April 12, 2021

The end is in sight

The past couple of weeks feel as though they have gone both very quickly and very slowly. I think that’s just a reflection on every day being almost exactly the same. I’m sure that you already know from my last blog, but I am currently in the midst of the revision block before my final exams in almost exactly 2 weeks. This is week 6 of 8, and I feel as though I have made startling progress so far. Mostly I have been going over things by myself, practicing my academic and clinical knowledge together to try and integrate things and bring all of the knowledge and skills we have acquired over the course into a homogenous whole. The university has also run some practice sessions for us which are similar to the actual final exams – one of these was the GP session I had last week. This session was run online by one of our GP tutors and involved taking a history from a simulated patient whilst the GP watched and then asked questions at the end. Doing a history online is quite…awkward! It is difficult to read a patient’s cues and facial expressions when you can’t see them. However, I think the session went relatively well and I had some good feedback from the tutor. It was also good practice because our final 'long case' exams this year will be online so getting used to talking via webcam is useful.

The last two weeks have also been exciting for a whole different set of reasons. As well as our final exams, we also have to be applying for doctor jobs if/when we finish the course and graduate. This process is complicated and starts at the beginning of final year and essentially you rank areas and then jobs in that area and then are scored based on your Medical School performance, amongst other things. I am delighted to say that I got into my first-choice deanery (West Midlands) which was essential to me as my partner can’t move due to work. This means that we can live together when I start work as a doctor and both commute into Birmingham. I am originally from Birmingham, did my History degree there, and now I’m going back! I don’t know which hospital I’ve been assigned to yet, but I’m not really too fussed – the jobs are essentially the same and I was just keen to be going home and around family and friends for what I’m sure will be a busy and exciting two years of the Foundation Programme. I’m excited to be returning to the second city to start my career as a doctor. Coming to a Birmingham hospital near you! (If I pass my finals that is…)

This week we had a clinical skills practice session at the George Eliot Hospital. I have spoken of my fondness for the George Eliot (or 'the Eliot' as some call it) previously, as the clinical education staff are fantastic and really go above and beyond to make sure we have a good experience. For this session, the clinical education department had set out all the equipment so we can practice our skills on things that come up in practical OSCE exams. These skills include things such as taking blood samples, doing an ECG, catherization, feeding tubes, airway procedures and delivering drugs via various methods. Going over the skills was really good practice and actually reminds us of how much we’ve covered over the course – our training is very broad based to enable us to be pretty competent at a huge array of things. I particularly struggle with catheterisation as there are a lot of steps to remember to make sure infection is not introduced, so having the chance to practice was super helpful. Knowing that a job is waiting for me at the other end is a big morale and motivation booster. Not long to go now.


March 18, 2021

Revision, Revision, Revision

I am now in the midst of week 5 of my ‘Revision Block’ and, you’ve guessed it, it has been full of revision. The days are starting to blur into one if I’m honest, but it is the final push to the finish line of medical school so I am actually feeling very motivated to work as hard as I possibly can. Our 8-week revision block is actually a long time to be constantly revising, so to keep things fresh, I like to mix and match in order to keep things fresh and stop myself feeling too fatigued. One of my favourite revision techniques involved a whiteboard: I find it a great way of summarising notes of a topic and drawing out diagrams, it also gets me on my feet so is a little bit more involved than sitting at my desk reading.

Aside from studying alone, I have also been getting together with my clinical partner. We take it in turns to “teach” a topic to one another, which is a fantastic way of helping us both fill gaps in our knowledge. We also invent patient cases and discuss together how we would approach them together. I honestly feel so lucky to have such a close relationship with my clinical partner, it makes the looming spectre of exams far less nerve wracking not having to go through revision alone. We’ve got through all of medical school together from first year anatomy, placements, and now is the last push!

Speaking of partners, my actual (non-clinical) partner has become my own personal simulated patient. He must have had more examinations than a ward full of hospital patients by now. It’s quite entertaining to see him start to pick up some medical knowledge simply by being exposed to it over and over. Whether it’s medical podcasts in the car or practising my abdominal examinations, it has been impossible for him to avoid it. In all seriousness, having someone to practice the examinations on has been really helpful in the build-up to practical exams.

The university is also hosting a variety of voluntary sessions that I have been making the most of. This week, for example, I am attending a practical skills workshop on obstetric palpation (feeling baby in a pregnant mother’s womb) and also a session on taking sexual health swabs. These sessions are overseen by clinical teaching staff who give us pointers on perfecting our technique and building on our knowledge. I find these sessions really useful because, whilst revision is self-directed, it is comforting to have the Medical School as constant source of support and guidance throughout this final push. 4 weeks to go – bring it on!


February 24, 2021

The Last Day of Placement

I had my Prescribing Safety Assessment (PSA) last Monday and I would be lying if I said I didn’t find it tricky! It was a weird experience sitting the exam at home, made more difficult by the lack of the adrenaline of the exam hall to really get you into exam mode. However, I sat it and it’s done – results pending. No-matter the outcome, I’m simply happy to move on and get stuck into revision for real.

Last week was my final official week of medical-school placements as my surgical block came to end. Whilst it was a milestone moment I felt it was all rather anticlimactic as I have spent much of the last fortnight revising for my two prescribing exams instead of at the hospital. However, we did have a mock-OSCE on Wednesday which was arranged by the block lead and some of the doctors involved in teaching the block. Just to remind you of what an OSCE is, is a clinical-style exam where you do activities and have a discussion with the examiner. This was just a practice but actually it was really useful for getting back into the swing of doing timed OSCEs and also for gauging where we are in relation to the level expected of us for finals. It feels strange to say, but I quite….enjoyed the exam! It involved various stations including one station where we had to do a suture whilst being observed. We were given marks for each station and then the highest scoring candidate gets a certificate. I’m proud (and very, very surprised) to say that I got the highest mark! I have to say that I probably struggle with confidence generally, but receiving this good news gave me a little boost and definitely makes me slightly more confident going into finals revision. Added to this is the fact that the surgical block has re-ignited my passion for medicine in general. I do think that in my surgery block I have seen the best of what medicine can do for people – seeing people at their worst moments, their moments of pain and tragedy, but also seeing how medicine can improve people’s lives.

What will I be doing now placements have ended? The next 8 weeks are a revision block called Advanced Clinical Cases (ACC), which is largely self-directed in nature. This means that the medical school and hospitals are putting on activities (such as examination practice), but it is totally up to us what we decide to go to depending on our own learning needs. I’ve booked in a couple of ward sessions to practice my examinations and history taking and also a couple of procedure practice sessions (so practicing taking blood on mannikins) – as these procedural skills do come up in finals. Warwick uses the ‘spiral’ curriculum method, which basically means that essential topics are visited several times throughout the course. The topics we learned in Phase I and Phase II come up again in finals, just in more depth. This means that we go over the basics several times and become really confident at managing common conditions such as heart attacks, lung infections and diabetes, because we’ve learned the principles of these conditions throughout the course. The next 8 weeks are sure to be tiring, but I’m excited to learn and improve. Bring it on!



February 02, 2021

Prescribing

The last 2 weeks have been full of prescribing. Here at Warwick, we have to sit 2 prescribing exams in our final year – one of these is a national exam, the Prescribing Safety Assessment (PSA). All final year medical students in the UK have to sit the PSA, which covers the most common drugs and prescribing scenarios newly qualified doctors are likely to encounter. The PSA covers a lot of emergency situations such as prescribing drugs for conditions such as anaphylaxis, infections, and heart attacks. In addition, newly qualified doctors work on medical and surgical wards, so some of the questions ask about long term management of common conditions, including high blood pressure, kidney problems and lung conditions. Other questions may be based around the complications of commonly used medications – one common example is high potassium levels in the blood, which is a very common side effect of blood pressure medications. There are a LOT of medications which are used in medicine, which can be daunting to learn. However, the scenarios in the PSA exam mostly focus around the most common drugs and drug categories, meaning that revising for it is actually really useful preparation for life as a doctor. This is because we will be seeing patients who take these medications on a daily basis. The PSA is mostly theory based and asks about the theoretical knowledge of prescribing.

The other prescribing exam we final years here at Warwick have to complete is the Warwick Prescribing Assessment (WPA). This exam is slightly different to the PSA in that only Warwick students sit it, and the content of the exam is more practically based. So, for example, the PSA may ask a question about what drug you would use for x condition, but the WPA will have a drug chart and ask you to prescribe it for use. I quite like the WPA in that it tests the actual skills required for prescribing – its good practice. That first time being asked to prescribe an anti-sickness medication as a new doctor will be less scary knowing I’ve done it several times before in practice for this exam. I feel as though this is in keeping with Warwick Medical School’s ethos that graduates should be good doctors who can fit into teams well and do the job to a high standard from the very beginning. COVID-19 has had an impact on our WPA exam, so rather than sitting it in an exam hall, this year we are doing the same exam at home whilst being invigilated remotely. This of course still tests the same knowledge but means that we can have a cup of tea with us for the exam which will surely help with those exam nerves.

The prescribing exams can appear quite daunting – there are so many different medications and it is impossible to know all of the drugs (including uses, side effects, monitoring) in complete detail. However, I feel as though some of my prior experience may come in handy - I worked for 2 years in between my History degree and starting medicine. For one of these years, I worked as a dispenser in a hospital pharmacy where I dispensed lots of medications and looked at quite a few drug charts. Hopefully that extra experience stands me in good stead for these exams. I will keep you updated!


January 18, 2021

Care of the Surgical Patient

I’ve come into this block feeling refreshed and rejuvenated after the Christmas holidays and have just completed the first two weeks of my Surgical Patient block (my final specialist block of medical school!!) When I look back over the last three (and a bit) years, they have been filled with highs, lows and plenty of hard work – but I wouldn’t change it for the world. I feel as though things have come in a neat roundabout circle as my last block is surgery and Gastrointestinal medicine, and my first block in my first year covered the basics of this area of medicine. I, too, feel like I have come full circle in terms of motivation and drive. I started Year 1 with energy and determination and I again feel energised and ready to approach the next few months with the necessary determination to hopefully finish the course.

…Which is good as there is a lot to do. I have two prescribing exams at the beginning of February, and then written and practical exams in March. As well as this, I still have to engage with this block and learn enough about surgery to be able to cope as a junior doctor on a surgical ward. So, what have I been up to? Well, for this block I have not one, but two surgeons, making me slightly spoilt for choice. I have a general surgeon (so digestive system amongst many other things), and a urologist (male reproductive tract and male and female urinary systems) as my consultant supervisors. Last week I was lucky enough to attend general surgery clinic which I found really interesting, which sort of surprised me. I am still unsure what career path to go down but had thought general surgery wasn’t for me up until this point. I found the clinic really interesting and actually quite innovative with some of the novel techniques they use to sort digestive problems. One of these techniques is what they call a seton, which is essentially a specialised string which they put through false passages which helps the passage heal correctly – very cool stuff!

We have also had lots of tutorials from experienced surgeons in this block, and one of the most engaging of these was a session I had last week where we were taught how to suture. Suturing is one of the most basic surgical skills, but that doesn’t mean it is easy! All doctors need to be able to suture, of course surgeons need to be able to suture to close wounds, but also doctors working in A&E or General Practice need to be able to close small wounds and injuries if necessary. We had three experienced consultant surgeons teaching us how to handle the equipment and do a basic interrupted suture. This is where the needle goes through the base of the skin and is then tied above the skin to close the wound. We were also offered a challenge – one of the surgeons had created a laparoscopic training ‘game’. Laparoscopic surgery is commonly called ‘keyhole’ surgery as rather than large incisions, small incisions are made, and a camera and tools are used to complete the surgery. The game involved a webcam and two tools inside a box, and involved picking up rubber bands and putting them on small pegs. The person who did the most of these was the winner and would get a certificate, and unbelievably, I won! As I said earlier, I haven’t really considered surgery as a career in seriousness, but I found the game fun and have really enjoyed this block so far, so you never know…



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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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