All entries for February 2019

Did someone say the E word?

Yes … they did. Today. In Anatomy. They counted how many days we had to go. My heart nearly stopped. I keep saying I will start my revision in March but now I realise that March is next week. Gulp. So, like any good student. I have chosen to put it off a bit more and distract myself with other things to do!

It really has been a busy couple of weeks with a lot going on. My clinical teaching this week brought a couple of firsts with one patient sticking in my mind. They had a cardiac condition to which I was able to hear my first heart murmur and felt heaves and thrills! This was incredible to see as we are taught about these things in clinical exams and we are so used to performing on each other that we forget what we are meant to be looking for so to see this in the clinic was unforgettable!

One major thing that has happened is that some of my year participated in some research regarding the use of VR in anatomy teaching. I was intrigued as I used some VR in my previous degree, and I am really struggling to pick the anatomy up this block so I wondered if it would help. There was a control and experimental group but both groups could use the VR once the experiment had ended. The kit was incredible in the fact you could manipulate the limb in so many ways including looking at each muscle’s individual movement. I could easily study from it and I really hope to see it come into teaching soon! I’m pretty sure it would have been a good giggle to record us using the VR set as a bunch of students, waving their arms around with massive headsets on would have been a sight to see.

I also had an event that I had signed myself up to in September not realising just how busy I was to become! This is the National Undergraduate Neuroanatomy Competition held in Southampton. I genuinely love Neuroanatomy so I thought it would be a good challenge to learn some further anatomy and see how much I could remember from block three. It was an incredible day and I really enjoyed it, even though I couldn’t answer half the questions! An example is in block three we are expected to name the vessels in the Circle of Willis and not many more, here they had a pin pointing to a random artery peeking through the cerebral surface and a faint grey line on a Neuro Angiogram. Safe to say, I don’t think “Artery” alone quite cut it. However, when it did come to the block three material, I could recall most of it, so I am pleased with how I did! I can’t wait to go back next year, and I am aiming for Top 10. Currently, St. Georges seem to do brilliantly in this competition, so I am keen for Warwick to knock them off the top spot!

Obviously, another highlight was the free(ish) food (we had to pay to enter the comp) consisting of pastries the size of your hand and pizza… a lot of pizza. There were some stands from the BMA (from which I now have three bones pens and some pen torches) and we also managed to get a mug for one of the third years who couldn’t go… We love freebies!

Another thing that has happened was going over to my medic family/student seminar team house for tea. We normally don’t meet for student seminars the first week of every block, so we descended for an evening of pizza, games and just a much-needed night off. It was also nice to see my medic mum and uncle as with the second years now in full-time hospitals, we don’t see them that much. I also gained a new half-sibling as my student seminar pal announced she needed to be adopted so my student seminar teachers decided to adopt her. I am looking forward to next year (if I get back in – sorry I am superstitious, and I am not taking any chances) teaching and hopefully adopting some freshers as my medic kids …. Let’s just hope my cooking skills improve in time for Medic Family Tea!

Abbie

Megan Earle : 26 Feb 2019 14:57 |  Tags: Abbie Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

New Block New Me

So, the beginning of February brought the end of block three and the beginning of block four. I felt a little sad as I really had enjoyed block three and it had cemented for me the reason of why I want to pursue neuro as a career. I had really enjoyed the labs with the last one recording EEG measurements. This was basically an excuse to nap of the floor of the lab for half an hour …. I gladly took that sacrifice for my team. However, it had to come to an end and we now are on block 4…. The penultimate block before the E word of which our Anatomy Professor has already mentioned once.

I am enjoying the content of the block, but it is taking me A LOT longer to pick things up, even in the anatomy side of things which is normally my strong point. The lower limbs are surprisingly complicated but all it is going to take is some hard work and I’m sure it will click in the end …. Hopefully. It is proving to be a weirdly entertaining block however as so far in lectures we have been standing up holding our own bums (demonstrating gluteus maximus), dragging each other standing up (demonstrating the sliding filament theory) and everyone is performing weird movements in the anatomy labs. Something tells me that I will be able to tell if any block 4 questions are being answered in the exam room.

We also had to submit our first written work this week which was our community day reflections. I found this hard because I had to essentially reflect on a conversation I had with a patient as part of a group. If you have ever tried to reflect on a conversation before you can probably see where I am coming from. It felt strange and for someone who must work at communication more than most (I have Asperger’s) it was a challenge to know what to write about. However, there was plenty of support and I did my best so hopefully it gets a pass. We also started another written assignment this week which was the case reports. Essentially, we have to find a patient and write their presentation up and submit it to our clinical tutor. We had an SDL session for this where we could go around the hospital at will, find a ward, find a patient and write up what we find. Terrifying for a first year. What if the ward does not want to let us in? What if the patient is too complicated? What if no doctors want anything to do with you? These were all the thoughts racing through my mind on Tuesday but Maariyah and I braved it alone and ended up on the cardio ward. The nurse we met was lovely and thankfully Maariyah did most of the initial talking as I was too nervous to put words into my own mouth. I relaxed a bit after we found a patient and I enjoyed looking through notes to build up what we knew about the patient and getting to talk and examine a patient without supervision. I’ve said it before but moments like this where all the work you do outside of the hospital comes into its own. It is also nice for the old self esteem as you realise how much you have picked up (even though you think you haven’t learnt anything) since you started.

I am also making sure I take a break from medicine and it’s in the form of my own blog that I am rather proud of. It’s developing slowly and I also use it to take stock on what I have done every week by writing a bit of a weekly summary. I looked at week one the other day and (after getting over how excited I was) it really did hit home how far we have come since those naive days in September. I also got some messages this week from people I had given advice to throughout the application cycles saying they had got into Warwick! This really did make me happy as I liked the fact, I may have had some small input to helping them.

Looking towards the E word, I really do need to start learning the drugs list (sorry WMS I haven’t started it yet). However, I had a bit of an epiphany moment when I woke up this morning (because what else are Saturday mornings for) and I realised that I know most of the drugs by what their packaging looks like as I worked as a dispenser for over a year, so why not put that to use?!

It’s the little things that keep you going ….

Abbie

Charlie Gallan : 21 Feb 2019 13:45 |  Tags: Abbie Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Difficult Conversations

The week started on Monday with me teaching my BLS (Basic Life Support) to first year medical students. This was my last session as a trainee BLS instructor (like a probationary period), and after completing it, I am now qualified as a fully-fledged BLS Instructor! We will hopefully be teaching some of the first-year medical students here at Warwick Medical School very soon, providing high quality BLS training. Watch this space!

Tuesday is GP day, which has quickly become one of my favourite days of the week. In GP we get to lead several consultations per day each, which is very fun, and a little bit of lucky dip, because you aren’t sure who will walk through the door! The GP supervising us is very supportive, and tries to encourage us to take the consultation, even when the medical issue the patient has isn’t straight forward. This is great because it gives us a chance to deal with conditions and issues that we might not be totally confident with but means that we get to push ourselves and try and learn as much as we can. The great thing is that if we do get stuck or go off topic, our GP is observing and jumps in to help out. Overall, it’s a great chance to practice our skills, to try and develop, but is in a safe environment with us being watched by experienced hands.

Today we spent our first proper day with the Respiratory department at George Eliot hospital. For each CCE block we have to get specific activities signed off, including examinations, histories and procedures and also what is called a Case Based Discussion. We do these with the education doctors (Clinical Education Fellows - CEFs), who then give us feedback on our skills. We wanted to get our Case Based Discussion done today (roughly by the middle of the block) so we booked a session with one of the CEFs to try and get this signed off.

There was only one thing missing – a patient! A CBD is where we see a patient on our own (doing a history and examination), and then meet up with the CEF afterwards and discuss the case, including how the diagnosis was made and what management we would provide for the patient. Our CEF session was booked for 9am, and we needed to have seen a patient before then, so my clinical partner and I went in for an early start at 8:10 and went straight to the ward. We ended up finding a lovely patient and doing our history and examination and also having a nice chat – bonus! All in all, it went well and our history and exam definitely went more smoothly than it was at the start of this block (only in January, 5 weeks ago). It’s a nice feeling when it comes together, and you feel like you’ve done a really comprehensive history and good exam. In CCE we do history and examinations pretty much every day (and multiple times a day on GP days), so we have plenty of time to really improve our skills.

After doing our Case Based Discussion, we headed to the ward to find someone to shadow and just get settled in, including just introducing ourselves to everyone. The ward was very busy so it took us a little while to find someone who was free to talk, but in the end we found a lovely registrar (the level in between foundation doctor and consultant) who let us follow while they saw some of the sickest patients on the ward. They asked us to read an ECG and work out the diagnosis which is never, but between the two of us we seemed to work out that the ECG was normal, and the registrar confirmed that it was. I think it was beginners’ luck! The registrar also ended up seeing a sick patient and having a very difficult conversation with a relative about the prognosis of the patient, which was extremely difficult to witness, but unfortunately an important part of the work of a junior doctor. The registrar did a very good job, and I took notes as to good practice and an example of how to do it well. It is important while on the wards and clinics to find doctors who can act as good role models of how to be a compassionate and competent medic and I learned a lot today about how to have a sensitive conversation.

All in all, it has been a busy and challenging week. Despite this, there is definitely a feeling of growth – I don’t feel nearly as out of place as I did at the beginning of this block and have sort of worked out who we need to speak to on the wards to find the best learning opportunities. It’s weeks like this that remind you how amazing it is to be a doctor – to be with people in the best and worst times of their lives. Hopefully you can make them feel better too!

Jordan

Charlie Gallan : 18 Feb 2019 15:25 |  Tags: Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Second Community day and Conferencing

Block three has been chugging along and it is my favourite block of the year. The anatomy content has been sticking in my head and I am enjoying learning more about the anatomy and physiology of neuroscience, building on what I had been taught in my undergraduate degree. A couple of us have also been contacting a neurosurgeon up at UHCW with the possibility of observing/ working on projects with them.

We also had our second community day. This time we had a paediatric patient which I was excited about as I know I want to go into paediatrics when I specialise. We had some problems initially as the area we were visiting had no signal and all we had was a rough map of the area to find the house, so we were touring the area before we finally found it. It was a different experience to last time as we were not talking to the patient but rather to the parent. It was slightly hard as we only found out about the condition 5 minutes before we arrived, so we were doing some quick thinking as we walked up to the house. The parent was knowledgeable about the condition, so it was easier for us to interview them and we got a lot of information out of the day. The child was also sweet and shy at first but, after lapping the living room on their toy car several times, they gained the confidence to come up to us and show us their hands as they related to the condition they had. It’s difficult to describe this case as it is rare so could be easily identifiable.

We must present our cases next week, so this is going to be something we must keep an eye on. We also visited the local primary school and we all had flashbacks to when the only stress in life was who you were going to line up with to go to assembly. The school was fantastic, and we were told about the adjustments that schools make for children with needs and policies regarding the safeguarding of vulnerable children. The teachers were lovely and the headmaster offered us the opportunity to go back for some experience or to work with the school. I was excited about this as I want to run a STEM outreach day at some point and it would be interesting to look at the affect of outreach days on children’s wellbeing.

We also visited the hospital to talk to a nurse about pre-natal screening in which we were told about the pathways used when a mother is identified as Hep-B / HIV positive. They also highlighted a new test coming into the NHS which will screen the baby’s DNA that is circulating in the mother’s blood which is safer than taking a sample of the amniotic fluid and more accurate than taking measurements from a scan. We finished at 3.00pm and due to some problems with the roads we could go straight to campus, so I was able to get some work done before my student seminar in the evening.

This term has given me a bit more breathing room to start thinking about how to build up my portfolio and as someone who wants to go into surgery, I want to make sure I stand out from the crowd. The surgical society put on a “Women in surgery” evening where some surgeons from the local trusts came and talked to us about their careers. They were very keen to highlight the point of finding a good mentor and not letting a career in surgery become a choice between being a surgeon or having a family.

This weekend I also took a trip down to London along with a couple of other Warwick Meds to a conference on Careers in Neurosurgery. This is a field I have dreamt of going into after reading Henry Marsh’s book in Year 13. Henry Marsh was meant to be at the event, but he was ill on the day so could not attend. However, it was still a great day and I picked up a lot of tips and information about how to build up my portfolio to stand a good chance of getting an interview. There were some other presentations about the tools used in Neurosurgery and the ones that are being developed. One memorable one was the AI camera which could analyse the procedure and tell the surgeon when it was time to move onto the next step. It wasn’t perfect but it could help to train new surgeons and I am watching the world of AI as this is going to become a more commonplace in hospitals as we progress through our career.

Abbie

Charlie Gallan : 04 Feb 2019 10:55 |  Tags: Abbie Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem