All entries for May 2018

Sorry, I’m just the medical student…

I’m now 4 weeks into assistantship and have finished the first part of my placement. I have been in A&E at Warwick Hospital for the last 4 weeks and now I’m moving onto the Haematology Ward. I can’t believe how fast assistantship is going, 8 weeks seemed like a long time at the start, but now I’m halfway though I’m getting more excited but also increasingly nervous about finishing.

I’ve really enjoyed my time on A&E. I have an A&E job as my last rotation of foundation year 1 so it’s been a good experience to see what’s expected of the FY1 Doctor. I’ve gained a lot more confidence in my clinical procedures as well as my histories and examinations in A&E. I have picked up some good tips about note writing which will be invaluable to me going onto a medical ward where you write a lot of notes for ward rounds. Part of the A&E FY1s responsibilities also include medical on calls. Every few weeks instead of being on your normal base ward you head to the acute medical ward for handover from the night shift medical team.The day team then split themselves between the ambulatory unit and the acute medical ward. These shifts are quite intense as they are ward based 9-5 and then from 5-9.30pm the day team are responsible for providing medical cover to the whole hospital for the evening until they handover to the night team.

While these on call shifts are very busy, they have been great learning opportunities. Many of the patients from A&E who need admission move onto the acute medical ward unless they need specific treatment by a speciality team or will be in hospital for longer than 2-3 days, this means I got the chance to follow up lots of the patients I had clerked in A&E which was interesting. I also got experience of completing more ward based tasks such as chasing blood tests and scan results. For one patient I was the person liaising with another hospital where they were receiving treatment for a long-term condition which was a bit scary! I was also involved more with relatives, explaining to them the treatment plans and talking about discharges. You spend so much time as a medical student observing, it’s been enjoyable in assistantship to be doing more and feeling like I’m contributing to the ward team.

The downside to having a bit more purpose and looking like you might know what you’re doing is that nurses on the ward come up to you and ask you about patients, medical students in lower year groups ask you if any of the patients on the ward are good for practice histories and examinations. At the moment I can still say “Sorry, I’m not a doctor, I’m just a medical student”. I can’t use that excuse for much longer though which is equally exciting and terrifying!

Joanne

Joshua Galvin : 30 May 2018 15:04 |  Tags: Joanne Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Assistantship – Putting Learning into Practice

Now that we’re done with finals, elective is over and most of the difficult assessments are behind us, our cohort members are able to relax a tiny bit and enjoy the final tasks of medical school: trailing F1 doctors, getting stuck into teams in the hospitals, and learning the practicalities of how doctors actually do their jobs on the wards. This is the Assistantship phase, in which we learn what it takes to be a junior doctor, and prepare properly for our role in two short months! It’s hard to believe that we’re so close to finishing now.

The medical-school admin team try to match up students who are staying locally for their foundation years with the team that they will do their first rotation with. This way they can get to know the actual team and wards they’ll be based on when they start. It seems such a nice way to ease into the world of working on the wards and relatively stress-free. Those of us who aren’t staying around, however, are unfortunately not so blessed. I am planning to go to a hospital in the Southwest of England and therefore my experience on Assistantship, like the majority of the cohort, is sadly more generic. It’s absolutely fine, however, and every bit as useful as I would expect.

However, I think I have been lucky with Assistantship in some respects: two of my rotations in my first year of the Foundation Programme are respiratory medicine and upper-gastrointestinal surgery, and these are the two areas where I have been placed for Assistantship. This means that I will have some idea of what to expect next year and what F1s are expected to do in these roles. Although each trust is different (this is stressed a lot), some things will be common between all hospitals in the UK. I imagine this includes things like the types of procedures that are carried out in surgery, the demographics (roughly), the types of conditions that are present on respiratory wards, the general treatments and so on.

Outside of Assistantship, I still try to teach students in younger years when I can for a couple of reasons. First, I honestly believe that nobody should be in competition with one another in medical school – we are all here to help one another out, because if we become better doctors, then our patients are the ones that win. Second, I have certainly attended more than my fair share of peer-support sessions over the years and the least I can do is repay the favour in kind. A few weeks ago, I taught some second-year students at a weekend (people give up their weekends to be taught – amazing dedication!) and, I have to be honest, I’m quite glad that that part of my life is behind me. Although medical school has been fun, there are some parts that I’m quite happy not to repeat! Now I’m looking forward to the future, and enjoying the last parts of the journey along the way.

John

Joshua Galvin : 30 May 2018 12:39 |  Tags: John Mbchb Student Warwick Wms |  Comments (2) |  Close comments |  Report a problem

Smooth sailing on the assistantship…

It’s been a pretty hectic few months, finals followed quickly by our Elective. When we arrived back from elective we went straight into the last part of our medical degree, the Assistantship. This is an 8-week block where we shadow the current Foundation year 1 doctors closely, so we are ready to start our jobs as FY1s in August!

Our assistantship started with 2 days of lectures at the medical school covering various topics about life as an FY1 doctor, including some top tips from current FY1s. How to stay on top of the dreaded Eportfolio and how to survive a night shift were topics I found especially helpful, if slightly scary to think about! The assistantship is split into 2 4-week blocks, with students covering a medical ward and then a non-medical ward such as surgery or psychiatry depending on what placements are available. For students staying in the local area one of their 4-week bocks will be on the ward they are due to start on in august, so they will have lots of opportunity to learn how their new ward works and soak up all the wisdom they can from the FY1 currently doing their future job!

For my assistantship I have started on A&E and then I move onto a Haematology Ward for the last 4 weeks, both at Warwick Hospital. Starting on A&E has been a great experience. The FY1 I am shadowing has been so welcoming and friendly and is full of helpful tips on how to survive FY1. In A&E I have been able to clerk patients as they arrive so have had lots of practice with my histories and examinations. If any patients need bloods taken or a cannula inserted the nurses have been sending them to us so we have lots of opportunities to practice. I’m getting better but still struggle with some patients, fortunately they seem to be the ones that even my seniors find difficult so at least I know it’s not just me! Getting confident with these clinical procedures is something I really want to do during my assistantship, if I can do the basics well as an FY1 the rest of my day will be much easier!

The FY1 I am shadowing also has some shifts as medical on calls, during the week this means covering either the acute medical ward or the ambulatory unit but on the evenings and weekends this means being part of the on-call team that covers the whole hospital out of hours. Having joined them on a few of these shifts, the amount of responsibility can be a bit overwhelming but that’s why you are part of a team. I must remember that just because I’m the FY1 doesn’t mean it’s just me-I can ask lots of people for help!

I’m looking forward to the rest of my A&E placement and then moving onto the Haematology ward. My first job is on a medical ward so it will be good to learn how a normal medical ward works differently from the fast pace of A&E.

Joanne

Joshua Galvin : 21 May 2018 10:15 |  Tags: Joanne Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Assistantship – Learning how to be a Foundation Doctor

The logical progression for medical students who graduate from the MB ChB programme at Warwick is to move into the foundation programme. This is a nationwide, structured programme that cycles all recent med-school grads through six four-month rotations over two years within a particular deanery (or region of the country, of which there are currently twenty). Every deanery is different: some will rotate you between hospitals or trusts depending on the job you do, and some will let you stay at the same hospital for the full two years. It all depends on the deanery you end up in and the jobs that are available. I have been allocated to one of my top choices: a large district general hospital in the southwest of England, where I plan to be for the full two years.

The Foundation Programme is relatively uniform across the country, in that F1s (those of us in our first year of the programme) and F2s (doctors in their second year) are expected to complete more or less the same things and cover the same ground over the course of their years. For instance, I believe that all F1s are required to have a surgical rotation, and all F2s are required to have either an A&E, GP or GUM rotation. And all foundation doctors round the country all rotate jobs on the same days throughout the year – it’s kind of scary yet oddly comforting that our careers are planned out for us until August 2020! That will be six years since the beginning of medical school, but at the same time as least there shouldn’t be too many unpleasant surprises in our broad timetable and we can plan accordingly.

By definition, when the current F2 doctors leave their posts, the current F1s become F2s and we medical students become F1s, the collective experience level across foundation doctors drops by a year overnight. I gather that this might have had serious impact in the past on learning curves, efficiency of work, etc. However, in order to minimise the impact of this effect, the GMC, and by extension the various trusts and medical schools, take great pains to ensure that incoming F1s are adequately equipped to step into their roles. Foundation Trusts do this through inductions and shadowing at the beginning of our F1 year, and medical schools do this through including an Assistantship phase after finals.

As we are done with finals and our electives, we are now in that Assistantship phase. This is where we really ensure that we have the skills needed to be competent and functional F1 doctors. Our Assistantship placements are carried out in local hospitals, an arrangement with its plusses and minuses. On the plus side, we are all very familiar with the hospitals, their layouts, their wards and many of the doctors. However, many of our cohort will not be working in this deanery in the autumn, and so we will have to adjust our working practices to those of our base hospitals when the time comes. This might seem a minor point, but so many of the little things that F1s need to know about (how the imaging/patient-data systems work, how the stores cupboards are stocked, how procedures are requested) are completely different. It will require some adjustment. But at the same time, it appears to be a very well-run and well-thought-out block. Most importantly, we can learn on the wards without the threat of exams hanging over our head – always a bonus!

John

Joshua Galvin : 14 May 2018 09:23 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Elective bliss…

Over 4 months ago I had just finished my final specialist clinical placement and was embarking on the epic task of finals revision. The first week of my Christmas holiday was spent trapped in my study, I was allowed out only for tea and bathroom breaks! This was a bit of miserable start to my holidays but it meant that I could take a whole week off over Christmas and enjoy spending time with my family. Our first exam was in the middle of February so before that we had 6 weeks of our revision block, Advanced clinical cases. All the local hospitals organised revision seminars for us, we had practice OSCE days (clinical skills like cannulation and wound care) and you could go on the wards to practice your history and examinations. Going into hospital was a welcome break from my study, and when exams were finally over in the first week of March I could finally breathe a sigh of relief!

It’s a strange feeling when you finish exams, you feel great, but almost immediately the worry about results sets in. Despite the horror that was the last few months of revision and how hard the last 4 years have been, it was all worth it as I passed! On the day of results, I had a quick celebratory cup of coffee with my friends and then instead of heading to the pub I had to sort myself out for my elective as I was flying 2 days later! I hadn’t wanted to jinx my results and think too much about elective so this meant that I had a lot to do! So less than 48 hours after getting my results I was on a plane to Addis Ababa, the capital of Ethiopia, for 6 whole weeks!

I enjoyed my elective so much, it was been a totally unique experience and one I certainly won’t forget. I’m interested in psychiatry and academic medicine so for my elective I had organised a small research project focusing on the mental health of mothers and the long term consequences for their children. I also spent some time in the local psychiatry clinics and made the most of my spare time and explore Ethiopia! I really enjoyed working on my project, it was totally different to any research I’ve ever done before and certainly made me think about how much of an impact mental illness can have on an entire family, not just on an individual. I’m still in the process of writing it up for publication, so fingers crossed! Gaining clinical experience in Ethiopia was very eye opening, there are only 70 psychiatrists in the entire country and culturally mental illness isn’t well understood, with most patients, even those with psychosis, been taken to religious sites seeking a cure for spirit possession or the “evil eye” before coming to the attention of a medical doctor.

I didn’t go all the way to Ethiopia to just sit on my laptop or in a dusty outpatient department so I made the most of my free time exploring Ethiopia. I stayed with a wonderful host family who cooked beautiful traditional Ethiopian food for me and I was invited to join them for their Easter celebrations, which involved the sacrifice of two very plump chickens to mark the end of fasting-this bit was tricky for me to enjoy as I’m vegetarian! I saw hippos in the Rift Valley lakes, fed monkeys from my hand, visited several UNESCO world heritage sites and enjoyed the most fabulous coffee in the whole world (Ethiopia is where coffee was originally grown and brewed!).

I arrived back from my elective yesterday yet it feels like I only just got my exam results. My elective supervisor kept introducing me to people as the newly qualified doctor, which felt very strange, but I suppose that’s what I am…almost. For the next two months I will be on my “Assistantship”, where I shadow the FY1 doctors closely and make sure I know what I’m doing before I am let loose on the wards in August! I haven’t taken any blood or inserted a cannula for about 6 months so wish me luck!

Joshua Galvin : 11 May 2018 10:08 |  Tags: Joanne Mbchb Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem