All 9 entries tagged Gp
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September 15, 2020
I’m tired!
The last two weeks have been….BUSY! My General Practice block has been coming to an end. Like with all my placements, I have had to get sign offs from the doctors to say that I have performed to a good standard, engaged with everything and completed all the necessary tasks on placement! One of the GPs that we have been with quite a lot filled in our “End of Block form”, which they sign giving feedback on areas such as attendance and engagement etc. We received some nice feedback from that GP who said it was a pleasure to teach us, which is always nice to hear! My general ethos in life is to always put your best foot forward and go in full steam – always work to your best ability. If you don’t do as well as you could or you could improve, that’s okay! I do think this makes the job of teaching easier and shows respect to those teaching you – the most frustrating thing in trying to teach is when you ask for volunteers and no-one says anything!
Thursday last week I also did some teaching! Warwick has a very strong tradition of students teaching students, and I have gotten involved with this throughout my time here – I taught seminars to first years and also taught life support last year. I really believe that one of the best ways of learning is to teach. The first years have had their exams delayed this year due to COVID – usually they are in June, but they have been pushed back a few months, so these are coming up soon. I picked the chance to teach shoulder anatomy to the first years, mostly because I have recently had my musculoskeletal block and so the knowledge is fresh and also because shoulders are cool! Unfortunately, the session was online this year rather than in person which does limit things somewhat. Usually in my seminar sessions I like to have activities and demonstrations to show concepts but being online makes this harder. Despite this (and also some technical issues) I did manage to teach I think some useful hints and concepts to the first years and enjoyed myself while doing it. Hopefully they found it useful!
On Thursday I also had my end of block assessment for GP block which took the form of history taking with an actor and discussing management with one of the doctors who was marking me as if this was my final exam. I got some nice feedback in terms of my communication and actually really enjoyed the assessment. I know that’s probably quite weird! It was actually quite fun to have a practice and also super useful as it reminded me of lots of things that I need to go over (ahem…ECGs..).
This week I have also been trying to exercise more and improve my wellbeing as I’ve been quite worn out. GP block has been really fun but also very tiring as its very busy. I’ve (re)joined the gym and am going to try and go a couple of times a week to try and destress. I think my next block is less busy timetable-wise so I can have a bit of a rest. So that’s the end of GP block. My next block is Obstetrics and Gynaecology, in which hopefully I get to see some cute babies! See you in my next blog!
September 10, 2020
Getting back to normal
I am writing this from my second home today, the medical school computer room! I am so grateful to be back in this room as I had just begun to fall out of love with my desk at home. It’s nice to be back in a room my brain is conditioned to work in.
It’s all slightly different though as there is now a one way system which I can guarantee will cause a few grumbles as we will now have to walk outside to get back to the lecture theatre from the CBL rooms, and there are a few more hand sanitizer stations around! We also have to book computers and half of the suite is now out of use to aid social distancing. I don’t know why they put a number on my spot. I’m here so much they might as well have called it Abbie’s spot! However, it does mean we are one step back to normal, whatever normal is now going to be.
I’ve also had my second Covid-19 scare of the year as I came down with all the symptoms bar the cough over 24 hours. I booked my swab on the day I was ill but it had all magically cleared up the day after, I still attended my swab appointment though and luckily I was negative. I do feel sorry for the amazing care workers and district nurses who have to have this swab done on the regular. It is no way comfortable and you end up with a weird sneezing and coughing combo driving out of the centre.
Talking of the C word. We are officially back in GP practice and the difference between hospital life and GP life is clear with regard to Covid-19. In hospital, patients get swabbed once every couple of days whereas in GP practices, you have no idea what is coming in through the door so safety measures are heightened. We had one patient attend for a face to face appointment and we were donned in our visors, masks, gloves and plastic aprons. It felt so weird and nothing like the afternoons I loved last block.
I really do miss patients in GP. Having our student appointments was what made GP days my favourite day of the week. I loved chatting with patients and seeing a couple of them progress every week. Now, we hear a voice at the end of a phone and that is it. You now don’t get the “lucky dip” of what comes in through the door which keeps you on your toes, as all the appointments have a reason as to why they have a call. I have managed to take one history from a telephone call which did test me as it was dermatology, not my forte. My clinical partner and I were happy to discover there was a café near our practice that was offering the “Eat Out to Help Out” scheme which immensely cheered us up. There is also a Lidl which means Lidl pizzas for lunch!
September also means it’s the start of medical school for lots of people across the country. My best friend from undergrad starts at Swansea so I am immensely happy for her. It also means we have 200 fresh faces here at Warwick. I am looking forward to meeting them, though I do feel sorry for them as they won’t get the welcome experience we had. Hopefully, we can still keep some Warwick traditions alive such as Revue and medic family dinners. I found out I have two medic granddaughters and two medic grandsons from my medic kids this month. This makes me feel old as it wasn’t 5 minutes ago I was getting my medic parents. I just hope I am older than one of my grandkids as I didn’t seem to achieve that with my medic kids.
That’s it for now! See you guys in two weeks !
August 28, 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!
August 10, 2020
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.
February 10, 2016
A balancing act…
Now that we are on the wards I’m starting to fully appreciate the monumental struggle doctors face to maintain a healthy work life balance. The hours are punishing and the work emotionally and physically draining. Even as a medical student the balancing act is tough. At the moment I’m in hospital 4 days a week 8-5 and on my day in GP land we are in 9-7 to see a late surgery. An average day is a long time on your feet, a few periods of absolute terror (usually when taking blood and missing!) and a lot of mental effort. I usually get home and collapse in a heap, so finding time to study is difficult and finding time to relax even harder. Having said all that even after 4 weeks it’s getting easier and I’ve simply learnt that when it gets to a certain time I just have to switch off no matter what needs doing!
In first year I didn’t get involved in many extra-curricular things although I had a small part time job on campus. I’ve kept it up this year and I’m still enjoying a couple of evenings a week totally free from medicine. I speak to graduates of the university so I get plenty of helpful tips and advice from previous students, many of whom are now practicing doctors in the local area.
A big change for me this year has been getting more involved in societies. I’m involved in the committee with a new society that is gong out into schools to teach teenagers about mental health and reduce stigma. Getting involved in projects like this is great and you feel like even as a medical student you can make a real difference and get involved in causes that you are really passionate about. I’m organising a few talks and events this year with other societies and finding more and more people in the medical school who are equally passionate about those topics. You can feel a bit odd if you’re not really into anatomy or your sole aim in life isn’t to be a trauma surgeon, but there are so many graduates studying at Warwick and so many societies you will find people who share similar interests and passions and who will point you in the direction of some amazing opportunities.
Juggling hospital, a part time job, and extra-curricular commitments is hard enough but then the medical school throws in academic days which come with the usual lectures which must be prepared for and revised as well as our case based learning sessions. Our academic days happen every two weeks on a Friday and they are very long and busy days. They are usually around one topic so it’s quite an intense day where you question if you remember anything for phase 1, but it’s also a good chance to catch up with everyone over coffee.
This week we had our first day in GP. GP consultations are so different to histories and examination in hospital so I feel like I’m having to reinvent the wheel on top of everything else! Having said this I had a great day and saw a huge variety of patients and conditions. I even used an interpreter in one of the consultations. Working in different clinical environments is a juggling act in itself and I’m sure I’ll drop a few pins before I get the hang of it!
Joanne