All 19 entries tagged John

Musculoskeletal Health Care…

Our cohort is a few weeks into the first of our eight Specialist Clinical Placements (SCPs) and 2017 is stretching out before us. Although it seems long, the time is actually going by quite quickly. I wouldn't say it's exactly fun, but I'm enjoying myself tremendously on this block and am learning a great deal.

My first rotation is the MSK block (musculoskeletal health), which is pretty self-explanatory. In this block, we become more familiar with problems of joints, muscles and bones (and nerves and connective tissue and some skin and so many other things as well...). Many people run a mile when they think of anatomy and memorising lists of muscles and bones, but block 4 in the first year (Locomotion) was actually my favourite block and I'm loving the MSK placement. We've seen so many things that I wasn't expecting and we're only just over three weeks in.

As is probably fairly obvious, a lot of the work revolves around bones and joints - so we see fractures and their treatment, joint replacements, and that sort of thing. But of course they don't exist in a bubble - for instance, fractures are often accompanied by soft-tissue injuries and we have to know all of the repairs that come along with them. Getting a new knee or a new hip is a major operation and can take weeks or months to recover from fully. A lot of the learning we've done in earlier years around the biological, psychological and social impact of health conditions has come in very handy in understanding the lives that our patients live and how injuries might change them. It's proven incredibly applicable now that we are seeing more patients in a clinical setting than we did in the first years of the course.

I was not expecting that we'd be taught rheumatology as much in this block as we have been. It's a very diverse field and there's so much going on! The more I see of it and the more I learn about the speciality, the more interested I become. The patients are very interesting and diverse, and being an effective rheumatologist requires extensive knowledge of many branches of medicine and the ability to pull them all together very quickly. Since rheumatological diseases can affect multiple body systems, specialists in this field need to be quite broad in their knowledge and approach. We have seen patients with rheumatoid arthritis (of course) but also psoriasis (and the multiple effects that it has), polymyalgia rheumatica, systemic lupus erythematosus and several other conditions that we've only seen in textbooks before now.

I'm enjoying the block so much, I'm really gutted that it is coming to an end so soon. But of course new adventures await in the next placement, too.

John

Luke Pemberton : 26 Jan 2017 14:46 |  Tags: John Mbchb Patients Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

The Start of Specialist Clinical Placements

We third-year students have successfully navigated a lot in our medical career so far, but it looks like 2017 is going to be the busiest – but most exciting! – phase yet. We’ve had a year and a half of pre-clinical work, covering all major systems of the body and lots of multi-system disease presentations. We’ve had a long spell of core clinical education. We’ve all done our own research projects, complete with lengthy write-ups and, of course, reflection. We’ve been through two cycles of exams and have made it out the other side. And now we have just started the final push: earlier this week, we began the first of our Specialist Clinical Placement (SCP) blocks, where our education now focuses on particular areas of medicine in preparation for finals and practice beyond.

Our cohort is split into eight groups of roughly equal size, and these groups rotate through eight placements across our main hospital sites. My clinical partner and I are in the Musculoskeletal Healthcare (MSK) block, which is actually extremely interesting – much more interesting than I was expecting. The great thing about the Warwick curriculum is that it is spiral learning, which means that we are encountering topics and building upon knowledge that we’ve got several times throughout the course. For the MSK block, this means that a lot of knowledge we gained in Block 4 of the first year – the one called Locomotion – is really coming in handy now. Our knowledge of muscle and bone anatomy, innervation and blood supply is being called upon with alarming regularity!

Of the five blocks we had in the first year, my favourite was actually Block 4. I liked the tangibility and unchanging nature of human anatomy. There are some structures that are complex, but they just need to be learned. And once the difficult material has been learned, it really isn’t going to change. Now I’m most looking forward to seeing how specific pathologies present and how they are corrected, and spending some serious time in clinic with specialists. I’m also looking forward to surgery and watching some hands-on reconstruction work happening.

And even though I was expecting this SCP block to be heavily anatomy-based, there is a great deal of rheumatology taught as well. This is a topic area to which we aren’t exposed very much in Phase I and Phase II, but we are making up for it now in Phase III. We are scheduled to attend several rheumatology-teaching sessions and have already spent lots of time in rheumatology clinics and so on. It’s been really interesting and we’ve seen a wide variety of cases – obviously there is rheumatoid arthritis, but also polymyalgia rheumatica, psoriasis, osteoarthritis and lots of other conditions. Patients of course will also have several comorbidities as well. I know this sounds naïve, but I had no idea the field of rheumatology was so varied and interesting. I might have to look into it further for possible career options...!

John

Luke Pemberton : 06 Jan 2017 09:09 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Autumn Term drawing to a close.

The autumn term of our third year is drawing to a close and it’s hard to escape the feeling of mild terror that surrounds me. It’s been a great term, and I’ve learned so much, but I know that things are going to get a lot busier for the rest of my time at medical school after the coming Christmas break.

First we had eight weeks of our Student-Selected Component, a research project designed to acquaint us with the world of medical research. Students could either design their own projects or use one which was arranged by the medical school. I elected to do my own, and after a herculean feat of organisation and form-filling, managed to spend a month in The Gambia collecting data for an audit on tuberculosis investigations. It changed my life. The research project was very interesting, and it piqued my interest in global health – and especially the plight of those outside of the UK who are far less fortunate than we are. I read a lot of articles about TB diagnosis and spent (probably) far more time than I would have ever thought I would poring through WHO reports.

After SSC, we enjoyed three weeks of Advanced Cases 2, which combined lots of familiar elements of our course. Over the three weeks, we had Monday and Tuesday in lecture, and Wednesday through Friday on the wards. The lectures have been either covering old topics, introductions to the upcoming Specialist Clinical Placement blocks or covering an entirely new topic afresh. It’s been great to spend some time in the lecture theatre again after a few months of being away. I appreciate the structure and have found that it helps me learn better.

We also met our new CBL groups – after the first two years with the same CBL groups, we have now landed with an entirely different bunch of people. But the great thing about our course is that (I strongly feel) the people really are selected because of, among other things, their ability to work with others. I don’t know anyone in my group terribly well, but I know that we’ll get on just fine because everyone in the cohort is a very easy and personable person to work with. Initial suspicions have so far proven completely correct.

I’m looking forward to the start of clinical placements but have a little bit of apprehension as well. When I think of what we need to know – and know automatically, without hesitation! – before our final exams, a mere 14 months away, I am frankly terrified. But a very wise GP (also a Warwick grad, of course!) once told me that the key to memorisation is repetition. The more you see something, the more likely it is to stick in your head. I’m hoping she’s right. Now it’s just a matter of getting all that stuff onto paper and seeing it in practice. I know what I’m doing over my Christmas break!

John

Luke Pemberton : 09 Dec 2016 10:31 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Back to Lectures and Wards…

The Student-Selected Component phase in our curriculum has come to an end, and despite the fact that we are all feeling a bit more refreshed and ready to dive back into some more structured learning opportunities, there certainly was not much rest for the weary this week. For the next two-and-a-half weeks, we are participating in Advanced Cases 2. This is basically an introduction back into the world of lectures and wards and clinics and preparation for Phase III, which starts next year. In each of these three weeks, we have two days of intense lectures followed by three days on the wards to re-acquaint ourselves with the buzzing hospital world.

The four weeks I spent in The Gambia collecting data for my project seem about a million years ago now. Getting used once again to the autumn weather in Coventry after what felt like a scorching heatwave in Banjul (but was evidently a perfectly normal autumn, albeit one with highs of 35!) was tough, but I was able to gain a great deal of clinical exposure out there alongside my data collection, and I saw first-hand what it was like to practice medicine in a developing country with much fewer resources than we can access here. This has affected my perception about healthcare here in the UK as well, and will definitely colour my approach to practicing medicine in the future. For one thing, I have learned to never take for granted the provision of plentiful, adequate supplies and antibiotics. For another, we are extremely lucky in the UK to have excellent primary-care services which are provided free at the point of contact. This is lacking in many parts of the world.

We had lectures earlier this week about varied topics that we will be encountering next year in our cycle of speciality placements, including things like foetal development and monitoring, gynaecological emergencies, childhood neurological development and safeguarding – and that’s just over two days! It’s been extremely interesting and extremely relevant, and we’ve had a great time re-acquainting ourselves with these topics. Among other things, it underscores the value of repetition to assist memorisation. It’s really daunting to think about how much stuff needs to become automatic before we’re fully qualified, but when I look back over how much I’ve learned since starting med school 27 months ago, I’m confident that we can all do it.

Now, in addition to lectures, we have been turned loose on the wards again. But this time, if only for a short interlude, it’s different to CCE: it’s great to be in an environment where we can refine our clinical skills – and for the next few weeks, we can do so without the pressure of assessment. Once again we are distributed across our main hospitals in this trust, but this time, as opposed to CCE during our second year, it doesn’t feel like we’re dropped in the deep end! We are much more familiar with how each practice works and the layout of each of the wards, and it seems to be going really well. I am really looking forward to getting as much as possible from this part of the course.

John

Luke Pemberton : 28 Nov 2016 15:10 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

My return to the UK

I have spent four of the eight weeks of our Student-Selected Component research period collecting data from a large regional hospital in the Gambia, and I returned to the UK just over a week ago. It’s been a tough transition. The Gambia was a wonderful place, full of extremely pleasant people and experiences., most importantly, it was warm and pleasant weather. But there were lots of things I missed about England whilst abroad. Getting fresh vegetables in West Africa was really difficult – it usually involved a 20-minute walk one-way under the baking sun (I stupidly forgot my sunglasses, because I never use them at home! At least I remembered suncream). And most food products were imported and thus twice as expensive as UK shelves.

Yet there are, of course, many things that the Gambia lacks but that we enjoy in this country. For instance, on one of the weekend afternoons towards the end of my stay, we were at the beach and there was a scare that someone had been swept too far out to sea (it turned out to be a false alarm; it was a buoy that looked like a head bobbing above the waves). But it took over an hour for anyone to muster a boat and mount a rescue mission. In the UK, there is no doubt in my mind that the RNLI would be out as soon as possible, rain or shine, and would be hauling any victims on board without delay. Such an infrastructure simply doesn’t exist in the Gambia (or most of the world, for that matter). Once again, we are very lucky people and mustn’t forget it.

The data-collection portion of my research project was fruitful and extremely beneficial. I was able to collect a lot of information about requests for tuberculosis investigations and how different patients were handled clinically – both before and after admissions to the wards. Now that I have all of these data, I am going to spend the next couple of weeks writing up my findings, and hopefully turning it in at the beginning of December. The purpose of my project was to conduct an audit – this involves measuring current practice against a recognised standard and making recommendations for improvement. But even though my current work just involves clinical investigations, I collected a great deal of information about treatment and clinical outcomes as well. The local staff and I are hoping to get a lot more information out of this work and perhaps even a publication or two.

Now that I’m back in the UK, I need to improve my work-life balance once again – no more weekend afternoons at the beach! I’ve become reacquainted with the jumpers at the back of my wardrobe. I’ve got used to driving in the dark again. It’s not necessary to sit next to the AC for two hours to cool down after walking back from the main campus. But I can go to my choice of supermarket and get any fresh vegetable I want! And I can visit my GP if I’m worried about my health. Probably the main, and most important, lesson that I’ve learned from this experience is that we are extremely lucky in the UK to have such an advanced and developed society and one that looks after all those within it. Long may it continue.

John

Luke Pemberton : 09 Nov 2016 16:27 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem