Care of the Medical Patient Week Two

Monday

Straight of the bat at 9am with a bedside teaching session. These are sessions where we get a doctor (aka someone who knows what they are actually doing) to take us and teach us conditions at the patients bedside. We had a fascinating patient with both a lung and heart problem which baffled us no end. You mean patients can have more than one thing wrong with them?!?

I managed to get my history “just” under time, but it is difficult to get the histories down under time with real patients as everyone wants to chat. In our exams, SIM patients are given a script so know exactly what they need to say and when – hence OSCE’s being timed.

Anyway, this was an interesting patient as it was difficult to nail a diagnosis from the history. You learn pretty early on in medical school that you should have an idea of a diagnosis at the end of the history. Your examinations and investigations serve to rule out other differentials rather than back up your own. However, at the end of this case. I had no idea.

We had a discussion about our case afterwards and it was one of the best teaching sessions I have had, so now Klaudio and I officially have a favourite doctor.

After our session we ended up rushing back home as we had an online lecture for which we thought we had to be on teams for.

Turns out we could have just stayed at the hospital as it was a virtual/ live event. Oh well, more time to work and then an earlier time into bed for me! (Yes, I am an old granny who likes being in bed by 11pm).

In the evening I also released my TikTok parody to Dr Glaucomaflecken which got a lot of views on TikTok, all except from Dr Glaucomaflecken. I will make it my life’s mission to get him to see it (or maybe not because of you know – whole whole becoming a doctor thing).

Tuesday

Online Learning

Wednesday

Full day on the wards to ourselves ! We decided to head to radiology to see some pacemaker insertions as we didn’t get to see our lovely patient get their pacemaker the other day. I had forgotten how heavy lead gowns are and felt as if I had the weight of the world on my shoulders (which – is very representative of a medical degree).

It was a fascinating procedure and the doctor running the procedure again was lovely and talked us through what we were seeing on the x-ray. It did slightly clear things up, but I have to admit – I believe X-rays will be forever a black and white mystery to me.

I was in awe of the technique. A whole life-saving device inserted via a couple of wires. The procedure went on a little longer than expected but wow. Taking our gowns off at the end was a relief, I think I had forgotten just how heavy they were. The doctor came out at the end and sat down with us and took us through what was going on. I even began to understand why the x-ray machine was moved in certain positions and what the reason was for the minor delay.

I don’t know. I’m not sure if it’s because we are third years, but Medicine is starting to feel more serious now, like I am actually studying for the rest of my career, not just an exam.

Heart pacemaker: MedlinePlus Medical Encyclopedia

We ended up grabbing a lunch after and attempted wards. We went to our Hogwarts ward as we knew the doctors better there and we were not disappointed. Our favourite doc was there plus a Warwick Grad FY2!! I swear 1:2 doctors we meet are Warwick grads. Must be something in the water keeping everyone round Coventry.

We ended up chatting to the patient who had their pacemaker fitted the other day and then chatting further about ECG’s and pacemaker affects on ECG’s. We may be getting a bit cocky, but I think Klaudio and I are finally getting used to ECG’s.

Thursday

April Fools Day!!! I had been thinking about how I could get a prank in before 12pm and I DID IT. Managed to convince Klaudio that the beloved Ice Cream bar at Gelliot was closing. Well, I managed to have him fooled for all of 10 minutes but I count that as a win.

We had a case based discussion session which was useful as we talked through taking a history of a patient presenting with a fall ( a lot more to consider than you might think) but it was a bit rushed. There was a miscommunication between Warwick/ Hospital and us so it ended up being more of a mini-cex session than CBD but it’s ok, still got something out of it!

I then went to meet my consultant who was reporting cardiac MRI scans and it blew my mind the sheer detail of the picture. We talked through his timetable and what wards he does and when so I hopefully will have a better idea of planning my week out!

We decided to cut the day short after that as we were both shattered for some reason so went home to do some work in the beautiful sun that we were getting treated to.

and you know what….. I actually did manage to get things done on a week that I had found it difficult to get into the swing of work. Gangrene on a Thursday evening. Mmmh mmh mmmmmmh

#Problemsofamedicalstudent

Im thankful we have masks to cover up the acne that is caused by the masks.

Friday

Good Friday

Care of the Medical Patient Week 1

Monday

Online Learning (I’ve decided not to describe these as we all know what Teams teaching is like).

Tuesday

Online Learning

Wednesday

AND WE ARE BACK !! Wow, it really has been a while, huh? It honestly felt like second year was never going to end. One and a half years trapped in a year that kinda feels like a stop over between clinical and non-clinical but now, we are full pelt to the finish line.

Technically, I am now a finalist as our Years Three and Four are merged into one year but a shot of … well… horror and terror shoots through me when I say that.

We had a intro to the block and headed straight to Ward Hogwarts where we had been assigned. I was a little hesitant as I was through with the whole hanging round the wards thing hoping for something to do.

Boy was I about to be surprised.

We had a ward round on our tiny little ward which was a tad crowded but I have never had so much teaching on a ward round in my life. The consultant encouraged us to interpret ECG’s for them and I even felt confident to step forward and examine patients during the round. I kept catching eye contact with Klaudio with both of us shocked at this level of teaching.

We had interesting patients including diabetic feet (something amazing with this patient but can’t go too much into detail), COPD, Atrial Flutter and Fribilation (will I ever get my head around the difference between these two, stay tuned to find out). We even chatted to someone who was due to have a pacemaker fitted! Our consultant also seemed to be a lover of bedside echos and spent time orientating us to the image in front of us.

It felt so good. We heard there was going to be a cardioversion in the afternoon so ran off to get lunch and make it back for the procedure.

A cardioversion is shocking a heart which is in A Fib/ A Flutter back into sinus rhythm. It sounds backwards to shock a heart which is not in V.Fib but is actually the gold standard treatment for A fib and A Flutter ! We had to go up to theatres as our patient was a bit risky but wow. It was amazing to see.

They were made a bit drowsy to begin with (well, you would want to be drowsy too if you were going to be shocked) and their heart rate was roughly 150 upwards. One shock administered later and it dropped to 80bpm. That was a drop of 70bpm in less than 10 seconds.

Medicine is amazing.

Thursday

Back in again, but we had teaching in the morning. I love having this amount of teaching. It really does help with guiding what we should be learning. First topic up was Stroke. Except our teacher was not in the room.

I remember back in Primary School we would come up with concepts for the future and one of the suggestions was a virtual teacher, and here I am living the reality.

It felt a bit big brotherish to have a massive face up on the screen with us sat in the room but did end up working well and I enjoyed the rest of the morning !

Unfortunately, having teaching in the morning means the rest of the day is a bit awkward. You miss ward round and bloods so there tends to not be much else to do. Oh, well.

Friday

First Academic Day of Third Year ! Wow, and what a hit of reality this was. The whole first half of the day was taken up with talks about UKFPO (the process of applying to our FY1 jobs) and our various extra exams such as the SJT and PSA.

I think during the morning it was a slap of reality. I can’t believe that I am so close to finishing. I don’t feel like I’ve been here long enough for that to be the case. I remember first year like yesterday and second year was a nightmare I am willing to forget.

I sat there listening to all this information about the application process and the exams just having a crisis. This was all getting too real.

But we survived, and I spent the rest of the afternoon learning about prescription writing in hospitals and wrote my first ever mock prescription:

That felt pretty good.

We also had our first CBL session which meant another new group. We actually have a good mix of interests and personalities so the session was ok! I never thought I would spend 2 hours talking about UTI’s and Nitrofurantoin (Antibiotic for UTI’s).

And that was it. My first full week in my Care of the Medical Patient Speciality Block.

Here we go.