All 129 entries tagged Wms
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!
Now that final exams have become nothing but sweet memories, we are currently making our way through our final block at Warwick Medical School. This is Assistantship, in which we learn everything that foundation doctors in their first year (commonly known as F1s) actually do. It’s a transition period where we put all of our accumulated knowledge into practice, so that we can hit the ground running in August when we start working as qualified junior doctors. It’s all becoming a bit real now!
The great thing about Assistantship is that we have a sign-off list of tasks that we have to be certified as having completed, but we don’t have the stress and pressure of exams hanging over our heads. This means that we can throw ourselves into learning in a supportive environment without feeling like we are missing out on revision or learning elsewhere, or feeling bad because there’s something else we should be doing (like burying our noses in books). And of course we get to trail F1s, who were in our places just one short year ago. It’s very collegial. The sign-off tasks include things like being present for death certification, shadowing nurses on drug rounds, making sure that we can complete an electronic discharge summary (a major part of the F1’s jobs) and many other day-to-day tasks on medical and surgical wards.
We are also required to complete a couple of out-of-hours shifts with our F1s. This is to prepare us for our medical on-call shifts when we are junior doctors and show us what it’s really like. I spent an overnight shift with my F1 earlier this week and it was really useful. Many people are understandably apprehensive about these shifts, because we’ll be on call overnight and the first doctor that most nurses will contact. But the good thing about having a couple of these shifts under our belt during assistantship is that we really see how well supported the F1s really are throughout the night. There are senior nurses on almost every ward, and loads of people (like registrars and even consultants) whom you can phone to ask questions if you need to. It’s all about knowing when you need help and whom to contact. I wouldn’t say that I’m going to be an expert by any means, but shadowing in this role during Assistantship has definitely helped prepare me and set my mind at ease – and that’s really the point of the entire block, isn’t it?
It’s hard to believe that it’s all coming to an end now. We are all packing up our houses and our lives and getting ready to move to another part of the country and be actual doctors! I think it’s really helpful, however, how the medical school manage the transition. Assistantship is exactly what it should be: a post-exams period to help bring us up to speed with the daily tasks and role of the junior doctors we will be in a few short weeks.
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.
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.