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April 12, 2021

The end is in sight

The past couple of weeks feel as though they have gone both very quickly and very slowly. I think that’s just a reflection on every day being almost exactly the same. I’m sure that you already know from my last blog, but I am currently in the midst of the revision block before my final exams in almost exactly 2 weeks. This is week 6 of 8, and I feel as though I have made startling progress so far. Mostly I have been going over things by myself, practicing my academic and clinical knowledge together to try and integrate things and bring all of the knowledge and skills we have acquired over the course into a homogenous whole. The university has also run some practice sessions for us which are similar to the actual final exams – one of these was the GP session I had last week. This session was run online by one of our GP tutors and involved taking a history from a simulated patient whilst the GP watched and then asked questions at the end. Doing a history online is quite…awkward! It is difficult to read a patient’s cues and facial expressions when you can’t see them. However, I think the session went relatively well and I had some good feedback from the tutor. It was also good practice because our final 'long case' exams this year will be online so getting used to talking via webcam is useful.

The last two weeks have also been exciting for a whole different set of reasons. As well as our final exams, we also have to be applying for doctor jobs if/when we finish the course and graduate. This process is complicated and starts at the beginning of final year and essentially you rank areas and then jobs in that area and then are scored based on your Medical School performance, amongst other things. I am delighted to say that I got into my first-choice deanery (West Midlands) which was essential to me as my partner can’t move due to work. This means that we can live together when I start work as a doctor and both commute into Birmingham. I am originally from Birmingham, did my History degree there, and now I’m going back! I don’t know which hospital I’ve been assigned to yet, but I’m not really too fussed – the jobs are essentially the same and I was just keen to be going home and around family and friends for what I’m sure will be a busy and exciting two years of the Foundation Programme. I’m excited to be returning to the second city to start my career as a doctor. Coming to a Birmingham hospital near you! (If I pass my finals that is…)

This week we had a clinical skills practice session at the George Eliot Hospital. I have spoken of my fondness for the George Eliot (or 'the Eliot' as some call it) previously, as the clinical education staff are fantastic and really go above and beyond to make sure we have a good experience. For this session, the clinical education department had set out all the equipment so we can practice our skills on things that come up in practical OSCE exams. These skills include things such as taking blood samples, doing an ECG, catherization, feeding tubes, airway procedures and delivering drugs via various methods. Going over the skills was really good practice and actually reminds us of how much we’ve covered over the course – our training is very broad based to enable us to be pretty competent at a huge array of things. I particularly struggle with catheterisation as there are a lot of steps to remember to make sure infection is not introduced, so having the chance to practice was super helpful. Knowing that a job is waiting for me at the other end is a big morale and motivation booster. Not long to go now.


February 24, 2021

The Last Day of Placement

I had my Prescribing Safety Assessment (PSA) last Monday and I would be lying if I said I didn’t find it tricky! It was a weird experience sitting the exam at home, made more difficult by the lack of the adrenaline of the exam hall to really get you into exam mode. However, I sat it and it’s done – results pending. No-matter the outcome, I’m simply happy to move on and get stuck into revision for real.

Last week was my final official week of medical-school placements as my surgical block came to end. Whilst it was a milestone moment I felt it was all rather anticlimactic as I have spent much of the last fortnight revising for my two prescribing exams instead of at the hospital. However, we did have a mock-OSCE on Wednesday which was arranged by the block lead and some of the doctors involved in teaching the block. Just to remind you of what an OSCE is, is a clinical-style exam where you do activities and have a discussion with the examiner. This was just a practice but actually it was really useful for getting back into the swing of doing timed OSCEs and also for gauging where we are in relation to the level expected of us for finals. It feels strange to say, but I quite….enjoyed the exam! It involved various stations including one station where we had to do a suture whilst being observed. We were given marks for each station and then the highest scoring candidate gets a certificate. I’m proud (and very, very surprised) to say that I got the highest mark! I have to say that I probably struggle with confidence generally, but receiving this good news gave me a little boost and definitely makes me slightly more confident going into finals revision. Added to this is the fact that the surgical block has re-ignited my passion for medicine in general. I do think that in my surgery block I have seen the best of what medicine can do for people – seeing people at their worst moments, their moments of pain and tragedy, but also seeing how medicine can improve people’s lives.

What will I be doing now placements have ended? The next 8 weeks are a revision block called Advanced Clinical Cases (ACC), which is largely self-directed in nature. This means that the medical school and hospitals are putting on activities (such as examination practice), but it is totally up to us what we decide to go to depending on our own learning needs. I’ve booked in a couple of ward sessions to practice my examinations and history taking and also a couple of procedure practice sessions (so practicing taking blood on mannikins) – as these procedural skills do come up in finals. Warwick uses the ‘spiral’ curriculum method, which basically means that essential topics are visited several times throughout the course. The topics we learned in Phase I and Phase II come up again in finals, just in more depth. This means that we go over the basics several times and become really confident at managing common conditions such as heart attacks, lung infections and diabetes, because we’ve learned the principles of these conditions throughout the course. The next 8 weeks are sure to be tiring, but I’m excited to learn and improve. Bring it on!



January 18, 2021

Care of the Surgical Patient

I’ve come into this block feeling refreshed and rejuvenated after the Christmas holidays and have just completed the first two weeks of my Surgical Patient block (my final specialist block of medical school!!) When I look back over the last three (and a bit) years, they have been filled with highs, lows and plenty of hard work – but I wouldn’t change it for the world. I feel as though things have come in a neat roundabout circle as my last block is surgery and Gastrointestinal medicine, and my first block in my first year covered the basics of this area of medicine. I, too, feel like I have come full circle in terms of motivation and drive. I started Year 1 with energy and determination and I again feel energised and ready to approach the next few months with the necessary determination to hopefully finish the course.

…Which is good as there is a lot to do. I have two prescribing exams at the beginning of February, and then written and practical exams in March. As well as this, I still have to engage with this block and learn enough about surgery to be able to cope as a junior doctor on a surgical ward. So, what have I been up to? Well, for this block I have not one, but two surgeons, making me slightly spoilt for choice. I have a general surgeon (so digestive system amongst many other things), and a urologist (male reproductive tract and male and female urinary systems) as my consultant supervisors. Last week I was lucky enough to attend general surgery clinic which I found really interesting, which sort of surprised me. I am still unsure what career path to go down but had thought general surgery wasn’t for me up until this point. I found the clinic really interesting and actually quite innovative with some of the novel techniques they use to sort digestive problems. One of these techniques is what they call a seton, which is essentially a specialised string which they put through false passages which helps the passage heal correctly – very cool stuff!

We have also had lots of tutorials from experienced surgeons in this block, and one of the most engaging of these was a session I had last week where we were taught how to suture. Suturing is one of the most basic surgical skills, but that doesn’t mean it is easy! All doctors need to be able to suture, of course surgeons need to be able to suture to close wounds, but also doctors working in A&E or General Practice need to be able to close small wounds and injuries if necessary. We had three experienced consultant surgeons teaching us how to handle the equipment and do a basic interrupted suture. This is where the needle goes through the base of the skin and is then tied above the skin to close the wound. We were also offered a challenge – one of the surgeons had created a laparoscopic training ‘game’. Laparoscopic surgery is commonly called ‘keyhole’ surgery as rather than large incisions, small incisions are made, and a camera and tools are used to complete the surgery. The game involved a webcam and two tools inside a box, and involved picking up rubber bands and putting them on small pegs. The person who did the most of these was the winner and would get a certificate, and unbelievably, I won! As I said earlier, I haven’t really considered surgery as a career in seriousness, but I found the game fun and have really enjoyed this block so far, so you never know…



December 17, 2020

One exam…

The last two weeks have been…very busy! I have been continuing my Care of the Medical Patient (CMP) block, which covers most of general and internal medicine. Because it covers so much of medicine, it has been very busy because there is simply a lot of content to cover. However, I do think that this block has been one of the best learning experiences. One of the most useful things that I have been able to do this block is attend bedside teaching sessions. One of the original proponents of bedside teaching was the great physician William Osler (after whom several clinical signs are named), who believed that medics learned best at the bedside, by doing. This seems odd to us today, where we would expect trainee doctors to come into contact with patients but 100 years ago this wasn’t necessarily the case. Derived from the practices of William Osler, our bedside teaching in my CMP block is where two medical students are joined by a doctor and they go and see a patient. One medical students usually take a history (i.e. ask the patient what brought them into hospital) and the other student often does a physical examination of the patient. The doctor observes and teaches and gives us students feedback on our history and examination skills. Because of COVID, we have had less opportunities than normal to be able to see patients, so getting this practice under supervision has been really useful. Having an experienced doctor observing and providing feedback allows us to identify our strengths and also areas where we may improve.

Last week I also had an exciting opportunity to attend a Diabetes outpatient clinic with one of the Professors from the Medical School. We have known this professor since first year so it was interesting to observe them doing consultations and experiencing their reputation for amazing teaching first-hand. Diabetes is a really common condition and often comes up in medical final exams – so much so that if I was a betting man, I would say it will definitely come up somewhere. It was really good preparation to go over the basic management of Diabetes.

And here we are, Merry Christmas! Or…not quite! We break up next week, but first there is one last hurdle before that long-awaited break. The Situational Judgment Test (SJT) is an exam that has featured in my blog previously, and I think that pays tribute to just how important it is. The SJT is an exam which is based around what you would do in certain ethical and workplace dilemmas. My result in the SJT will be an important factor in what doctor jobs I will get when I graduate, and even decides the area you are placed. Thus, the result is really important, and it is a very high stakes exam – if you get below a certain mark, you are removed from the job application process and may not get offered a job as a doctor. I’m told this is very unusual, but that doesn’t stop the worry that I could be one of the only ones…So over the last few weeks I have been doing practice questions and reading ethical guidance to hopefully get me over that line, get a good result and hopefully get the chance to be a doctor next year. I can’t wait for Christmas to just relax after a stressful year, and I’m sure many of you reading this will feel the same. Wish me luck in my SJT exam and I hope you all have a great Christmas!


Care of the Medical Patient

My current placement is Care of the Medical Patient, which is an overarching block which touches on many different areas. Medical patients include cardiology patients, respiratory patients, gastroenterology patients and many others. One area which comes under the umbrella is neurology and stroke care and for this block I have been attached to a stroke ward at George Eliot Hospital. Initially, I was apprehensive about being on a stroke ward because of how poorly stroke patients can be. In addition to this, I would say that personally neurology and stroke is one of my weakest areas academically. I think the anatomy of the brain and spinal cord is so complicated, I struggle to get my head around it. I suppose it’s good that I will get some practice in this area and hopefully become more comfortable with this area. Last week we attended a ward round on the stroke ward with one of the stroke consultants during which the consultant did some teaching about the management of various types of stroke. It was a really useful experience and we even got the chance to do some examinations as part of the round which was a good recap of the neurological examination (one of the hardest ones!)

Then, last Friday I attended an outpatient clinic looking after Parkinson’s Disease patients. Parkinson’s is a disease where one of the chemicals in our brain (dopamine) becomes depleted and this leads to issues with movement, including tremor amongst other issues. Having never seen a patient with Parkinson’s disease before I hadn’t appreciated the fact that there are many different types of the disease and that the course of the disease is so individual. Some patients progress quickly and some people remain stable and do not get any worse for years and decades. I also hadn’t realised how multi-disciplinary the management is. For example, Parkinson’s patients often have help not only from doctors, but specialist nurses, speech and language therapists, physiotherapists and dieticians.

This week I had been booked on to attend an ILS course (Immediate Life Support). All medical students have to have this course to be able to graduate as doctors and it teaches resuscitation in a hospital setting – including skills such as managing an airway, doing CPR and using a defibrillator. I really enjoyed the course and it sort of drew together and consolidated several sessions we have had before. None of the information or skills were new to us, but the application and practice using simulated sessions really refreshed that knowledge and I’m sure will be really useful revision for finals.

The week ended with Friday afternoon which was small group teaching on ECGs and heart problems. Being able to interpret ECGs (electric scans of the heart) is one of the most difficult skills expected of junior doctors, so having some recap and revision of some of the most common rhythms was useful. I haven’t seen an ECG in a long time as I have been doing Paediatrics, Obstetrics and Orthopaedics, so I had completely forgotten everything! Luckily, I quickly clicked back in with looking at ECGs and feel much more confident having a go now! Next week will be a busy one, with a few teaching sessions and hopefully some clinical skills practice. It should be a good one!


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About our student blogs

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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