All entries for Thursday 27 March 2014
March 27, 2014
The light at the end of the tunnel, the thing that has kept us all going through the exam periods is finally upon us. We have all just finished our first week of our first rotation in hospital (or general practice).
Phase II starts with Junior Rotation where we have six eight-week blocks rotating through different specialities. I am starting with Orthopaedics and Anaesthetics, so simply put bone surgery and putting patients to sleep. We do this with our ‘clinical partner’, someone in our year that we have chosen to work with. When you pick your clinical partner it is suggested you pick someone of the opposite gender. The process of asking someone to be your clinical partner is like being back in secondary school and asking someone out to a school dance (at least I imagine this is how it would feel - I went to an all-boys school). All being well you will be with your clinical partner for over two years, it doesn’t take a genius to know that you have to pick your partner wisely!
Now, Phase II is very different to Phase I. Phase I was very structured; our days were full and we knew well in advance where we have to be and at what time. It is very much like our undergraduate degrees in this respect, but perhaps a little bit more full on. Phase II, the clinical phase, is very different to this. Before we start our block we are sent emails with our timetabled teaching (these are fairly spartan when compared to our previous timetables) and the name of our consultants, that is it. The rest is up to us. The guidance on the knowledge we should have acquired before sitting our final exams is in the form of learning objectives for each block. Some objectives are specific and some are vague, I imagine we will eventually develop the skill of determining how much depth to go into, but until then I will be drowning in an endless sea of medical information. This is all very alien when contrasted with the regimented style of learning used during Phase I. This is very exciting!
For each hospital rotation/block students are allocated two consultants, in this block I have one Anaesthetic and one Orthopaedic consultant. Students have to establish what the consultants expect; for example, when you will attend their clinical sessions (such as clinics and theatre), as well as deciding what we would like to get out of the block. My partner and I have decided that what we want from the block will mostly be dictated by the learning objectives.
Queue day one; we have nothing scheduled for our block so my clinical partner and I decide it would be wise to try and arrange a meeting with both of our consultants. We just have their names, so a call to the hospital switchboard and several different (wrong) phone numbers later and we have arranged a meeting with our anaesthetist and established that our orthopaedic consultant and his secretary are both on leave. This was quite handy as it meant we could devote our first week to one consultant and specialty allowing us to find our bearings and ease into things.
In my last blog I told you a bit about how much fun I was having speak to, and examining patients on the ward. I also wrote about how good my clinical tutor is and how nice he had been to us.
This week, while we were making our way round the wards, all together for the last time, a junior doctor stopped my clinical tutor to tell him that there was a lady on the ward with a really interesting heart murmur and that he should take us to go an have a listen. The junior doctor also wasn't quite sure what the murmur was so wanted our clinical tutor to confirm the diagnosis. Anyway, my tutor approached the patient and asked her if it would be OK for us to have a listen to her heart. Since he had recently explained heart sounds to me for the 16th time this term, he said I should listen because he was sure I'd get it.
I approached the patient and asked politely if I could have a listen to her heart and would she mind if I reached through her nightwear to do so. I think for a first year, this bit is always so embarrassing, even though there really isn't anything to be embarrassed about. I noticed she didn't have any underwear on, so asked if it was OK to just place my stethoscope under her breast. Of course she said it was fine, not giving it a second thought while I stood there awkwardly trying to co-ordinate lifting, whilst trying to put my stethoscope in place, whilst going slightly red and causing a fuss over nothing.
I managed to maintain some of the patient’s dignity when the junior doctor came in and said that this was not the patient that we were meant to be listening to, and it was in fact the patient in the bed opposite. My clinical tutor just made me stop what I was doing and I sheepishly apologised to the patient for the trauma she'd just experienced - (don't worry, she actually wasn't harmed during the process of my poor cardiovascular examination). We tottered off to the other patients’ bed quickly before the whole room noticed- the curtains are soundproofed too, right? I made sure I didn't go first this time, but on the plus side I did manage to get it right for a change. I blame my clinical tutor :-)
We're fast approaching the Easter break now which means one thing...... exams are just around the corner. Panic is setting in all around. It seems so ridiculous, being nervous about exams when there is still quite a long period of time between now and then, but here we are, five months into our medical degrees and it has flown by!
We have five blocks of learning in our first year, and at the end of each block we have a formative assessment, to help us identify how we have got on with the block and hopefully point us in the direction of what we need to revisit before the summative at the end of year. Unfortunately, every time I do a formative, it just seems to highlight that I need to revisit absolutely everything and makes me feel a bit more nervous about the summer. Anyway, we have five nice, long, revision filled weeks to buckle down before the last block. I'll have to make sure I have time to enjoy at least one Easter egg though.
See you soon