approaching, and as an added bonus I haven’t fainted in theatres (yet)-win win!

Joanne


July 05, 2017

Fly on the wall

As a medical student, I spend a lot of my time hovering awkwardly behind consultants and other doctors as they see patients on the ward. In clinics, myself and my clinical partner are also squeezed into the room, often sat across from the patient, it feels like a follow up appointment in the form of a panel interview! I am always so grateful to patients and their relatives who are happy to put up with a committee of people on ward rounds and very crowded clinic rooms all so we can learn. I have been even more grateful over the last few weeks during my care of the medical patient block to patients and their families who have allowed me to sit in on clinics where doctors are regularly breaking bad news: the oncology clinics.

Cancer biology was not my strongest subject during my biomedical science undergraduate degree but in medicine it’s not just the underlying cellular and molecular biology that’s important, we need to know all the clinical manifestations so we can diagnose cancer, when to refer and what investigations are needed. So, in this block I decided to make a concerted effort to try and improve my clinical knowledge of both the diagnosis and investigation of cancer and of oncology as a speciality.

One of the clinics I attended was a fast track clinic for suspected lung cancer. GP’s can refer patients with symptoms or signs indicative of lung cancer and they will be seen in hospital within 2 weeks. Patients attending this clinic have often had a chest X ray and in some cases a CT scan before they attend so the consultant can in either reassure the patient or show the patient where the problem is that they need additional information from, perhaps in the form of a biopsy or a different scan. What struck me most in this clinic was the number of patients who were told that they had a suspicious mass in their lung but decided not to have further investigations, many were elderly and were quite clear that they didn’t want to undergo any further procedures. Having these conversations requires a very sensitive and perceptive type of doctor and is a very different type of medicine to what medical students probably envisioned before medical school.

Attending the oncology clinics, patients already knew they had a diagnosis of cancer but often didn’t know what treatment if any was available. These appointments lasted up to an hour and the doctors were clear that the appointment lasted until the patient wanted to leave, they encouraged questions from the patient and their family, and took the time to explain things multiple times. They comforted patients and relatives as they cried at the prognosis and then did it all again for the next patient.

All the time I’m sat in the room, a fly on the wall, observing how the doctor handles the different consultations, learning how they manage these complex patients, but all the while I’m trying my best to not get emotional too and reminding myself that it is a real privilege to be invited into people’s lives to experience their best and their worst times.


Joanne


June 30, 2017

Learning outcome number 1: Learn all of medicine!

My task this year, to learn medicine, all of it. The medical school would say I am exaggerating but this is what it feels like to be a medical student. It’s so difficult to know how much we need to know and in what detail, learning outcomes are supposed to be a guide and can therefore seem vague and textbooks vary so wildly that you start to believe that maybe Wikipedia does have all the answers (note to self, it doesn’t!). This is a universal problem for medical students but it’s especially true of the Care of the Medical patient block which I am just finishing.

In third year, our speciality placement blocks are just 6 weeks long. I’m sure I’m not alone when I say medical students are often quite organised people and are good at compartmentalising their learning. So far this has worked in my favour, Paediatric block, focus on children’s health, then for Obstetrics and Gynaecology focus on women’s health. This theory doesn’t work in Care of the medical patient…which bits of medicine, or just all of it in just 6 weeks? I started the block wanting to see and learn everything medicine had to offer but after trying to sort out a timetable and plan of action going forward quickly realised this was unrealistic and impossible!

Thankfully at UHCW our block lead had taken the time to give us a timetable to guide our learning with some gaps in that we could choose to fill (or not!). Every week we are assigned to clinics from different specialities to give us a flavour of the sort of patients those doctors see. I particularly enjoyed a haematology clinic where I learnt lots about haematological disorders (such as blood cancer) as well as loads about interpreting blood tests. I also got the opportunity to attend a Fast track clinic for suspected Lung cancer, this clinic has patients referred from GP with symptoms that could be indicative of lung cancer. Attending this clinic reinforced the symptoms and signs all doctors should be aware of to identify a lung malignancy and how you would investigate it. One day a week we are also assigned to a different speciality ward. Tied in joint first are my days on the Gastro ward and on the Stroke ward. The Gastro day saw us attend an epic 5 hour long ward round seeing patients with liver and pancreatic disease all over the hospital. On the stroke ward we got to take some interesting histories from some of the patients recovering from severe strokes which really helped me understand more about potential risk factors and warning signs for stroke, we also got the opportunity to examine patients and see neurological signs first hand.

As well as days and clinics in different medical specialities we are assigned to a care of the elderly (or geriatric) ward. Geriatric wards have bad reputation among medical students. Common beliefs are that all the patients have dementia or are confused so no one can give a good history, or that patients aren’t medically unwell so there’s no point in examining them. Having spent 6 weeks on the geriatric ward there is some truth to these beliefs but it doesn’t mean there is nothing to learn as a medical student. On the geriatric ward you learn more about co-morbid disease than anywhere else in the hospital, you learn how a person’s psychological state and their social situation impacts on their health and how this needs to managed by a whole team of people and not just a doctor with prescription pad.

So, I haven’t learnt the whole of medicine in 6 weeks but I’ve learnt a lot about being a doctor that can’t be specified in any learning outcome.


Joanne


June 15, 2017

Education, education, education!

You would have thought having gone through an undergraduate degree and then a PhD prior to coming back to medical school I would have had my fill of education but apparently not! Along with another student, I got involved in organising an optional course for third year students in medical education. Attending the course and then organising it this year has been a great experience and I’ve learnt so much about medical education and teaching theories and techniques. It’s helped me understand the different approaches the medical school use in our curriculum-combining lectures with more structured groupwork and then student led case based learning.

Before medical school I had some experience of teaching junior students in the laboratories I used to work in and at medical school I have taken part in OSCE teaching and student seminars, initiatives run by second year students in year 2 for students in first year. There are lots of opportunities to teach if this is something you are passionate about and its certainly something I would like to remain involved in as part of my future career. My enthusiasm for teaching and medical education has been encouraged by the medical school after I was asked to present my work on the medical education course at a regional conference. Myself and other students involved in student led medical education projects presented our work as part of a workshop, engaging with the audience and taking questions about our work. I also got to present my work at the local Warwick medical education conference. At both these events I got to learn so much about the challenges medical education faces and the new developments that are been made to continue improving medical education and training high quality and happy doctors.

Learning more about medical education theories certainly makes you assess your own learning from a new perspective! Having survived my speciality block 3 in Obstetrics and Gynaecology I have now moved onto my fourth block, which for me is Care of the Medical Patient. As the blocks fly by exams seem to be creeping ever closer and a sense of panic is starting to set in amongst myself and my fellow students.

Along with 3 other students I am placed at UHCW (the big hospital in Coventry) for my Care of the medical patient block. This block is designed to give us a broad overview of different medical specialities and allow us to fill in gaps we have from second year. There are a few things that I didn’t experience during core clinical education, so I’m hoping I can see more gastroenterology as I’ve made it this far through medical school without seeing many gastro patients! I would also like to see some procedures like endoscopy and bronchoscopy which I’ve never seen before. I think it’s much easier to explain a procedure to a patient if you have seen it done yourself and as this is a task that we can be asked to do as part of our clinical exams, I want to make sure I know what I’m talking about!

Watch this space to see if my enthusiasm for medical education theory can be translated into my own learning and practice!


Joanne


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Our Med Life blogs are all written by current WMS MB ChB students. Although these students are paid to blog, we don’t tell our bloggers what to say. All these posts are their thoughts, opinions and insights. We hope these posts help you discover a little more about what life as a med student at Warwick is really like.

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