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October 19, 2020
Child Health
The last two weeks saw the end of my Obstetrics block and the beginning of the Child Health block.
My last week of Obstetrics was a busy one for many reasons – the main reason is that I have been running around trying to get my end of block sign offs from my consultant. Part of this is a mock assessment called an OSLER, which is, in short, an observed patient encounter. During the assessment you see a patient, take a history from them and perform an examination of them. Following this you have a discussion with the supervising consultant about the condition the patient may have and what you would do to manage their care. The patient I examined and took a history from was lovely which makes the whole process a lot less daunting. I always really appreciate the patients who allow us to examine and interact with them as being in hospital is stressful enough without having an eager student assessing you! Without the help of the patients we see our education would not be a true reflection of the career that lies ahead of us.
I have really enjoyed this block overall. Whilst it can certainly be a little bit more exhausting with the long labour shifts and sometimes emotionally charged situations, I have appreciated being able to get stuck in. I love interacting with patients and helping guide women through labour is so rewarding (and the cuddly with the new-borns are so cute!) the experience is something I know I will never forget.
The first week of my latest block, Child Health, has been steady for me, which is something I feel I have needed. I have certainly been feeling a little burnt-out the last week so have taken things a little steadier intentionally just to give myself a little breather. I’m looking forward to the week ahead and experiencing a side of medicine I have yet to go in-depth on since my enjoyable year working at Birmingham Children’s Hospital prior to coming to medical school.
This weekend I have had the privilege of attending GERMCON – which is the Graduate-Entry Medicine Research conference. By attend, I actually mean turned on my computer and listened as this year the conference was completely online due to COVID-19. It has been a strange experience attending an online conference but still interesting and still had some very inspiring talks, including from Professor Vinod Patel, who gave the keynote address on the last day of the conference. Professor Patel is Warwick’s Academic Lead for Clinical Skills and oversees our clinical skills education in first year and clinical exams later on in the course. Research is such a huge part of life in medicine, and it was great to see the diversity of projects and approaches to research that were highlighted in the conference.
October 07, 2020
The power of positivity
This week I had three shifts on labour ward at Warwick Hospital. Each one started at 7:30am sharp with the midwife handover, and then I was assigned a midwife to help/shadow for the day. On my first shift I stayed with the same patient all day and things ended with a birth which was amazing to see. It does sound cheesy, but welcoming new life into the world is one of the highest privileges there is. And the babies are very cute!
On Saturday I received some great news – one of the block coordinators forwarded me some feedback sent into the ward by one of the families that I had worked with this week which mentioned me by name! Studying medicine is sometimes a process of continual confidence building, followed by realising how little you do know. A lot of the feedback we receive is about how to improve, which does sometimes feel like negative feedback as it concentrates naturally on what you didn’t do but should have done. This is of course all in the interest of patient safety – one must continually improve to ensure one reaches the competence expected of a doctor. It honestly makes such a difference to receive some positive feedback and after a long and tiring week makes it all feel worth it.
The positive impact this had on me reminds me of something I think I’ve spoken about before in this blog – Learning from Excellence (LFE). LFE is an initiative which was started by one of the consultants I worked with before medicine but is an idea which is gaining considerable traction. LFE focuses on inverting the traditional “Incident reporting” which operates in hospitals – i.e. where an incident occurs, and it is reported so that measures can be taken to prevent it happening again. LFE instead focuses on reporting excellent practice so that we can make sure it does happen again. Of course, both of these approaches have their place and really work in tandem – but LFE focuses on raising morale and also ensuring excellent care. Positive feedback about what went well is just as important as what didn’t go well.
Something else I think is very important is showing kindness and humanity to others in healthcare. When stressed it is so easy to get offended or start on a poor tone, but kindness and positivity has such an important impact. I believe it is key to try our best to be kind to everyone we meet – staff members and patients alike. One of the consultants at University Hospital Coventry actually gave an excellent TED talk which I would recommend – “When rudeness in teams turns deadly”, which talks about the direct consequences of being rude, or of being unkind and inversely the importance of being civil and being kind.
The lesson to take away is that kindness costs nothing apart from your time, and whether it takes the form of positive feedback or just being nice to someone - it can make all the difference. It could make someone’s week – it made mine this week!
September 29, 2020
Welcome 2020 Cohort – Is your WIFI working?
We now have two sets of first years, the ones who are nervously cramming for their exam which has finally come around, and the new ones taking pictures with our infamous lanyards. I was honoured to be asked to talk to the new first years about “Succeeding in Medical School”. In my head I re-named it to “Don’t do anything I did in first year”. Medical school can be overwhelming, so I was keen to get across to the newbies that it is more important they get time out from the world they have just entered than try and finish that last lecture.
They all have been lovely, and I do feel sorry for them. I remember how good (if exhausting) my first week was. I loved the welcome ball, the medsoc nights out and generally getting to know the place I was calling home for the next four weeks.
My favourite part was heading up to the hospital for the first time which happened exactly a year ago today. That cheesy picture of us in front of the hospital makes me grimace now but at least we had the opportunity to get one. I also got to chat to some of them one their one day of the week they could come in. There were a lot of questions about foundation year applications which blew me away as I did not even know what the UKMLA was in my first year, and we were meant to be the first cohort to take it!
There was also a lot of concern about settling into Warwick which I fully get, however, I hope they will take use of campus. I must have advertised Curiositea (the on-campus coffee shop with the BEST hot chocolates) until I turned blue. I wonder if I can get a share of their profits? I hope they are not pulled out of face to face education for any longer than they need to be.
Meanwhile, I am still stuck in second year and with the first years taking their exam next week, I think it is really starting to hit home how long we have been stuck in this year. Describing myself as a second year makes me seem more in experienced than I am but I am not jinxing my exams by calling myself a third year yet! We are keen to move on, we have to just wait until January. However, the rising Covid-19 cases across the country do make me nervous about the future of my degree and if we are going to face being pulled out of placement again or even allowed to take practical examinations.
I am now at the end of my Medicine block and out of tiredness, myself and my clinical partner have decided to make this week a home study week (bar our GP placement). This means we can make sure we are fully caught up before surgery block begins. I am getting fit tested tomorrow, so I hope to be included in the anaesthetic process too!
Campus itself is becoming busier and I am having to remind myself that noise outside my room at 10pm is a normal thing again. We have had six months of silence, so it feels like a strange new world to have freshers back in the halls. I have some nice students and even though I am having to remain distant, I hope I can support them through one of the weirdest academic years of their lives.
That is it for now, I am excited to get to Surgery block. I really hope to Scrub In and give surgery another try before I completely rule it out. I wish all the luck to our 2019 cohort. I remember how terrified I was last year, make sure you give yourself at least Sunday off, and remember, You’ve got this !
September 18, 2020
Babies and bellies
I have now started my Obstetrics and Gynaecology block, for which I am based at Warwick Hospital. Warwick Hospital is one of the smaller hospitals for our medical school but one of the best in terms of the experience that you get. I have only been at Warwick before for a day here or there and never for a long time, so I was excited to start a 5-week block based at Warwick. Obstetrics and Gynaecology covers pregnancy, childbirth and women’s health, and for the block we have two midwives supervising, teaching and organising us. For our first week we had mostly lectures covering some of the basics of this speciality, some of which is revision and some of which was new information. The lecturer midwives who were teaching us did a fantastic job of breaking these topics down and giving just the right amount of information to make it digestible. We also had sessions on obstetric palpation (feeling babies in pregnant tummies), which I have always found tricky. The only way of describing what it is like is having an action man in a inflated balloon and then trying to feel what clothes action man is wearing. It can be tricky so I’m glad we got some more supervised practice!
This week we also had Genito-Urinary Medicine (GUM) day, which is a whole day in this block which covers sexual health and medicine. We don’t get much exposure to this speciality as a medical student, but I actually find it really interesting and varied. The day involved some lectures on HIV and different sexually transmitted infections (STIs), as well as some interactive sessions. This included practice conducting intimate examinations of male and female genitals, and then we also had some practice taking sexual histories. As I said, we don’t get much exposure so having some interactive practice makes tackling these sometimes-difficult areas a bit easier.
Today we had some bedside teaching. At Warwick Hospital we are very lucky to have booked sessions with doctors and midwives where they take us onto the wards, we find a patient and then see the patient under supervision to practice our history taking and examination practice. In the morning we were doing Gynaecological histories with one of the education doctors and in the afternoon, we were taking pregnancy histories and feeling tummies under the supervision of the midwives. Overall, the day was tiring but also really useful and we managed to get some hands-on practice, which is definitely needed at this stage!
I started my Obstetrics and Gynaecology block feeling as though it wasn’t really for me. I’m not really sure why – I think I find it difficult and so don’t enjoy it for that reason. However, after 2 weeks I feel as though it has been demystified a little bit and I definitely feel more comfortable already, with still 3 weeks to go. Im excited to see what the rest of the block brings!
September 15, 2020
I’m tired!
The last two weeks have been….BUSY! My General Practice block has been coming to an end. Like with all my placements, I have had to get sign offs from the doctors to say that I have performed to a good standard, engaged with everything and completed all the necessary tasks on placement! One of the GPs that we have been with quite a lot filled in our “End of Block form”, which they sign giving feedback on areas such as attendance and engagement etc. We received some nice feedback from that GP who said it was a pleasure to teach us, which is always nice to hear! My general ethos in life is to always put your best foot forward and go in full steam – always work to your best ability. If you don’t do as well as you could or you could improve, that’s okay! I do think this makes the job of teaching easier and shows respect to those teaching you – the most frustrating thing in trying to teach is when you ask for volunteers and no-one says anything!
Thursday last week I also did some teaching! Warwick has a very strong tradition of students teaching students, and I have gotten involved with this throughout my time here – I taught seminars to first years and also taught life support last year. I really believe that one of the best ways of learning is to teach. The first years have had their exams delayed this year due to COVID – usually they are in June, but they have been pushed back a few months, so these are coming up soon. I picked the chance to teach shoulder anatomy to the first years, mostly because I have recently had my musculoskeletal block and so the knowledge is fresh and also because shoulders are cool! Unfortunately, the session was online this year rather than in person which does limit things somewhat. Usually in my seminar sessions I like to have activities and demonstrations to show concepts but being online makes this harder. Despite this (and also some technical issues) I did manage to teach I think some useful hints and concepts to the first years and enjoyed myself while doing it. Hopefully they found it useful!
On Thursday I also had my end of block assessment for GP block which took the form of history taking with an actor and discussing management with one of the doctors who was marking me as if this was my final exam. I got some nice feedback in terms of my communication and actually really enjoyed the assessment. I know that’s probably quite weird! It was actually quite fun to have a practice and also super useful as it reminded me of lots of things that I need to go over (ahem…ECGs..).
This week I have also been trying to exercise more and improve my wellbeing as I’ve been quite worn out. GP block has been really fun but also very tiring as its very busy. I’ve (re)joined the gym and am going to try and go a couple of times a week to try and destress. I think my next block is less busy timetable-wise so I can have a bit of a rest. So that’s the end of GP block. My next block is Obstetrics and Gynaecology, in which hopefully I get to see some cute babies! See you in my next blog!