November 28, 2019

Back to Hospital

This week we ended our research block and started on Advanced Cases 2 (AC2). The idea of AC2 is to get us back into the swing of clinical medicine again, after not doing anything clinical for over 3 months! On Monday and Tuesday this week we had lectures which cover very broad topics: chronic disease management, emergency surgery and revision of diabetes. These lectures are mostly things that we have done before in Phase II, so they serve as revision of core topics and also build slightly on our pre-existing knowledge, with more of a focus on actually managing a patient. Phase I introduced us to the basic science needed for medical practice, Phase II aimed to make us comfortable with clinical history and examination, including some basic diagnosis. Phase III starts here, and the overall emphasis is on how to diagnose and treat people as they come through the door.

Today in hospital we had our first Case Based Discussion of Phase III. A Case Based Discussion is where we go out and find our own patient to talk to, and with this patient we talk to them about why they came into hospital (i.e. take a history) and examine them. Then we meet up with a doctor and have a discussion about what we found out and what we would do to investigate, diagnose and then manage that patient. In our first discussion of Phase III, it is clear that a lot more is expected of us than last year. It was very much clear that we need to not only be able to take a good history and examination, we also need to be focused and able to logically think through diagnoses, eliminating them as we go. It was a bit of a shock to the system to firstly not have done any clinical medicine for months, and secondly, have a lot more expected of us! Needless to say, I was very rusty and not very smooth. I hope that as I get back into the swing of things and become a little bit slicker than I was today…

November 26, 2019

Off to GOSH I go

I’ve decided to make this blog not about transition week, but about the GOSH conference I was lucky to attend. I arrived into Euston at 7:30am from the 4:45am wakeup call and hopped over the road to the Welcome Collection. I have never been more grateful to have the conference so near to the station! I arrived and basically jumped straight into helping. I was invited down to help with the conference, but it was not until I had arrived that I realised exactly what I was doing. They were letting me loose with the official GOSH PGME twitter account. I was a bit in shock, me? I got down to helping lay out the lanyards and said hi to the faces I knew from the team and was re-united with faces who I saw at the Summer School in July.

The day began with some speeches from an ex-patient at GOSH who talked about her condition and how she lives her life outside of just medical treatments. It was such an inspiration to be able to sit and listen to her and she explained how best to support children with the transition from child to adult services. We then had a speech looking at physician health and how we can prevent burn out. The quote that stuck with me here was “we can’t prevent burn out, but we can support it and prevent it getting worse”.I have to fully agree with this quote. We can try our best to keep heads above the water but we will get tired of treading water and will sink. However, it’s about not making the situation worse that it falls into depression. It was such a powerful speech that I nearly missed the beginning of the next one. Professor Dame Jane Darce talked about cracking the glass ceiling in medicine. She began by asking the crowd if we thought we had cracked the glass ceiling. Considering about 50-60% of the people in the room were women, only two people put their hands up. She then asked about if we had made a chip. Nobody put their hands up. Dame Darce then went on to talk about some of the micro-aggressions she had faced throughout her career and I was shocked that attitudes still existed in today’s NHS. She went on to talk about how we need to fix this culture through male allies and by strong role models. She ended by quotingMadeleine Albright — 'There is a special place in hell for women who don't help other women'.

We then had a quick coffee break with the BEST cookies in the world (yes, I know I should be talking about the conference but conference food is amazing). I was given freedom to move about the conference as I pleased so I went to a talk titled how to Harness the power of your learning environment. I considered since I was now in a different learning environment, this would be helpful. She talked about her LOAF and BREAD model and how this incorporates into the main theatre list briefing.At the end everyone in thetheatre introduces themselves, role and what they want to achieve from the day.This allows everyone to be reminded about names, roles and more importantly, competency levels. I could see how this would be incredible for us students as it can be a bit intimidating to ask to cover one area so to be invited to speak up, would be so useful. We then had a presentation by Mr Ross Fisher who talked about how not to do presentations. It was easily one of the best talks I have sat in all year. He talked about the statistics behind long conference talks and uptake of information (1.5% of every 200 facts). He talked about how we need to re-look at our education as PowerPoints serve less of a purpose than they once did. With food for thought, it was lunch time and an opportunity for me to look at the posters presented. I hope to present one day here myself but for now, I’m happy just to look at the posters. I also got to have a go on some simulation software in the form of a computerised dummy which can cry, has a palpable pulse, shows capillary refill time and has a head that turns to sound as well as other features. It was incredible as I’ve never seen something like that before even though it was slightly terrifying to watch.

In the afternoon we had further talks on ethics in caring for the child in hospital, the ins and outs on how they managed to anaesthetise the two conjoined twins over the past year (venous system, arterial system and finally the craniums) and how the GOSH school runs alongside medical treatments. A powerful quote came from the GOSH school speech which was “how can you expect me to become a doctor if I can’t get off the ward into school”. It hit home about not just treating the child but their entire life outside of their condition. We could be treating the next prime minister, the next break through scientists but if we don’t allow them the opportunity to have the chances medically fit children do, they will struggle to achieve their potentials.

I could go on about the GOSH conference for a few more pages but I am aware of the word limit we have on these blogs! The day finished with a final lecture about the DRIVE team at GOSH who are developing new technology for use in healthcare and then a performance from the London International Gospel Choir. They were incredible and such an amazing end to a brilliant day. I am so grateful for the opportunity to help out and I know one day, I will end up at GOSH because they are the type of people I know I want to work with in the future.

November 15, 2019

Can I step outside for a minute?

We have been chugging along nicely with AC1 counting down the weeks until transition period. I am feeling slightly less nervous about it, but I am still a bit apprehensive about what is to come. However, we have had our last double weekly CBL sessions and have had our first “big” once weekly session, of which we will have in CCE1. I really did enjoy this, it was faced paced and it felt like we got a lot done in such a small amount of time. I got to indulge myself using my new whiteboard markers as I was scribe for this session. The board looked like a unicorn had given their fair share of input by the end.

We have also come to the end of my CLO sessions. My last session was with the vascular access team at UH where I was to watch a PICC (Peripherally Inserted Central Catheter – totally didn’t have to google that) line inserted into the arm of a patient who was unfortunately having to undergo chemotherapy. lt was such an interesting morning as I got to see several medical devices used. First was the ultrasound machine. This was used to see if the veins in the arms were viable for use of the catheter. Veins collapse under pressure from the probe whereas arteries do not, I was standing in the corner of the room watching this machine with awe trying (and failing again) to go over my anatomy of the vessels in the arm. I also got to see a very basic ECG machine used as this helps the vascular access team determine if the line is correctly placed in the heart. The ideal spot for the line is just above the right atrium where the pacemaker cells for the heart are also located. This means when the metal wire enters this area, we would see a change in the ECG in the form of a heightened P Wave (this is the wave the heart produces when the top (atriums) of it contracts). I was eagerly watching the screen of the ECG machine, but I suddenly began to feel very hot, and suddenly very ill. I tried to see if it would pass but after 30 seconds there was a very real possibility, I was going to be ill over the patient which isn’t really what you want to be doing so, I asked to step out. I was really annoyed because I had been in so many surgeries before, seen lots of blood, bones, gore and brains and loved every second. Yet, a simple PICC line with some bleeding made me take a turn. I was confused as I had eaten that day, had my morning coffee, yet this still happened. I went to sit in the break room where I bumped into Sam who is an ex ODP in my year and he was chatting to me and just cheering me up in general. It was the frustration more than anything that was bringing me down.

It is perfectly normal to feel a bit funny at any point of any procedure and I know the staff at the hospital would rather that we took ourselves away rather than, well, throwing up on the patient. Apparently, it creates some sort of infection risk, who knew? However, I can’t wait to get into surgery, I want to scrub in, and I want to be able to help in ops but I guess I just have to accept that I had one funny turn.

We have also now been allocated our transition week and thus our CCE departments. Turns out I won’t have to wait that much longer to get into surgery as I am in the anaesthetics department!! I have a consultant whose name reads as “Dr Ready” which I believe is the best name you could have as a doctor (apart from Watson or Who). This has slightly made me happier about transition weeks but since I am in a department and not a Ward, I am worried about how I settle in to my new “lecture theatre”. I can’t wait to start feeling more like a doctor though, more like I can be useful on the wards. I keep reminding myself I already know some consultants (Dr Burbridge I can imagine will be getting a couple of visits off me) and I do know some Warwick Grads who are now F1’s. I imagine my next blog will be reflecting on how transition weeks have gone. I guess the biggest downside is having to catch the 50-minute bus from campus every day, it’s bad enough having to get it once a week! Thankfully I now have a driving test booked for January so hopefully, I'll be less of a bus hobbit come the new year. Onwards and upwards !

November 13, 2019


As I approach the last 2 weeks of my research module, I have been reflecting a lot on research so thought I would share some of my musings with you all! Both during our studies at medical school and throughout our careers as doctors, we are expected to practice reflectively. This involves looking over our experiences, considering what went well and what could have been improved, and reflecting on how we can learn and grow both professionally and personally going forward. Personally, I find it useful to have a model to help structure my reflections, one of my favourites is Gibb’s model. This model breaks down the reflective process into; describing an event, considering your feelings about the event, separating the positives and negatives, and finally analysing it to ultimately figure out what you could do better next time. It’s not important to stick to this structure rigidly, but it can give you a helpful guide to gather your thoughts.

As part of my teaching certificate and research project I have had to write reflections for grading, which, whilst it sounds scary, I actually find useful in organising myself and getting things off my chest. I know many of you reading this will be aiming to get into medical school, and at your interview, you will be expected to have reflected on your experiences from work experience and during your previous degree, explaining how you have learned from what you have done and how this has helped your personal development.

To give you an example of how I write a reflection I have shared one with you below from my research project.

‘The most challenging aspect for me was the period of drafting the protocol. One of the most difficult aspects of this was the fact that at the same time as writing the protocol, I also still had my second-year academic commitments, so was still attending placement and trying to get signoffs to complete my engagement criteria. At times I felt as though because I was juggling two workstreams which were equally demanding [albeit in different ways], I could not give quite 100% commitment to either. At times this was frustrating as my personality is that of a perfectionist, so I find it unsatisfying to not produce work up to the highest standard. Overall, although difficult at the time, I now accept that it also taught me an important lesson on that of the life of a doctor in the 21stcentury – increasingly doctors are embracing ‘portfolio’ careers with several themes and have to be the master of many trades. In hindsight, I should have accepted the iterative process that research is and accepted that improving upon each redraft is enough. Work doesn’t need to reach the unrealistic standard that I sometimes set myself and I also need to ensure I maintain my time for wellbeing when under a heavy workload. Being more aware of my personal tendency to perfectionism is a personal lesson I will take away and as a result in future when needing to balance many competing interests. I would take a more relaxed approach and try and get less stressed, perhaps being kinder on myself and more realistic about the quality of a 7-week research project.’

By reflecting as I go through in this way, I can think about how things are going and overall grow, in both confidence and abilities. The research module has been slower in terms of pace but it has given me a calmer period to take stock of everything I’ve learned so far and how far I’ve come from the first work experience I had in a local GP surgery when I first “tasted” medicine and realised this was what I wanted to do. The first step is a big one, but if you have an inking it may be for you; take the leap. And don’t forget to reflect on it!

October 31, 2019

The Life of a Researcher

This week I continued to teach first year students Basic Life Support. Over the last few weeks we have covered basic first aid, as well as skills such as dealing with bleeding, choking and drowning. Next week my group of first years have their exam to earn their qualifications and I have to say I’m nervous for them!

This year Warwick Medical School have established a new programme to develop our teaching skills, having the opportunity to work towards a certificate or qualification in teaching. This also includes lectures and workshops from members of the faculty on how to teach effectively and be the very best teachers we can be. Over the last few weeks I’ve attended a session on teaching theories and soon I will be attending workshops on group work, giving lectures and giving feedback. These are delivered by faculty members who have been involved in medical education and have years of experience in teaching medics, so we get a chance to learn from the best! It’s really exciting that all the peer teaching we do is recognised and supported by the medical school and that we also get a certificate for our portfolios and develop teaching skills for our future careers.

During this time, I have also been carrying on with my research project module and have been conducting further interviews over the last few weeks. The people I am interviewing have freely given their time, for which I am hugely grateful! I was supposed to be doing 10 interviews but have really struggled to get participants to take part, which is one of the challenges of doing a student research project where there is no funding and only 8 weeks to do the research. Added to this, my research is interviewing an underrepresented population who are traditionally hard to get to take part in research. I’ve certainly given myself a challenge! I have however enjoyed the slower pace of this module, with pretty much all of my time free for self-directed learning. It has been a welcome recovery period after the rollercoaster of first- and second-year medicine.

We also received our timetables for all of Phase III recently as well. Phase III is third and fourth year and makes up the final part of our course. We are split into streams and rotate around areas of medicine and surgery over the space of 18 months. My first placement is in Psychiatry, starting in January and lasting 6 weeks. I’m glad to have Psychiatry first as it is certainly one of my weaker areas and Psychiatric issues appear in other clinical settings such as GP, A+E etc. Getting a good strong ground in Psychiatry from the start will hopefully stand me in good stead for the rest of Phase III.

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About our student blogs

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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