Switching blogs

Hi everyone,

I wanted a complete revamp of this blog and decided that it would probably be easier to just start a new one.

It’s going to be similar sort of content still tracking my way through medical school with anecdotes from my life mostly focussed on the people I meet and the mental times we have.

My new web address for this blog is https://untilthepiecesfalltogether.wordpress.com/

Hope to see you all over there ūüôā

Radio Silence

I’d like to first start out this post by apologising for the radio silence over the last few months (is it that long? I’ve lost track) but I’ve been stressed with exams and deadlines.

On the plus side exams are now done which is a wonderful feeling (sorry to all of you who are still going… keep on trucking!). I have made full use so far of my free weekend with much wine and fun. I went to a cider festival yesterday at my favourite club and spent 12 hours there in a mission to win a gold card which gets me in free for the next year. I am pleased to report that the mission was successful and I am now the happy owner of a card that I probably won’t have time to use next year. Well done me. But the day was really fun so no regrets.

And I’m done with the second year of medical school. All that stands between me and a summer back at camp in America is a couple of weeks of workshops on my dissertation for next year. I can’t believe how quickly these past two years have flown. It’s also extremely scary that we have now had most of our teaching, it’s pretty much clinical from here on out! I’m very excited to leave lectures behind actually; they get very tedious after a while.

Onto the next challenge which is my research project. I’m conducting mine in colorectal cancer and looking at liver metastases and their gross characteristics and how this influences survival. It’s going to be exciting and scary to write a research paper but thankfully my supervisor is wonderful and extremely helpful. So the next two weeks involve putting all the applications etc in for the project and learning about how to do all the statistical analysis that I’ll need. Fun, fun, fun! But there is also a lot to look forward to in the next couple of weeks.

I’m involved in a 24 hour show which is exactly as it sounds; we find out, rehearse and perform the show within 24 hours. I intend to document it on this blog because I think it will be highly amusing to watch me deteriorate as I get more and more sleep deprived but I guess it’s good practice for future night shifts! So look out for that, there will probably be multiple snapchat photos involved in the telling.

Then I’m off to America so there won’t be much occurring, though I will be filling in with anecdotes from working at camp when I get back. Then it’s onto the research project and finally clinical years where I’ll hopefully have some interesting stories to tell via the old blogosphere.

Anyway, I am rather enjoying my lazy Sunday in bed so I’ll be off on that note. I’ll try and avoid the radio silence in future. Good luck to anyone still with exams, whatever the level!

Results and still no time!

So results came out… (they actually came out a while ago but I am too unorganised and didn’t write a post about them!)

I imagine you’re curious to know how I did?

I PASSED! With pretty good marks actually, averaging 83% on Neuro and 70% on Respiratory, Cardiovascular and Renal (not bad considering I did next to no revision for that particular paper).

So I’m really pleased. All my friends also passed which is wonderful and we had celebratory wine/ice cream night but are yet to go out to celebrate because none of us have any time at the moment. (Though we did go to Turtle Bay for lunch and cocktails the other day so I guess that mildly counts.)

I have also confirmed details of my project and am pretty much sorted for my return to America which is incredibly exciting! ¬†There is still so much going on at the moment though with the medical school piling on the deadlines, the usual burden of a medical degree and the two shows that I am involved in, I am metaphorically dying under the weight of my commitments. But I’m also having so much fun at the moment! In rehearsals we have a lot of banter and moral boosting things like all dancing to the Cha Cha Slide in the middle of a rehearsal for no other reason than because we want to. Lectures are also pretty interesting at the moment. We’re looking at reproductive function so all of the gags and innuendos from our lecturers vastly lighten the mood on those days when it’s just lecture after lecture. I cannot wait for clinical years now, lectures are getting a bit tiresome and it’s always nice to get out on the wards/gp surgeries and meet actual patients and learn skills that we’ll be using in the future.

On that note, I have another rehearsal to go to so I’ll be leaving things there – I hope anyone else who had results in Jan/Feb was happy with them and for those of you with impending deadlines/midterms – all the best!

Exams are done and I’m no less busy! Typical!

Exams have been and gone for over two weeks now and yet I feel much more busy and swamped with things to do than during revision time!

Whilst we’re on the subject… exams went fine for the most part as far as I can tell. I felt good about all but one of them and so we’ll have to see how that one goes. I didn’t get a chance to revise that much for it as I focussed a lot of my effort on the other content which was more challenging so if I have to retake it, I have to retake it. I’ll find out soon enough as results are literally a week today! It’s come around so fast, I can’t quite believe it. For those of you interested in the structure of pre-clinical medical school exams – certainly for my medical school anyway – we tend to have 3 each sitting. We normally have a multiple choice paper, a written paper and a practical anatomy spotter paper across two modules covering broad system areas of basic science. It’s alright actually as the exams are done within 3 days though the period of revision leading up to them is not particularly fun. Generally the pass rate is 50% but it is adjusted based on difficulty of the paper. To most people who aren’t yet at medical school that sounds astronomically easy as I’m sure you’re used to getting at least 80% for your A grades but it can be quite difficult to achieve due to the amount of content that theoretically can be covered in each¬†of these exams. Anyway, I’ll let you know how results pan out. If they’re alright I’ll no doubt be bouncing off the ceiling!

Now that exams are over though I’m more stressed than I was before, oh the irony. It’s because I (rather stupidly) have got on board with three different productions of musicals with my students union. One of them finished last week and went so well but I still have rehearsals every evening for the other two. It’s madness! Still it is good fun, I am a little bit concerned about the lack of time that I have to do work however. The module that we’re currently doing is thankfully extremely forgiving (we’re doing a gastrointestinal module which after a nervous system module focussing entirely on the central nervous system is a nice relaxing step down!). We move on in a weeks time though to a module about endocrine and life cycle which is going to be much busier and more conceptually difficult so I will have to keep on top of that.

Other exciting news (sorry this has now totally turned into a mega splurge update post) is that I will be returning to America this summer to work at the summer camp I worked for last year! I’m so excited I can’t even contain myself! For those of you unaware – which is probably everyone as I don’t think I’ve yet mentioned this on this blog – I went to Virginia last year with Camp America to work at a summer camp for adults with disabilities. It was THE most fantastic thing I’ve ever done and a couple of weeks ago I decided, screw it, and have decided to go back despite the costs etc etc. (The picture at the top of this post is a snap from my travels after camp from Santa Monica beach in LA) So immediately after the end of the semester I’ll be flying out to see all the wonderful people I met last year again. I think my medic friends are already getting bored of my over excited anecdotes from last year and the constant updates on the progress of my visa and flight booking escapades but oh well! Life is for living, you have to grab it by the horns and I won’t have a summer long enough to ever do this again so I’m going for it.

Anyhow, I will let you know the outcome of results and if anything else interesting crops up I’ll be sure to write about it.

Speaking of which I have just remembered – I had a bizarre almost out of body experience today in the anatomy lab. I was looking at a dissection in which all of the abdominal fascia and peritoneum around the spleen had been removed, hence the spleen was free enough that you could pick it up still attached by its vessels and hold the whole thing. I picked it up without really thinking and was having a conversation about something completely irrelevant with my friend when it occurred to me how casually I was holding this spleen without finding it at all strange. It’s bizarre because, however horrible, as a medical student you quickly become immune to the anatomy lab and the fact that you are looking at dead people who have kindly donated themselves for your education. There are moments in the lab when you look at the situation as though from outside eyes and realise how weird it is. I had one of those moments today whilst holding¬†that persons spleen and¬†found myself wondering about the person who the spleen belonged to. It’s unfortunately far to easy to forget that once it belonged to a walking, talking complex human being. I was reminded today of the importance to¬†take a minute to be grateful to the people who have agreed to donating their bodies for the education of medical students.

On that reflective note – until next time!

Graduating from Medical School and Hightailing it to New Zealand.

I’ve recently been looking towards the future and have come to the conclusion that as much as I love the UK I will want a change of scenery by the time I graduate. Hell, I’d be happy for a change of scenery right now.

It’s a long way off, and I imagine I will complete my foundation years here in the UK to allow me to return should I want to but I am sorely tempted to head off to NZ once I graduate.
I have looked into the USA and Canada but from things I’ve heard it seems incredibly difficult to get a training post out there. In NZ things are apparently easier and to be perfectly honest who wouldn’t want to live in a country that seems to have its work-life balance way more sorted than most other places.

Obviously this may be subject to change as I may meet someone and decide to settle down here in the UK, but I can’t help but be tempted by the more peaceful, less crowded and frankly beautiful country that is New Zealand.

It’s a dream and probably a wild one which will never happen but at the moment it is something that I’m really considering. If anyone has done this, what was it like? How did you find the process? I’m struggling to find clear, concise information about the requirements and how to go about moving over. It would be wonderful to hear from someone who has done this and who could shed some light.

Enough daydreaming for one day. I should really hit the books to make sure I get to graduation let alone to NZ!

Another Professionalism Debate

Professionalism is something that I personally reflect on a lot. I want nothing more in my medical career than to do no harm and to be professional so that I provide the best for my patients.
At medical school I always seem to be coming across situations in which I question the professionalism of the doctor/healthcare professional I am working with. I understand that in stressful situations when there is a lot to do and think about sometimes common courtesies get missed, but there are times when I see things that make me question professionalism and how we come across as medical professionals.

The case that got me thinking about this issue again this time was on our hospital placement. Each fortnight we go around the wards and practice on unsuspecting patients our history taking and examination skills. For patients this must be a really daunting prospect anyway. Our hospital tutor goes to the patients and asks them if they would be willing to talk to, and get prodded by the medical students in advance of our session and ¬†if they say yes in we go. There are six of us and you can see the shock and mild panic at the number of students on every patients face as we file into the bay and crowd round them, hemmed in by the curtain. And then our hospital tutor introduces them and we take a history/do our examination. The poor patient has to sit there whilst 6 of us go through the motions one after the other. Nothing we are subjecting them to is painful¬†and I think some of them enjoy it as a way to pass the time but there are occasions when we go in and it is clear that the patient wants to go back on their previous ‘yes’ to being a guinea pig. For example there are occasions in which the patients family are there and they clearly want to spend this time talking to their family member and not to us.
In this situation though what is the right thing to do? Should we be quick (this is often the option that our hospital tutor goes for, allowing only a couple of us to do the examination or taking a rapid fire history himself) or should we recognise that the patient doesn’t want to be examined right now and leave them be. I personally would prefer the latter. Whilst it is important for us to be able to practise examinations, none of these patients actually have signs, we are more just looking at normal at the minute so we can practice on ourselves. I don’t see that there is any need to disturb them when they clearly don’t want to be disturbed. I wonder how we come across if we don’t pick up on these signs and act accordingly and I worry that we come across as rude to the patient.

There was a specific situation during our hospital placement that made me particularly uncomfortable and after discussing it with my colleagues it was clear that they felt the same. There was a patient on the neurology ward who we went to see to practice¬†respiratory examinations. When we entered his bay it as clear that it would be difficult to take the respiratory examination as he had his arm in a sling and a neck brace on and we were informed that we shouldn’t sit him forward. He also had external fixation on one of his legs and it was difficult to get in close to him. I was expecting our hospital tutor to leave him be and not let us examine him because none of use wanted to risk hurting him but he pressed on and let one of my colleagues have a go. As soon as we entered the bay it was clear that the patient wanted to chat, he was talking in confused sentences but appeared to believe wholly that he was getting his point across. What made me uncomfortable was that our consultant completely ignored him and talked only to us. All the time that he was talking the patient was trying to get his attention to tell him his story, from what I could gather, but our consultant continued to ignore him.

This made me uncomfortable. Understandably though we were rushed for time and I know he was trying to get the best for us from an educational point of view.¬†I would have felt much more at ease if our consultant had spoken to him a little, even just said yes at the end of a few of his sentences to appear as though he was listening. This type of thing makes me question how we come across. In my mind that made him less professional but the patient, who was admittedly very confused, didn’t seem hugely fazed. Our consultant redeemed himself by talking to the patient very well after my colleague had finished her examination but it still grated on me that he had ignored him until that point.

It also makes me wonder about a larger problem. The NHS and medical care in general is supposed to put patients first and yet we as trainee doctors are constantly doing procedures which our seniors could perform better than us. How is that putting patients first? It is putting our medical education first surely? Of course new doctors have to be trained for the future well-being of patients and I suppose that finding the balance is the key.

Anyway enough reflection. I need my bed to have a productive day of revision tomorrow!

Our Future Specialty: Getting ahead of the game in medical school?

What specialty we will practice for the rest of our careers is a discussion that frequently crops up amongst my peers at medical school. We have even decided it will be quite amusing and interesting to write down the specialty that we see ourselves in and the specialty that we see each other in and open them in 6 or 7 years time to see how they match up. Could be entertaining. I honestly have no real idea what I would like to put down at the moment though.

Currently, I’ve just picked my area of interest for my BMedSci intercalated degree and have decided to do a project in something related to surgery. I’m currently in the process of chatting to supervisors and coming up with a specific project. Surgery appeals to me because of the idea of fixing the problem that is in front of you, as you see it. I have my misgivings about surgery mostly because of the sexism that still unfortunately exists around this career choice but I cannot deny my fascination with it, and no not just because of Grey’s Anatomy (though I absolutely¬†love love love¬†Grey’s on another note!). I hope that by conducting my research project in this area I can gain more insight into surgery and the demands of this career, because undoubtedly it will be a tough road should I choose to go down it.

It is extremely difficult whilst at medical school to know how to go about gaining the necessary evidence to show your investment in a particular specialty. These days we are told that because competition is fierce we should get ahead of the game and start getting some relevant experience and go to relevant conferences. On the other hand though you can’t go to conferences for every subject and specialty and¬†I don’t want to narrow down just yet. Interestingly a lot of people in their foundation years who I have spoken to have said not to worry about it too much at medical school and just to try and get exposure to specialties that you feel you would be interested in. But then again, having experience such as a¬†publication¬†in your future specialty must surely be a boost?

I recently (I say recently, I literally just) read this article in the student BMJ about what some people had said they would have done differently to smooth out their career paths with hindsight.

Here’s the link:
http://student.bmj.com/student/view-article.html?id=sbmj.g7554&locale=en_GB

(You may have to register for free to be able to read the full article, but if you are interested I’d recommend a read.)

For me at the moment I think the most relevant points are to:

–¬†Take more opportunities to experience different specialties

–¬†Ask more questions about different specialties¬†

So I will take that into my project and my chats with supervisors to try and gain some experience to see if surgery really is for me and if it’s not then I’ll take a look at some other specialties.

I think that for the most part that is the most important thing we can do in medical school, ensure that we really want to do said specialty for the rest of our careers. By all means if you are certain that being a GP is your calling then gaining relevant experience and publications/presentations in primary healthcare will help you no end but for the rest of us just working out exactly what we want to do is the first, and most important hurdle.

Anyone else reading who is currently in medical school, what are your thoughts on getting ahead of the game?

Revision… WA WA WA

Oh revision, my old pal. You never cease to visit me every Christmas do you? And every Easter, you are so thoughtful that way…

Yes this is another revision angst post and yes this is mostly a procrastinatory revision angst post. I seem to spend my entire life plonked down at our kitchen table, books spread like margarine all over said table precariously adding to the teetering tower of coffee mugs that gets gradually taller throughout the day.

It is more than a little depressing to have nothing more to do with your life than sit and learn neuroanatomy from day to day. On the bright side, one of our anatomy tutors is frankly hilarious and his emails/ e-learning resources brighten up revision considerably. For instance:

I asked him a question by email and I get this response:

Correct!

Scott,
Sent from my IPhone: Android is for suckers.

I probably laughed more than I should have at that, but in my defence revision does send me mildly insane and delirious.

Does anyone else have the need to consume endless chocolate when revising? I do. I’m convinced that over exams I should¬†put on more than half of my body weight again from the number of Smarties that I eat. Smarties are particularly good for revision motivation as you can make a to-do list and put a Smartie next to each item so that when you complete it, you get to eat it! What could be better? My issue is that I just eat them all after achieving one thing on my list, and then move onto the biscuits.
I am of course completely exaggerating. Though I am partial to a packet of Smarties here and there when revising.

To be fair, this year I have drastically cut out my procrastination. I used to be a queen but I seem to be flunking my procrastination class this year. This is, of course, wonderful for my marks. I used to do¬†anything¬†to get out of revision, including pulling out the fridge/freezer to clean behind it something that never otherwise gets done. I also pick back up old hobbies whilst I have no time for them, such as writing. I am in the process of writing a book but I am useless at writing with any regularity and yes, you guessed it, I suddenly get the urge to get writing regularly again when the revision season comes around…¬†typical.¬†Still I’m much better these days and can survive most of the day without procrastination.

She says…. writing a procrastinatory blog post.

Well on that note, I will leave you and return to the coffee cup mountain covered with worksheet snow.

Farewell, see you on the other side of exams. Best of luck with any of your revision everyone.

Thank you for reading!

The Theory of Everything

There was no better way to see in the¬†New Year today than by watching the wonderful movie that is ‘The Theory of Everything’. For those of you unsure, this is the new film about the life of Steven Hawking and his progressive journey through life¬†with Motor Neuron disease. He was given approximately two years to live but he is still with us today.¬†As¬†a future medic I found this film extremely thought provoking. One line particularly caught my attention,

‘Your thoughts won’t change, it is just that soon people won’t know about them’.¬†

This quote, I think,  profoundly sums up the suffering of those with motor neuron disease. To be totally aware of your decline, to have your thoughts as intact as they were from the days when you can still walk to the days where you require constant assistance must be torturous.

This movie has captured that struggle immensely well and I cannot commend Eddie Redmayne enough for his highly considered performance. I am so glad I watched this film as I think I understand this suffering to a greater level now.

I have a new found respect for Steven Hawking and the incredible hurdles he has overcome, both personal and professional. He is one of the greatest minds of our time and he has not let his MND sway him from his work. He is an inspiration.

I’ll leave you with this quote which contains a mentality I wish to adopt for the New Year:

‘However difficult life may seem, there is always something you can do and succeed at.’

Thank you, and Happy New Year!

Christmas is Nearing!

I have a bit of a love/hate relationship with the Christmas holidays, on the one hand, the tinsel covered festive hand, I love Christmas because I get to spend time with my family and eat nice home cooked meals for once. On the other, pen covered hand, shrewn with paper cuts it is the time of revision and more revision in prep for January exams.

I’m sure most people with January exams will agree that it is really hard to enjoy Christmas to its full extent due to the never ending feeling of guilt that follows you everywhere when you aren’t working. Even on Christmas day I fell guilty which is ludicrous, and have been known to ram in a little bit of revision on Christmas day itself in the mornings whilst waiting for my teenage brother to surface from his duvet cocoon.

This year though it’s sure to be even worse because coming up in Jan are the exams that are notoriously the ones that people at my medical school are most likely to fail simply because of the volume of neuroanatomy we are expected to know. I have been trying to start revision now but¬†with all the secret santas to organise and the shows I’m directing/am in and auditions coming up I just have no time.

Lets hope I get the balance right! Good luck to everyone else starting your revision – you’re not alone in your pain!

And Merry Advent!

(Still need to get myself an advent calender – the picture of organisation as ever.)