Medicine Block : Week1

THE BEE IS BACK!

Wow, it’s been a while hasn’t it. I’m not sure how this blog is going to work from now on forward because the medical degree I was once on, has changed dramatically.

I am now only in placement for two days a week. Later on this month I will also be starting GP so that adds an extra day but there isn’t going to be a lot to type about.

Lockdown has been hard and there has been times when I never thought we would never get back into placement. However, Warwick has been great at, keeping us busy and we have been completing our third your research project in replacement of our placement blocks. They have also been brilliant with communication and keeping us updated with what is going on but doing that project was a nightmare.

I appreciate a research project is nothing compared to some med schools which have piled on the work for their students but I was so glad to click submit.

We all had to do systematic reviews which I desperately did not want to do. I had my project planned out and I was really excited about it. I also had an incredible supervisor, so when I got that email I was devastated. There were worse things going on in the world then though.

Anyway, long story short my third year project is complete and I am hugely thankful it is over. I’ll write another post about it soon but for now, let’s just stick with the medicine.

Day one of two

That was such a depressing title to write. That is how it is going to be though. We arrived Wednesday morning, donned the classic blue mask on entrance and signed in. We were only 20 minutes into the day and the mask was beginning to annoy me, guess I am going to have to get used to it again.

We also ended trekking back and forth over the whole hospital to pick up our scrubs. Warwick had said scrubs would be provided as we have to wash all clothes at 60 degrees and the fact is, my primark clothes just are not going to cut it. We received three pairs of some dark blue scrubs which are actually really nice! Problem is for me is that I am a tad too big for the medium top ( I like slightly baggy clothes) and the large is too big. End of the tale is that I am now attending placement in a tent.

We headed up to our assigned ward and introduced ourselves. It’s a world away from UH where I once was. We were put to work straight away writing in the notes, preparing for the ward round whilst waiting for the consultant to turn up for the ward round. Due to the type of block we were in, I’ve never actually been on a ward round before so this was a first.

They are kind of useful, I like seeing how the team functions and how the consultant develops treatment plans but there isn’t a huge amount of learning. Especially when the consultant is in pain or in a rush so they don’t get time to explain things. I only point this out because I wasn’t expecting to have teaching, but when we finished the consultant apologized to us for not teaching and explaining things. I nearly fell over, this is normal?

We then helped the docs on the ward with their duties. Halfway through a new doctor joined us, and I am talking new. Finally, we had someone else that was just as lost as we were! He was lovely and spent the majority of the morning trying to get IT to work – classic NHS.

We got split up between the two docs and the PA (Physicians Associate) on the ward. This is probably going to sound bad but , I didn’t realize just how advanced PA’s are and what they can do. Our PA was practically running the ward and I am looking forward to having more interaction with PA’s. I got to spend the morning helping make radiography requests before running off to lunch.

In the afternoon I got to attempt my very first ABG. I missed the artery and normally you “rummage” around slightly to get the vessel but with it being an ABG and not a venous blood sample, I was nervous as I knew the structures running around that area so the SHO ended up taking over. I still felt some source of accomplishment though!

Kaludio and I also got to try and take some blood off one of our patients. They were an ex-midwife so we were happily chatting away to them whilst we were trying to get some samples finding out abut their time in the NHS. Unfortunately, three med student attempts and two PA attempts later and none of us were able to obtain a sample, so we ended up leaving it there.

Overall, it was a pretty good day. I felt like I had accomplished something and I was excited to get back in on the Thursday, albeit at the slightly later time of 8:30am.

Day Two

We trudge in for a slightly later start but surprisingly, a “harder to get out of bed” start. I practically dragged myself to get ready, thankfully due to the scrubs, very little effort needs to be used when getting ready in the morning.

We headed back to the ward and ended up awkwardly killing time waiting for the ward round to start. We had a different consultant today and actually it’s interesting to see the differences in everyone’s medical practise and how they run ward rounds.

It was slightly long as we had seen all the patients the day before but it meant we could listen on more closely for management plans and how they differed day to day especially when it related to scans we had requested the day before.

That day we had a particularly hard hitting patient to see and although I can’t say much else, it was a first for me and I ended up just staying with the patient whilst the ward round moved on. We sat and had a chat which I hoped helped them for as long as I could get away with not following the ward round.

We heard of an MDT meeting that afternoon so we stayed on the ward to help out with any bloods we could do and then ran off for lunch. We got to the MDT meeting and got to listen in to discussions about GI cancer which included a couple of patients we were familiar with. It was good to sit there as although most of the discussions were over our head, we got to examine scans which was helpful as I need to get it out of my head that you look at CT/MRI from the head down. It’s actually a bad thing I have got this in my head as all the organs are in the wrong places in my head and it takes me twice as long to interpret a scan as anyone else.

At the end we managed to catch a consultant and headed to their clinic. These are very different to pre-Covid-19 as there are now no patients physically in the room. We sit and listen on a phone to discussions which still is helpful, but I am worried about how the lack of opportunity to do patient examinations how impact our progression as doctors. We still have our normal OSCE’s come January and with significantly less patient contact both on the wards and through consultant/ GP clinics, I can’t see how we will be expected to be as prepared as previous years,

Anyway, we learnt some lab examinations needed to make diagnosis of IBD and treatment options for those struggling. It’s a common presentation and a lot of the time, people are having to have cameras put into their GI tracts to find out what the problem is.

It was a useful clinic and we finished at a nice round 5pm and headed home.

Friday

This is the only entry for the remainder of year 2 about academic days. We only had our CBL today which should have marked the end of our teaching for second year. Normally, I would be stressed up to my eyeballs with exam revision ready for September so, it felt strange to hit this milestone so early.

We also had a discussion about getting back in the med school after the case concluded. I personally can’t wait as I knew I had 5 days of no face to face contact ahead of me. I understand why some of my course mates don’t want to come in due to fears over mixing the virus but when we are in a clinical environment for learning, I struggle to see how sitting in a classroom would make any difference. That’s probably just me though. There was also a comment about travel efficiency which ok, yes it does seem overkill to get us to come in for something that can be done online but it’s the human interaction that you then loose.

Academic days aren’t just for lectures and CBL but for some of us it’s the only time we get to see others who are in different rotations or are at different trusts, and it’s that I really miss about not having a physical learning environment. I got a little miffed about this comment as it’s a 10 minute drive to the MTC for most people and compared to the utter solitude and lack of seeing people you want to see outside a clinical environment (without risking mixing in pubs or restaurants), I think a 10 minute drive is a small thing.

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