Friday, 5 November 2010

Busy Busy!

Wow, well I'm not sure what happened to that week.  I survived the AMK.  I answered 22 questions, so I have somewhere between -4.4% and 17.6%, which I'm happy with.  There were probably some questions I could have guessed at - I got a few down to a 50:50 choice that I really couldn't pick between so I left.  Equally there were some where I didn't understand any of the answers, so I sensibly left them too.  There were a lot of Don't Know answers, but I find I'm not as freaked out by that as I was expecting to be.  When I left one of the guys who finished at the same time as me only answered 2, and I've found someone who answered 122, so the odds of me being somewhere in the middle and therefore passing seem pretty good.  The top 5% get excellents, the bottom 5% fail the next 15% up from that get borderline and everyone else gets satisfactory.

I promised some information on my placement.  I was shadowing a community midwife in one of the roughest, most deprived areas of my city.  This was a really big culture shock to me, and the first time I've had my views really challenged.  We went on a home visit to an 18 year old girl with a 7 day old baby.  The baby had been sleeping fine, but the night before was up crying all night and the mother didn't get much sleep.  She was sobbing on the phone when we said we would come round and she continued to cry almost constantly throughout the visit.  Her mother was there and was being really supportive, although her two younger sons (around 7 and 14 I guess [7 years old and an Uncle!]) were running around being noisy which possibly didn't help.  The mother was telling us how she had fed the baby every time it cried, but still couldn't get it to settle.  The baby was a little grisly when we got there, and didn't like being weighed, but when the midwife held him it was like she knew a special off-switch, the baby was instantly silent and sleeping.  The midwife explained that babies need other things besides food, and at that age they don't know what it is they want exactly, just that they aren't happy.  The biggest thing for me was how young she was.  Inside my head was screaming go back to school, you shouldn't be having to deal with this, you poor thing.  I kept thinking of my housemates who were 18 and how they couldn't look after themselves, let alone a baby.  I know that at that age our bodies are most prepared for having a child, I guess it's just that it's so incongruous with my upbringing, where the focus has always been on education.  The second girl we saw was 20, with a two year old running around and a history of miscarriages.  She was living in a one bedroom flat paid for by the council, and her partner was living with his mum so the council continue to pay her rent.  She had had a big argument with her boyfriend the night before, had no job and her previous successful pregnancy had left her with post natal depression, which she was still being medicated for two years later but had stopped the pills immediately when she found out she was pregnant, although the pregnancy was planned.  Again, I just couldn't help thinking this is no environment to raise a baby in.  I'm not saying she shouldn't have kids, I'm just saying she should get a bit more stability in her life first.  She did come out with a gem though: when asked if she had any heart problems she said "No.....Though I do have a heart murmur, does that count?"

My my am I looking forward to Christmas when the PBL groups swap over.  I really like PBL, I get a lot out of it and prefer it to lectures (especially since a lot of this is revision for me, which is nice).  My problem is the closed-mindedness of my group.  I get the impression that because I look the same age as them, they aren't going to take anything I say seriously - if they haven't done, it can't be true.  When it was explained to me, Peninsula like grads because we can bring our prior knowledge to the group and help out a bit.  My group just shoot me down and get really arsey with me.  Now, normally I can stand up for myself, but when it's 8 against one ad it happens every time, I'm seriously losing patience and am thinking of just shuting up in class and let them do it the hard way.  But I can't really do that, because we get judged on how much we talk in class and how much prior knowledge we bring, so I'd just end up shooting myself in the foot if I'm quiet.  An example being in our case unit this week.  It's on immunology and they decided one of the questions they wanted was when is it not appropriate to give antibiotics (the stimulus being a mother wants antibiotics for her child who has a respiratory infection and you as the Dr don't want to give them because they won't help).  Now, I don't know the A-Level syllabus, but I said well, antibiotics wouldn't help if it isn't a bacterial infection, so only give it if it's bacterial.  Would they believe me? No.  Another was what was the age of consent for medical treatment.  Now we covered this in the first case unit with what age can you get an abortion at.  We should also have looked it up for interview prep because Peninsula is hot on ethics.  Apparently they only looked up rules on contraception, and thought it might be different for everything else?!  So I explained Gillick's competency and Fraser guidelines and so it's 16 normally or minimum 13 with Fraser guidelines but still they wouldn't listen.  We ended up with questions about what is a respiratory infection, and what does a practice nurse do?  Seriously!!!  They are smart people, why the stupid questions?  And I don't even think it's just making questions for the sake of it to pad out the number we have to make it look more impressive.  Any paper evidence I bring to class is shot down and I'm made to feel like I'm disrupting class, being deliberately difficult or something.  Arrgh, rage!!!!  In any other setting I get on really well with them, because we are together for quite a lot of things, it's just PBL.  I guess it shouldn't bug me really, because it just means I have a really easy question to answer, I just get frustrated that I don't feel like a group equal, that my knowledge doesn't count for anything and that they can be so childish and un-accepting.  Meh, maybe this is just the storming part of group dynamics and it'll calm down, but somehow, I don't think so.

In more exciting Dr news... I learnt how to take blood.  Eeeee!!!!!  It's actually real now.  I am bean the medical student, and no one is going to say they made a mistake and I shouldn't be here.  Tomorrow I'm going here :)  Us Devon folk are right nutters!
Tar Barrels!

Good luck GAMSAT people, not long to wait now.
Bean x


Anonymous said...

Why are you so judgmental of patients?! Believe me, you will see far more shocking things than a pregnant 20 year old- so grow up and deal with it!

Anonymous said...

You ought to be careful about the kind of things you write about patients. You are very close to breaching confidentiality. Not so sure the Medical School would be happy to see this!

Also, are you aware your PBL group could be reading this? They might feel the same about you!!!