All 15 entries tagged Jordan
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May 20, 2019
This week marked the end of CCE 2, I cannot believe how quickly the months are going by.
The most enjoyable aspect of this block for me is definitely my GP placement, so it was sad to say goodbye to the fantastic team at the surgery we have been assigned to this week. My clinical partner and I have grown really fond of the picturesque village of Upton-on-Severn in Worcestershire where we have been attached for the last 7 weeks.
During our lunch break last week we even managed to hire a small boat and have a little adventure on the river which was great fun and the perfect antidote to a busy morning surgery! Fun aside, over the course of this placement, I have really felt as though I have been the closest to actually being a doctor than I have at any point so far on the course. We’ve had the chance every week to lead the consultations and diagnose patients, all under support and supervision, but largely the onus is on us to lead the consultation. This is a huge responsibility, but I believe that definitely the best way to learn is experientially, by “doing”. The support from the amazing GPs at the surgery gave me the opportunity to lead consultations with confidence and really build on the skills I have been taught so far, as well as put them into practice for real. It was no longer a case of ‘watch and learn’ but rather ‘do and learn’ and I really feel my time spent at this placement has been so valuable to my growth as a budding clinician.
As this week is the last week of the block, I spent some time finding my consultants to try and get my sign offs for the end of this block. It has been bittersweet discussing my progress this block, reflecting on the various things I’ve done but also the fact that it is now over and we will be moving on soon. One highlight has been attending kidney clinics and the dialysis ward with our renal consultant. I wasn’t the biggest fan of kidneys at all after first year due to the complicated physiology, and I suppose in part the fact that I am from an arts background so all of the physiology was completely new to me. However, actually seeing these patients in clinic and on the dialysis ward this block has been really enlightening. Clinical nephrology (the study of kidneys) is actually a very involved speciality where you really get to know the patients as you see them long term and are also involved in preparation and assessment for kidney transplant and evaluation for dialysis treatment. I certainly don’t have the same fear of kidneys now, and in fact I actually quite like them!
We now have a week off (during which I’m going to County Mayo in Ireland for what I think is a well-earned break!), before starting back for our third Core Clinical Education block. This is our only week off from January-September, so I feel as though I really need some time off. Everyone always says that Graduate Medicine is intense, but you don’t realise how true this is until you get here. Despite this, I wouldn’t want to do anything else.
I cannot believe that this is our last block of this year before our exams, and I feel as though it has gone so quickly. However, I would say that it also feels like its been a long journey in terms of the amount we have learned and the progress we have made, into budding clinicians and doctors. After all, this is why we signed up to the course – to be doctors! For my next block, I am attached to Orthopaedic surgery and Obstetrics and Gynaecology. Stories of many babies and tibias to come!
May 07, 2019
We’ve had quite a few clinical skills labs recently, and this week we’ve had labs on fundoscopy and then a workshop on suturing. Fundoscopy also called (ophthalmoscopy) is shining a light into the eye to look at the retina (at the back of the eye) to check the blood vessels and look for changes which could be caused, for example, by diabetes. Although it sounds easy in principle, as I quickly found out in the skills lab, it is not!
At first I couldn’t see anything. I’ve been told that it takes years of practice to master this skill, and I’m sure it will take this long as all I could see was redness... The second clinical skills lab I had was suturing, which is essentially sewing up a wound. I’ve done a little bit of this before, so it wasn’t completely new to me, as my partner brought me a suturing kit from the internet last Christmas. (would recommend as a relaxation tool, practising your suturing while watching TV…) The session was facilitated by a surgical nurse practitioner and a surgeon, which was great to get tips from the people who do it multiple times a day! Practice makes perfect, and we have further teaching on suturing and surgical skills in future years, so it was good to be introduced to this skill at an early stage in our careers.
Recently, I have been thinking more and more about what direction I want my career to take post-graduation, and even what specialty I want to end up in. As a second year, graduation is still some way away, but in two year’s time, we will have finished finals and be waiting to start our first job as qualified doctors. When I first started the course, most of my work experience was in acute medicine – so I thought I wanted to work in A&E, Intensive Care of Anaesthetics. I have enjoyed my placements in these areas but I have also been surprised at how much I have enjoyed General Practice too. I think that my personality is well suited to a generalist specialty, where you might be seeing a heart patient one moment and a baby the next. I get bored easily and think I would struggle in a speciality without this variety. General Practice has been fantastic so far, and I have really loved the chance to see so many interesting cases and practice my examination skills. I also love the fact that you build up a rapport with patients and get to know them and their stories, and hopefully see a good outcome for them in the end. I’d never considered it before, but I think GP may be for me, although time will tell whether I still feel this way in two year’s time. Putting this down in writing I may look back on this and wince at how I end up not doing this at all, but these are my thoughts at the current moment.
April 18, 2019
This week I have had my Psychiatry placement. I haven’t had any previous experiences in psychiatry before, so I was really looking forward to spending a week learning more about the speciality. All of the students have different placements for ‘Psychiatry Week’ so our experiences will all be different. My placement was in community learning disability services, which was interesting as I had already encountered some patients with learning disabilities in my GP and hospital teaching, so the week would give me an opportunity to learn more about the specialised care these patients receive.
We arrived at our placement on Monday morning and spent the day meeting the team, which included more professionals than I expected! The team included doctors, nurses, physiotherapists, psychologists, social workers, speech and language therapists and many more. I had no idea about all of the different groups that were involved in learning disability services.
On Wednesday we had a chance to attend a meeting which was facilitated by the psychiatrist to which we were attached for the week. It was really fascinating to observe how the psychiatrist communicated to the service user, and will really make me think more about my own communication skills and how my approach is accessible to all patients. In the afternoon we spent time in a respite centre for individuals with learning disabilities, which gave us the chance to meet some service users and also chat to the carers about what they do. The centre was really well run and supportive in helping their service users when they needed to stay over to give their parents or carers a respite break.
We also attended a home visit with one of the trainee psychiatrists, this gave us the chance to meet a service user in their own environment and see how they are cared for at home. The psychiatrist also had to deal with physical health problems while they were there, and I hadn’t considered this before – I had thought psychiatrists only dealt with mental health issues which definitely isn’t the case! Overall, the week really made me think about how we help service users with learning disabilities; both how we communicate with them and also how they could receive substandard care in a standard hospital environment not tailored to their specific needs. Taking the time to understand someone’s needs in a busy hospital environment can be challenging but it can really help us to make a difference in improving their health and providing the best care we can.
I also found out this week that a poster that another medical student and I submitted to a medical education conference actually won best poster! I unfortunately wasn’t able to go to the conference because of other commitments, so it was a nice surprise. The poster was the result of a project I was involved with over the summer with other students and members of faculty and focused around how to teach professionalism to medical students. The ensuing poster was around a mnemonic that another student came up with to help students deal with tricky scenarios while on placement. As medical students, we can often find ourselves in difficult situations and haven’t been around the medical field for long so can struggle to decide what can be the most professional or appropriate action to take. The mnemonic offers a structure to aid thinking around these issues. It was lovely to hear that others who are often experienced in medical education found our work interesting!
April 05, 2019
This week we visited a dialysis unit with our current consultant who is a renal (kidney) doctor. We have already attended quite a few renal clinics and seen and spoken to patients who are being prepared to have renal replacement therapy (i.e. dialysis). Dialysis is designed to replace the function of your kidneys in cleaning waste materials out of your blood and so designed to keep patients with kidney failure both safe and healthy. On average, patients come in three times a week for dialysis, with each visit lasting around 3-4 hours. It was fascinating watching the dialysis machines being set up and talk to patients undergoing the procedure while they read books and sometimes slept, all while their blood was cleaned. I had always been unaware of what dialysis really involved and whether it hurt, but for the patients we met, it was very routine and almost straight forward for them. While on the dialysis unit, they also have access to a kidney doctor, which gives them the opportunity to ask questions about their condition and/or any changes to their medications needed. This is an amazing service, as I know many dialysis units don’t have the chance to have a kidney doctor on-site in this way, so they are very lucky as a unit to have this service on site.
On Tuesday, we had our first GP day of this block. Our allocated GP surgery is in a small village in rural Worcestershire. For GP, the medical school tries to allocate us GPs nearby, but most people get one GP practice which is further afield and is a great opportunity to see how medicine is practiced in a rural GP setting. We had a relatively uneventful journey down to the surgery and were surprised when the reception staff knew exactly who we were before we even said where we were from (we must look like students!). The surgery had organised a busy timetable for us, which included two clinical sessions a day with a GP (a morning and an afternoon), and also patient home visits and governance meetings.
In the morning we were in surgery with our GP mentor, who is our overall supervisor and makes sure we are really getting the most from our placement. The patients we saw included ear and throat infections and also some management of chronic diseases such as high blood pressure. I even got a chance to practice looking into ears with the otoscope! We then had a patient home visit, which was a great excuse to visit someone in their own home and ask them about their health issues while drinking plenty of cups of tea. At lunch, we had a meeting on frailty and how these patients are identified within the practice and was fascinating as it gave us an insight into how general practice is funded – via certain clinical targets which the practice must meet to receive funding. The day was nicely rounded off by another clinical session in the afternoon, this time with a different GP. This GP was really enthusiastic to teach and did some mini-assessments on our clinical history taking and examination skills, which I’m sure will be really useful practice for when our exams come around.
On the topic of exams, these are definitely on the radar for us, despite being 4 months away. From what we have been told, more is expected of us in our second-year exams in terms of diagnosis and management, both of which are still very new skills to us. I have been gradually working my way through the presentation list (which we are examined on) and am currently about 60% done. While I am on target, I need to slightly pick up the pace to leave myself a month or so to revise at the end, so am planning a couple of long weekends in the near future to get ahead. Next week we have a week-long placement in psychiatry, which I am very excited about!
March 21, 2019
The last two weeks have covered the first two weeks of Core Clinical Education 2 (CCE2), and my placement has been at University Hospital Coventry and Warwickshire (UHCW). UHCW is the main teaching hospital for Warwick Medical School, and is the largest hospital in the region, also encompassing a major trauma centre. One of our named consultants is a renal/kidney doctor, and we went to one of the renal outpatient clinics. The majority of patients attend for routine monitoring of kidney damage, with the majority of causes of this being due to diabetes and heart issues. This provides some good revision of our heart failure and diabetes learning and just goes to prove that no area of medicine is an island – everything is connected! And I thought we were attending just a kidney clinic!
On Tuesday, we taught our last student seminar of the term, and the last before the Easter holidays for the first years. The first years have a month off for Easter, then 5 weeks of Block 5, and then their exams. The exams are definitely looming large in many of their minds, with about 2 months to go before the end of year 1 exams. We did some teaching on getting the most from revision, and also offered some reassurance that everything will be okay! I remember being in the same position this time last year, and how worried I was about the exams. Our focus was mostly on getting a good work-life balance over Easter – it is key revision time, but also the last time off they will get before exams, so it is so important to also have some down time.
We have also had a couple of community days over the last two weeks, where we went into the community to learn about how patients are managed in care homes, GP surgeries and in their homes. The first community day was focussed on clinical audit, with teaching sessions on how to do a clinical audit, which we will be doing with our GP practices throughout CCE2. Clinical audits are activities in which we will be involved for the rest of our working lives, no matter what area we go into, so its good to have some focused teaching on this now. In addition, if we present audit findings at conferences etc, this stands us in good stead when applying for jobs. Unbelievably, our first jobs as doctors are little over two years away – and I’m sure this time will fly by in the blink of an eye!
Our second community day involved a patient visit to a brain injury unit, which was a really valuable learning experience in terms of how brain injury patients are cared for in the community. It really made me think about my own life too, and about the things that I value and reminded me that it is really important to enjoy life as you go by. It is so easy when very busy to not take notice of small things - the small victories and valued experiences with family and friends. Medicine sometimes makes you really appreciate your own life and I think this is one of the empowering aspects of meeting so many different people. It can be quite a cool career really!