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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!
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 25, 2020
Hot Wards and Cold Equipment Rooms
SO we are well into the run of our 10 week block of medicine and as unpredictable as the British weather is, we have had a heatwave on the busiest week of my timetable. Whilst temperatures were hitting 30 degrees outside, we were trying to find the coolest part of the ward which was normally strategically standing near patient’s fans (of which there were three) or running to the equipment room undetected. The masks don’t help either as they just reflect warm ari back into your face but if they keep the patients safe, it’s a small price to pay. However, despite losing all my body water in the first 10 minutes, it proved to be a really productive day on the ward. We had a lovely consultant who was keen to teach us and told us more than once we really should be outside and enjoying the sun and not on the wards. What was an added bonus was that we got all our sign off’s done for the 10 weeks in one morning. Before running off as we were told, myself and my clinical partner stopped at GEH famous ice-cream bar. The ice-cream is incredible and after putting it on Instagram, I was met with lots of jealousy from medical students and doctors at other trusts! I am officially team general district hospital!
This week in all has been just incredible for our learning and progression. We have a lovely F1 and an incredible Physicians Associate who have just included us into the team from day one. On the Friday we had another incredible consultant who literally sent us off on our way to manage a patient by ourselves. I stood wide eyed like a deer caught in headlights but actually, this was the best thing for me as I finished with my lovely patient and actually, for the first time, I actually felt like I was going to be a doctor in 2 years (Covid-19 depending). It’s nice to be praised and have the support there and this week has just been a huge confidence booster, which was needed as my PassMed average is lower than I’d like it to be.
Getting used to an emptier timetable than last block has been a bit of a feat but, I actually like this way as I have a chance to breathe. I can do more of my theory work during the day and not at 10:30pm when I would rather be in bed. It also means I can do more extra-curricular things like inhaling half of the pool water at the gym as apparently my swimming technique is far from desirable. The perks of being in the same ward every week means we become far more integrated into our ward team and we go into the wards with some determination to get things done as we have less clinical exposure time. We have also been encouraged by the doctors to leave the ward and go home if we aren’t learning anything. I really enjoy going to placements now and developing professional relationships with the team and patients is just the icing on the cake.
We start GP next week and I am a little sad not to be going back to our original practise in Nuneaton as we loved being there and our supervising GP was amazing. It is also going to be dramatically different not actually seeing patients which I am sad about. It’s surprised me how much I love chatting with patients during their history and seeing them week after week, which I thought I would never say as someone who has difficulty with communication. I’m sad I wont be able to chat to people face to face and instead just listening to consultations over the phone before performing my own consultations. I know it’s important to learn phone skills as it is likely this is the new way of working for GPs and hospital clinics but it’s still sad knowing there wont be any patients.
So far, so good in the big picture though. I really love being back on placement and it beats sitting at my desk every day typing the same words for my SSC2 over and over again. We are still waiting for results but we are so busy with clinical learning that I forget it is even a thing most days!
That’s it for now! See you in September!