All 142 entries tagged Student

Goodbye George Eliot, until next we meet

The end of CCE 1 is upon the second years and I for one cannot believe it. It seems like 5 minutes ago I was writing my blog at Christmas talking about starting CCE and how different my life was going to be as a clinical phase medical student. For that reason, I think this is quite a good juncture to pause and take stock of how CCE 1 has been for me!

First of all, the final weeks of CCE 1 (weeks 9 & 10). As mentioned in the previous blog, we have spent these final weeks doing our audit in George Eliot Hospital into surgical complications. Basically, the audit involves finding out the operation lists for each day and then finding the patient after surgery and going through the notes, looking for complications and consequences of surgery. We have been incredibly busy doing the audit over the last few weeks – staying in hospital until 10:30pm one evening going through hundreds of pages of medical notes and making sure our data collection was accurate. I won’t say it hasn’t been challenging, because it has been extremely exhausting! At the same time though, having done the audit is great experience and has taught us lots about abdominal surgeries and types of surgical incisions (interesting, if not immediately useful!). This week I also had to apply to do my research project for next year. I will (hopefully!) be doing something to do with bereavement care in the UK – watch this space!

Coming to the end of CCE 1 means we are a third of the way through our Core Clinical Education, so it is also a good time to stop and think and take stock of what I’ve learned about both medicine and myself this block at George Eliot Hospital. My statistics for CCE 1:

- 10 weeks (January to March)
- 4 supervising consultants (2 cardiologists, 1 respiratory doctor and 1 anaesthetist)
- 9-10 bloods taken
- 4 clinical skills labs (acute assessment, blood gases, oxygen masks, cannulation)
- 7 days spent with our GP practice
- 9 workshops (on topics ranging from fever to weight loss)
- 5 academic days
- 1 clinical partner – Cliona
- Lots of awkwardly standing on the wards trying to make eye contact!

Coming to the end of my placement at George Eliot Hospital is bittersweet. We did our very first clinical experiences in first year at this hospital and has been here ever since (about 16 months – our entire medical degree until this point). All of my stream really have started our medical careers here at George Eliot and created great relationships with the undergraduate staff and education team alike. I think they’ve seen us grow from nervous first year students into slightly less nervous, and slightly more competent second year medical students! George Eliot is a smallish hospital, but it will be the first of many hospitals in my medical career, and I think for that reason, I’ll always be a little bit fond of it. Next week I’m off to University Hospital Coventry, which is the main teaching hospital for the University of Warwick, and this will bring different challenges, but is also really exciting in the wider range of specialities we will get a chance to see there. Until next time!

Jordan

Charlie Gallan : 08 Mar 2019 14:16 |  Tags: Jordan Mbchb Student Warwick Wms |  Comments (2) |  Close comments |  Report a problem

Anaesthesia, Audits

Over the last couple of weeks, I have busy getting stuck into my Anaesthetics block. This has mostly involved time in main theatres with the anaesthetists. We follow the patient journey through their operation, which was great as we saw the patient on the ward before the operation for their pre-operative assessment (to make sure they are fit for surgery), then in the anaesthetic room before surgery and then into theatre throughout the operation. The patients are understandably anxious before their surgery, and it was really nice to chat to them as they had their anaesthetic and hopefully distracted them from their anxiety (and the needles!), if only for a minute or two.

We saw some really interesting aspects of anaesthesia, including patients undergoing general anaesthetic (being sent to sleep), but also local anaesthetics and spinals (where an injection into the spinal cord directly numbs the nerve roots). I hadn’t really considered the fact that patient can undergo major surgeries with only spinal anaesthesia, meaning that they are awake throughout the procedure. I think more and more surgeries are being done in this way now, meaning that the risks and after effects of general anaesthesia can be avoided.

Another activity that I’ve been involved in recently is clinical audit. We have to do a research project as part of the course in third year (called Student Selected Component 2), but most students are also involved in additional audits or projects whilst studying. I think before I joined the course I hadn’t really considered anything other than getting onto the course itself and wasn’t really sure how to get involved in audits and the like or the value of doing these.

Students decide to take part for many reasons – prime amongst these is that an audit counts as extra “points” for foundation scheme places and thus makes you more likely to get the Foundation Doctor job that you want. As well as this, it gives you experience in research (essential aspects of a doctor’s career) and also gives you a chance to shape or contribute to improving patient care. Finding research projects isn’t too difficult – just chatting to some of the doctors that you meet during your placements anyway leads them to mention various projects they are involved in/want to start and most are very keen to get students on board to help with data collection.

One such chance encounter happened to me and my clinical partner whilst we were shadowing one of the doctors in anaesthetics, meaning that we are now involved in a project to look at complications post-surgery. We are involved in data collection, which involves looking at patient notes and recording details of the operation and then recording complications after the surgery has concluded. So far its been a very good experience of being involved in research and serves as good practice for reading patient notes to boot.

After a busy week, I definitely need a chance to unwind, and it so happens tonight is that chance. I’m part of the Teddy Bear Hospital Society and tonight we are holding a movie night for charity, and it happens to be a showing of The Greatest Showman – sing-along version! I’ve been rehearsing all week in preparation….

Jordan

Megan Earle : 04 Mar 2019 12:00 |  Tags: Anaesthesia Audits Mbchb Student Teddybearhospital Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Did someone say the E word?

Yes … they did. Today. In Anatomy. They counted how many days we had to go. My heart nearly stopped. I keep saying I will start my revision in March but now I realise that March is next week. Gulp. So, like any good student. I have chosen to put it off a bit more and distract myself with other things to do!

It really has been a busy couple of weeks with a lot going on. My clinical teaching this week brought a couple of firsts with one patient sticking in my mind. They had a cardiac condition to which I was able to hear my first heart murmur and felt heaves and thrills! This was incredible to see as we are taught about these things in clinical exams and we are so used to performing on each other that we forget what we are meant to be looking for so to see this in the clinic was unforgettable!

One major thing that has happened is that some of my year participated in some research regarding the use of VR in anatomy teaching. I was intrigued as I used some VR in my previous degree, and I am really struggling to pick the anatomy up this block so I wondered if it would help. There was a control and experimental group but both groups could use the VR once the experiment had ended. The kit was incredible in the fact you could manipulate the limb in so many ways including looking at each muscle’s individual movement. I could easily study from it and I really hope to see it come into teaching soon! I’m pretty sure it would have been a good giggle to record us using the VR set as a bunch of students, waving their arms around with massive headsets on would have been a sight to see.

I also had an event that I had signed myself up to in September not realising just how busy I was to become! This is the National Undergraduate Neuroanatomy Competition held in Southampton. I genuinely love Neuroanatomy so I thought it would be a good challenge to learn some further anatomy and see how much I could remember from block three. It was an incredible day and I really enjoyed it, even though I couldn’t answer half the questions! An example is in block three we are expected to name the vessels in the Circle of Willis and not many more, here they had a pin pointing to a random artery peeking through the cerebral surface and a faint grey line on a Neuro Angiogram. Safe to say, I don’t think “Artery” alone quite cut it. However, when it did come to the block three material, I could recall most of it, so I am pleased with how I did! I can’t wait to go back next year, and I am aiming for Top 10. Currently, St. Georges seem to do brilliantly in this competition, so I am keen for Warwick to knock them off the top spot!

Obviously, another highlight was the free(ish) food (we had to pay to enter the comp) consisting of pastries the size of your hand and pizza… a lot of pizza. There were some stands from the BMA (from which I now have three bones pens and some pen torches) and we also managed to get a mug for one of the third years who couldn’t go… We love freebies!

Another thing that has happened was going over to my medic family/student seminar team house for tea. We normally don’t meet for student seminars the first week of every block, so we descended for an evening of pizza, games and just a much-needed night off. It was also nice to see my medic mum and uncle as with the second years now in full-time hospitals, we don’t see them that much. I also gained a new half-sibling as my student seminar pal announced she needed to be adopted so my student seminar teachers decided to adopt her. I am looking forward to next year (if I get back in – sorry I am superstitious, and I am not taking any chances) teaching and hopefully adopting some freshers as my medic kids …. Let’s just hope my cooking skills improve in time for Medic Family Tea!

Abbie

Megan Earle : 26 Feb 2019 14:57 |  Tags: Abbie Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

New Block New Me

So, the beginning of February brought the end of block three and the beginning of block four. I felt a little sad as I really had enjoyed block three and it had cemented for me the reason of why I want to pursue neuro as a career. I had really enjoyed the labs with the last one recording EEG measurements. This was basically an excuse to nap of the floor of the lab for half an hour …. I gladly took that sacrifice for my team. However, it had to come to an end and we now are on block 4…. The penultimate block before the E word of which our Anatomy Professor has already mentioned once.

I am enjoying the content of the block, but it is taking me A LOT longer to pick things up, even in the anatomy side of things which is normally my strong point. The lower limbs are surprisingly complicated but all it is going to take is some hard work and I’m sure it will click in the end …. Hopefully. It is proving to be a weirdly entertaining block however as so far in lectures we have been standing up holding our own bums (demonstrating gluteus maximus), dragging each other standing up (demonstrating the sliding filament theory) and everyone is performing weird movements in the anatomy labs. Something tells me that I will be able to tell if any block 4 questions are being answered in the exam room.

We also had to submit our first written work this week which was our community day reflections. I found this hard because I had to essentially reflect on a conversation I had with a patient as part of a group. If you have ever tried to reflect on a conversation before you can probably see where I am coming from. It felt strange and for someone who must work at communication more than most (I have Asperger’s) it was a challenge to know what to write about. However, there was plenty of support and I did my best so hopefully it gets a pass. We also started another written assignment this week which was the case reports. Essentially, we have to find a patient and write their presentation up and submit it to our clinical tutor. We had an SDL session for this where we could go around the hospital at will, find a ward, find a patient and write up what we find. Terrifying for a first year. What if the ward does not want to let us in? What if the patient is too complicated? What if no doctors want anything to do with you? These were all the thoughts racing through my mind on Tuesday but Maariyah and I braved it alone and ended up on the cardio ward. The nurse we met was lovely and thankfully Maariyah did most of the initial talking as I was too nervous to put words into my own mouth. I relaxed a bit after we found a patient and I enjoyed looking through notes to build up what we knew about the patient and getting to talk and examine a patient without supervision. I’ve said it before but moments like this where all the work you do outside of the hospital comes into its own. It is also nice for the old self esteem as you realise how much you have picked up (even though you think you haven’t learnt anything) since you started.

I am also making sure I take a break from medicine and it’s in the form of my own blog that I am rather proud of. It’s developing slowly and I also use it to take stock on what I have done every week by writing a bit of a weekly summary. I looked at week one the other day and (after getting over how excited I was) it really did hit home how far we have come since those naive days in September. I also got some messages this week from people I had given advice to throughout the application cycles saying they had got into Warwick! This really did make me happy as I liked the fact, I may have had some small input to helping them.

Looking towards the E word, I really do need to start learning the drugs list (sorry WMS I haven’t started it yet). However, I had a bit of an epiphany moment when I woke up this morning (because what else are Saturday mornings for) and I realised that I know most of the drugs by what their packaging looks like as I worked as a dispenser for over a year, so why not put that to use?!

It’s the little things that keep you going ….

Abbie

Charlie Gallan : 21 Feb 2019 13:45 |  Tags: Abbie Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Difficult Conversations

The week started on Monday with me teaching my BLS (Basic Life Support) to first year medical students. This was my last session as a trainee BLS instructor (like a probationary period), and after completing it, I am now qualified as a fully-fledged BLS Instructor! We will hopefully be teaching some of the first-year medical students here at Warwick Medical School very soon, providing high quality BLS training. Watch this space!

Tuesday is GP day, which has quickly become one of my favourite days of the week. In GP we get to lead several consultations per day each, which is very fun, and a little bit of lucky dip, because you aren’t sure who will walk through the door! The GP supervising us is very supportive, and tries to encourage us to take the consultation, even when the medical issue the patient has isn’t straight forward. This is great because it gives us a chance to deal with conditions and issues that we might not be totally confident with but means that we get to push ourselves and try and learn as much as we can. The great thing is that if we do get stuck or go off topic, our GP is observing and jumps in to help out. Overall, it’s a great chance to practice our skills, to try and develop, but is in a safe environment with us being watched by experienced hands.

Today we spent our first proper day with the Respiratory department at George Eliot hospital. For each CCE block we have to get specific activities signed off, including examinations, histories and procedures and also what is called a Case Based Discussion. We do these with the education doctors (Clinical Education Fellows - CEFs), who then give us feedback on our skills. We wanted to get our Case Based Discussion done today (roughly by the middle of the block) so we booked a session with one of the CEFs to try and get this signed off.

There was only one thing missing – a patient! A CBD is where we see a patient on our own (doing a history and examination), and then meet up with the CEF afterwards and discuss the case, including how the diagnosis was made and what management we would provide for the patient. Our CEF session was booked for 9am, and we needed to have seen a patient before then, so my clinical partner and I went in for an early start at 8:10 and went straight to the ward. We ended up finding a lovely patient and doing our history and examination and also having a nice chat – bonus! All in all, it went well and our history and exam definitely went more smoothly than it was at the start of this block (only in January, 5 weeks ago). It’s a nice feeling when it comes together, and you feel like you’ve done a really comprehensive history and good exam. In CCE we do history and examinations pretty much every day (and multiple times a day on GP days), so we have plenty of time to really improve our skills.

After doing our Case Based Discussion, we headed to the ward to find someone to shadow and just get settled in, including just introducing ourselves to everyone. The ward was very busy so it took us a little while to find someone who was free to talk, but in the end we found a lovely registrar (the level in between foundation doctor and consultant) who let us follow while they saw some of the sickest patients on the ward. They asked us to read an ECG and work out the diagnosis which is never, but between the two of us we seemed to work out that the ECG was normal, and the registrar confirmed that it was. I think it was beginners’ luck! The registrar also ended up seeing a sick patient and having a very difficult conversation with a relative about the prognosis of the patient, which was extremely difficult to witness, but unfortunately an important part of the work of a junior doctor. The registrar did a very good job, and I took notes as to good practice and an example of how to do it well. It is important while on the wards and clinics to find doctors who can act as good role models of how to be a compassionate and competent medic and I learned a lot today about how to have a sensitive conversation.

All in all, it has been a busy and challenging week. Despite this, there is definitely a feeling of growth – I don’t feel nearly as out of place as I did at the beginning of this block and have sort of worked out who we need to speak to on the wards to find the best learning opportunities. It’s weeks like this that remind you how amazing it is to be a doctor – to be with people in the best and worst times of their lives. Hopefully you can make them feel better too!

Jordan

Charlie Gallan : 18 Feb 2019 15:25 |  Tags: Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem