All entries for February 2015

A typical day in the life of a Med Student

Being a student in the acute environment can be great, but also a bit challenging at times. Here is a typical day on placement in A&E:

8.30am
Arrive and introduce myself to the consultant and nurse in charge today. Pounce on a junior and ask what they're up to. As its early, the department is quite quiet and the juniors are mostly doing paperwork, and no one is in a particularly friendly mood. I go to the notes trolley and have a flick through to see who might be good to go and see.

9am
Go and take a history and examine a patient with my clinical partner. The patient is an elderly lady with pneumonia who is with her daughter. The patient has already been seen by the doctors and needs admitting, but is waiting for a bed. She is quite happy to have a chat to us as she is pretty bored!

10am
We hear a resus alert over someone's bleep and ask if we can attend. Resus is where the really sick patients are brought into the department, usually by ambulance or helicopter. This time it's a lady who collapsed and had a cardiac arrest out shopping. She is receiving CPR, and my clinical partner helps with the chest compressions. The resuscitation attempt continues for about 20 minutes but unfortunately (like most out of hospital arrests), the patient didn't survive.

11am
Back Into the main department, and it's strange to go straight from a resuscitation attempt to clerking and examining patients in majors. There is a new patient to see and a junior agrees to watch me take a history and examine the patient, and then questions me on my management plan. I then cannulate the patient and take some bloods.

1230
Lunchtime! As a student no one knows whether you've eaten or not, and it's important to keep fed and hydrated, as I have learnt the hard way in the past! (If the worst happens sit down, put your head between your knees and ask someone for a glass of squash and a biscuit!)

1330
Back in ED and it's getting busy. The consultant checks to see if the next patient is appropriate for me to see, assigns me a cubical and off I go. I see a young woman with abdominal pain on a background of chronic bowel disease. I present my findings to a registrar and suggest a management plan, and the reg agrees with me and implements my plan- it's such a good feeling when this happens!

1500
The department is really busy now. The pressures on A&E are evident and it's frustrating for staff who want to see patients but who have no cubicles or spaces to see them as beds are clogged by people who are awaiting admission, but who haven't been moved yet due to the bed crisis in the actual hospital. Staff are quite stressed and there isn't much to do, so I pop down the corridor to minor injuries to see what's happening.

1530
A builder has cut his hand at work and can't make the bleeding stop. The doctor asks me if I've stitched anyone up yet (only pigs trotters so far) and asks the patient if I can help. The patient agrees,the doctor shows me what to do and I put in my first stitch. It's hard to say if I or the patient was more nervous, but we both did ok! I write the patients discharge summary and then an orthopaedic reg pulls me over to have a look at an x-Ray. I know it's a distal radius fracture, but In the heat of the moment the word, 'ulna,' comes out of my mouth, which provokes a 5 minute rant about the quality of medical school anatomy teaching nowadays. Oh well, you can't win them all, and I won't make the same mistake again.

1630
Time to head home!

Megan Earle : 24 Feb 2015 14:02 |  Tags: Mbchb Sarah Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

What’s wrong with your bear?

Well it’s the end of another block, so that’s three down, only two more to go before my first year exams. Block 3, Brain and Behaviour, has been a really enjoyable block for me as I have a background in neuroscience.

I have still found it really tough though, despite my background this course is very clinically focused from very early on. This means that we are already interpreting scans and learning drug names and mechanisms of action - not my strongest skills at the moment after only 5 months of Medical school. This early exposure to clinical scenarios and cases is one of the reasons why I love the course at Warwick but it is a totally different approach to my previous degree which does take some getting used to!

This early clinical focus means that right from the first week we are working on our clinical skills. At first it’s in small groups at our Friday hospital sessions, then it’s with individual patients in their homes on our community days and now we are actually putting those skills into practice with patients on the wards during our hospital placements.

In order to develop our clinical skills further we are always receiving feedback from our tutors and our peers but last week we went one step further by recording ourselves during a history consultation. We were all filmed individually taking a history from an actor; we then received feedback from the rest of the small group (who are watching you doing the consultation!) and from a GP facilitator. I was so nervous waiting for my turn but actually received really good feedback from my group.

Watching the video back again I can hardly believe it’s me (I’m sure I don’t sound that squeaky!). Getting the right body language and right questions are skills that we are still developing but it’s great to see how much progress I have made in such a short space of time.

This week I was also pleased to find out that I had passed all the stations in my formative OSCE. An OSCE is not something many people have experience with, you have ten minutes per station (7mins task, 3mins feedback) then the alarm goes and you leave and read the instructions on the door of the next room until the alarm goes again and you start the next task. It’s quite a nerve wracking experience so I’m very relieved that I passed and I feel more prepared for the summative OSCE in the summer.

Sometimes it may not seem it but there is time for fun as a first year medical student, I have started to volunteer with Teddy Bear Hospital, a society that works with young children to teach them about health and hospitals. We have stations about exercise, healthy eating, when to call 999 and also a station where the kids can put bandages and casts on their Teddies. I helped out with a group of Beavers and after an hour dealing with thirty hyperactive 6 years olds Medical school looked a lot easier!

Joanne

Megan Earle : 12 Feb 2015 10:55 |  Tags: Joanne Mbchb Student Teddybearhospital Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Access all areas

Everyone seems to have got over their January blues, people have given up on their new years’ resolutions and everyone has settled into our new routine for this block.

We have started our bedside teaching in hospitals which means we have NHS badges with our names and a very dodgy photo declaring that we are medical students. We spend half a day a week with our clinical tutors visiting different wards of the hospital and getting the chance to practice histories and examinations.

I’m based at Warwick hospital, which is quite small but has great facilities for the medical students. There is a library for students and a study room as well as a room to practice clinical skills, there are also lots of Clinical education fellows who are passionate about teaching and who are often not long qualified themselves so are very sympathetic when we forget things (which happens a lot!).

I was very nervous about going to take a history and examine a real patient, but she was so lovely and patient and said she was happy to help us. We learn so much from patients and the feedback they give us, I’m hoping I can use our hospital placements to really refine my clinical skills and with practice I will hopefully be less nervous!

In addition to my first time on the wards, I also had my formative OSCE this week. This was a small practice version of the exam we will have in the summer which tests our clinical skills in an exam setting. Unlike in the summer exam we were told which skills we would be tested on so we could focus our practice. I have been practicing a lot with my CBL group which has proved invaluable!

The medical school has blood pressure cuffs and resuscitation dummies for us to practice with so we have had a few practice sessions where we all give each other feedback and go through things we aren’t sure on. It’s been very helpful as everyone has slightly different ways of doing things so you can pick up some good tips just from observing!

Another new thing for this block has been the start of our student selected component. This is part of the course we get to pick from several options (including Trauma medicine, Tropical and Infectious diseases and Global Health) a module that we can attend additional sessions on. I chose the Sleep Medicine module as I was quite interested in how sleep is affected in a lot of psychiatric and neurological disorders. I’m really enjoying the sessions so far, we are learning about how sleep can be measured and how disrupted sleep can lead to multiple health problems as well as some strange things such as sleep walking and nocturnal head banging.

These sessions are much less pressured than lectures as we aren’t being examined on them so we can just relax and enjoy learning new things. My group will also be visiting a local sleep laboratory so I will have to remember to bring my pyjamas to that session!

Megan Earle : 09 Feb 2015 09:38 |  Tags: Examination Joanne Mbchb Patients Wards Warwick |  Comments (0) |  Close comments |  Report a problem

Applications!

Before we broke up for Christmas we had 2 group work sessions on careers and applying for speciality positions. We were given the opportunity to think about what things were important to us in the first session – whether it was things like location, money, work-life balance, being in a management position, research, and many more. We all had a completely different list of things, and it was interesting to hear what everyone thought.

The second session looked more at applying for jobs. We were given a list of the applications per job for last year, and could see which specialities were the most competitive. We also looked at how many people applied for multiple specialities, and how many applied for GP alongside a hospital-based career.

The main idea of these sessions however was for us to start thinking about what we can be doing now that will tick off boxes in our applications later on. It was encouraging to see that a lot of the skills that we need evidence of we have already been doing, or could easily start doing. For example, evidence of working in a team can be shown from our CBL sessions.

In September we will have our second Student Selected Component (SSC) opportunity, and this time we are to each take on a research project. This will tick off another box or two! We can choose whether we want to do lab-based research, perhaps questionnaires in patient experience, or an audit for example. We also have the option to either select a project from a list that the university has created and found for us, or arrange and come up with a project ourselves. This allows us to find something that we are really interested in, and even tailored towards possible career paths.

As I am interested in potentially doing Paediatrics, I would love to do a project in that area. Even though a lot of the things we need to check off on the application forms are generic, it would look great if I did end up applying as it would show an ongoing interest. This was one of things that they suggested to us in the sessions – if you have an idea of what area you’d like to go into then we should make the most of any opportunity to show an interest. This could be attending a talk or conference, writing an essay or doing a poster, or perhaps even choosing your elective in that area.

Another great way to show interest is also to be a part of that speciality’s society. A lot of the societies are looking for a new committee at the moment as the final year students are preparing to hand over and leave. Being able to write that you held a committee position would not just look good for showing a keen interest but also help demonstrate different levels of responsibility.

Even though we still have a way to go, it is helpful to have an idea of what to expect in the future and perhaps begin to prepare. It is crazy how fast this term is going already!

Megan Earle : 06 Feb 2015 11:35 |  Tags: Mbchb Paediatrics Patients Rachel Warwick Wms |  Comments (0) |  Close comments |  Report a problem

New Year, New Block

After the end of Block 2 my fellow first years and I were desperately in need of a break. I spent the first two weeks catching up on some work, albeit at a much more leisurely pace. It was hard work to motivate myself to do work over the holidays initially but I made some revision notes which will save me lots of time in the Easter holidays and I feel much more organised and prepared for this new block.

After the first two weeks though I decided it was time for a real Christmas break and just gave myself time to relax and enjoy myself! The first semester didn’t allow much time for catching up with family or friends so I really made the most of my time, visited old colleagues in Scotland, caught up with friends and family from Home and even squeezed in a romantic get away with my boyfriend at New Year. I started this Block feeling very relaxed and pleased with myself as I had even managed to do the pre reading but after only 1 week it’s like our 4 week Christmas break never happened!

Our first week of Brain and Behaviour has been pretty full on to say the least. My background is in neuroscience so it’s not all new to me but it’s still a lot of information to take in at once. I love studying the brain, the anatomy is incredible and the disorders very interesting. In our Friday clinical skills session we were all wielding our tuning forks and testing each others reflexes, which was lots of fun and reminded me that medicine isn’t just about lectures and late nights studying.

As well as starting our new block we’ve also had another community day this week. I really enjoy our community days; it’s really interesting to see how healthcare works out in the community especially with people with long term conditions. I feel privileged that people invite us into their homes and tell us all about themselves and they do this just to help us!

We have also been assigned to our hospital based placements for clinical skills. I’m really looking forward to this but also terrified of performing clinical examinations in front of our clinical tutors!

I should probably focus my terror more on our upcoming formative OSCE, this is a mini practice version of our clinical exam in the summer. We have to complete 6 stations testing different clinical skills such as history taking or a respiratory exam, sounds tricky doesn’t it, then factor in the fact that each station is only 7minutes long=PANIC! I’m feeling quite nervous but hopefully over the next few weeks my friends will be willing subjects for me to practice on - one of the many perils of been friends with a medical student, another important one being inappropriate dinner conversation - something to work on over the next 4 years!

Megan Earle : 02 Feb 2015 16:27 |  Tags: Joanne Mbchb Warwick Wms |  Comments (0) |  Close comments |  Report a problem