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April 18, 2019

A first taste of Psychiatry

This week I have had my Psychiatry placement. I haven’t had any previous experiences in psychiatry before, so I was really looking forward to spending a week learning more about the speciality. All of the students have different placements for ‘Psychiatry Week’ so our experiences will all be different. My placement was in community learning disability services, which was interesting as I had already encountered some patients with learning disabilities in my GP and hospital teaching, so the week would give me an opportunity to learn more about the specialised care these patients receive.

We arrived at our placement on Monday morning and spent the day meeting the team, which included more professionals than I expected! The team included doctors, nurses, physiotherapists, psychologists, social workers, speech and language therapists and many more. I had no idea about all of the different groups that were involved in learning disability services.

On Wednesday we had a chance to attend a meeting which was facilitated by the psychiatrist to which we were attached for the week. It was really fascinating to observe how the psychiatrist communicated to the service user, and will really make me think more about my own communication skills and how my approach is accessible to all patients. In the afternoon we spent time in a respite centre for individuals with learning disabilities, which gave us the chance to meet some service users and also chat to the carers about what they do. The centre was really well run and supportive in helping their service users when they needed to stay over to give their parents or carers a respite break.

We also attended a home visit with one of the trainee psychiatrists, this gave us the chance to meet a service user in their own environment and see how they are cared for at home. The psychiatrist also had to deal with physical health problems while they were there, and I hadn’t considered this before – I had thought psychiatrists only dealt with mental health issues which definitely isn’t the case! Overall, the week really made me think about how we help service users with learning disabilities; both how we communicate with them and also how they could receive substandard care in a standard hospital environment not tailored to their specific needs. Taking the time to understand someone’s needs in a busy hospital environment can be challenging but it can really help us to make a difference in improving their health and providing the best care we can.

I also found out this week that a poster that another medical student and I submitted to a medical education conference actually won best poster! I unfortunately wasn’t able to go to the conference because of other commitments, so it was a nice surprise. The poster was the result of a project I was involved with over the summer with other students and members of faculty and focused around how to teach professionalism to medical students. The ensuing poster was around a mnemonic that another student came up with to help students deal with tricky scenarios while on placement. As medical students, we can often find ourselves in difficult situations and haven’t been around the medical field for long so can struggle to decide what can be the most professional or appropriate action to take. The mnemonic offers a structure to aid thinking around these issues. It was lovely to hear that others who are often experienced in medical education found our work interesting!


Jordan


April 05, 2019

The dialysis unit and a new GP

This week we visited a dialysis unit with our current consultant who is a renal (kidney) doctor. We have already attended quite a few renal clinics and seen and spoken to patients who are being prepared to have renal replacement therapy (i.e. dialysis). Dialysis is designed to replace the function of your kidneys in cleaning waste materials out of your blood and so designed to keep patients with kidney failure both safe and healthy. On average, patients come in three times a week for dialysis, with each visit lasting around 3-4 hours. It was fascinating watching the dialysis machines being set up and talk to patients undergoing the procedure while they read books and sometimes slept, all while their blood was cleaned. I had always been unaware of what dialysis really involved and whether it hurt, but for the patients we met, it was very routine and almost straight forward for them. While on the dialysis unit, they also have access to a kidney doctor, which gives them the opportunity to ask questions about their condition and/or any changes to their medications needed. This is an amazing service, as I know many dialysis units don’t have the chance to have a kidney doctor on-site in this way, so they are very lucky as a unit to have this service on site.

On Tuesday, we had our first GP day of this block. Our allocated GP surgery is in a small village in rural Worcestershire. For GP, the medical school tries to allocate us GPs nearby, but most people get one GP practice which is further afield and is a great opportunity to see how medicine is practiced in a rural GP setting. We had a relatively uneventful journey down to the surgery and were surprised when the reception staff knew exactly who we were before we even said where we were from (we must look like students!). The surgery had organised a busy timetable for us, which included two clinical sessions a day with a GP (a morning and an afternoon), and also patient home visits and governance meetings.

In the morning we were in surgery with our GP mentor, who is our overall supervisor and makes sure we are really getting the most from our placement. The patients we saw included ear and throat infections and also some management of chronic diseases such as high blood pressure. I even got a chance to practice looking into ears with the otoscope! We then had a patient home visit, which was a great excuse to visit someone in their own home and ask them about their health issues while drinking plenty of cups of tea. At lunch, we had a meeting on frailty and how these patients are identified within the practice and was fascinating as it gave us an insight into how general practice is funded – via certain clinical targets which the practice must meet to receive funding. The day was nicely rounded off by another clinical session in the afternoon, this time with a different GP. This GP was really enthusiastic to teach and did some mini-assessments on our clinical history taking and examination skills, which I’m sure will be really useful practice for when our exams come around.

On the topic of exams, these are definitely on the radar for us, despite being 4 months away. From what we have been told, more is expected of us in our second-year exams in terms of diagnosis and management, both of which are still very new skills to us. I have been gradually working my way through the presentation list (which we are examined on) and am currently about 60% done. While I am on target, I need to slightly pick up the pace to leave myself a month or so to revise at the end, so am planning a couple of long weekends in the near future to get ahead. Next week we have a week-long placement in psychiatry, which I am very excited about!


Jordan


March 29, 2019

Highlighters, Blue pens and Common Room Heaters

This is it. The big revision break is here. I am happy to say it is going well as far. I have got myself into a nice routine and even discovered I am a bit of an early bird starting at 8am every day. I have also found that I work well in the common room but it is freezing in here, so I have kidnapped a heater from the CBL rooms and I now am as toasty as …. Well … Toast? I am also finding (rather oddly) that moving round the common room day to day is helping me to revise and not procrastinate so I am making full use of have the entire room to myself.

It’s going ok and I am pleased with my progress for once! I have decided to hit three blocks over Easter as I wanted to take things a slowly rather than trying to cram four blocks in four weeks without a break, so I will tackle Block Three (my favourite block) with Block 5. I am hoping that will work, as I would rather get a good breadth of information rather than trying to work myself to the bare bones and burn out before exams. I am a lot calmer than I was last week, I think this is because I am finally able to review and learn the things that we didn't have time for when in the blocks. You have to get used to taking in content quickly as you are hit with new information every day, and I worked out that we have had 21 solid weeks of new content since September. It sounds scary, but it's all coming together, and I can finally see the connections between lectures so it's making it a lot easier to learn. You just need to keep in mind that the human body is an intricate puzzle and you have to see the bigger picture to understand how each part works.

Not much has gone on here apart from me walking into the MTC at 8am to start revision and leaving between 5pm and 8pm to go home and collapse on my bed. However, I did pop back up to Preston for a couple of days over the last week which is where I completed my undergraduate degree. It was nice to see my old lecturers and catch up with my old course mates and of course my best friends. It’s important to keep in touch with your non-medic friends during the course as it can get lonely when you're in week 7 out of 10 and the only people that you talk to are other medics. I got to go into my old SU bar and have a pizza of which I had been craving for a while, and in the evening, we headed to a “place of entertainment” of which I had missed a lot and sung every song that came on at the top of my lungs. It was amazing to catch up with them and even though I haven't seen them since July, it felt like I had never been away. It was good to get out of Coventry and away from my textbooks and now feel a little bit less like a walking textbook, albeit a rather blank textbook.

There has also been the introduction of a #MedStudentTwitter this week on Twitter so I have been following it as part of my revision/ procrastination breaks and people have been sharing tips on clinical learning and revision for exams. It is a nice way to be reminded that you are part of a wider community of future doctors and that we are all banding together to support each other through the intense world of medical school.

I'm looking forward to the open day next week as I am doing the student life talk for the incoming perspective med students. This feels a bit deja vu as I used to do the student life talks for my old university in front of more than 500 people so, it will be nice to do what I loved. I know the university are overtaking the common room for the open day so, I guess I am going to have to find somewhere else to make a revision nest in. I don't mind I guess these people will be in their first year when I'm in my third, which is quite a scary thought!

I have procrastinated enough writing this blog……. back to Gas Laws and Tubular Flow it is!


Abbie


March 21, 2019

University Hospital & The Community

The last two weeks have covered the first two weeks of Core Clinical Education 2 (CCE2), and my placement has been at University Hospital Coventry and Warwickshire (UHCW). UHCW is the main teaching hospital for Warwick Medical School, and is the largest hospital in the region, also encompassing a major trauma centre. One of our named consultants is a renal/kidney doctor, and we went to one of the renal outpatient clinics. The majority of patients attend for routine monitoring of kidney damage, with the majority of causes of this being due to diabetes and heart issues. This provides some good revision of our heart failure and diabetes learning and just goes to prove that no area of medicine is an island – everything is connected! And I thought we were attending just a kidney clinic!

On Tuesday, we taught our last student seminar of the term, and the last before the Easter holidays for the first years. The first years have a month off for Easter, then 5 weeks of Block 5, and then their exams. The exams are definitely looming large in many of their minds, with about 2 months to go before the end of year 1 exams. We did some teaching on getting the most from revision, and also offered some reassurance that everything will be okay! I remember being in the same position this time last year, and how worried I was about the exams. Our focus was mostly on getting a good work-life balance over Easter – it is key revision time, but also the last time off they will get before exams, so it is so important to also have some down time.

We have also had a couple of community days over the last two weeks, where we went into the community to learn about how patients are managed in care homes, GP surgeries and in their homes. The first community day was focussed on clinical audit, with teaching sessions on how to do a clinical audit, which we will be doing with our GP practices throughout CCE2. Clinical audits are activities in which we will be involved for the rest of our working lives, no matter what area we go into, so its good to have some focused teaching on this now. In addition, if we present audit findings at conferences etc, this stands us in good stead when applying for jobs. Unbelievably, our first jobs as doctors are little over two years away – and I’m sure this time will fly by in the blink of an eye!

Our second community day involved a patient visit to a brain injury unit, which was a really valuable learning experience in terms of how brain injury patients are cared for in the community. It really made me think about my own life too, and about the things that I value and reminded me that it is really important to enjoy life as you go by. It is so easy when very busy to not take notice of small things - the small victories and valued experiences with family and friends. Medicine sometimes makes you really appreciate your own life and I think this is one of the empowering aspects of meeting so many different people. It can be quite a cool career really!


Jordan


March 14, 2019

Goodbye Block 4, Hello Easter “break”

This week we did our final Phase One community day. It was a bittersweet day as although I will miss our tutors and how beautiful the town is, I won’t miss doing the presentations nor the rain which seemed to appear each day we went to Stratford. Our tutors have been lovely, and it was always nice heading back to the base to see them after a long day and discussing how our days with the patients and other representatives have been. They have always managed to get interesting patients and gave us some incredible feedback. I was told that my communication skills were good and for someone who isn’t exactly wired to be amazing at this, I was rather pleased!

We have also had to submit our first clinical case reports which was slightly nerve-racking as there was an essay element to it meaning I had to drag out the skill of writing academic essays from the depths of dissertation land as I have only really been writing in bullet points since September! However, I strangely enjoyed doing this as I got to direct my own learning and find out more of an area of care which intrigued me. I ended up writing about the use of fibrinolytic therapy as pre-hospital medicine and I hope that I will be able to use this new information next year (if I pass my exams). I found out this is mostly what clinical learning consists off after having seen the year 2 resources, so I am looking forward to being able to direct my own learning next year (if I pass my exams).

We also had the deans breakfast this week which I was intrigued about as I had to miss the last one due to illness. I very nearly missed this one as I had woken up at 6:30 am so I could get ready and amble up to the med school, only to have had a nap and ended up waking up at 7:30. I’ve never been so grateful to be living on campus where I could throw on some (less crumpled) clothes and leg it up the hill. Essentially, we have breakfast with the dean (which I suppose is self-explanatory) and a couple of senior staff such as Colin McDougall and we were encouraged to chat about what is going well and what isn’t. We were all keen to mention that having Wednesday off has been a blessing as it has meant we have had some room to breathe and catch up so hopefully, this will continue for the year below us. We also suggested about trying to get some of the main campus services to the Med School such as food from Rootes etc. as we just don’t have the time to be wandering down to campus and back and eat the food in the lunch break we have and it would be nice to have some choice as to what we have for lunch up here.

Despite the windy weather now, we have also had some beautiful sun which we all took full advantage of by sitting out in the sunshine working on our notes and actively learning about Vitamin D and UV rays. We suggested that we could have a (non-alcoholic drinks of course) bar on the Med School balcony and call it the Guillain-Barre. We could also have “The Grubby Goose” but I prefer the former. On that day, I also met with my fellow Warwick MedLife blogger Jordan to discuss our slides for the upcoming Open Days. It was finally nice to put a face to a name and I like to way our PowerPoint is looking, a touch of fear followed by a wave of “it’s all going to be ok”.

I am feeling a bit calmer about exams and revision than I was the other week, but you can tell the apprehension is building in the year. We ran a Tea and Empathy society this week and the topic on everyone’s minds was what they are going to do over Easter, and how they were going to revise. I think I have had an idea, but I have also been asking the year above us what tips they have, I just have to keep telling myself that I can learn it – and not start panicking. I have so many plans for the second year, so I am going to try my hardest to not have to retake and continue my medical education. I think we are all worried in some way or another about not making it to next year, but we have Easter break for revision and tonne of support we can access.

We can do this guys !


Abbie


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Our Med Life blogs are all written by current WMS MB ChB students. Although these students are paid to blog, we don’t tell our bloggers what to say. All these posts are their thoughts, opinions and insights. We hope these posts help you discover a little more about what life as a med student at Warwick is really like.

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