All entries for August 2020

Where to?

Another two more weeks of our GP block have passed by. Our block is 5 weeks long and each week we have some days at our GP practice and some days of online tutorials. Every Thursday we have online tutorials by the medical school tutors which focus on communication skills and also common conditions seen in GP. The communication skills sessions involve what are called “simulated” patients, who are actors hired by the medical school to pretend to be a patient. You treat them like any other patient and talk to them about their medical problems and other things. The communication part of this comes in in that with these patients the task we have to do with these patients is to break bad news to them - so tell them a test result came back abnormal or the cancer has returned. Then they are trained to react in a certain way – so they may get upset or angry – and you have to respond and deal with their issues. This can be really challenging and sometimes emotionally difficult, but it is much better to practice these conversations in a safe simulated environment before we ever have to do it for real.

We’ve been really lucky with our GP surgery as they are very keen to teach and get us doing consultations on our own. We speak to a patient and decide what to do, only running our findings and plan past the GP to check it is correct and that they are happy. The GP is always there for support, but it is really satisfying to be able to tell the patient what is wrong and what you think should be done, and for the GP to totally agree. More than any other block, I feel like a doctor now – GP is very busy and almost feels like working full time, with patients specifically booking in to see the medical student. That responsibility of “this is your patient to look after” is new, terrifying, and affirming. This, after all, is why I started this journey 3+ years ago. It feels so rewarding to be able to reassure the patient and offer them a solution or plan to deal with their issues.

This coming Friday we have an online academic day about applying for the UK Foundation Programme. Basically, medical school isn’t the end of training for doctors. Exactly the opposite - graduating from medical school is just the beginning. New doctors apply to and work for two years as part of the Foundation Programme. These are special posts which are designed for a new doctor and the aim is to develop all of the skills learned at medical school and become a confident, capable doctor. As I am in my final year for med school, I have increasingly found myself thinking about the next steps and thinking about some of the decisions I will need to make when applying. The main decision is which foundation school to apply for. The foundation schools cover geographical areas and often cover several hospitals. I was born in the Midlands, I did my Undergraduate degree at Birmingham, worked in the city for 2 years before medical school and of course Warwick Medical School is in the Midlands. Part of me wants to try somewhere else now – but I have ties to the Midlands which mean that I can’t really move away, so I will probably stay around here for foundation. This also has the advantage of not having to get used to a new city while also getting used to being a new doctor at the same time. Some areas are more competitive to get into than others – for example London is super competitive to get a place at, but the Midlands aren’t too bad so hopefully I have a shot!

Megan Earle : 28 Aug 2020 09:00 |  Tags: Covid19 Gp Jordan Mbchb Onlinelearning Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Hot Wards and Cold Equipment Rooms

SO we are well into the run of our 10 week block of medicine and as unpredictable as the British weather is, we have had a heatwave on the busiest week of my timetable. Whilst temperatures were hitting 30 degrees outside, we were trying to find the coolest part of the ward which was normally strategically standing near patient’s fans (of which there were three) or running to the equipment room undetected. The masks don’t help either as they just reflect warm ari back into your face but if they keep the patients safe, it’s a small price to pay. However, despite losing all my body water in the first 10 minutes, it proved to be a really productive day on the ward. We had a lovely consultant who was keen to teach us and told us more than once we really should be outside and enjoying the sun and not on the wards. What was an added bonus was that we got all our sign off’s done for the 10 weeks in one morning. Before running off as we were told, myself and my clinical partner stopped at GEH famous ice-cream bar. The ice-cream is incredible and after putting it on Instagram, I was met with lots of jealousy from medical students and doctors at other trusts! I am officially team general district hospital!

This week in all has been just incredible for our learning and progression. We have a lovely F1 and an incredible Physicians Associate who have just included us into the team from day one. On the Friday we had another incredible consultant who literally sent us off on our way to manage a patient by ourselves. I stood wide eyed like a deer caught in headlights but actually, this was the best thing for me as I finished with my lovely patient and actually, for the first time, I actually felt like I was going to be a doctor in 2 years (Covid-19 depending). It’s nice to be praised and have the support there and this week has just been a huge confidence booster, which was needed as my PassMed average is lower than I’d like it to be.

Getting used to an emptier timetable than last block has been a bit of a feat but, I actually like this way as I have a chance to breathe. I can do more of my theory work during the day and not at 10:30pm when I would rather be in bed. It also means I can do more extra-curricular things like inhaling half of the pool water at the gym as apparently my swimming technique is far from desirable. The perks of being in the same ward every week means we become far more integrated into our ward team and we go into the wards with some determination to get things done as we have less clinical exposure time. We have also been encouraged by the doctors to leave the ward and go home if we aren’t learning anything. I really enjoy going to placements now and developing professional relationships with the team and patients is just the icing on the cake.

We start GP next week and I am a little sad not to be going back to our original practise in Nuneaton as we loved being there and our supervising GP was amazing. It is also going to be dramatically different not actually seeing patients which I am sad about. It’s surprised me how much I love chatting with patients during their history and seeing them week after week, which I thought I would never say as someone who has difficulty with communication. I’m sad I wont be able to chat to people face to face and instead just listening to consultations over the phone before performing my own consultations. I know it’s important to learn phone skills as it is likely this is the new way of working for GPs and hospital clinics but it’s still sad knowing there wont be any patients.

So far, so good in the big picture though. I really love being back on placement and it beats sitting at my desk every day typing the same words for my SSC2 over and over again. We are still waiting for results but we are so busy with clinical learning that I forget it is even a thing most days!

That’s it for now! See you in September!

Megan Earle : 25 Aug 2020 09:21 |  Tags: Abbie Covid19 Mbchb Ppi Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

General Practice

Monday was the start of my 5-week GP block. Here at Warwick in our third and fourth years we do Specialist Clinical Placements (SCPs), and there are 8 of these which cover the main areas of medicine. During these placements we spend time with these teams in their clinical setting, get practice seeing patients and hopefully gain knowledge to help us pass our final exams and practice as competent doctors. GP for me is my fourth rotation of the year, meaning that once it is over, I will be halfway through my rotations.

GP is a block that I have really been looking forward to in so many ways. During second year we had GP days and they really built my confidence and abilities as a clinician because, more so than any other rotation, you get the chance see and interact with patients in a similar manner to how a qualified doctor would. GP is in a smaller setting and is more generalist, meaning that you see lots of different conditions, from a sore toe to chest pains. I find the variety refreshing and it really tests your knowledge because you need to know something about every area. So far we have seen a bit of everything, and hopefully that continues!

As we are now final years, we have the opportunity to consult independently. This means that as a pair we have our own clinic a couple of times a week where patients book in to see us. We then see the patient, ask them about their problem, decide what we would like to do and then check everything with the GP (who checks the history and may ask some other questions). Our GP practice has been very keen to get us going with independent consults, so we had our own clinic in the afternoon of our first day! Although scary, actually just jumping in and getting going is the best way of learning, and of course we were closely supervised by our lovely GP who seemed happy with most of our management plans. Hopefully our patients were happy as well!

I couldn’t let a blog go by without mentioning the topic on everyone’s lips – COVID.

It has had a big impact on General Practice, with the main difference being that almost all of the consultations are telephone appointments. This has been slightly strange, and can be very odd when the patient calls up with a problem which really you need to see – for example rashes, lumps and other skin conditions. Trying to get them to describe the size and shape can get you so far, but nothing beats that visual recognition. Often these patients have to pop in and see us, but most other things can be managed over the phone – for example blood test results, medication reviews, aches and pains. Its certainly provided the push for General Practice to go virtual, and how much of GP stays telephone/video consultations afterwards will be interesting to see.

Megan Earle : 10 Aug 2020 11:30 |  Tags: Covid19 Gp Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

SSC2 Lockdown

HELLO I am back!

I apologize for the two months silence. My blogs were getting harder to write as I was mainly sitting at my desk completing my SSC2, so it would not have been hugely interesting for you guys but, I have officially clicked that submit button and the relief is immense!

As we couldn’t go into hospital, Warwick made us third years for 3 months and we completed our third-year research module a couple of months early and we will be completing our second-year placements later on in the year. Again, because we were not allowed in, we all had to do systematic reviews, the one thing I specifically did not want to do. However, after frantic searching of PubMed and Google scholar, I found a topic of Medical Education that had not been reviewed as far as I could see. I must be careful with what I say as our reviews are marked anonymously so I can’t give anything too specific away about my project as our marks haven’t come out yet.

It was… let’s say… trying. I came across so many hurdles including a panicked afternoon where I thought my project would have to be scrapped and re-started again, four weeks before the deadline. However, looking back, I am so proud of getting through it and now have another skill under my belt for my future career (all be it a rather shaky skill). I also developed a bit of a better idea about the world of research, something I ran away from in my undergraduate. I was offered a paid-for masters by my supervisor (I have no idea why, I was useless, all my cells kept dying!) and I shuddered as I had no idea about this world beyond undergraduate. However, through connecting with others on twitter and developing ideas, I am excited about including research into my career. Twitter has been my saviour throughout lockdown. I have developed connections across the UK and it has landed me some of my closest friends. I have a friend in Cardiff who I have never met but I consider like a sister! It’s also shown me the different ways I can incorporate research and how to develop my portfolio (just by spying on other people’s lives!).

This has meant I have begun to think about what I want to do post Warwick. I may be starting the final phase of the medical degree here seven months late but I am still in the mindset that I am nearly a third year. I’ve decided I want to do an AFP programme incorporating medical education however, I want to work at home in Kent. Unfortunately, Kent does not have a separate AFP programme and is incorporated into the South Thames programme which includes London. Kings College (where I want to apply) requires me to be minimum third decile of the cohort to even get short listed, so it’s clear I have a LOT of work to do.

However, I have keeping steady process with my extra-curriculars to be prepared for speciality applications. This year I helped with the GOSH Summer School running their social media account for the conference. I love the team I work for there and got to have a shout out at the end of the conference via zoom which felt amazing. I love GOSH and all the staff there are just amazing as well as welcoming to any medical student and they have added fuel to my fire to get into a paediatric speciality…. I’m just not sure which paediatric speciality yet! I have also been chosen to be on the JASME (Junior Association for the Study of Medicine) national committee as part of their media team which I am over the moon about. Their conference at Warwick got cancelled this year but I am excited to help run it in 2021!

Lockdown has been hard. I lived on my own for 10 weeks and I could go a week without directly talking to anyone and adding this to the sleep deprived state my brain was in due to night shifts and the stress of SSC2, I really did struggle. However, this was beneficial as I realized the importance of having a good social network around me. I ended up going home and continuing my project there. It was chaotic but was the best option for me. I had my dog around to distract me and the cats to walk across my keyboard. It also meant I got some free meals that I didn’t have to cook!

I feel like I have kind of cheated my medical degree. When we started back in 2018 I never thought we would have 21 weeks out of education and now, I am going back to a totally different degree. We are only in clinical two days a week which means we must make the most of every opportunity we can get, and clinics are mainly over the telephone which reduces the amount of patient exposure we get. GP placements will be the same with patients only coming in if absolutely needed. It does worry me that this reduced patient contact may impact my skills, however, this new way of doing things may be the new future for the NHS so it’s important we train to be adaptable to this. Covid-19 really has changed the UK beyond what my January self would believe.

Anyway, that is enough for now. I’ll see you again Mid-August!

Hattie Trigg : 04 Aug 2020 14:39 |  Tags: Abbie Mbchb Medicine Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem