All entries for Monday 10 February 2020
February 10, 2020
This week we got to have our first taste at being a GP. I have to admit , it’s not a career that I have ever seen myself going into. I thought it was all going to be colds and coughs but, I was proved wrong!
Our GP is the Gabels Medi Centre so, it isn’t too far to get to and when they said our first week started at 10am, my tired brain celebrated! I could get up after 7am! We were welcomed and made to feel part of the team immediately and it felt amazing to be there. I was initially out in to observe a nurse and I got to see 12 month vaccinations. It sparked a conversation about the anti-vax movement which is increasing in the UK and the mum herself knew of someone who was anti-vax but had managed to be persuaded to give her child the vaccinations. It was interesting and gave me a bit of food for thought for the day.
In the afternoon we attended the sister practise up the road and met our mentor who was to oversee us through the next 7 weeks. We also run our own consultations in GP but I didn’t expect to be running them on the first day. I did feel a little out of my depth but I soon began to enjoy it. It’s nice having the GP there in the back of the room to glance to for help. In fact, on my first case I virtually ran to her in my mind as my patient had a rash from a suspected diabetic foot complication. They were a lovely patient but unbeknownst to me, I had severely over run my appointment! Must.Get.Better.At.Directing.Consultations......
However, my other patients were also lovely and the most surprising thing to me was the variety. I honestly did not expect to be jumping around each system between appointments, especially at this time of the year when colds and coughs are rife. It was also nice to get feedback from both my CP and GP and also give the same to my CP. I think we are both wobbly on histories and we both need to work on getting our consultations quicker but we came out of that day beaming.
It felt like we had made a difference to patient care, especially when the GP was going off our suggestions! I had my foot patient coming back for the next week so I need to read up on diabetic treatment. It felt amazing to be put on the spot but also to drag information from the depths of your brain and put it into practical use out in healthcare. I think we both went home thinking a lot more about GP as a potential career but I know that paediatrics is still my forward choice at the moment.
We’ve also had our first community midwife shifts and again, I loved every second. I met a two day year old baby and I had to control every fibre of me that just wanted to pick her up and have a cuddle. The visit was to check in on both mum and baby and to answer any questions mum and dad have. It was clear the little one was a tad early but apparently that’s all babies, appear when you’re not quite ready ! I also got to see a heal prick test carried out on a 5 day old which was nice to see as we were taught about these in Block 5 last year.
In the afternoon I got to sit in on some check up visits with mums still pregnant and help the midwife with urine dipsticks and got the chance to feel the bumps for babies' head and bum. It felt amazing to be allowed into such an important part of the couples lives and I was allowed to take a maternity information pack away with me to look at in my own time.
Im finding that I love the clinical side of the medical degree. It’s making me think of other career options and being able to put into place all the theory I learnt last year, put all that work last year into context. We’ve got labour ward shifts coming up which I am really looking forward to… well, apart from the early starts! 'Til next time – Abbie.
It has been another busy week for my clinical partner and I. Up until now most of our experiences with psychiatry have been in an outpatient and community settings, so we were both looking forward to seeing how acute psychiatric issues are dealt with. This week, we have been placed on an acute psychiatric ward this week, in a Psychiatric hospital. It was interesting being able to sit in on the ward rounds and see the various conditions the team must deal with on a day to day basis. These conditions are amongst some of the hardest to treat medical conditions and include; severe depression, anxiety, mania and personality disorders.
Our consultant was keen that we get involved and gave us the opportunity to practice our history taking with patients where we could get consent, although admittedly it was a whole new experience when compared to your standard history taking scenario. Some of the conversations we had and listened to this week were very emotionally difficult for all involved, and I have huge admiration for the staff and indeed the patients who have to work to improve often difficult situations.
This week we also had an academic day where we were given an introduction to prescribing. I had been looking forward to this for some time, as prior to starting medical school I worked in Pharmacy as a dispenser, so I was waiting for an opportunity for my pharmacy knowledge to become useful! We had lectures which focused on the basics of pharmacology relevant to prescribing, a lot of which was revision from our first-year studies (which feels like a long time ago!) We also had a lecture on some of the pitfalls of prescribing, for example, making sure that you write units in full to avoid confusion and also about some of the common errors junior doctors make. It turns out that junior doctors make 90% of prescribing errors, which I suppose demonstrates both how junior they are and also the fact that most hospital prescribing is done by the juniors. It was all slightly terrifying to think about how much responsibility we will have in just over a year’s time. I know first-hand from my previous work experience how crucial it is to get things right and minimise mistakes to make sure the patient gets the correct treatment.
We also had a lecture on the UK foundation programme, the two-year programme that all UK graduates must complete immediately after graduation. Up until this lecture I had happily forgotten how soon this process kicks off – by the end of this year we will have applied for our first jobs as doctors and ranked the areas we would like to work. Currently I want to stay in the West Midlands after graduation as I have had experience of many of the hospitals in the area, and I feel this will make the transition from student to junior doctor smoother. Allocation is completely points based, with 50% of your mark coming from your achievements at medical school and the other 50% coming from a test called the Situational Judgement Test. This test is sort of a test of reasoning. For example, the questions will be something along the lines of “This thing has happened. What is the most appropriate thing to do?”. We get lots of practice questions and cases in CBL, lectures and other aspects of the teaching so I hope that I will pick up the knack to it.
Next week is last week of our psychiatry placement, which means that we have to finish our sign-offs and say goodbye to our faculty team before moving on to our Acute placement block. Looking ahead at our timetable for Acute it looks to be a busy block, with lots of long days and night shifts. Some of these are in A+E, and others on acute medical wards. After Psychiatry, which is a very separate field to “physical” medicine, I have to admit that I am excited to get stuck in and have some exciting experiences on the very front-line of Medicine. However, it will be stressful – here’s hoping that my knowledge from exams comes rushing back….