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September 18, 2020

Babies and bellies

I have now started my Obstetrics and Gynaecology block, for which I am based at Warwick Hospital. Warwick Hospital is one of the smaller hospitals for our medical school but one of the best in terms of the experience that you get. I have only been at Warwick before for a day here or there and never for a long time, so I was excited to start a 5-week block based at Warwick. Obstetrics and Gynaecology covers pregnancy, childbirth and women’s health, and for the block we have two midwives supervising, teaching and organising us. For our first week we had mostly lectures covering some of the basics of this speciality, some of which is revision and some of which was new information. The lecturer midwives who were teaching us did a fantastic job of breaking these topics down and giving just the right amount of information to make it digestible. We also had sessions on obstetric palpation (feeling babies in pregnant tummies), which I have always found tricky. The only way of describing what it is like is having an action man in a inflated balloon and then trying to feel what clothes action man is wearing. It can be tricky so I’m glad we got some more supervised practice!

This week we also had Genito-Urinary Medicine (GUM) day, which is a whole day in this block which covers sexual health and medicine. We don’t get much exposure to this speciality as a medical student, but I actually find it really interesting and varied. The day involved some lectures on HIV and different sexually transmitted infections (STIs), as well as some interactive sessions. This included practice conducting intimate examinations of male and female genitals, and then we also had some practice taking sexual histories. As I said, we don’t get much exposure so having some interactive practice makes tackling these sometimes-difficult areas a bit easier.

Today we had some bedside teaching. At Warwick Hospital we are very lucky to have booked sessions with doctors and midwives where they take us onto the wards, we find a patient and then see the patient under supervision to practice our history taking and examination practice. In the morning we were doing Gynaecological histories with one of the education doctors and in the afternoon, we were taking pregnancy histories and feeling tummies under the supervision of the midwives. Overall, the day was tiring but also really useful and we managed to get some hands-on practice, which is definitely needed at this stage!

I started my Obstetrics and Gynaecology block feeling as though it wasn’t really for me. I’m not really sure why – I think I find it difficult and so don’t enjoy it for that reason. However, after 2 weeks I feel as though it has been demystified a little bit and I definitely feel more comfortable already, with still 3 weeks to go. Im excited to see what the rest of the block brings!


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!


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.



July 16, 2020

Business

Placement has resumed. Hoorah! For the last two weeks I have been on my musculoskeletal placement which was delayed for 3 months due to COVID. Thankfully, things are back to (nearly) normal. Monday started with induction, where the administrator of the block gave us our timetables and our new uniform – scrubs! So far in the course for placement we have been expected to wear smart clothes – for me a white shirt with the sleeves rolled up to the elbows, smart trousers and smart shoes. However, due to infection control, we have been told to wear scrubs, which can be washed at higher temperatures and more often to kill any nasty bugs. I’m certainly not complaining – while I like wearing my own clothes, ironing all my shirts on a Sunday night is not the relaxing activity you need before the start of a new week. Scrubs are comfortable and easy to wear, with no thought about which trousers go with which shirt. It does feel very informal to be wearing what basically feels like comfortable pyjamas, but I’m not complaining.

On Tuesday we spent all day in theatre with our consultant working through the trauma list, so the operations were focussed around fixing acute problems such as broken bones. It was pretty cool to be back in theatre and a welcome reintroduction to medicine after 3 months off. I have to admit, I had sort of forgotten….well everything really. But luckily there were some lovely scrub nurses around to help remind me how to scrub in for theatre. “Scrubbing in” is an odd term really, but what it actually means is washing your hands in a very specific way to remove any bacteria or viruses and then donning a sterile gown and gloves in a very specific way to make sure they are clean and don’t infect the patient. I’m sure on TV you’ve seen the surgeon and their assistant wearing a long gown and gloves right next to the patient while everyone else stands further back just wearing scrubs. In theatre we get a chance to put on the gown and stand next to the surgeon, and even help out a bit by holding tools and things like that, which was pretty cool. Our consultant is very good at explaining what is happening at stages of the operation, which really helped. I think all medical students should spend time in theatres seeing common operations. Even if you don’t want to be a surgeon, you should know what an operation involves and by seeing it done, you will be better at explaining it to patients. For example, even a GP will be doing some of the aftercare of a hip replacement, and if you’ve never seen one, it can be harder to explain what it involves and recognise when the patient may have complications afterwards. As well as that, it helps things stick in your memory for final exams!

I also got some news this week – I’m a final year! We were told that we progressed from third into final/fourth year. It was more of a formality than anything else, as we basically just needed to be signed off for our first two blocks to progress with no exams this year, but it was still nice news. It does feel slightly odd to change my introduction when talking to patients from “Hi I’m Jordan and I’m a third-year medical student”, to “I’m a final year medical student”, and hits home that I am on the final stretch. It seems both a long time ago and only yesterday when I was the scared first year trying to understand anatomy and not knowing how to talk to patients other than “Have you got any pets?”. Ironically whether they have pets tells you more about their medical condition than you might suppose…Anyway, In one year, I will have done finals, and (hopefully) have passed and become a doctor. Scary indeed, but I’m ready to face the challenges ahead.


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Our Med Life blogs are all written by current WMS MB ChB students. Although these students are paid to blog, we don’t tell our bloggers what to say. All these posts are their thoughts, opinions and insights. We hope these posts help you discover a little more about what life as a med student at Warwick is really like.

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