All 112 entries tagged Student

Assistantship – Learning how to be a Foundation Doctor

The logical progression for medical students who graduate from the MB ChB programme at Warwick is to move into the foundation programme. This is a nationwide, structured programme that cycles all recent med-school grads through six four-month rotations over two years within a particular deanery (or region of the country, of which there are currently twenty). Every deanery is different: some will rotate you between hospitals or trusts depending on the job you do, and some will let you stay at the same hospital for the full two years. It all depends on the deanery you end up in and the jobs that are available. I have been allocated to one of my top choices: a large district general hospital in the southwest of England, where I plan to be for the full two years.

The Foundation Programme is relatively uniform across the country, in that F1s (those of us in our first year of the programme) and F2s (doctors in their second year) are expected to complete more or less the same things and cover the same ground over the course of their years. For instance, I believe that all F1s are required to have a surgical rotation, and all F2s are required to have either an A&E, GP or GUM rotation. And all foundation doctors round the country all rotate jobs on the same days throughout the year – it’s kind of scary yet oddly comforting that our careers are planned out for us until August 2020! That will be six years since the beginning of medical school, but at the same time as least there shouldn’t be too many unpleasant surprises in our broad timetable and we can plan accordingly.

By definition, when the current F2 doctors leave their posts, the current F1s become F2s and we medical students become F1s, the collective experience level across foundation doctors drops by a year overnight. I gather that this might have had serious impact in the past on learning curves, efficiency of work, etc. However, in order to minimise the impact of this effect, the GMC, and by extension the various trusts and medical schools, take great pains to ensure that incoming F1s are adequately equipped to step into their roles. Foundation Trusts do this through inductions and shadowing at the beginning of our F1 year, and medical schools do this through including an Assistantship phase after finals.

As we are done with finals and our electives, we are now in that Assistantship phase. This is where we really ensure that we have the skills needed to be competent and functional F1 doctors. Our Assistantship placements are carried out in local hospitals, an arrangement with its plusses and minuses. On the plus side, we are all very familiar with the hospitals, their layouts, their wards and many of the doctors. However, many of our cohort will not be working in this deanery in the autumn, and so we will have to adjust our working practices to those of our base hospitals when the time comes. This might seem a minor point, but so many of the little things that F1s need to know about (how the imaging/patient-data systems work, how the stores cupboards are stocked, how procedures are requested) are completely different. It will require some adjustment. But at the same time, it appears to be a very well-run and well-thought-out block. Most importantly, we can learn on the wards without the threat of exams hanging over our head – always a bonus!

John

Joshua Galvin : 14 May 2018 09:23 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Elective bliss…

Over 4 months ago I had just finished my final specialist clinical placement and was embarking on the epic task of finals revision. The first week of my Christmas holiday was spent trapped in my study, I was allowed out only for tea and bathroom breaks! This was a bit of miserable start to my holidays but it meant that I could take a whole week off over Christmas and enjoy spending time with my family. Our first exam was in the middle of February so before that we had 6 weeks of our revision block, Advanced clinical cases. All the local hospitals organised revision seminars for us, we had practice OSCE days (clinical skills like cannulation and wound care) and you could go on the wards to practice your history and examinations. Going into hospital was a welcome break from my study, and when exams were finally over in the first week of March I could finally breathe a sigh of relief!

It’s a strange feeling when you finish exams, you feel great, but almost immediately the worry about results sets in. Despite the horror that was the last few months of revision and how hard the last 4 years have been, it was all worth it as I passed! On the day of results, I had a quick celebratory cup of coffee with my friends and then instead of heading to the pub I had to sort myself out for my elective as I was flying 2 days later! I hadn’t wanted to jinx my results and think too much about elective so this meant that I had a lot to do! So less than 48 hours after getting my results I was on a plane to Addis Ababa, the capital of Ethiopia, for 6 whole weeks!

I enjoyed my elective so much, it was been a totally unique experience and one I certainly won’t forget. I’m interested in psychiatry and academic medicine so for my elective I had organised a small research project focusing on the mental health of mothers and the long term consequences for their children. I also spent some time in the local psychiatry clinics and made the most of my spare time and explore Ethiopia! I really enjoyed working on my project, it was totally different to any research I’ve ever done before and certainly made me think about how much of an impact mental illness can have on an entire family, not just on an individual. I’m still in the process of writing it up for publication, so fingers crossed! Gaining clinical experience in Ethiopia was very eye opening, there are only 70 psychiatrists in the entire country and culturally mental illness isn’t well understood, with most patients, even those with psychosis, been taken to religious sites seeking a cure for spirit possession or the “evil eye” before coming to the attention of a medical doctor.

I didn’t go all the way to Ethiopia to just sit on my laptop or in a dusty outpatient department so I made the most of my free time exploring Ethiopia. I stayed with a wonderful host family who cooked beautiful traditional Ethiopian food for me and I was invited to join them for their Easter celebrations, which involved the sacrifice of two very plump chickens to mark the end of fasting-this bit was tricky for me to enjoy as I’m vegetarian! I saw hippos in the Rift Valley lakes, fed monkeys from my hand, visited several UNESCO world heritage sites and enjoyed the most fabulous coffee in the whole world (Ethiopia is where coffee was originally grown and brewed!).

I arrived back from my elective yesterday yet it feels like I only just got my exam results. My elective supervisor kept introducing me to people as the newly qualified doctor, which felt very strange, but I suppose that’s what I am…almost. For the next two months I will be on my “Assistantship”, where I shadow the FY1 doctors closely and make sure I know what I’m doing before I am let loose on the wards in August! I haven’t taken any blood or inserted a cannula for about 6 months so wish me luck!

Joshua Galvin : 11 May 2018 10:08 |  Tags: Joanne Mbchb Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Nearing the End of our Elective Period

We’re nearing the end of our elective and it’s been a fantastic opportunity to explore a different aspect of medicine to the typical hospital- and community-based experiences that we have had so far. Whilst I like being in hospital or in a surgery, a lot of patient contact happens in the field and it’s great to get an experience of this in a supportive and structured setting – especially without the pressure of looming exams. I think I’ve had enough of that pressure for a little while!

I spent the first half of my elective in the Emergency Department of a local hospital in Greater London, which was interesting if not quite similar in nature to the acute block, part of our Phase III Specialist Clinical Placements. I loved it, and felt that I was able to integrate in the team quite quickly, but the format and scenario was not a million miles away from what I have been doing throughout medical school so far.

For the second half of my elective, I’ve done something completely different and am removed from the usual clinical setting. I’m using this opportunity to broaden my horizons and get exposure to a new medium in which medicine is practiced – and that’s what elective is about after all, isn’t it? I’m working with a company which does outsourced work by police constabularies around the country. I am shadowing healthcare professionals (known as FMEs, or forensic medical examiners), who are all either trained nurses, paramedics or doctors and all of whom have loads of healthcare experience. FMEs assess people who are detained by police officers and brought into custody to be held before either being released or brought to court, and the job of the FME is more or less to determine whether the detainee is fit to detain and fit to interview by police, based on either any self-declared health condition or anything brought to their attention by the custody officer.

This is a very niche area of medicine, and one that I have never had anything to do with before – and I’m seeing a whole new side of our society. Aside from having my mobile phone stolen over ten years ago, I can’t remember the last time I spoke to a police officer. It’s been very interesting so far – the hours are tough (twelve-hour shifts, and I’ve had a few overnights) but of course crime can happen at any time. The teams of officers in the custody are very tight, with good reason, and all members are always scrupulously professional in their interactions with the public and each other. It’s very nice to see.

The area of the country that I’m based in isn’t known for its high levels of violent crime, which is just as well, although of course people can be detained for all sorts of reasons. A lot – but by no means all – of the offences seem to involve people taking various intoxicants usually combined with either driving or hurting other people. It’s a very interesting view into a part of our society that I never see, and I’m glad that I’m using this opportunity to broaden my horizons just that little bit more.

John

Joshua Galvin : 24 Apr 2018 10:27 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Halfway through the Elective Period

Our post-finals elective period is six weeks long, and we’re right in the middle of it. It’s going well – I’m seeing loads of notifications from social media about my coursemates in all sorts of exotic places around the world and I have no doubt that lots of medical experience is being gained regardless of location. After the stress of finals, it’s been a wonderful opportunity for us to experience clinical care in a new surrounding.

We have the option to spend all six weeks in one placement, or we can split it into two – application-approval dependent, of course! Submitting the different forms was a module in and of itself! I have elected to split my elective, and have just finished the first half, which was three weeks in an A&E department in outer London. It’s been really interesting and eye-opening. Our acute block gives us some exposure to A&E (majors, minors and resuscitation) but we only have five or six shifts over six weeks. The great thing about the elective was that it allowed me to spend time doing exactly what I liked and doing it every day.

The doctors – and all of the healthcare professionals, for that matter – in the A&E department were all very helpful and lovely and were keen for me to learn. A typical day involved me turning up in mid-morning and finding a doctor to shadow for the day – usually an F2 or a reg. I would choose a patient from the list of new arrivals, take a history and do an exam, present back to the doctor and then we would see the patient together to talk about investigations and management. It was very similar to the acute block, but as I became more stuck in with the team I found that I was taken under the wings of the doctors and taken very seriously. It was a nice feeling of semi-autonomy. Occasionally I would spend the days in the resus department helping the nurses and stationary paramedics (qualified paramedics who spend time stabilising patients in hospital instead of driving around in ambulances), and it was very good to help with the most acute cases. I really loved A&E and am looking forward to my placement there in the Foundation Programme.

One thing stuck in my mind from this placement: a young patient presented with complications from a serious and notifiable disease, for which his mother chose not to get him vaccinated when he was a young child because of unfounded risks which have since been widely debunked. I found it very unfortunate that diseases, which we think of as relegated to our grandparents’ generation, are still affecting people in our very rich society. Although parents have the choice as to whether or not to have their children vaccinated, if they choose not to then they have to accept that their children very well might contract life-threatening diseases later in life and live with the complications. I had never seen this particular disease in a person before, but I don’t think I’ll forget it anytime soon.

Joshua Galvin : 09 Apr 2018 09:14 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Post–Finals and Medical Electives

After a seemingly unending course of exams – clinicals, writtens, and then practicals – we finally got our results from our finals last week. After having been through this process a couple of times (both Phase I and Phase II results periods were similar), we were pretty used to the drill. Still, this didn’t reduce the anxiety and uncertainty in the buildup to results day. It’s like this big clock constantly ticking in the background and you barely notice it getting louder and louder until eventually you can’t ignore it any longer. Knowing the exact date and time that results will be released – whilst appreciated and necessary – doesn’t make the anxiety any easier! I don’t know a single person who was entirely certain that they’d made it through. Everybody was on edge. And just like Phase II results, we didn’t have much of a buffer zone between results day and getting ready to go off on the next stage: this time, it was our elective – we found out the news on Thursday and our elective period started four days later on the following Monday. Those who were successful on their finals were permitted to proceed to their elective.

I’m delighted to say that I passed. More than elation, I’m just relieved. Although it is a bit strange to know what to do with myself – I’m so used to being in the revision mindset that I am having a really difficult time just relaxing without the compulsion to be doing something exam-related. I’m really glad my passmedicine subscription expired the other day – otherwise I’d probably still be doing a few dozen questions a day!

Lots of people in my cohort elected to spend their elective overseas, so I’m already hearing stories of fabulous times in the most exotic locations. The purpose of the elective period is to experience medicine in a different surrounding, thereby allowing us to compare, contrast and grow as clinicians when we return to a more familiar surrounding. As you can imagine, after forty-three months of extremely hard and intense work with very few breaks, most people apply the ‘different setting’ rules rather liberally – and with good reason. It’s a great opportunity to travel somewhere exotic and new and experience some better weather than what we have in England – and why not? All electives require approval from the medical school, so it’s all perfectly legitimate, but once that approval is given then we’re good to go.

I spent a month for our SSC2 block (October 2016) in the Gambia, researching TB investigations. For this reason, I was less motivated to have another big overseas elective experience – also because I couldn’t have borne cancelling it had I not been successful in my finals. So instead of going somewhere like India, Sri Lanka, Colombia or New Zealand (all destinations of people in my cohort) I decided to return to my old home in Greater London. For the first three weeks of this six-week block I’m based in the A&E department of a medium-sized district general hospital in an affluent area of the capital, and am enjoying myself tremendously. The acute block in Phase III was my favourite block, and being able to relive these experiences in a different setting and get properly stuck in is so much fun, and really what I understand the elective period to be all about.

John

Joshua Galvin : 22 Mar 2018 11:01 |  Tags: John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem