Saturday, 31 March 2012

Hell Week Debrief

Hell week is over and I'm a week through Easter Holidays.  I got my AMK results back and I'm very happy to say I'm back on track.  I'm up from 28.4 to 38.4 and back in the top half of the cohort.  I was a little more cautious this time and answered less questions; too few to be honest.   They say you should aim for half right and half wrong, and I got 54 right and 24 wrong, so I should attempt a few more next time.  I'm still waiting for the results of the competencies.  I think I've passed all bar one but it might work out ok in moderation.  I was so annoyed with myself because it's the iv cannulation one I've probably failed - the one I practised over and over until I had it down slick.  I made such a silly mistake, worse because I didn't know it was a mistake.  I got flashback and it started dribbling out the end so I put my thumb over the hole to stem the flow.  I had gloves on and the last thing I touched was an alcohol swab so I thought it would be fine, but apparently that's still contamination.  So frustrated with myself!  I've heard Plymouth people got failed if they didn't get flashback so I'm hoping when they moderate the scores I'll come out all right.  I'm not too worried about it because you get several chances to pass and that was the only mistake I made so I'm sure I'll rock it next time.

Sunday, 11 March 2012

Hell Week

This coming week I'm asking for all your good thoughts my way please, we're about to enter what we are affectionately calling Hell Week.
Monday: PBL feedback session presenting our findings to our small group
Tuesday: Competency exams in IV cannulation, cranial nerves and motor examination
Wednesday: PBL feedback and the third AMK of the year
Thursday: Competencies in choking baby, choking child, paediatric basic life support, basic airway management and adjuncts and basic life support with 2 rescuers
Friday: Part 2 of PBL feedback, if we haven't done it Wednesday morning because we are trying to reschedule it so it's not the morning of the AMK.

Not looking forward to this week much.  It's a spectacular fail in timetabling, or it's just a ploy to test us to see how we cope under pressure.  Either way, not a happy bean.

Sunday, 4 March 2012

Differential Diagnosis Of...

After the nice break for study week we were straight back in with cervical cancer this fortnight.  It was quite a light case compared to the last two, which should be nice, but just gives me a feeling of unease that I've missed something.  Our PBL facilitator is a consultant at the hospital and normally rips it out of us each week.  He talks really quietly, and it's not unless you listen carefully you realise he's just said something sarcastic about what an utter moron you are for deigning to offer such a ridiculous answer.  It's good practice for next year on the wards, but until now every facilitator we've had has been sickeningly sweet and lovely.  Well, with the exception of my last one of course, whose reply to me being 10 minutes late for class and hopping in on crutches was "I've sprained my ankle and I still managed to cross London with three tube changes to get to my lectures on time and I didn't need crutches".  Well bully for you.

Our current facilitator doesn't like fluffy stuff, hard science and management plans only please.  It's not enough to know what drug to give in a situation, we have to know dosages and timings as well.  Don't get me wrong, I love him and wouldn't have anyone else.  I feel like I learn so much more, it's just taken a bit of adjusting too.  He always prepares a slideshow of real life cases he's seen relating to the topic for the fortnight, and we play a what's wrong and what would you do game.  Gynae though, is really far from his speciality and he's been eerily quiet this time.  We'll give an answer to a question and cast a sly glance his way to see if he's about to erupt or if we've done well.  He's just been sitting there nodding silently.  His only contribution was to dissolve into fits of giggles and ask us differential diagnoses for a female with pneumoperitoneum.  We hesitently suggested trauma or infection.  Parachuting apparently, something he remembered from his med school days.  The air goes up and out through the tops of the fallopian tubes.  I just have images of fimbriae flapping in the breeze.  I know, I know, there's fluid, but that doesn't make such a pretty picture.  Colposcopy is apparently more likely to cause this through the same mechanisms though.