All entries for March 2017
March 27, 2017
2 blocks down, just 6 more to go!
I can’t believe I’ve reached the end of my second specialist clinical placement, 2 down, just 6 more to go! I enjoyed my time on the paediatric ward. Paediatric history and examination is obviously very different to adult medicine, the differential diagnosis can also be completely different which takes some getting used to! I’m also not used to being around babies or young children so I was quite nervous around them at first but over the 6 weeks after taking lots of histories and examining lots of children of all ages I’m pleased with how much I improved. I can make a neurological exam a fun game and can see the tonsils of the iratest of toddlers and even get nods to yes or no questions from a stubbornly silent child.
I’m now leaving the relative safety of the children’s ward and moving back into the world of adult medicine, starting with the Obstetrics and Gynaecology block. Last year in Core Clinical Education we spent several shifts on the labour ward and with the community midwives, I got to see lots of babies been born and attended antenatal and postnatal check-ups with the midwives. In the O&G speciality block in Phase 3 we will spend some time on the labour ward but will also be in the clinics seeing women with problems during and after their pregnancy. On the gynaecology side, we will be in theatre and clinics seeing a variety of conditions that affect women of all ages.
As well as being in hospital I’ve been busy in my role as president of the Psychiatry society. We’ve had two events in the last few weeks that we organised with the GP society. Both events were on topics that we don’t receive much teaching on in medical school, sexual abuse and eating disorders, both taboo subjects that we as future healthcare professionals need to know about. Our Sexual Abuse Awareness evening had a talk from a Paediatrician who specialised in safeguarding children as well as a talk from a representative from a local charity CRASAC that supports victims of sexual abuse Hearing practical advice about how victims of abuse are assessed and supported by the health service and powerful stories from survivors who receive ongoing support from CRASAC was really powerful and generated a lot of discussion. Hearing personal stories helps us as medical students to understand these sensitive issues so we can be better prepared to help our patients in the future who may have experienced these issues first hand. The same was true of our Eating disorder awareness evening, where we had a talk from a Psychiatry trainee who has worked at an eating disorder treatment centre and a talk from a BEAT (an eating disorder charity) Young ambassador. Hearing from the young ambassador about their own personal experience of suffering from an eating disorder put the medical information from our other speaker in context and was incredibly moving. The turnout for both these events was great and everyone had lots of questions. It’s great to be involved in organising these events and inspiring other students to be passionate about often neglected subjects.
I think I’ve said before that one of the best things about medical school is that there is always a society or club that you can get involved in no matter what your interests or passions. Getting involved extracurricular activities does help your CV, but for me it keeps me motivated and stops me getting bogged down in medicine too much. Sometimes you can get to wrapped up in the seemingly never ending cycle of placements, sign offs and exams and having something else to focus on helps me keep some perspective. So here’s to block 3 of 8-bring on Obstetrics and Gynaecology!
Joanne
Luke Pemberton
27 Mar 2017 09:39
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March 13, 2017
Vulnerability
We’re just over halfway through our six-week GP block, the second of eight Specialist Clinical Placements. Our surgery is a lovely, pleasant place in an area which draws on a very diverse population. We get to see a variety of problems and presenting complaints – although as it is wintertime, we are definitely seeing more than our fair share of coughs and colds. I am slightly relieved, however, as we have been told that hayfever season is just round the corner- it’s such a shame, but unfortunately we are going to miss it!
A lot of GP work involves what we typically think of a GP as doing: there are consultations in surgeries in the famous ten-minute slots (or fifteen minutes, if you’re a medical student). Some surgeries have also started introducing telephone consultations, where they assess patients over the phone (where appropriate, obviously) or home visits, for patients who are very infirm. Our surgery does all of this, and more, and it’s been really interesting watch the different ways in which they engage in the community and serve the members.
It’s probably less well known that many GPs also see patients who are at care homes or nursing homes as part of their daily or weekly routine. We accompany the GPs along on some of these visits for several reasons. We go to get a good feel of how care homes are run and patients’ problems present there. We go to see different ways in which GPs’ knowledge is put to use. We also go to gain an understanding of other patients’ experiences and to see how they live and are cared for.
Recently, we visited a care home which houses patients who have suffered brain injuries. It was very interesting and – I can’t lie – it made a profound impression on me. It made me think of many things at once. I am so happy and we are all so lucky to live in a society where people who are vulnerable (or in some cases completely unable to look after themselves) are still treated with dignity and care. It made me proud that they are still able to get care from the NHS. (I come from a country in which such a thing absolutely does not exist.) Finally, it made me realise that being a good doctor, a good GP, is not just caring for those people with coughs and colds and allergies; it is looking after everybody in society. We are trusted to help and care for those who are vulnerable and it is a massive responsibility. I will never forget visiting that care home, and I will never forget the dignity those patients are given, day in and day out. It made me proud to continue doing what I am doing.
John
Luke Pemberton
13 Mar 2017 09:15
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March 07, 2017
Life on the children’s ward
Well I survived my first graded OSLER which took place in the last week of my General Practice block. It was hard to take the history in ten minutes and answering lots of questions about differential diagnosis and investigations from the examiners was daunting but I received really positive feedback and I’m very happy with that after my first senior rotation! 3 weeks on and I’m now half way through my child health block at Warwick Hospital. It’s strange been back in hospital having not been in full time since before second year exams. In some ways it feels like a step backwards, from conducting entire consultations and delivering management in GP, I’ve now gone back to loitering behind a consultant on ward rounds and standing sheepishly in the corner waiting to present cases.
At Warwick hospital our placement is organised around time on the children’s ward, the special care baby unit and in outpatient clinics. The children’s ward is a very busy place and very different to other wards. There is a playroom and all the walls are covered in animal paintings and each bay or cubicle is full of family members and a variety of toys. Many children are sent straight to the ward and bypass A&E so there are lots of new patients every day, which means there are lots of people for medical students to clerk! Conducting histories and examinations in children can be tricky to say the least; histories often come from multiple people, parents, grandparents, school staff and the child themselves if they are old enough. Histories are taken while shouting over the top of a screaming child and examinations are opportunistically performed on children trying to wriggle away!
The special care baby unit (SCBU) in contrast is the quietest place in the hospital. This is for premature babies (under 34 weeks or under 2.5kg) and term babies who need additional care. We have lots to learn about common problems that can occur in premature babies and in the immediate postnatal period so there is lots to learn on SCBU. It’s also a great place to get to grips with how to look after newborn babies-something which most of us have little experience of! We can also visit newborns on the postnatal ward and help with the newborn baby checks which is always fun.
In contrast to UHCW, Warwick children’s department is very small but there are still lots of clinics to attend. There are some specialist clinics, for example for children diagnosed with Type 1 diabetes and there are general clinics with a wide variety of conditions. For example in clinic today I saw children presenting with bed wetting, abdominal pain, and headaches as well as children who just weren’t gaining weight. A lot of what paediatricians do is reassure parents and give advice about normal development in children, this may seem a bit dull at first but they have to always consider more sinister causes and ensure these are ruled out. Children can often present with non-specific symptoms and it can be difficult to take a good history, so from what I have seen so far I think you need to be a good detective in order to succeed in paediatrics-something I will need to practice!
Joanne
Luke Pemberton
07 Mar 2017 10:46
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