All 7 entries tagged Wards

The End of Pre–clinicals and the Start of Clinicals

For the past year and a half, we have spent a great deal of time in the lecture theatre and in other practical sessions getting to know the human body inside and out (literally). We have studied the structures of cells, tissues and organs, how they work together, what can go wrong and how to manage it. Most of the work we’ve done up till now has been very theoretical – although WMS does a good job of integrating (or at least introducing) clinical exposure into the curriculum, we have still had to endure more Power Point than any human should have to. This is understandable, of course, as the amount of information we must absorb is just huge and the pace is quick and we need to be able to access a lot of it in the future.

The end of the autumn term also marked the conclusion of the pre-clinical phase of our curriculum. Our weeks of lectures and intense group work have morphed into something much more hands-on and practical in its delivery –and most of us our going into this period with many different emotions swirling about. It’s exciting that we’re finally going to be on wards and working with teams like proper doctors do (which of course we are not, yet). It’s a little scary that our hands are no longer going to be held quite so tightly as before – a lot of our learning is self-directed and self-managed. But it’s also very encouraging to know that we are given responsibility by the medical school (and its overseers) to manage our own education to a high degree.

From what I have heard, Warwick are quite pro-active and advanced regarding clinical exposure as compared to other medical schools around. Although (of course) all students in the country complete the same amount of clinical exposure by graduation, and all must meet the same standard, WMS introduces the exposure far earlier in our medical-school careers than many other medical schools, thus making the process of speaking to patients far less daunting than it might otherwise be. We meet several patients during the first year through a variety of means: ‘community days’, in which we meet non-hospital patients in the community with medically complex conditions; brief hospital-ward introductions and examination practice; and various other opportunities.

But now, as of Monday 4 January, we will be joining the hospitals full-time and our focus will shift to learning in the clinical environment. It’s very exciting. We’re focusing on history-taking and examination of common diseases in our first ten-week block. Although my partner and I are based on a respiratory block, the focus is not on respiratory ailments as such, but rather the basics of patient interaction from the doctor’s perspective. All of our cohort are distributed throughout the three main hospitals in the Warwickshire area, across numerous wards, but all will be following the same basic curriculum. I am very much looking forward to the transition towards becoming a member of the hospital team and putting my efforts into learning in the clinical environment.

John

Megan Earle : 06 Jan 2016 11:51 |  Tags: History Hospital John Mbchb Patients Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Access all areas

Everyone seems to have got over their January blues, people have given up on their new years’ resolutions and everyone has settled into our new routine for this block.

We have started our bedside teaching in hospitals which means we have NHS badges with our names and a very dodgy photo declaring that we are medical students. We spend half a day a week with our clinical tutors visiting different wards of the hospital and getting the chance to practice histories and examinations.

I’m based at Warwick hospital, which is quite small but has great facilities for the medical students. There is a library for students and a study room as well as a room to practice clinical skills, there are also lots of Clinical education fellows who are passionate about teaching and who are often not long qualified themselves so are very sympathetic when we forget things (which happens a lot!).

I was very nervous about going to take a history and examine a real patient, but she was so lovely and patient and said she was happy to help us. We learn so much from patients and the feedback they give us, I’m hoping I can use our hospital placements to really refine my clinical skills and with practice I will hopefully be less nervous!

In addition to my first time on the wards, I also had my formative OSCE this week. This was a small practice version of the exam we will have in the summer which tests our clinical skills in an exam setting. Unlike in the summer exam we were told which skills we would be tested on so we could focus our practice. I have been practicing a lot with my CBL group which has proved invaluable!

The medical school has blood pressure cuffs and resuscitation dummies for us to practice with so we have had a few practice sessions where we all give each other feedback and go through things we aren’t sure on. It’s been very helpful as everyone has slightly different ways of doing things so you can pick up some good tips just from observing!

Another new thing for this block has been the start of our student selected component. This is part of the course we get to pick from several options (including Trauma medicine, Tropical and Infectious diseases and Global Health) a module that we can attend additional sessions on. I chose the Sleep Medicine module as I was quite interested in how sleep is affected in a lot of psychiatric and neurological disorders. I’m really enjoying the sessions so far, we are learning about how sleep can be measured and how disrupted sleep can lead to multiple health problems as well as some strange things such as sleep walking and nocturnal head banging.

These sessions are much less pressured than lectures as we aren’t being examined on them so we can just relax and enjoy learning new things. My group will also be visiting a local sleep laboratory so I will have to remember to bring my pyjamas to that session!

Megan Earle : 09 Feb 2015 09:38 |  Tags: Examination Joanne Mbchb Patients Wards Warwick |  Comments (0) |  Close comments |  Report a problem

Happy New Year!

Happy New Year

Christmas is over, and it’s time to return to hospital. I had a really nice 2 week break and got to spend some time with my family and friends, and I didn’t open a textbook or read a medical article once! I love not having exams in January.

This is my last block of “general clinical education” before finals and I am currently placed in Acute Medicine. Acute block covers Accident & Emergency and EMU, AMU or whatever acronym a hospital has chosen to call their admissions unit. We also have various lectures and simulation sessions which use SimMan mannequins to let us practice assisting at and leading various medical emergencies.

The most advanced SimMan has a pulse, breathes, can speak and make noises, and can even be sick. Oh and you can catheterise him, which gives you some idea how anatomically correct he is. In Sim sessions the SimMan is programmed to have a specific condition and reacts to the interventions that you give him, which makes it pretty realistic!

We also see real patients on Acute Block, both in ED (Emergency Department) and after admission on post take ward rounds. ED is a great place to be as a medical student as you get to see patients when they are, “fresh,” and before anybody else has influenced your thinking with their diagnosis or management plan. On the ward it’s easy to slip in some obscure differential diagnosis when you’ve heard it muttered by the registrar, you’re thinking on your own in ED!

This is the place where you can clerk patients, order tests (under supervision) and suggest what you would do next, and the place where, when things are going well, you most feel like you can and will be a doctor one day. Because it’s often so busy, juniors are more than happy for you to help out and patients are generally happy to see you as you can sometimes speed things up a little bit for them.

Acute Medicine is also a great block to finish medical school on, as you literally have no idea what will walk through the door and you have to be able to pull any focussed history or examination out of the bag, and do it well. This is different to other blocks where you know that you’re doing a cardiology ward round, so it might be a good idea to read up on cardiology…

Having spent the last 3 and a half years saying, “I will start revising properly for finals after Christmas of 4^th year,” the time has finally come. I’m sure the next few months are going to be pretty stressful, but I’m finding it satisfying to see how all the knowledge and skills I’ve learnt are slowly starting to knit together and make some sense. There is light at the end of the medical school tunnel, and I can see it now.

Megan Earle : 16 Jan 2015 14:49 |  Tags: Mbchb Newyear Patients Sarah Simman Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

In the deep end

My first week on my Orthopaedic and Anaesthetic block was dedicated entirely to Anaesthetics. For anyone who doesn’t know, an anaesthetist is a doctor whose responsibility it is to ensure a patient is asleep and comfortable during an operation. The majority of an anaesthetist’s clinical commitment is spent in theatre.

Our first proper day with our consultant was on a Tuesday. Our instructions were to meet him on the pre-op ward for the Obstetrics and Gynaecology list. Simple enough instructions, but it took us a good deal of walking around the hospital to find the right ward and by the time we had got there the anaesthetist had already seen the first patient. No worries though as he seemed to sympathise and we quickly found ourselves observing him performing a pre-operative assessment on a patient. After watching him assess the patient he turned to us and said “Okay, so now you have seen one you can do the other two between yourselves. I will see you in theatre.” I laughed, but before I had realised it wasn’t a joke, he had already left the ward.

This is what it has felt like since starting on rotation, as though you are in the deep end, and I love it! Whilst it is incredibly daunting, I wouldn’t have it any other way. I hate standing around watching people talk and do things; I much prefer to be doing it myself. Unfortunately, what I also hate is doing things wrong, and I seem to have been doing a lot of that lately, but I guess that is part of the learning process.

Fast forward two less than ideal anaesthetic pre-assessments later and we find ourselves heading to theatre. We walk into the reception area and without even opening our mouths we are greeted with “Are you medical students?” Now, yes, we are medical students but I am amazed how many people know this without me even saying it. Patients aren’t so good at telling, but hospital staff seem to be experts at knowing, it’s almost second nature. It keeps happening. How, how on earth does almost every hospital employee know we are students? Either there is a big sign over my head that I can’t see, or I don’t have as good a poker face as I’d like to think and I constantly look how I feel – a mix between a deer stuck in headlights and child in a sweet shop! Unfortunately, I think it’s the latter.

On this occasion however I am glad we were noticed as fresh-faced medical students because the first time you turn up to theatre is quite intimidating. Much like everyone who realises we are medical students, the operating theatre manager was very good in showing us where the changing rooms and operating theatres were and letting us know what to do. It is really nice how helpful people have been to us.

When you go into an operating theatre you have to wear scrubs, and if anyone hasn’t told you, they are one of the most comfortable things in the world to wear. I think a lot of anaesthetists love their job because essentially they wear pyjamas for the most of the day.

Now I’m pretty sure I’m not alone in thinking this, one of the biggest challenges of any surgical or anaesthetic rotation is finding clogs that match! Clogs are the shoes that you have to wear in an operating theatre. When you arrive in the changing room you are greeted by a box of clogs which look as though they have been filed away using the same system a toddler uses to put their toys in a toy box. It is chaos. If you are contentious enough (like you will be in your first week at least) you will spend at least five minutes searching for a pair of clogs that are the right size, the same colour and the same design. Basically a matching pair, but I am pretty certain there are no matching pairs in these boxes.

I have rambled on a bit about things that are quite non-medical in this post. Next time my post will be more medically focused. A lot of time and energy does need to be spent on learning where places are, different etiquettes in different areas and how to get the most out of our time. Now that’s out the way, I feel I can focus purely on Medicine; let the fun and games really begin!

Amrit :-)

Sarah Hill : 31 Mar 2014 10:06 |  Tags: Amrit Anaesthetic Mbchb Patients Scrubs Student Theatre Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem

First week on placement

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.

More soon,

Amrit

Sarah Hill : 27 Mar 2014 11:28 |  Tags: Amrit Anaesthetic Consultant Mb Mbchb Orthopaedics Student Wards Warwick |  Comments (0) |  Close comments |  Report a problem