Good News

I wrote recently about an elderly lady who I'd been to see, I suspected some sinister pathology and the GP referred her under the 2-week rule for urgent investigations. I followed her up today and was pleased to see that her tests had come back. Other than a bit of oesophagitis the tests were negative, oesophagitis doesn't really explain her symptoms but its a much better diagnosis than what it might have been. I was really pleased that she is ok.

It was my last day at my GP today and I'm sad to be leaving. I've learnt a lot. It was a great placement with a great GP. Much much much better than the previous placement which was nothing short of a disaster. Now I have to pick an 8 week community placement for my 5th and final year, unfortunately none of the good GPs I've been to seem to be offering placements. Tits.

In other good news - only 5 days left of obs and gynae!

OSCEs

Its that time of year again, as we approach the end of the module, examinations loom. Yes ladies and gentlemen its OSCE time (well it will be in a few weeks.)

I made my revision timetable at the weekend and I'm already a couple of days behind. Oops, I could do with some motivation. As it happens I don't mind OSCEs too much, in fact, in a sadistic kind of way I enjoy them although this time round it includes obs and gynae which automatically makes me want to shoot myself.

So 15, 5 minute stations, over 2 days, on paediatrics and obs and gynae. Simply by looking at previous years its easy to predict that there will likely be a few recurrent examiners favourites; breast exam, vaginal exam, family planning and various paediatric histories to name a few. At the top of all my revision notes is the phrase "WASH HANDS, INTRODUCE SELF AND OBTAIN CONSENT" I work on the proviso that if I do that in every station everything else will just kind of follow.

Maybe I should be more scared than I am about this OSCE, especially as I havn't exactly been enthused by obs and gynae and as a result have spent most of my time avoiding work. I can't wait till its out of the way and that post-exam feeling of having fuck all to do for a few days. The best thing about an upcoming OSCE is the fact that I can avoid the last 2 weeks of obs and gynae by attending as many revision sessions as possible. WOOOOOOO!!

Just for the record psych is still marginally ahead of obs and gyane in the 'firms that suck' league table.

A Week In The Life Of Me

Gynaecology Update - Been on delivery suite this week, not seen a great deal due to being male and less than enthusiastic about gynae in general. Made the most of the time to start OSCE revision. Two weeks left and I can't wait till its over with (except for the whole exam thing at the end! - shit)

Laptop Update - Finally after weeks of waiting and 'communicating' with technical support, they've decided to replace the laptop (3 years later than they should have.) Why they couldn't have just said that 6 weeks ago is beyond me. Now we just have to wait for the vouchers before we can go and get a new one. Something tells me we've not heard the last of this so watch this space.

Roller Disco - This week saw me don some skates and take to the floor... unfortunately I'm shit and can barely stand up let alone skate around a dance floor. In the drunken shenanigans I managed to crash into my girlfriend twice [although completely by accident, whatever she might say] bringing her crashing to the floor and injuring her coccyx. Honestly what was I supposed to do?

Girlfriend Talking In Her Sleep - Perhaps its related to her coccygeal injury... who knows. Each night she usually falls asleep before me and when I come to roll over she sits upright and proceeds to either a) declare her undying love for me b) tell me to "shut up, shut up, SHUT UP and SIT DOWN!" (wtf?!?) or c) talks complete gobledeegook for a couple of minutes. She never remembers it either, but I love her all the same because she's great.

Food, Glorious Food - The girlfriend has spent much of the week making oodles of yummy cakes/biscuits/other tasty foodstuffs which has resulted in me gaining about a stone in weight. But its all so yummy...what can I do? *polishes off the last of the vanilla shortbread with extra sugar*

Psychosexual Lecture - The most anticipated lecture of the entire medical degree (for some at least.) Two hours of all you need to know about sex and patients, this involved games such as thinking of as many words as possible for vagina and penis (snigger) and me role-playing as a 50 year old man with erectile dysfunction. It was interesting and quite useful, although I'm not sure I feel any more prepared in asking 60year old ladies if they are sexually active.

The Budget - Wine up 5p a bottle, shit!

Money - I've got none... ideas on a post card please.


So, that about sums up my week, watch this space for more gynaecological fun, sleep talking girls and tasty food.

Where is my £250,000?

Inspired by this post by a biomed student who for some reason wants to do medicine I'm going to do some maths.

• Ok, so its a well known fact that it costs £250,000 to train a doctor.

• In my year there are roughly 400 students which equals a staggering £100,000,000 to train all of my year to become doctors.

• This equates to £20,000,000 per year or about £50,000 per year for each student.

That leaves me with a question....where the fuck does all that money go? I for one have seen little evidence of it. Next time i'm in the skills lab I'm going to need to use a fuck load of equipment to get my money's worth.

These figures are even more baffling considering the incompetent nature of some of the staff who are supposed to look after us but thats another story which will have to wait till another time.

I'm Famous... well, sort of.

Four years ago I spent months drafting and redrafting my personal statement for my application to medical school. After roughly 26 drafts I ended up with an almost perfect statement about me. It began "From an early age I have been fascinated by the workings of life. The human body is a remarkable machine with many diverse systems producing an organism that could never be artificially reproduced." It worked out quite well and I received 4 interviews although perhaps not for the places I should have applied to.

After starting medical school, as a favour to a friend and in order to help others writing their personal statements, I released it to the world. Reading it back now its rather cringe-worthy but it was all my own work and is all true, I'd spent years beforehand doing work experience and ticking the teamwork, leadership and communication boxes. As a scientist, writing has never been my forte but I don't think it turned out too badly and it was obviously what they wanted to hear.

Last week a story broke here and here about prospective university students using the Internet to cheat in their applications. The focus was on a phrase about burnt pyjamas which a staggering 234 students used as their own personal anecdote [that must have been a particularly flammable batch of pyjamas.] However, it seems an even greater 370 lifted my fascination for the workings of life. I cannot deny that anyone willing to make their career out of the human body would fail to find it interesting, its hardly an original idea in itself. It seems however that my opening has been copied word for word as is written in The Times article.

Perhaps I was naive to think that potential medical students would be able to come up with their own original phrasings. I anticipated that some might lift sections of my statement but never envisaged such a proportion would do so. It doesn't particularly bother me that they've plagiarised my statement, they're not in direct competition with me so why should it? I am quite shocked and disappointed but at the same time quite flattered that my statement is deemed good enough to rip off.

With the introduction of the MTAS application form, the ability to sell oneself is more important than ever. I'm sure this process won't be immune to plagiarism and with successful candidates such as this one allowing their answers to be scrutinised by the world, it probably won't be long before the MTAS shortlisters are reading exactly the same phrases over and over again. I think I can safely say that when it comes to my turn to enter the dragon's den that is the MTAS system my answers will be kept under lock and key.

edit: Links fixed

Mr Bean shows us how it should be done.

Life as a 21st Century YP (Young Person/Professional)

Welcome to our guest blogger for today: missbliss.

Our regular travel routes...

Whatever happened to home towns? It seems we YPs are destined to live a life in transit. Admittedly, The Little Medic and I brought some of this upon ourselves by being in a long distrance relationship (LDR for those in the know). At best we were 180 miles apart, at worst 280. Still, I’d graduate eventually and then we’d show ‘em.

Last summer, I finally did graduate and in order to be with The Little Medic, I decided to take my PGCE (teacher training) in the same city as him. After 18 months in a LDR we would finally be together. Hurrah! Unfortunately, the medical school had an ace up their sleeve and placed him in a hospital 40 miles away from said city. We had been hoping to have a nice little rented place together and be able to use public transport to get to our respective school and hospital. So much for that cunning plan. We have the (very) little flat, but also monster commutes: both travelling approximately 4 hours a day thanks to school and hospital placements. [God knows what this is doing for our ‘carbon footprint’. At least we don’t jet off to foreign climes on a regular basis. If only.] We joke that he used to travel a 360 mile round trip at the weekend to get to see me, whereas now he travels a 78 mile daily round trip to get away from me. Still, he’ll graduate eventually and then we’ll show ‘em.

But will we ever be able to settle down and makes roots? Not if MMC or MTAS have anything to do with it, it seems. For them, ‘upwardly mobile’ has a different meaning altogether: we will stick you wherever we want. Got a house, family, friends, commitments? Not any more you don’t. Shiny Happy Person is a perfect example of someone in a horrendously regrettable situation.

So when we were counting down the years to having a house near to our workplaces and maybe contemplating a f..f..family (gosh, that’s scary to type out loud) we were sorely mistaken. It seems settling is a thing of the past, or at least it is for today’s YPs.

We’re also pushing to the back of our minds the £50,000+ combined debt we’ll be in to the Student Loans Company come 2008. Shunted backwards and forwards, loaded with debt. That’s the way they like to treat educated, ambitious, public-sector keyworkers in this country. The question: “is it worth it?” is never far from our minds.

I'm a Medical Student, Get Me Out of Here

If there is one thing that I regret about my time at Medical School its that I applied to the wrong universities. The most important piece of advice I give to anyone who is thinking of applying is to consider very carefully where to apply. I applied naively and based my choices mainly on where I thought I was most likely to get in rather than where I actually thought would be good - what a stupid idea that was. I ended up doing better than I thought I was capable of at A-Level and feasibly could have applied anywhere and stood a chance of getting in. I'd never even visited the medical school I finally accepted other than for my interview, I'd not even been to any of the cities I applied to apart from the one closest to home.

Looking back at least 2 of my 4 choices would have been different, probably 3 or perhaps even all 4! Don't get me wrong, I really like the city where my medical school is based but then they fucked me over and sent me somewhere else for 3 years so that backfired. I would still have applied to this university but knowing what I know now about how they treat their medical students I think my first choice would have been somewhat different.

For a while I even considered applying to Cambridge, one of the only reasons I didn't was because I didn't have the confidence that I could get the likely offer of 3A's. However I don't think the Cambridge course would have suited me at all, especially hearing what Angry Medic has to say but I feel a bit stupid looking back and realising how silly I was 4 years ago. [I still ended up visiting Cambridge every weekend for the best part of 2 years to spend time with my girlfriend who was at uni there.]

Perhaps regret isn't the right way to describe how I feel but I'm looking forward to being able to get the fuck out of the place I'm stuck in now. Were it not for the fact that the hospital is OK and some of the people are quite nice I'd probably have dropped out ages ago.

In other news:

• Obs and Gynae isn't quite the disaster I expected it to be although I don't really like it and I've managed to avoid a lot of it so far.
• Its no longer dark when I set off in the morning which is spiffing!

Patient: "So...what do you think is wrong with me?"

As a medical student I dread this question, I never answer the question with a direct diagnosis because its not my place to do so as a student. In fact, often I've got no idea anyway but we've all got some knowledge tucked up somewhere and usually have some idea, in our own little heads, what might be going on.

It's worst when its a textbook case of something sinister. Today for example I was asked the question by an elderly lady who'd given me an almost textbook history of a certain pathology with an extremely poor prognosis. She had no idea that what she'd described to me might be serious and she was the nicest of old ladies who offered drinks and biscuits despite being barely able to walk. She had no idea that I had a diagnosis running through my head, I just politely replied that I had no idea what was wrong and the doctor who would be seeing her later would be able to discuss the problem further. As far as I'm concerned this was the right thing to do and although we've had 'training' on breaking bad news, I'm not looking forward to the day when it's my turn to give some life changing information to a patient or their family.

I pray that I'm wrong, perhaps she didn't have anything wrong at all (although the GP did send her for urgent investigations.) In a few weeks I'll chase up her results and see for myself, in the meantime all I can do is hope that she is ok.

Our World Is Crumbling Around Us.

I was asked, 4 years ago, at my interview for medical school; "Why do you want to be a doctor?" The answer I gave had been well rehearsed but it was the whole truth. I mentioned a desire to help people, an interest in science and medicine since childhood, a wish to use my abilities to benefit society and a thought that a career in medicine would be challenging but rewarding at the same time which would suit me.

I was also asked "What do you think a career in medicine entails?" to which I replied something like this; "A lot of hard work and commitment for starters. You must have a desire for what you do, a wish to help people and an interest in life-long learning. A career in medicine is a long ladder from start to finish whereby you must progress up the ranks by furthering your knowledge. It is a secure career with safe job prospects.

Was I really that naive? When I applied I thought medicine would be a job for life. I was filling in my UCAS form whilst MMC was but a lightbulb above some bigwig's head. I look back now and think why did I even bother. Now in my fourth year, MMC has taken a firm hold of our profession and ripped it to shreads. I sit here wondering what my answers to those interview questions would be? Would I have even bothered entering the dragons den that is medical school had I known what I know now? Do I even still want to be a doctor?

Fortunately I can say with certainty that I do still want to be a doctor, whether or not i'll make it won't be so much up to me, more how the system decides. Many people would say I'm mad to still want to be a doctor. You only have to look at fellow bloggers to get an idea of the huge problems facing junior doctors today. HospitalPhoenix, is obviously a great surgeon, he has a passion for medicine, he was fearful of his future but was one of the lucky ones. Shiny Happy Person was less lucky her life in tatters, she faces an uncertain future. Dr Crippen has done a number of MTAS related posts outlining some of the discrepancies in the MTAS process.

In and around the hospital it seems everyone is aware of the problems, among them the MTAS disaster. Nurses keep saying "Get out whilst you still can!", midwives are asking "Why are you bothering?" Junior doctors, some of whom have interviews some who don't are heard debating emigrating, unemployment or changing career. Consultants are just as disapproving and can be heard ranting about the ludicrous methods of scoring application forms. One particular junior doctor was seen crying quietly in a corner on Monday, coming to terms with having no interviews and perhaps no career. She was in clinic at the time and had taken 5 minutes to check out her future on the MTAS website, 5 minutes after learning her fate she was back seeing patients, doing what she wants to do, what she deserves to do, what she is needed for but what the system might stop her doing come August.

I think the angry medic sums it up well:

"Some of my friends have advised me to switch to law and run whilst I can.
I'm seriously thinking of listening to them."

I keep hearing similar comments, perhaps we should all consider our future before its too late, we've already devoted years to this but with good doctors being kicked in the knackers at all stages of their careers why are we even bothering? Junior doctors are being treated atrociously and we as medical students have it all to come in the future. We [those of us who don't leave now for a better, more secure future] can only pray that the system is sorted by the time it is our turn. We should also keep our fingers, toes and any other appendages crossed for those currently drowning in the MTAS/MMC pool.