All entries for October 2016

4 Weeks later…

I’m coming to the end of a four-week stay at a large regional hospital in The Gambia. I came down here to do research for the SSC2 (Student-Selected Component) part of our curriculum. Every Warwick MB ChB student does a self-directed research project during the autumn of our third year, and it’s proven to a really interesting and thought-provoking experience for me for many reasons.

Although I’ve got experience working within several NHS hospitals, I’ve never spent much time in a healthcare setting outside of the United Kingdom. Seeing how a different system operates is absolutely fascinating to me. There are many things that I would change, and there are many things that I think are done quite well. I am still surprised and quite taken aback by the lack of primary care in The Gambia. All of the clinical staff in this hospital are consummate professionals, and they make the very best of what they’ve got, but resources are limited, and patients do tend to present to clinic or onto wards with more advanced stages of illness. That is something I never expected.

There is also a lack of trained specialist doctors. For instance, I don’t know if The Gambia has any endocrinologists within its borders; I’ve heard there are none.. This has caused me to reflect: the people here are just as human as anyone in the UK, and in an ideal world, they would be just as entitled to healthcare as the rest of us. Being at the thin end of the wedge here has made me think much more about global health and the importance of providing a basic service to those most in need.

Since my project was to conduct an audit of tuberculosis diagnostic-technique requests, I spent a LOT of time trawling though patient notes and trying to figure out what investigations and diagnoses were requested, and when. It was a very painstaking, manual process. I have definitely learned that writing clearly and concisely in patients’ notes is essential – even if you think nobody is ever going to read them again, you might be very wrong! Although I *generally* got used to the handwriting styles of the different doctors, sometimes it was a bit of a struggle.

The most different thing about being here is definitely the weather. I checked the climate forecasts on Wikipedia before I came down here, but I must have misread something as I brought a hoodie “just in case”. It’s been over 30 every single day, and I haven’t seen a drop of rain since leaving England in September. Since I’m Fitzpatrick skin type 1 (thank you, Phase II dermatology book!), I have been slathering on the sunblock. I’m kind of looking forward to returning to England if, for nothing else, some respite from the sun overhead. I suspect I’ll regret this within forty-eight hours of returning though!

John

Luke Pemberton : 26 Oct 2016 13:51 |  Tags: John Mbchb Student Warwick |  Comments (0) |  Close comments |  Report a problem

Running out of time…

We are now 4 weeks into our 8 week student selected component (SSC2) and I can’t believe how fast time is going! My project involves designing a questionnaire for medical students and alumni of the medical school to investigate the effect of gender on career aspirations of medical students, in particular trying to find out why women don’t choose careers in academic medicine. I spent the first few weeks of my project designing my questionnaire. I even got a bunch of friends to be my test group (in return for Chocolate!) and give me their feedback on the questions. After a few tweaks I was really pleased with the final version and since it was sent out I’ve been franticly checking the response rate! I’ve never done this sort of research project before so I really don’t know what to expect from the results, but thanks to all great students so far who have filled in my survey at least I will have plenty of data to analyse!

As well as getting to grips with my project I’ve been catching up with my extracurricular activities. Everything seemed to come to a grinding halt during revision over the summer so it’s nice to get involved in new projects for the new academic year. The role I’m most excited about is my new role as President of the Psychiatry Society. We have started organising our next events and brainstorming for the future and trying to come up with ways to expend the society so I’m excited for the coming year and working with the rest of the new committee. I also led the first training session of the new year for MedMinds a society that educates schoolchildren about Mental Health. Leading sessions like this is really nerve-wracking, it’s not just public speaking but getting students involved in interactive activities and encouraging participation which can be tricky in a large group. The training session was really busy and full of students from lots of different courses which was great to see. It’s also a nice reminder that while the medical students may be stuck up on Gibbet Hill there are opportunities to step outside the bubble!

I’m also involved in organising a medical education course for my fellow third year students. Myself and another student are in charge of organising the speakers, planning the sessions and the scariest job of all, selecting students to take part in the course from anonymous applications. Medical education is something I’m very interested in for the future, so I’m glad as part of SSC2 I got to take part in a Journal Club on the subject. Journal Clubs in SSC2 are a great opportunity to learn critical appraisal skills, another valuable research skill that all doctors are expected to have.

While I am learning lots of different skills in SSC2, skills which I am actually able to put into practice with my extracurricular activities, I am worried about my total lack of clinical skills! It’s been so long since I’ve been in hospital I’m not sure I’ll be able to take history, or blood for that matter! I’m glad in Advanced Cases 2 before Christmas we have dedicated time in hospital to refresh our skills so we are fully prepared for our specialist placements in January. Not long now!

Joanne

Luke Pemberton : 26 Oct 2016 13:34 |  Tags: Joanne Mbchb Warwick |  Comments (0) |  Close comments |  Report a problem

Self–Directed Research Project (Gambia)

At the beginning of our third years, all students are required to participate in the second Student-Selected Component of our curriculum (with the first being in the winter and spring of our first year). SSC2, as this one is known, is a self-directed research project that we are expected to undertake and conduct on our own, under the guidance of at least one supervisor whose profession and speciality depend on the nature of the project. For my project, I am conducting an audit to investigate the requests for tuberculosis diagnostic tests at a large, charity-run hospital in The Gambia and compare what actually happens in clinical practice to the country’s recognised standard. I will be here for the month of October.

Last week was, needless to say, a bit of a blur! We got our exam results on Monday, started with our SSC2 seminars on Tuesday, carried on throughout the week, and then on Saturday I woke up at an inhuman hour and flew from Birmingham to Banjul. I still couldn’t quite believe it, even when the plane took off. My first impression: it is hot! It was 8 degrees out when I left Coventry last Saturday and it was 31 when we landed in The Gambia. I know we’re in the tropics, but I was not expecting this. Mind you, I’m not complaining. My other impressions: it is really lush and green, and the people are all so friendly with such a vibrant look. So many people have such decorative and colourful clothing and are really striking – it’s a welcome change from what can often be monotonous dark and grey so commonplace in England this time of year (or any time of year, let’s face it).

Although my project involves inspecting patient notes and monitoring requests for laboratory tests, I have had the opportunity to observe some clinical activities as well. I have sat in with several one-on-one, doctor-run clinics (similar to GP consultations in the UK in structure and function) and have also watched a few ward rounds. But I think that this is where the similarity ends. Since primary care doesn’t really exist for most people here, many of the patients present with advanced stages of diseases that aren’t normally seen in the UK – at least I’ve certainly never seen them. For instance, conditions such as extra-pulmonary tuberculosis and Tetralogy of Fallot are common enough that I’ve seen a few of each in the week that I’ve been here. You certainly don’t see many of those in Warwickshire!

I know that I keep coming back to the same point, but seeing healthcare outside of England always makes me that much more appreciative of the NHS, and that we are lucky enough to live in a rich and developed country. I could not imagine having to make a life-or-death decision based on how much money my family has or how easy it is to go to a city several hours away in a neighbouring country for treatment on an ongoing basis. These are decisions that people here are confronted with quite frequently, and it breaks my heart to see this happen even once. Confronting such dilemmas must be such a difficult thing to do, and spending this time at the coal face has impressed on me even more the importance of a strong and dedicated health service.

John

Luke Pemberton : 18 Oct 2016 10:33 |  Tags: John Student Warwick |  Comments (0) |  Close comments |  Report a problem

Hello Phase 3!

After a long summer stuck in my study myself and the other 2^nd year students sat our exams in September. Two week later we all made our way, nervously, to the Medical School to see if our names were on the pass list. Walking up from the main campus seemed to take forever as I nervously chatted to my friends, trying to keep it together and stay positive. Well, my name was there which meant that I was officially a 3^rd year medical student entering Phase 3! There was little time to celebrate as we officially started Phase 3 the following day, thus I started phase 3 regretting how much wine I had consumed the night before!

Phase 3 consists of an 8 week research project (SSC2), followed by 3 weeks of lectures and hospital placements designed to get us back up to speed before we start our specialist placements in the new year. The first week of our research project has been lecture based, designed to give us research skills we may need to complete our projects. I used to work in laboratory research with animal models of psychiatric disease but decided that for my SSC2 project I wanted to do something completely different. I am designing a questionnaire to investigate the effect of gender on career aspirations of medical students, in particular trying to find out why women don’t choose careers in academic medicine (where you combine clinical work with research). This project will allow me to develop completely new research skills and work in a totally different area which will be really interesting. Other students are going back to labs they used to work in before medical school, others are conducting audits in the local hospitals and some are even going to Africa as part of their projects. It’s going to be a really fun 8 weeks and a chance to do something completely unique!

As well as getting to grips with my research project I also want to use SSC2 as a chance to get my work/life balance back on track. I found it difficult to get the right balance during Core Clinical Education last year when we spent long days in hospital and revision doesn’t exactly bring out my healthy side! The problem is that this is what I’ve signed up to do, come January I’ll be doing my final clinical placements in hospitals and as the year progresses finals will be ever closer, and once I graduate I’ll be at the mercy of a hospital rota. I have to try and get the balance right now and maintain it so I don’t let it slip again either in final year or once I graduate. Coping with stress and not letting work take over your life is a big part of life as a doctor and something I still need to learn! So here’s to SSC2 and the start of phase 3. Only 16 months until finals!

Joanne

Luke Pemberton : 03 Oct 2016 09:54 |  Tags: Joanne Mbchb Student Warwick |  Comments (0) |  Close comments |  Report a problem