After another long hiatus, I am back! This time as a worldly (joking) F2 doctor.
I was lucky and thoroughly enjoyed my F1 year - a fantastic and supportive DGH, where by the end we felt like a bunch of close knit friends. It was a steep learning curve, and at times could be tough, but overall I had a great time.
F2 has been a step up - I've moved to a a big central London teaching hospital, and went from being a relatively protected F1, to suddenly 'the SHO on call'; is there any worse role than being the medical ward cover SHO? Perhaps second only to the on call med reg.
I started off on surgery which I quite enjoyed, relaxed ward days, lots of theatre time, but the nights and on calls were tricky. As SHO you accept referrals and run the take (very different to medicine), which was pretty daunting! I went from being a bit clueless to seeing 15+ 'RIF pain ?appendicitis' in a day. During this job I was making decisions about whether or not to apply for core surgical training (CST), despite really enjoying surgery, I found the lifestyle tough. I looked into alternatives; interventional radiology? GP with a specialist interest in minor surgery? In the end I did a taster week in Ophthalmology and ended up loving it - a good mix of medicine and surgery, mainly outpatient and well patients, great lifestyle, lots of scope for academia, and also - never ever having to do ward cover. So I put a tentative application in!
Of course I had managed to pick one of the most competitive specialties going - it ended up being a lot of hard work; trying to maximise portfolio points, revising for the MSRA exam, and then the interview felt like an exam itself. I have to stay in London for reasons relating to my non-medical partner, so have fully accepted I might not get a job this round and may need to apply next year. But still, fingers crossed, aye. I did um and arr about taking an F3, but ultimately I am not keen on the locuming life, preferring to have stability, also I am not the best traveller! A month away is the maximum for me personally, so an exotic year in Auz/ NZ/ elsewhere wasn't really for me. I have applied for some research and teaching jobs as a back up.
I have GP next which I am nervous about, but hopefully can learn lots and enjoy all my free weekend and evenings in the summer sun!
Until next time
18 February 2020
06 January 2019
Working as an F1 doctor
Hello and happy new year!
I am back from a blogging hiatus. It turns out being a doctor keeps you quite busy.
I am currently on my second block of F1 which is geriatrics, after a first four months of Orthopaedics.
I loved Orthopaedics! Everyone was providing me with horror stories of managing 60 dying patients alone as my seniors bullied me, but luckily this was not my experience at all. I had a fab team and I got on very well with the other juniors. Yes, the Reg's perhaps weren't the best with medical problems, but they were useful for Ortho problems and very nice to us all. I got quite a lot of time in theatre and in clinic, and I really feel like surgery is more for me. I enjoy the management side of things, being in theatre, the practical skills such as pulling a joint, and also that you often know exactly what's wrong with your patients.
Whilst Geriatrics has been lovely with a very supportive team, I don't particularly enjoy the unselected medical take, trying to pick apart why exactly a patient has come into hospital, and then after multiple investigations diagnosing '1) UTI, 2) Delirium secondary to UTI'...
Having said that, I am learning lots on this block and there is definitely a we're-all-in-this-together atmosphere with medical teams, especially during my 13h christmas eve shift on take.
I have seen some interesting cases such as encephalitis, pericarditis, CNS lymphoma, amongst others, but still unsure if that beats an open tib/fib fracture.
Everyone says, and it's true, that being an F1 is a massive (seemingly endless) learning curve. I have definitely felt this - remembering my first day nervous as a kitten on the ward round, sweating in the 35C heat wave and nervous I would forget everything. With each ill patient, with each new scenario, I feel more confident and more settled in.
Not to say I am now some amazing doctor! I still have lots of unsure moments, and lots of times when I feel wholly out of depth and stressed, but I'm definitely improving and slowly getting there.
Some of my colleagues have been having tough times and getting very stressed - remember to look after yourselves out there.
Looking forward to the rest of F1, I mainly feel quite excited! I really like my hospital, it's small and nice and supported. I'm going to start thinking about speciality exams and all that other stuff, a pretty scary prospect. And hopefully the moments where I feel overwhelmed and terrified will become less often...
Happy 2019 to everyone!
I am back from a blogging hiatus. It turns out being a doctor keeps you quite busy.
I am currently on my second block of F1 which is geriatrics, after a first four months of Orthopaedics.
I loved Orthopaedics! Everyone was providing me with horror stories of managing 60 dying patients alone as my seniors bullied me, but luckily this was not my experience at all. I had a fab team and I got on very well with the other juniors. Yes, the Reg's perhaps weren't the best with medical problems, but they were useful for Ortho problems and very nice to us all. I got quite a lot of time in theatre and in clinic, and I really feel like surgery is more for me. I enjoy the management side of things, being in theatre, the practical skills such as pulling a joint, and also that you often know exactly what's wrong with your patients.
Whilst Geriatrics has been lovely with a very supportive team, I don't particularly enjoy the unselected medical take, trying to pick apart why exactly a patient has come into hospital, and then after multiple investigations diagnosing '1) UTI, 2) Delirium secondary to UTI'...
Having said that, I am learning lots on this block and there is definitely a we're-all-in-this-together atmosphere with medical teams, especially during my 13h christmas eve shift on take.
I have seen some interesting cases such as encephalitis, pericarditis, CNS lymphoma, amongst others, but still unsure if that beats an open tib/fib fracture.
Everyone says, and it's true, that being an F1 is a massive (seemingly endless) learning curve. I have definitely felt this - remembering my first day nervous as a kitten on the ward round, sweating in the 35C heat wave and nervous I would forget everything. With each ill patient, with each new scenario, I feel more confident and more settled in.
Not to say I am now some amazing doctor! I still have lots of unsure moments, and lots of times when I feel wholly out of depth and stressed, but I'm definitely improving and slowly getting there.
Some of my colleagues have been having tough times and getting very stressed - remember to look after yourselves out there.
Looking forward to the rest of F1, I mainly feel quite excited! I really like my hospital, it's small and nice and supported. I'm going to start thinking about speciality exams and all that other stuff, a pretty scary prospect. And hopefully the moments where I feel overwhelmed and terrified will become less often...
Happy 2019 to everyone!
11 June 2018
5th year in review
I have enjoyed 5th year, it was much more relaxed than the notoriously difficult 4th year, and it was nice to get back to general medicine and surgery after focusing on clinical specialities.
It started off with an amazing elective - I headed down under and spent most of my time on a massive road trip in a trusty bright yellow 4x4, and did very little medicine...
Choosing a deanery
Next 5th year begins, with a whirlwind of career talks it suddenly all feels very real - FPAS, UKFPO, SJT, EPM, PSA, what does it all mean!? Before I knew it was I was going to be making very serious life choices with very little information, as the foundation programme applications opened up in October.
This is a little gripe I think we all have in medicine, it's hard to think of many other job examples where you apply for the location of the job 10 months in advance, with very little information about the jobs/ availability/ working conditions, or anything really. My non-medic partner finds the whole process bizarre, and soon I felt like I needed to make a powerpoint to explain the convoluted application process to all my family members.
Eventually we decided to move down to London, and I tentatively researched the 3 deaneries and was horrified to see the score cut offs and competition ratios. This led to a lot of tooing and froing but I got a good decile + intercalation, and put down North East and Central London. This was mainly because most of the hospitals were actually in London, and it seemed a bit more affordable and nice to live in than North West London. South Thames was too sprawling for me, the idea of a guaranteed long commute didn't appeal!
Luckily this year we were allowed to change our deanery choices up to February, which I think a lot of people ended up doing last minute out of stress! I will leave it to you whether you think this is a good thing or a bad thing.
Our placements were mainly a mix of medicine and surgery with 4 weeks of GP. I found (to my horror) I was enjoying surgery more and more. I had always thought of myself as a proper medic, no cutting here thank you. But as I found myself gravitating to theatres (by choice!) and revelling in interesting cases, x-rays, and CT scans, I couldn't deny the growing enjoyment I was feeling. This led to some serious soul-searching, and massively influenced by job ranking for F1 and F2.
I've never been the best attendee... I did start to feel a bit guilty about missing empty afternoons on the ward, and or the 3rd IBD clinic of the month. I wonder if this is universal to medics? Talking to my friends it appeared lots of people skipped seemingly pointless aspects of placement, to go to the library and do more productive learning. I suppose it's an important part of being an adult learner, you identify what you actually need to go to! But I think now that I am a few weeks away from being an F1, I am desperately regretting leaving at 2pm on Friday - what if I missed a clinical scenario I will now be faced with alone! I suppose this is all part of the 'new doctor' jitters.
SJT and PSA
The year plodded on, I found the SJT a very challenging exam time-wise, and had about 30 seconds to spare at the end. I hadn't paid for any expensive courses, or bought any books, and I worried I would be at a disadvantage, but in the end did well. The PSA (prescribing exam) was fine really, if you can quickly search the BNF you will be okay!
I passed the PSA with a good margin, and managed to get 46 on my SJT! I was in absolute shock. It was a snowy day and I woke up to about 50 texts off various medic friends with their news and asking about mine. I still remember logging in and being manically happy and seeing I had got my first choice deanery. That good mood stayed with me for days!
There will also be friends who have not got what they wanted - it's important to check up on these people, and make sure they know they're cared for, and it's not a reflection of them as a person. I had a friend who missed out on his first choice deanery by one mark, and he was devastated - it's sad that the process appears to be such a lottery, and as he will honestly be a fantastic doctor.
Choosing jobs
Then comes the very stressful process of ranking jobs. In my deanery, you are essentially sent a spreadsheet with 300+ jobs, and are asked to rank them. There was no information online about any of the jobs, and I essentially just googled the hospitals. Luckily I was in a Facebook group where a few F1/F2s from the same deanery posted some reviews, I would have loved a bit more information though!
The process was markedly different across the deaneries - in some you were further subdivided and had to rank areas of the deanery before choosing jobs, in some they went even further and you picked hospitals and then only had about 10 job options to choose from.
I found the whole thing very stressful, it felt like it was a massive choice, deciding your entire life for the next 2 years.
It was a careful balance between location and jobs, with a seemingly perfect job combination, but one year is a bit of a commute away at a hospital with a bad reputation. In the end I tried to settle on location as my first priority.
My main job factors were to avoid A&E - I really did not fancy spending my winter in an understaffed, at-breaking-point A&E department. Many people were surprised at this, as they want to locum in A&E, but it's not for me at all. I also wanted a surgical job at the beginning of F2 to see if it seriously for me, and a possible career choice. This was actually incredibly difficult - there was at least 20+ with no surgery at all (not even OBGYN/ITU - apparently A&E can count?), and very few with surgery + no A&E.
In the end I managed to get my first choice at 2 fantastic hospitals (actually in London) - including 2 surgical jobs, gentle GP for a break, cardiology which I really enjoy, with no A&E or Psych (awful for some, but a dream for me!).
Ultimately you have to do whats best for you - if you don't have the most competitive score, you might put rotations with more undesirable specialities further up (i.e. psych) if its hospitals you really want, etc etc.
Finals
After all the excitement of everyone getting their jobs and deaneries, real life begins. I feel like finals snuck up on me, I had been so focused on other things. It didn't feel like last year, where I worked incredibly hard year round, terrified of the notoriously difficult exams.
Lots of people use 'Alasdair Scotts' notes - whilst they are a fantastic resource, I prefer writing and revising from my own, mainly using OHCM, patient.co.uk and passmedicine. Also some of his management plans are a little out of date.
I tend to revise in the library, finding being stuck at home too lonely. We all plodded through passmed and our notes, laughing at the same question comments and finding the same things hard.
I also spent 1-2 days a week doing about 5-6 hours of OSCE's. I find OSCE revision considerably more draining and difficult than revising for written/ picture exams. All the talking, all the preparation. As a little group we wrote our own stations and used books, which seemed to work well.
Now, all the advice from friends in the year above had been 'the written aspect is so simple you could sit it at the beginning of 5th year and pass, the OSCEs are brutal' - this turned out to the complete opposite. Perhaps med school like to mix it up?
The OSCEs were very fair and really okay, there was some stations I clearly messed up on and found challenging, but overall they were similar to what I was expecting. The written on the other hand, ye God. It was a brutal. Anyways, all over now!
After finals we had a long and good celebration, including lots of BBQs, nights out, and a weekend away medic grad ball, which was so fantastic, I will cherish all my memories dearly.
After all the ups and downs, the amazing experiences, friends, relationships, and genuinely farcical moments, I really can't believe it's all over.
Well med school, you've been a ride, what a joyous experience.
To a new chapter and beginning!
It started off with an amazing elective - I headed down under and spent most of my time on a massive road trip in a trusty bright yellow 4x4, and did very little medicine...
Choosing a deanery
Next 5th year begins, with a whirlwind of career talks it suddenly all feels very real - FPAS, UKFPO, SJT, EPM, PSA, what does it all mean!? Before I knew it was I was going to be making very serious life choices with very little information, as the foundation programme applications opened up in October.
This is a little gripe I think we all have in medicine, it's hard to think of many other job examples where you apply for the location of the job 10 months in advance, with very little information about the jobs/ availability/ working conditions, or anything really. My non-medic partner finds the whole process bizarre, and soon I felt like I needed to make a powerpoint to explain the convoluted application process to all my family members.
Eventually we decided to move down to London, and I tentatively researched the 3 deaneries and was horrified to see the score cut offs and competition ratios. This led to a lot of tooing and froing but I got a good decile + intercalation, and put down North East and Central London. This was mainly because most of the hospitals were actually in London, and it seemed a bit more affordable and nice to live in than North West London. South Thames was too sprawling for me, the idea of a guaranteed long commute didn't appeal!
Luckily this year we were allowed to change our deanery choices up to February, which I think a lot of people ended up doing last minute out of stress! I will leave it to you whether you think this is a good thing or a bad thing.
Our placements were mainly a mix of medicine and surgery with 4 weeks of GP. I found (to my horror) I was enjoying surgery more and more. I had always thought of myself as a proper medic, no cutting here thank you. But as I found myself gravitating to theatres (by choice!) and revelling in interesting cases, x-rays, and CT scans, I couldn't deny the growing enjoyment I was feeling. This led to some serious soul-searching, and massively influenced by job ranking for F1 and F2.
I've never been the best attendee... I did start to feel a bit guilty about missing empty afternoons on the ward, and or the 3rd IBD clinic of the month. I wonder if this is universal to medics? Talking to my friends it appeared lots of people skipped seemingly pointless aspects of placement, to go to the library and do more productive learning. I suppose it's an important part of being an adult learner, you identify what you actually need to go to! But I think now that I am a few weeks away from being an F1, I am desperately regretting leaving at 2pm on Friday - what if I missed a clinical scenario I will now be faced with alone! I suppose this is all part of the 'new doctor' jitters.
SJT and PSA
The year plodded on, I found the SJT a very challenging exam time-wise, and had about 30 seconds to spare at the end. I hadn't paid for any expensive courses, or bought any books, and I worried I would be at a disadvantage, but in the end did well. The PSA (prescribing exam) was fine really, if you can quickly search the BNF you will be okay!
I passed the PSA with a good margin, and managed to get 46 on my SJT! I was in absolute shock. It was a snowy day and I woke up to about 50 texts off various medic friends with their news and asking about mine. I still remember logging in and being manically happy and seeing I had got my first choice deanery. That good mood stayed with me for days!
There will also be friends who have not got what they wanted - it's important to check up on these people, and make sure they know they're cared for, and it's not a reflection of them as a person. I had a friend who missed out on his first choice deanery by one mark, and he was devastated - it's sad that the process appears to be such a lottery, and as he will honestly be a fantastic doctor.
Choosing jobs
Then comes the very stressful process of ranking jobs. In my deanery, you are essentially sent a spreadsheet with 300+ jobs, and are asked to rank them. There was no information online about any of the jobs, and I essentially just googled the hospitals. Luckily I was in a Facebook group where a few F1/F2s from the same deanery posted some reviews, I would have loved a bit more information though!
The process was markedly different across the deaneries - in some you were further subdivided and had to rank areas of the deanery before choosing jobs, in some they went even further and you picked hospitals and then only had about 10 job options to choose from.
I found the whole thing very stressful, it felt like it was a massive choice, deciding your entire life for the next 2 years.
It was a careful balance between location and jobs, with a seemingly perfect job combination, but one year is a bit of a commute away at a hospital with a bad reputation. In the end I tried to settle on location as my first priority.
My main job factors were to avoid A&E - I really did not fancy spending my winter in an understaffed, at-breaking-point A&E department. Many people were surprised at this, as they want to locum in A&E, but it's not for me at all. I also wanted a surgical job at the beginning of F2 to see if it seriously for me, and a possible career choice. This was actually incredibly difficult - there was at least 20+ with no surgery at all (not even OBGYN/ITU - apparently A&E can count?), and very few with surgery + no A&E.
In the end I managed to get my first choice at 2 fantastic hospitals (actually in London) - including 2 surgical jobs, gentle GP for a break, cardiology which I really enjoy, with no A&E or Psych (awful for some, but a dream for me!).
Ultimately you have to do whats best for you - if you don't have the most competitive score, you might put rotations with more undesirable specialities further up (i.e. psych) if its hospitals you really want, etc etc.
Finals
After all the excitement of everyone getting their jobs and deaneries, real life begins. I feel like finals snuck up on me, I had been so focused on other things. It didn't feel like last year, where I worked incredibly hard year round, terrified of the notoriously difficult exams.
Lots of people use 'Alasdair Scotts' notes - whilst they are a fantastic resource, I prefer writing and revising from my own, mainly using OHCM, patient.co.uk and passmedicine. Also some of his management plans are a little out of date.
I tend to revise in the library, finding being stuck at home too lonely. We all plodded through passmed and our notes, laughing at the same question comments and finding the same things hard.
I also spent 1-2 days a week doing about 5-6 hours of OSCE's. I find OSCE revision considerably more draining and difficult than revising for written/ picture exams. All the talking, all the preparation. As a little group we wrote our own stations and used books, which seemed to work well.
Now, all the advice from friends in the year above had been 'the written aspect is so simple you could sit it at the beginning of 5th year and pass, the OSCEs are brutal' - this turned out to the complete opposite. Perhaps med school like to mix it up?
The OSCEs were very fair and really okay, there was some stations I clearly messed up on and found challenging, but overall they were similar to what I was expecting. The written on the other hand, ye God. It was a brutal. Anyways, all over now!
After finals we had a long and good celebration, including lots of BBQs, nights out, and a weekend away medic grad ball, which was so fantastic, I will cherish all my memories dearly.
After all the ups and downs, the amazing experiences, friends, relationships, and genuinely farcical moments, I really can't believe it's all over.
Well med school, you've been a ride, what a joyous experience.
To a new chapter and beginning!
04 June 2018
Passed finals - Doctor here I come!
So, I've passed finals and made it! Officially a Doctor.
It feels absolutely insane - how much I've changed since I started this blog in 2009, writing thought out and lengthy pieces about medicine applications, to now, choosing a foundation school, ranking jobs, and ultimately finishing med school.
5th year has been great, and I currently feel warm with nostalgia.
August sees me moving down to the Big Smoke to start my new life as an F1, and what a journey it has been.
Many congratulations to any other finalists out there - we're doctors!
It feels absolutely insane - how much I've changed since I started this blog in 2009, writing thought out and lengthy pieces about medicine applications, to now, choosing a foundation school, ranking jobs, and ultimately finishing med school.
5th year has been great, and I currently feel warm with nostalgia.
August sees me moving down to the Big Smoke to start my new life as an F1, and what a journey it has been.
Many congratulations to any other finalists out there - we're doctors!
29 December 2016
Acute care 'sharp end' of medicine
My rotation just passed involved all the areas of acute care - anaesthetics, ED, ICU etc. It was fab as a medical student, especially on ED. Getting your own patients to clerk, do bloods and investigations on, take round to CT, refer and discuss with seniors, actually made me feel like a doctor. I felt useful and part of the team, helping to bring the waiting time down and doing jobs for everyone.
I was at a major trauma centre so my time on resus was great, very '24 hours in A&E', and also fascinating medicine. The acute assessment and diagnostic side of things is so interesting, especially with all the ultrasound technology etc. they have. Trauma pathophysiology really grabbed me, and also lead me to pick up a physiology book for the first time in about three years.
I can really understand how the faster paced, 'sharp end' of medicine grabs people, but I think for me I would miss the follow-up too much. Even now there's still patients who float into my head and I wonder what happened to them after they were wheeled away.
There were also some incredibly upsetting cases, a neonatal death, multi-mortality RTC etc. I can imagine it is a very emotionally draining speciality.
For example, an elderly lady was brought in with type 1 respiratory failure, severe confusion and drowsiness, and x-ray showed a florid chest infection. She was already elderly with multiple co-morbidities, and BiPAP on resus was failing to bring her O2 sats up. A quick decision needed to be made about escalation of care and DNACPR status, all the while still waiting for her family to arrive. Emotionally difficult for all involved, as DNACPR was decided and the lady eventually went into cardiac arrest and passed. Dealing with death in such a fast-paced way was not something I was used to. Previously, my main experiences with death had been in a Palliative setting, where it is profoundly prepared for, still upsetting, but much more time and consideration has gone into 'planning the death' for want of a better phrase. Although, the consultant told me it was unusual for someone like this lady (in a care home etc.) to not already have a DNACPR decision in place.
Anaesthetics was okay, I got to intubate, do lots of cannulas and LMA's, but I just didn't really enjoy it, not sure why. Maybe it was because of the acute NHS bed crisis, something that underlined all of my time in acute medicine actually. At least one list a day (normally many more) was cancelled due to there being no beds, meaning there was lots of running from theatre to theatre trying to catch them in time to be useful. Then of course there was competition with ODP students, paramedic students, and other medical students! I just always felt like I was awkwardly stood in corridors knocking on scrub windows and bothering people, maybe I just need more confidence.
I enjoyed ICU, but I didn't feel like I could do very much. And my feet! The agony! Those 12 hour shifts with little to do left me dreaming of bringing my own chair to sit on.
Overall, whilst really enjoying my time on the various acute specialities, I don't think they're for me. I can really appreciate why a F2 job in ED would be invaluable though, I feel like I learnt so much there.
I was at a major trauma centre so my time on resus was great, very '24 hours in A&E', and also fascinating medicine. The acute assessment and diagnostic side of things is so interesting, especially with all the ultrasound technology etc. they have. Trauma pathophysiology really grabbed me, and also lead me to pick up a physiology book for the first time in about three years.
I can really understand how the faster paced, 'sharp end' of medicine grabs people, but I think for me I would miss the follow-up too much. Even now there's still patients who float into my head and I wonder what happened to them after they were wheeled away.
There were also some incredibly upsetting cases, a neonatal death, multi-mortality RTC etc. I can imagine it is a very emotionally draining speciality.
For example, an elderly lady was brought in with type 1 respiratory failure, severe confusion and drowsiness, and x-ray showed a florid chest infection. She was already elderly with multiple co-morbidities, and BiPAP on resus was failing to bring her O2 sats up. A quick decision needed to be made about escalation of care and DNACPR status, all the while still waiting for her family to arrive. Emotionally difficult for all involved, as DNACPR was decided and the lady eventually went into cardiac arrest and passed. Dealing with death in such a fast-paced way was not something I was used to. Previously, my main experiences with death had been in a Palliative setting, where it is profoundly prepared for, still upsetting, but much more time and consideration has gone into 'planning the death' for want of a better phrase. Although, the consultant told me it was unusual for someone like this lady (in a care home etc.) to not already have a DNACPR decision in place.
Anaesthetics was okay, I got to intubate, do lots of cannulas and LMA's, but I just didn't really enjoy it, not sure why. Maybe it was because of the acute NHS bed crisis, something that underlined all of my time in acute medicine actually. At least one list a day (normally many more) was cancelled due to there being no beds, meaning there was lots of running from theatre to theatre trying to catch them in time to be useful. Then of course there was competition with ODP students, paramedic students, and other medical students! I just always felt like I was awkwardly stood in corridors knocking on scrub windows and bothering people, maybe I just need more confidence.
I enjoyed ICU, but I didn't feel like I could do very much. And my feet! The agony! Those 12 hour shifts with little to do left me dreaming of bringing my own chair to sit on.
Overall, whilst really enjoying my time on the various acute specialities, I don't think they're for me. I can really appreciate why a F2 job in ED would be invaluable though, I feel like I learnt so much there.
First rotation of 4th year
I'm back in medicine after a year out intercalating, and whilst it has been nice to get back into clinical practise I was apprehensive. Trying to remember which blood bottles were for what, and even a basic neurological exam proved difficult for me on the first week back.
However, I did have a gentle start back I was on a oncology attachment at a DGH. I really enjoyed oncology, and am starting to think it might be the speciality for me. I feel like the marriage of science and art is ever present in it, as you utilise complex cellular, pharmacological and radiological knowledge, with a truly holistic approach to your patients. Working in a DGH and staying in hospital accomodation was nice as well. I really got to know the whole team and the clinical areas, and felt like I had more autonomy over my timetable than you find in the large teaching hospitals.
In DGH's I feel like you get a lot more teaching, and have much more free reign of the hospital. In the main city I train in, you often feel like a redundant spare part, taking up precious space and time.
The actual oncology attachment mainly involved clerking patient's and sitting in on clinics. I tried to make sure I clerked with patients with common oncological emergencies, like spinal cord compression and neutropenic sepsis. One (obvious) hard thing in oncology was of course the devastating impact cancer has on patients and their loved ones. I saw an absolutely lovely lady who presented with spinal cord compression, after being in remission for 9 years. Her and her husband were incredibly anxious and distressed, but trying to stay positive. Her bone biopsy quickly confirmed that it indeed was a recurrence of her previous cancer, with a prognosis of <1 year to live, really grim. Despite that though, the patients were truly wonderful - I know that is a cliché, but it is the truth, and with the constant advancements in technology and treatments, there is huge motivation and drive within all the staff. The doctors and nurses were all kind and a lot of fun, this reminded me of some advice an orthopaedic surgeon once gave me 'find a speciality where you get on with everyone', promising!
Next I had a placement on GP, I find GP a snooze-fest, but I understand it's important. Our GP practise was particularly bad, we seemed to have 1-2 hours of clinic in the morning, a 4 hour gap, and then 1 hour of teaching in the afternoon... My placement group and I spent most of our time sat in a small pre-fab building doing SDL. I didn't see a patient alone until the end of my second week, back in 3rd year I had solo clinics daily! The disparity between different placements is always maddening, but hard to avoid for med school I guess. To be honest it probably didn't help that it was almost 1.5 hours drive away, adding a lovely 3 hour commute to what started to seem like a pointless day.
I just struggle to see the appeal of GP, I know it means you won't have nights and weekends, but honestly sitting in a room alone all day, trying to sort out complex (mainly) psychosocial problems and vague symptoms in 10 minutes, being continually vilified in the press, sounds like my idea of hell.
Once interesting difference was this was the first GP I was in to employ a physician associate (PA), a relatively new profession within healthcare, essentially brought in as a quick fix to plug the gap in doctors (as far as I can tell). It was an... interesting experience. Not necessarily positive, I've had much better experiences with hospital PA's. I can see the positives of the scheme, but I think PA's competencies needs to be more widely defined and understood, to be utilised properly.
Anyways, this once again just cemented that GP is not for me. We were all absolutely buzzing as we drove away for the last time.
However, I did have a gentle start back I was on a oncology attachment at a DGH. I really enjoyed oncology, and am starting to think it might be the speciality for me. I feel like the marriage of science and art is ever present in it, as you utilise complex cellular, pharmacological and radiological knowledge, with a truly holistic approach to your patients. Working in a DGH and staying in hospital accomodation was nice as well. I really got to know the whole team and the clinical areas, and felt like I had more autonomy over my timetable than you find in the large teaching hospitals.
In DGH's I feel like you get a lot more teaching, and have much more free reign of the hospital. In the main city I train in, you often feel like a redundant spare part, taking up precious space and time.
The actual oncology attachment mainly involved clerking patient's and sitting in on clinics. I tried to make sure I clerked with patients with common oncological emergencies, like spinal cord compression and neutropenic sepsis. One (obvious) hard thing in oncology was of course the devastating impact cancer has on patients and their loved ones. I saw an absolutely lovely lady who presented with spinal cord compression, after being in remission for 9 years. Her and her husband were incredibly anxious and distressed, but trying to stay positive. Her bone biopsy quickly confirmed that it indeed was a recurrence of her previous cancer, with a prognosis of <1 year to live, really grim. Despite that though, the patients were truly wonderful - I know that is a cliché, but it is the truth, and with the constant advancements in technology and treatments, there is huge motivation and drive within all the staff. The doctors and nurses were all kind and a lot of fun, this reminded me of some advice an orthopaedic surgeon once gave me 'find a speciality where you get on with everyone', promising!
Next I had a placement on GP, I find GP a snooze-fest, but I understand it's important. Our GP practise was particularly bad, we seemed to have 1-2 hours of clinic in the morning, a 4 hour gap, and then 1 hour of teaching in the afternoon... My placement group and I spent most of our time sat in a small pre-fab building doing SDL. I didn't see a patient alone until the end of my second week, back in 3rd year I had solo clinics daily! The disparity between different placements is always maddening, but hard to avoid for med school I guess. To be honest it probably didn't help that it was almost 1.5 hours drive away, adding a lovely 3 hour commute to what started to seem like a pointless day.
I just struggle to see the appeal of GP, I know it means you won't have nights and weekends, but honestly sitting in a room alone all day, trying to sort out complex (mainly) psychosocial problems and vague symptoms in 10 minutes, being continually vilified in the press, sounds like my idea of hell.
Once interesting difference was this was the first GP I was in to employ a physician associate (PA), a relatively new profession within healthcare, essentially brought in as a quick fix to plug the gap in doctors (as far as I can tell). It was an... interesting experience. Not necessarily positive, I've had much better experiences with hospital PA's. I can see the positives of the scheme, but I think PA's competencies needs to be more widely defined and understood, to be utilised properly.
Anyways, this once again just cemented that GP is not for me. We were all absolutely buzzing as we drove away for the last time.
27 April 2016
Intercalation year
Hello,
Long time no speak as per! This junior doctor contract malarky led me back to the Blog-sphere reading Doctor's opinions, and I thought it was about time I revisited this old place. I still get weekly emails from GCSE students asking me about their grades, but sadly my friends, and even my friends siblings, are far from GCSE age and I honestly don't know what the situation is at the moment.
I have heard applications for medicine are down by 18%, so maybe this is the best time to apply!
I have taken a year out of clinical medicine to intercalate this year, and I'm really glad I did. I chose a degree that was 50% research based (I missed science a little bit) and I feel like I've learnt a lot of invaluable skills, not to mention possibly getting a publication out of it (fingers crossed).
Even simple things such as genuinely being able to critically analyse papers, write abstracts, and perform statistical tests haven't really been covered in my degree thus far, but are obviously really important for being a 'doctor and a scientist' and I feel like it will serve me well in my career.
Additionally, having actual free time has been a God-send. On clinical placement you're (supposed to be) on the wards 9 - 5pm, and then have a huge amount of SDL to do. This can be very draining, to the point where it feels like placement is a waste of time because you know the mountain of conditions and drugs you have waiting at home to be learnt. Evenings, weekends and holidays are quickly eaten up by all the things you could and should be learning. The medic type 'A' personality is no help here; things quickly become slightly competitive and stressful, and before you know it you're memorising the waves of the JVP because someone mentioned it once came up in the OSCE 6 years ago.
Intercalating has allowed me to have a job, be on two society committees, volunteer and still have time to take evenings and weekends off work. I've been on three holidays in 2016 alone, and it's just been fab. Having afternoons off and dedicated lab time, with work loads that actually reflect 10/20 credit modules (instead of the ridiculous 100+ lectures for 20 credit modules we got in years 1 and 2) makes a huge difference, allowing you to actually learn and digest the material, instead of desperately cramming it.
I would really recommend it if you have the financial means/ interest in doing so. The majority of my friends who've intercalated are glad they've done so, and I feel like it's boosted my confidence now that I have a greater knowledge in pharmacology, physiology etc.
So if you're thinking about it, research it and go for it! And don't worry too much about Student Finance etc.. Even with my year of Biomed before starting Medicine I still got a loan.
Goodbye for now, once my clinical placements start up again I am hoping to blog more regularly - and thank you to all the Doctors out there protesting, as a medical student whom this contract will greatly affect, I am exceedingly grateful.
Also a little disclaimer: I am quite ready to get back to clinical medicine now. Whilst I have loved having free time and getting back to my scientific roots, staring down a microscope has limits to it's interest, and I have definitely missed placement and all the highs and lows it has to offer.
Long time no speak as per! This junior doctor contract malarky led me back to the Blog-sphere reading Doctor's opinions, and I thought it was about time I revisited this old place. I still get weekly emails from GCSE students asking me about their grades, but sadly my friends, and even my friends siblings, are far from GCSE age and I honestly don't know what the situation is at the moment.
I have heard applications for medicine are down by 18%, so maybe this is the best time to apply!
I have taken a year out of clinical medicine to intercalate this year, and I'm really glad I did. I chose a degree that was 50% research based (I missed science a little bit) and I feel like I've learnt a lot of invaluable skills, not to mention possibly getting a publication out of it (fingers crossed).
Even simple things such as genuinely being able to critically analyse papers, write abstracts, and perform statistical tests haven't really been covered in my degree thus far, but are obviously really important for being a 'doctor and a scientist' and I feel like it will serve me well in my career.
Additionally, having actual free time has been a God-send. On clinical placement you're (supposed to be) on the wards 9 - 5pm, and then have a huge amount of SDL to do. This can be very draining, to the point where it feels like placement is a waste of time because you know the mountain of conditions and drugs you have waiting at home to be learnt. Evenings, weekends and holidays are quickly eaten up by all the things you could and should be learning. The medic type 'A' personality is no help here; things quickly become slightly competitive and stressful, and before you know it you're memorising the waves of the JVP because someone mentioned it once came up in the OSCE 6 years ago.
Intercalating has allowed me to have a job, be on two society committees, volunteer and still have time to take evenings and weekends off work. I've been on three holidays in 2016 alone, and it's just been fab. Having afternoons off and dedicated lab time, with work loads that actually reflect 10/20 credit modules (instead of the ridiculous 100+ lectures for 20 credit modules we got in years 1 and 2) makes a huge difference, allowing you to actually learn and digest the material, instead of desperately cramming it.
I would really recommend it if you have the financial means/ interest in doing so. The majority of my friends who've intercalated are glad they've done so, and I feel like it's boosted my confidence now that I have a greater knowledge in pharmacology, physiology etc.
So if you're thinking about it, research it and go for it! And don't worry too much about Student Finance etc.. Even with my year of Biomed before starting Medicine I still got a loan.
Goodbye for now, once my clinical placements start up again I am hoping to blog more regularly - and thank you to all the Doctors out there protesting, as a medical student whom this contract will greatly affect, I am exceedingly grateful.
Also a little disclaimer: I am quite ready to get back to clinical medicine now. Whilst I have loved having free time and getting back to my scientific roots, staring down a microscope has limits to it's interest, and I have definitely missed placement and all the highs and lows it has to offer.
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