Tuesday, 26 October 2010

Another first

Today was the first time I got to use my stethoscope (Purple, initials engraved for those freshers who wonder) on a real life, actual person.  Ok, so it was another student, but it was the first bit of medicine I have done that wasn't pretend or on a manikin.  And it wasn't exactly taxing being as it was taking a blood pressure, but I'm still excited.  Well, excited but exhausted.  In the two hour session we covered examining a pregnant abdomen including determining position and lie, fundal height, fetal heart rate, blood pressure manually and with a steth, heart rate, respiratory rate, temperature aurally and under the tongue, and plotting it all on obs charts.  It was interesting and good fun, but man - my brain was leaking out of my ear by the end.  Just complete information overload.  And to top it off, we have competency tests on it in a couple of weeks.  Eeek!

Even more of an eek is that tomorrow I have my first exam.  An AMK - acquired medical knowledge test, that will be 125 questions in 3 hours, multiple choice with 4 options and a don't know option.  1 mark for a correct answer, -0.25 for an incorrect answer and 0 for a don't know.  The test is set at Junior Doctor level, although I was told last week that even a consultant would only get 60%, so I'm a little confused at that.  I also get the feeling this is the test that will be sat by all Doctors every five years after qualifying to retain their license to practice under the new guidelines.  I think we are only supposed to be getting about 2% because it's our first one, and technically it's formative so it doesn't count for anything anyway, but it's still fairly terrifying.

Most people on my course will be stressing I think because they will be used to getting 90%+.  Having done a degree and had proven to me on many occasions I know nothing, this does not bother me so much.  What is most nerve wrecking for me is that you can't revise.  I'm a great one for cramming, but you just can't for this.  There's so much I don't know, I wouldn't know where to begin.  I'm confident in what I do know, but that amounts to pretty much nothing in the grand scheme of what I should know in order to do well in this test.  I'm also worried that I'll recognise some of the words from my biomedical days and be tempted to have a punt and end up doing worse than I should.  The questions are all clinical cases including symptoms and test results requiring a diagnosis, or what would you do in this situation (with the answer conveniently being some GMC guideline on the appropriate action to take), so I think I might recognise some of the answers, but never have looked at the science in a clinical context I'm not going to know the symptoms.  Fingers crossed I can show restraint tomorrow.  Wish me luck!

I have more news to tell about my midwife placement and confrontations with my PBL group, but I think I will leave that to later on this week and go to bed now with some camomile tea to try and abate the insomnia I always get before an exam.  See you on the other side.
Bean x

Tuesday, 19 October 2010


Last Monday I went on my first placement.  It was at a GP's surgery, which just happened to be where I did some work experience about 5 years ago when I was first applying to medical school, so I already knew a few of the staff and how the practice works.  From start to finish I just had the best time.  From looking at it, I didn't get to do anything terribly exciting really, I just sat on a chair in the corner of the room and watched the consultations and spoke with the nurse or Dr about them afterwards, but from the grin that was on my face for the rest of the day you'd have thought I single-handedly diagnosed all the patients myself.

Firstly, I was introduced to all the patients as a student doctor, which actually made my day :)  I got to see a wide range of patients including knee pains, IVF requests, 12 month immunisations and cervical smears.  One of my two most memorable moments was sitting watching this lady ask for a referral to an IVF clinic as she had suffered 19 miscarriages and buried two children born prematurely, which was heartbreaking to hear about.  There's no way I would be strong enough to put myself through that, she was such an amazing lady.

The other moment was when I was observing a cervical smear from the other side of the room to give the lady some privacy, and the nurse some room because the table was sort of squished in an alcove.  The nurse asked permission if I could have a closer look, the lady consented and I bounded across the room - you have never seen a bean move so fast. I had a peer, saw the cervix, and then had a moment of realisation that I knew absolutely nothing, and here was this lady letting me peer at her privates as she is having an uncomfortable procedure and in possibly one of the most undignified positions you can be in.  It was really useful for me to see because it tied in nicely with the case unit we'd just been doing, so now I've seen it in books and real life but once she was dressed I made sure to thank her properly for giving consent.  It seemed the least I could do.  It might only have been a simple thing for her to do - to say yes - as I guess she was already embarrassed enough anyway, so having one more person looking probably couldn't add to that feeling, but it was incredibly useful for me.

The reverence required to be around patients when dealing with sensitive matters soon left our class however, as later on in the week we were doing genital exam on rubber manikins in clinical skills.  There were several incidents, including one person managing to fire the glans head of the penis across the room while trying to milk out any discharge, and the facilitator casually reminding us to be careful of where we put our thumbs.  We were all so intent on getting our fingers deep enough to feel the ovaries, we all had our thumbs firmly jammed on the clitoris.  Ooops.  Oh well, I guess clinical skills is the place to make these kinds of mistakes :)
We were told you can laugh as much as you like now, just make sure when you do it for real you aren't partnered with the same people, otherwise you'll make eye contact, remember this day and dissolve into fits of giggles.

Sunday, 10 October 2010

Week One Survived

Not counting Induction week, my first week at uni is finished, and all I can say is...WOW!  It's everything I hoped it would be and more.  It's so cliché, I know and for that I apologise, but I am just having the best time, there is such a big smile on my face all the time, albeit only visible through the frazzled, exhausted haze my life has become. The smile shines brightly through though.  This week has seen plenaries (lectures) on conception in culture, anatomy of the reproductive systems and pelvis, reproductive ethics and mitosis/meiosis; Life Science sessions on medical imaging, anatomical language embryology of the reproductive systems, the menstrual cycle, spermatogenisis and oogenisis; an essay handed in two days early (nerd that I am) and my first PBL revealing a case on the topic of conception.  Wow :)  Embryology was one of my favourite topics, and I'm so happy that things are coming flooding back to me, rather than struggling to learn them for the first time.  I am certainly glad I did a degree first, actually.  It was definitely the best way for me to do it.  I'm not afraid of hard work, and I know how to take lecture notes, which everyone else seems to be struggling with.

The work load is tough, I can't lie about that - there's so much to do although I do keep forgetting a case unit lasts two weeks so I have twice as much time as I think I do, sort of.  Bearing in mind I don't know what new stuff there will be next week yet... Argh, anyway, tough as it is, I'm loving it.  It's so nice to be back studying again, and to be studying things that are really interesting to me - this must be what it was like for everyone else who picked degrees they liked and got in first time.  I can sit down to study and look up three hours later thirsty and wonder where the time went.  It's awesome!  This was definitely the right course for me too.  I love how everything is taught with a bit of science and then here's the clinical context, straight away.  I went to a plenary on pelvic anatomy, I watched Aclands Dissection videos that we have access to online, I coloured in the anatomy colouring book, I played with models and felt the landmarks on my life science partner and I can now say that I fully understand the anatomy of the pelvis.  It's amazing.  I've never had that sort of clarity built by seeing things many times from different angles before.  Everything is built up, bit by bit and there's lots of cross over between sessions, but with a different slant, so instead of being repetitive, it's clarifying - you see one bit and then it's built upon because this other bit you're learning about is connected to it in some way.  I really hope I can stay this enthusiastic about the course.  I see other medics on TSR complaining about modules of their course, but mine is taught so differently from theirs, I hope it stays this interesting.

My beautiful God-daughter, Irys
In non-medic related news, Mr came down last weekend for my God-daughter's Christening, and he was down this weekend because it was our 3 year anniversary.  We went out for a meal Friday night, Saturday night I cooked for him - gnocchi and bolognese, all cooked from scratch I'm proud to say and enjoyed with wine and Seven Pounds, a Will Smith film I've been waiting to see for ages.  Sunday morning I cooked him his favourite breakfast in bed and then we took a wander up into town.  It was a lovely weekend and it was really nice to see the mr.  My housemates were looking jealously on as I cooked for my mr, and the little bean in my head was saying, well that's what you get having a steady girlfriend instead of a string of girls you pick up in clubs.  Catty bean :p

I'm feeling really lucky at the moment - I'm on a great course, making lovely new friends, with a fantastic mr, and only a few marly points.  Most recently being the fantastic people at SFE who decided to do a manual re-calc of my entitlement and pull my funding for the rest of the year "because my course dates changes"  Wha....? 0_0  Cue one very polite, quietly simmering, angry phone call and a hasty apology, "I have no idea why they did that, I'll put you in for another re-calc tomorrow.  It'll take 4-6 weeks to come through."  Stupid people...

I'm off for a shower before my first placement tomorrow and then blast through some more PBL questions.  Have an awesome week people, I hope my excitement rubs off on you and things go your way.  Good luck for the UCAS deadline potential medics!!!  It is totally worth it.