All 2 entries tagged Orthopaedics
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May 16, 2016
At the beginning of each CCE block we are assigned to a new consultant, whose job it is to teach us about their speciality and assess our competence in particular areas. The theme for CCE1 was “history and examination”, and the theme for CCE2 is “investigations and diagnosis”. My trust has assigned me to an orthopaedic surgeon for this block, so I’m seeing lots of bone and joint conditions – a lot more than I ever expected to!
Block 4 in the first year was called “Locomotion”, and it was a very anatomy-heavy block. We learned all about the muscles and bones that help humans move, the blood vessels that supply and drain them, and the nerves that control them. It was a very intense five weeks, but since I love anatomy, it was by far my favourite block. Being with an orthopaedic surgeon (or orthopod, as they are commonly known) has brought all of that knowledge back to the fore. My consultant loves to quiz me on random musculature and arteries. Lumbricals? The posterior interosseous nerve? The attachment point of fibularis brevis? It’s all fair game, and my powers of recall have been put under serious stress – but I suppose I had better get used to it.
We see patients in many different scenarios, depending on the nature of their visit. Some patients turn up in the fracture clinic (which actually has little to do with fractures, and apparently more to do with either re-assessment of injuries after surgery or ongoing assessment of chronic conditions). These fracture clinics have themes as well: some are focused on foot-and-ankle injuries, some appear to be more focused on hip-and-knee complaints, and so on. It’s been a really good way to practice hands-on the musculoskeletal examinations that we learned during the first year on real live patients.
Of course, since my consultant is a surgeon, he spends a fair amount of his time in operating theatre as well. I have also been lucky enough to accompany him on a few occasions. He does all sorts of things, from joint replacement to bone revisions to trauma and accident repair. I have seen a few different procedures (mainly joint replacements) and it is amazing – it’s like an anatomy lesson come to life! The knee in real life actually looks like how it does in the diagrams and flashcards. I don’t know why this surprises me, but it’s been fascinating all the same. My consultant also seems to do a lot of x-ray-guided joint injection of steroids – this is because the synovial space for some large joints can be difficult to reach with a needle in the absence of some guidance, hence the x-ray to help show the way.
It’s been a very interesting rotation and I’ve been enjoying myself. I’m not sure I’m cut out to be an orthopaedic surgeon – it seems to take a very specific skillset – but I’m still willing to remain open-minded. In any event, I’m glad to have the chance to see something entirely new.
March 27, 2014
The light at the end of the tunnel, the thing that has kept us all going through the exam periods is finally upon us. We have all just finished our first week of our first rotation in hospital (or general practice).
Phase II starts with Junior Rotation where we have six eight-week blocks rotating through different specialities. I am starting with Orthopaedics and Anaesthetics, so simply put bone surgery and putting patients to sleep. We do this with our ‘clinical partner’, someone in our year that we have chosen to work with. When you pick your clinical partner it is suggested you pick someone of the opposite gender. The process of asking someone to be your clinical partner is like being back in secondary school and asking someone out to a school dance (at least I imagine this is how it would feel - I went to an all-boys school). All being well you will be with your clinical partner for over two years, it doesn’t take a genius to know that you have to pick your partner wisely!
Now, Phase II is very different to Phase I. Phase I was very structured; our days were full and we knew well in advance where we have to be and at what time. It is very much like our undergraduate degrees in this respect, but perhaps a little bit more full on. Phase II, the clinical phase, is very different to this. Before we start our block we are sent emails with our timetabled teaching (these are fairly spartan when compared to our previous timetables) and the name of our consultants, that is it. The rest is up to us. The guidance on the knowledge we should have acquired before sitting our final exams is in the form of learning objectives for each block. Some objectives are specific and some are vague, I imagine we will eventually develop the skill of determining how much depth to go into, but until then I will be drowning in an endless sea of medical information. This is all very alien when contrasted with the regimented style of learning used during Phase I. This is very exciting!
For each hospital rotation/block students are allocated two consultants, in this block I have one Anaesthetic and one Orthopaedic consultant. Students have to establish what the consultants expect; for example, when you will attend their clinical sessions (such as clinics and theatre), as well as deciding what we would like to get out of the block. My partner and I have decided that what we want from the block will mostly be dictated by the learning objectives.
Queue day one; we have nothing scheduled for our block so my clinical partner and I decide it would be wise to try and arrange a meeting with both of our consultants. We just have their names, so a call to the hospital switchboard and several different (wrong) phone numbers later and we have arranged a meeting with our anaesthetist and established that our orthopaedic consultant and his secretary are both on leave. This was quite handy as it meant we could devote our first week to one consultant and specialty allowing us to find our bearings and ease into things.