Month: Jul 2019

Surviving the First year of Medical School

Posted on by medbeeblog

Textbooks

You do not need to buy any textbooks going into first year, especially not detailed cell biology ones. You just are not going to need them. You will figure out over the first few weeks what you do and don’t need. The only one I can really recommend for first year is Greys anatomy and a good physiology and pharmacology textbook.  It’s easy to think that coming in with a library of textbooks will make your life easier but the harsh reality of it is that you will not use half of them. Borrow them from the library at first, and then when you find you keep using the same one over and over, then consider purchasing it. However, you never need to buy brand new. Ask around as to who is selling one in your medical school or look on ebay. The BMA even have a free online library where you can access textbooks for free! They even have Greys Anatomy!

Lectures

Yes, they maybe recorded but try and go to them. I found I engaged more when I went to lectures and it also gives you the chance to socialise! Med School can get very lonely if all you are doing is sitting in your room listening to lectures and doing work. It also means you can ask questions in the lecture without having to chase over emails. Lecturers will also respect you a lot more if you are showing engagement with the course and it’s always easier talking to someone you know rather than a voice on a screen. As a GEM student this may not always be possible as you are more likely to have conflicting demands but I would say to go to most of them. It also allows you to follow group work as you will be fully caught up on the lecture content. This was especially true for me as I did not go to the Block 2 teaching because I didn’t get on very well with the lecturers style ( I enjoy story time but when I am struggling to grasp the concept, I just want lectures that are to the point). I found that CBL became a nightmare, and I was at one point 17 lectures behind. So yup, go to lectures, see the recordings as backups rather than first time lecture content. (Recordings can also fail and lecturers have the right to refuse recording of their lecture especially if they are talking about patient details).

Free Time

Have some. This is really important. You can not learn everything on the course. It’s just impossible. To this day I still have no idea about altered voiding. All I know is that kidney stones can get caught at certain points and one of the drug classes is called “Anti-spasmodic”. You make the free time in your life. My lecture often said, plan your week with your free time first. In put that two hours climbing every other day, or 4 hours for date night, then put in your academic work. This stops medicine becoming all you are, and believe me, falling down that particular rabbit hole is not pretty. A question I get asked all the time is “How do you find the time to have a break”, the simple answer is you make it. Apart from sign in sessions, there is nothing to dictate how you study or when you study. I could have done zero work from September to Easter and no one would have known. This is not school where homework is checked, this brings a little freedom into how you use your time. Obviously, med school is tough and there will be times where you feel like you can’t have that time off and that is ok, but it is important that you do take this time off elsewhere. On the opposite end of the spectrum, you do need to be keeping up with your work. The lectures come thick and fast and its not often the content that is the problem, it’s the quantity of it ! Do little and often, you do not need to be up to 11pm each evening working and doing this is a recipe to burn out. Even if you just do a quick review of what you have done, make sure you do not fall too far behind !

Ask For Help

There is no time for heroes here. If you are struggling, ask for help. A friendly second year or even a more experienced first year (don’t forget as a grad entry student you will be amongst those with PhD’s in topics you maybe struggling on). Medicine is a team “sport”. Universities that encourage competition I believe are doing nothing to help their students, you will never be turned away for asking about a patient in a hospital (yes you may just get a grumpy response) but you will never be left when a patient is concerned, so why abandon your course mates now (Doctors correct me if I am wrong on this !)? We formed a team over revision in our med school and people who had been studying alone actually came and sat with us towards the end and wished they had joined us sooner. This does not just cover academic means either. If you are struggling with anything else, talk to people. As I have said before on here, I spent a lot of time in my senior tutors office, even if it was going in there and letting her know what was going on before laughing over the fact a patient complained more about my sweaty hands than the fact I had accidentally knocked their cannula, I knew someone else knew what was going on and this was helpful in itself.

The “Look at Me”

Do not, I repeat, do not start worrying about how other people are approaching the course. Find what works for you. ANKI is HUGE in med school, but it really does not work for me. I get bored and start doing less and less each day. Instead I preferred question banks, writing notes out and drawing pictures. That is fine because I was still learning the content. However, I did worry because everyone else was carrying out their revision differently to me, focusing on different areas, doing things at a different pace.  We all passed though so it goes to show however you do it, make sure it works for you. Ignore everyone else.

Do not sacrifice something you enjoy for studying

Waaay too many times this year I’ve said “I can’t, I have too much work to do”. This is not an excuse. Especially on a Friday night when you know you would rather be doing anything else than working. Go to events that you want to go to, just work it into your timetable. A good example of this is Freshers Week and med school events. I would go to all of these events. They are fun, and it is an amazing chance to just let your hair down and forget about medicine. Every medical school has a Revue, go to it. It’s an evening where we make a mockery of the med school to raise money and it always ends up being a huge laugh and the talking point for most people for the next week. Go to the things you want to go to, enjoy life outside of med school. You can always come home and do an hour of work, it will always be there, nights out can’t be repeated.

Don’t Try and Copy Every PowerPoint

I really would invest in a computer/tablet/ unlimited printer budget this year. It is so much easier and quicker to input any extra notes that lecturers give into a completed PowerPoint than trying to keep up with the PowerPoint AND everything the lecturer is saying. Some med schools will even test you on things that were said in the lecture but may not be on the PowerPoint, ESPECIALLY if they are recorded. This is very rare but they can technically do it because they did teach you on it (another reason to attend lectures). Some lectures aid more to this than others such as anatomy where you really do not have time to be drawing out structures but in subjects such as VLE and Soc Pop, you can probably get away with it a bit more. A hack for the printers is to print double sided with 9 slides to a page and to double check the lecture slides beforehand. A couple of times we have had lectures where animations were not used, and it was 275 slides of pictures which can be cut down to 60 slides with text.   

Engage With Your Course

Sounds pretty straight forward right? If there is extra teaching, go to it. If there are careers sessions, go to them. Guest speakers? Go. Sometimes you just need the extra motivation by seeing people in the position that you want to be in one day. My Student Seminars were my godsends through the year and I learnt a lot through them. I sometimes felt more comfortable going to my student sem teachers than my lecturers (because I’m weird like that) so this was a huge benefit for me. Our ECG teaching was largely solidified by the 3rd and 4th years and ABG’s were something I understood only in student seminars. If you can go to it, go.

Enjoy it !!

I found first year a pain and I was stressed the whole year through. Looking back, I wish I had given myself more time off and did not work as hard (you read that right). I was too stressed and this was affecting me and having a negative impact on my work and my mood. I wish I had gone to more parties, actually talked to people who I didn’t talk to before Easter because I would have found the group of people, I call my closest friends a lot sooner. I wish I had found a group to have a pint down the pub with sooner as this is something I loved doing in my undergraduate. I wish I had gone climbing sooner and just enjoyed being in first year instead of worrying about exams from the get go. So enjoy being the babies of the med school, enjoy your first time in the hospital and your first time seeing patients, worry about everything else after… 😊

Abbie

Ps. Learn to love coffee too !

GOSH Summer School

Posted on by medbeeblog

Monday

On Monday I headed to GOSH for a 9:30 start of the summer school. I had been really looking forward to this for a while and I had the added bonus of a free ticket ! I managed to get there and of course you enter the awkward first moment of finding people to talk to. I ended up chatting with a soon to be doctor from Vienna ! People had actually come from afar to attend this event with people coming from Ireland and even New Zealand!

We had our first talk on general paediatrics delivered by Professor Caroline Fertleman. She arrived with her pink hair and talked us through her day to day job as a paediatric consultant. I was in awe and just her passion for the children she had seen and her interactions with the family was lovely to hear and you could tell she loved her job. This was actually a common theme throughout the rest of the summer school. It was clear these doctors would not rather be doing anything else, that is something I want from my future job.

We then had a quick break followed by a talk on the training pathways in paediatrics. The specialty that was originally the only one I wanted to pursue wasn’t actually covered by the paediatric route, instead I would have to specialise through the surgical training pathway. I guess that’s going to be a bit harder to make sure I get the paediatric exposure but I guess it’s worth it in the end!

We then had a talk from a general paediatric surgeon (Mr Simon Blackburn) about his work in paediatrics. We were told about the surgeries he had carried out and how he had undergone his training. He had also undertaken a masters degree in surgical education which is something I didn’t know was on offer. I do want to gain a masters degree one day and perhaps a PhD but I know research is not one of my strengths so I guess we will see where my training goes. This was the first time out of many for the three days where my mind wandered over to a specialty that was not neurosurgery. I’ve been pretty much set on this specialty since day one of med school so to suddenly think about another pathway was a surprise to me! The delicate surgeries used to correct birth defects in the gastrointestinal system was intriguing and it was the method of fixing the defects that captured my imagination.

In the afternoon we had breakout sessions. We had been randomly assigned to groups as I was put in the “design a research study one”. I was dreading it slightly but the group I was with worked really well together. Our facilitator was Prof Paul Winyard and he took us through designing a study and the tings you need to consider when trying to secure funding. This small exercise boosted my confidence approaching research projects now that I know a little more about them. We all came together in the afternoon to present our ideas. Other groups had different projects such as designing an App for Junior Doctors where they can access help when needed (and even without internet connection, a common problem in hospitals). I liked the idea of a coffee button that you press when you need to chat to someone. There were other projects such as tackling health problems in the community, running an outreach day with the appearance of Dr Ranj and how to improve doctor- patient interactions in consultations with paediatric patients. The presentations were part of a competition and my group ended up winning! We won a textbook for our efforts which was published by GOSH.

After we had a Q&A session with GOSH Young Peoples Forum. This was an organisation set up where patients of GOSH and their siblings could put their ideas forward about how the hospital was run. Members of the YPF have also sat on meetings for picking the new chief executive of GOSH. They have also been invited to give their opinions on new GOSH wards and what should be included on them. It was nice to be able to talk to the YPF as this was a opportunity to ask them what they wanted their future doctors to have in terms of qualities. There were two GOSH patients and a sibling of a GOSH patient so we were able to find out what it was like having a sibling at GOSH. I think the one thing that I got from the session was to involve the siblings in the child’s care as much as possible. The sibling mentioned about wanting to be trained so they could administer care to their younger sibling and they were not able to be trained until GOSH had actually offered them the chance. Offering the siblings a chance to get involved in the care of their brother or sister would be a good way to make sure all the family feel listened to and valued. It would also give the sibling more involvement and make them feel included in the treatment as much as the parents and patient.

That came to the end of day one. I was exhausted and it showed as I managed to get on the wrong train home and ended up having to travel a further 40 minutes to get back to where I needed to be.

Tuesday

Managed to make myself late today because the trains were all delayed due to signal cables being stolen further up the line from where I was. At half nine I was sprinting through London to try and get to GOSH as soon as I could. I arrived during a talk but I go there in time to hear the one thing which has changed my entire outlook on my career and myself. Dr Sharma was giving a talk on his career pathway and how he felt he wasn’t the correct personality type to pursue the career he did , until he found paediatrics. He said that you shouldn’t ever change yourself to suit the job you are going for, instead be bold and be the person to be different. I think this was the thing I took away most from this summer school. I had been constantly doubting that I was the correct person for surgery, I am quirky, excitable and loud. Not really something you see in surgeons but this small thought during the middle of a speech made me realise that actually, there’s no reason why I cant still pursue surgery, there’s nothing in the job description about personality wise. I later found out that Dr Sharma is actually the medical director at GOSH.

After Dr Sharma we had a talk from Prof, Paolo De Coppi about regenerative medicine in children. He was part of the team that performed the first Stem Cell Trachea transplant on Ciaran Finn-Lynch in March 2010. (https://www.gosh.nhs.uk/news/latest-press-releases/2012-press-release-archive/first-child-receive-stem-cell-trachea-transplant-doing-well-after-two-years)

This was incredible as in the next decade , Stem Cell transplants will probably replace any transplant we use from living/deceased donors. The trachea was derived from a donor in Italy and stripped of any cells down to the collagen. Ciaran’s Stem Cells were then isolated and applied to the tracheal skeleton. Ciaran is still doing well today and does not require any anti-rejection drugs, he even attended the GOSH award ceremony with the team for their work.

We then had lectures regarding how to strengthen our CV’s . This was useful as being a first/second year medical student as I still have time to work on mine. One common theme that kept recurring was taking an F3 year. This would be a break between becoming a fully qualified doctor and starting specialty training. There was also an added emphasis on taking breaks away from training to pursue other opportunities such as going over to other countries to become exposed to their healthcare systems and different consultants (as well as taking a quick 10 minutes to soak up some sun).

In the afternoon we had a careers fair. This proved to be incredibly useful as I got to chat with some of the specialties that had caught my eye. One of these was PICU / CATS. Paediatric Intensive Care wasn’t anything I had originally thought about, but it has become a specialty that has got me re-thinking my career pathway. Dr Andrew Jones was running that stall and it was interesting to hear about what he does day to day. He also informed us about CATS which is the Children’s Acute Transport Service. This is a service designed to take critically ill children to PICU units at hospitals where they are currently in a hospital without one. It is a specialised ambulance that can cater for critically ill children during transfers from one hospital to another meaning children can receive the best possible care at every stage of their journey. Dr Jones happened to be on a 48 hour on call during the fair so was multi-tasking to say the least! He was very open and honest when we asked why he chose PICU over NICU and I could see how retaining what you want from your career was important when choosing specialties.

I also managed to talk with Dr Bhate about Neurology and how to best get involved in research so show dedication to the field. He seemed receptive to the fact I already have a degree in neuroscience so I am hoping that will stand me in good stead with other clinicians. I also managed to sit down with Prof Paul Winyard about getting involved in research and what clinicans expect of their students. I was worried about the data manipulation side of research as this was something I just never really understood in my undergraduate. I think he sensed that I had little self-confidence and basically told me to get out there and just go for it. I must admit, sitting in a lecture hall knowing I was probably the only one who didn’t get straight A’s or A*’s for their A Levels , it was easily to feel like the underdog but the boost I got from Prof Winyard I think was needed.

We then had a Q&A session with the specialties and I believe the most memorable question was “ Is it as bad as Adam Kay says it is?”. This earned a laugh through the audience but we were told about how paediatrics was tough and that the days were long but , it’s the smiles of the kids and relief on parents faces that gets you though it.

We then had a presentation by GOSH arts which ended up being more of a group singing session. We were all stood up singing through this tune and for a bunch of people who have seen more of the inside of a hospital than the outside for the past couple of years, the harmonies were quite good. Despite feeling a bit embarrassed it was a really enjoyable session and it really hit home the power of non-medical treatment.

In the evening we had a small drinks party on the roof of GOSH with views all around London. It was nice just to talk to everyone from different medical schools exchanging OSCE horror stories and stories from the wards. I was also chatting final year students about their electives. I also found out about working Glastonbury as a medic and I got given the website so I am hoping to gather a group of us up next year ! I also ended up bumping into the guy who runs the media side of PGME GOSH and we were chatting about how despite the thousands of emails that got send out, only 44 people were there. I was saying about how emails can be easily missed but it might be better to have a student ambassador at each school pushing GOSH events, they seemed to like the idea! We ended up leaving at 8:45pm from the event that was meant to finish at 8:30pm but that’s a minor detail !

The view from GOSH

Wednesday

Final day. I didn’t want the course to end but I think we were all pretty shattered by Wednesday. Our first lecture was about DRIVE at GOSH which is the Digital Research and Informatics Virtual Environment. Apart from the slickest presentation I had ever seen, the tech they are developing at GOSH is incredible. It’s important to understand that as medical students in the 2020’s , we will be seeing an influx of technology into our daily working lives. One particular bit of software that caught my eye was their data collection as you could input the data you needed and then it would tell you what test to use depending on what data you selected. They were also developing programmes that linked with therapy for respiratory patients to games where they had to perform the therapy correctly. I am excited for what technology can bring to healthcare but I am also worried about how this will affect training. If an app can listen to heart sounds and correctly diagnose them, then why bother teaching medical students how to identify them. There’s also the question of data security as we have seen how the NHS is not impenetrable to attacks from hackers in the past however, I think the benefit for patients through this technology will be huge, we just need to know how safe it will be.

We then had a talk on Paediatric Ethics. Ethics is something that has grown on me a lot through this year and I am considering it for my SSC1 module next year. We were told about how GOSH ethics panel makes decisions based on ethical values and how they allow their patients in on the meetings in the children are well enough to attend. Although Charlie Guard and Alfie Evans were mentioned , we talked about how the ethics panel also decide on if it is ok to give an experimental treatment to a child, in the case we talked about the child actually sat in on the panel and was eventually allowed to undergo the experimental treatment.

Our penultimate lecture was looking at global health and how we can incorporate practising and teaching medicine abroad as part of our training. Again, it was highlighted that is it good to take time away from the conveyer belt of training and to do something with your career away from clinical practise. It was amazing to hear about the projects Dr Kingdon had worked on throughout her career in Africa educating nurses and future doctors as well as improving hospital standards in paediatrics.

Our final speaker was Anthony Bennett who was a former GOSH patient who had gone on to speak at national events about his journey and has now developed his own motivational speaking business. He took us along the treatment he had received as a patient at GOSH having survived 12 cardiac arrests from multiple infections after becoming ill on a school trip. We had a few laughs through the presentation as he spoke about his morphine hallucinations which actually turned out to be real visions ! Anthony spoke about listening to the dreamer voice rather than the “puller back voice” and I think we all left just that little more optimistic about the careers we have ahead of us. I managed to chat with Anthony at the end about how he got into his public speaking as it is something I would love to do with the view of educating pupils that just because something does not go right , does not mean you can’t reach your end goal.

And that was it ! Summer School over. It was an incredible experience and I feel like I have gotten so much more out of it than just how to become a paediatric doctor. I am so grateful to GOSH PGME for picking me as the winner of a free ticket ! GOSH seems just that little bit more realistic as a career goal now. I can see my personality reflected in the doctors I met and it was nice to chat to them with the traditional consultant/medical student barrier removed. I can’t wait to start second year now. I want to try and get as much exposure in paediatrics and neurosurgery as possible and possibly experience with anaesthetics as this is also something that has caught my eye as a specialty. There are a couple of GOSH conferences coming up that I would like to help out on to further see how research works within clinical settings and to hopefully talk with clinicians already where I want to be in the future.

Registration for 2020

https://courses.gosh.org/GOSH_SummerSchool