Of course you can prod and poke me

Today was the 4th Year OSCE for which I've spent the day being a patient. Yesterday I was informed that I should bring shorts, this was a surprise as I'd guessed that I'd be on the shoulder exam station (there is ALWAYS a shoulder exam - well there used to be!). From this I could deduce that I'd either be doing hip, knee or lower limb neuro examination.

As it turned out, I spent the day having my hips examined. It has been a very long day but despite that, it was good fun. I rotated with another volunteer but I must have had 25+ hip exams today, (my hips now feel far worse than they did this morning). It was actually quite exhausting, I don't know why, and I've lost count of the number of times I've confirmed my name and date of birth. By the end I was struggling to remember my own date of birth, at one point I confused one poor girl by telling her I was born in 1895, oops.

The quality of the students differed quite significantly, confidence seems to be the main differentiating factor. Take for example one guy who was very confident and whose knowledge was adequate compared to a very nervous but exceptionally knowledgeable girl. The girl's mark suffered as a consequence of her nervousness whereas the boy gained significantly by being confident (even though it might well have been false confidence).

I was there all day but at lunchtime the examiners changed. I was surprised just how much difference this made. This morning's examiner was quite harsh, he kept putting people off their rhythm with silly questions. The afternoon's examiner, was comparatively lenient, and he let the students get on with it. I suppose it all evens out over the whole exam, but still, they are VERY subjective.

The majority of students wanted to remove my shorts for the examination! Fortunately the first examiner explained that I was adequately exposed but when it came to the afternoon, even the examiner thought I should remove my shorts! Luckily one of the admin staff overheard and saved me. I did get poked in some awkward places though!

It was very interesting to see the exams from the other side of the fence, it was good experience (I could do a perfect hip exam now) and it was good fun. I've lost count of how many biscuits I ate throughout the day. Most of which were to make up for the awful free lunch we were given. Honestly the canteen could do with a visit from Gordon Ramsey, their food tastes like its come out of the wrong end of a cow.

I'm sure there was much more that I wanted to say about today but it escapes me, and right now I'm going to spend some of my hard earned cash from today on takeaway for me and missbliss. mmmmm tasty!

(There is one bit of extra gossip but that is suitable for reallm eyes only)

Are We a Hotel or a Hospital

One of the patients on my ward has been medically fit for well over a week, unfortunately he just won't go home. In fact, he probably never needed to be admitted in the first place. He does have a number of issues, and does require some level of support but not medically. At the moment he has his own room with private bathroom and he gets fed three times a day. We're not doing anything for him, he's just using the hospital as a free hotel!

He was admitted with complex symptoms which needed to be investigated but he could have gone home a few days after being admitted. Coincidentally, when he was admitted, his partner (who provides the care he needs) was to be admitted for an elective procedure the next day (so wouldn't be there to provide support for him). The cynical among the staff, suspect that this isn't the coincidence it was made out to be.

And so it is, we're stuck with him, don't get me wrong, I think he probably did need some help at home when his partner was going into hospital but hospital isn't the place. He's medically fit so is just tying up a bed at the moment and who knows when he'll go home. I suspect in the old days he'd have just been kicked out, but now, there are complex issues when it comes to discharges, especially in complicated cases. As a result, its almost impossible to get rid of someone who just won't go.

We're not a hotel, we're a hospital. A hospital that is currently in the midst of a serious bed crisis, so much so that we might be closed next week - not a surprise really with patients like this.

n.b. Patient details changed and omitted for confidentiality.

Being examined...

You guessed it boys and girls, its that time of year again, exams. Now the cleverest among you will be wondering what I'm talking about because I've said a few times previously that I've got no more exams until finals and this is true. I am of course talking about the year 4 exams which are happening this week. A year ago this week, I was frantically (hmm, perhaps not frantically but still) revising for the OSCE which covers psychiatry, orthopadics and neurology. When it came to it, I actually did quite well, I made some stupid mistakes which cost me but I was very pleased with my mark. Shortly after this event, I began my journey into blogville and have been going ever since. This of course means that my first blog birthday is coming up shortly but more on that later.

So, what is this post about then? Well, on Thursday I am being examined, not by examiners but by the year 4 students, that's right I'm being a patient in one of the OSCE stations. I've done this once before during last years exam where I was subjected to numerous respiratory exams, my trachea hasn't been the same since! I've got a fair idea of what station i'm going to be on this Thursday, but its only a guess and I shall wait till after the exam to talk about it - just so that in the unlikely event that a 4th year reads this, they won't benefit from knowing what is coming up (not that I know, its just a guess)

There are a few reasons for volunteering for this kind of thing, perhaps the most useful is the fact that you get to see the exam from the other side of the fence which is good experience and you get to see what exactly examiners are looking for. You also get to revise whatever station you're doing as you critique the students being examined. There are also bonuses such as free food and a day off (its a terrible shame that the exams don't fall in my community block). The fact that you get £40 for the day is of no importance at all (I promise ;) )

Check out the reallm for the latest juicy PBL gossip.

I Actually Like Medicine!

Yes ladies, gentlemen and others, I actually want to be a Doctor and I'm really looking forward to it. Just about every medical student, goes through periods when then think 'is this really for me?' and i've had my fair share of feeling like that but:....

I've not been this excited about medicine for....well, ever really. Sure when I first started clinicals the first week on the wards were exciting and interesting but following that I fell into sort of a hole whereby I just went along with the flow. I found the work mildly interesting but I wasn't really inspired by it. If I'm totally honest I drifted through most of 3rd and 4th year. I learnt things along the way and really enjoyed parts of it but I never really felt truly involved. I wasn't the first, and I won't be the last person who doesn't really put themselves forward for things. I mean yeah, I was always ready to try and answer questions when others would just stand silently staring off into space but when it comes to being keen or having to actively ask to do or be shown something I just tended to drift into the background. I know this isn't the way to do things, or a good way of learning things and I've always advised others to put themselves forward.

I think perhaps things started to change during my elective, for the first time ever I felt almost useful, like I could really help and make a difference. I liked the atmosphere, I enjoyed learning and I was interested in medicine. On my return I went back into somewhat of a lull, back to my old ways of coasting if you like. Perhaps this is because I was on somewhat of a come-down following the amazing experience of my elective.

I've never enjoyed a week of medicine as much as I've enjoyed this week, I've not done anything particularly special, or seen anything wildly exciting but for the first time in a long time I'm excited, I'm enthused, I'm eager to learn. Very rarely have I come away at the end of the day with the intention of reading up on something I've seen or learnt about, even less so have I followed through on that intention but now I feel like I want to, I'm inspired to. I think I'm behind some of my peers with regards to being involved, some of them have probably been at it since 3rd year. But I don't care, for me, its important that I've finally seen what medicine is really like and that I can see myself doing it, and doing it well. Perhaps its because its 5th year and that things are starting to come together and make sense (still very slowly but still, its progress!), I know what tests patient x needs and why, I no longer feel useless or in the way (although I still probably am) I enjoy helping the house officer out with jobs. I can pin-point one reason which might be contributing to my new found love of medicine - the one-on-one style of 5th year. I have a whole team to myself, there is nobody else to get in the way/compete with/hide behind. Not only do I learn a lot from one-on-one teaching, I find the whole experience much more beneficial, I'm more confident and much more willing to do things. Today, when I had my own patients in clinic I felt like a doctor, I was making taking complete histories, doing full examinations, making diagnoses, coming up with management plans all the things doctors do and I loved it. Ok, so they were not the most taxing of problems but for me, it made me realise that I really do like this medicine malarkey, I really do want to be a doctor, and I really can't wait...

This post is FAR too positive for me, so it should also be noted that I still hate the course and PBL. Perhaps I wouldn't have been so slow in finding my path if I had gone elsewhere, but not to worry, better late than never eh?

The Little Doctor, coming to a ward near you, and excited about it! (if I pass finals EEEK!)

New Firm, New World

I've not done a medical firm for a while and it was a bit of a shock to the system when I started my new firm this week. I've been used to the relatively relaxed surgical specialties for a while. Surprisingly I'm loving it! Although its only been 2 days, I'm already getting quite into it despite the long days that I'm not really used to.

Yesterday was my first day, the registrar is off on holiday, the SHO was off sick and the consultant was busy. It was left to the F1 to do a ward round so I tagged along with him. The F1 is really nice, I learnt lots and found it really interesting. There weren't too many patients on our list though each one had their own complex issues. Its supposed to be a gastro firm so why one of our patients is a myeloma patient i've got no idea, it was certainly interesting the two of us trying to take care of this guy (neither of us know much about myeloma) trying to arrange an MRI for query cord compression was a challenge, and I ended up getting shouted at down the phone by a neurologist who didn't want to do his MRI. I left at 5pm, having not even had a 2 minute break all day, I was knackered, god knows how the F1 was feeling, he didn't leave till 7 and he'd done a 14 hour shift the day before.

This morning, I arrived promptly and helped out the F1 by doing some of his jobs, before 9am I'd done all the blood forms and spoken to a nursing home to find out the normal condition of one of our patients. The SHO turned up shortly after 9 and I'd been forewarned about her by the F1, he wasn't wrong, she wasn't the friendliest person in the world but there is always one bad egg isn't there? The consultant came along and it was decided that I should just shadow the F1 for most of my time on the firm which I'm really happy to do as I've already learnt plenty, including lots of tips about being an F1 which will come in handy. I enjoyed the ward round and after lunch (fortunately we had time for lunch today which was kindly bought for me by the F1) I stayed and helped with the jobs. To round the day off, I did an ABG on an old lady with annoyingly mobile arteries, fortunately I hit it, which is surprising as I've not done it for since early in 3rd year!

I'm really enjoying this medical firm, despite yesterday's 8 hour ward round. I'm even surprising myself. I'm looking forward to getting stuck in over the next 4 weeks and getting some really good experience shadowing the F1. I just hope when the F1s change in December that I get a decent replacement...

My Second Favourite Thing in The Whole Entire World World

Second I hear you ponder? Well I didn't want to leave missbliss out and no, its not my new eee PC (although I do love it lots).

CAKE! - Fortunately for me, one of missbliss's finest attributes is making fantastically yummy cakes of all shapes and sizes. This goes hand in hand with one of my best attributes, the ability to gobble cake like no other living human!

This post is to celebrate the wonders of cake (particularly the chocolate cake I have waiting for breakfast), missbliss's ability to make said cake, and to rejoice in the chocolaty goodness of the world.

The amazing 'chocolate splurge' cake. (Or as I like to call it - breakfast)
The icing got a bit messy but hey - any mess involving chocolate can only be good right?

My birthday cake - made with 2 of my other favourite things - cream and raspberries.



CHRISTMAS CAKE! - one of the best things about Christmas (and missbliss doesn't even like it so all the more for me!)
This was last years wonder - decorated by none other than the little medic himself - with edible, gold painted holly made from icing

Its getting to the Christmas time of year which can only mean more cake - YIPEE!

UPDATE: After breakfast:

Gadgetery Goodness

If you're a long time reader of my blog you'll probably be aware that I'm a bit of a techno geek when it comes to gadgets. If I had the money I'd buy all-sorts of goodies. Sometimes, gadgets come along which are just too good to miss out on (at least in my opinion.)

This situation happened last week and I decided to splash out on a new toy. I was fortunate to find them in stock as they're very new and in demand (for those who know what they are that is.)

Its quite expensive, but also a bargain, and I hope to be able to earn the money to pay for it, well, I've already bought it, but I'd like to earn some of that money back through the following:

a) Selling my PDA on eBay - as much as it pains me because its also a gadget and I love it its sort of redundant now as I have my Nokia N95 and my new toy which effectively take care of anything the PDA can do.

b) Selling old books on Amazon - I've already sold a few, and hopefully will earn a few pennies this way whilst also freeing up some bookshelf space (much needed in our house *glares at missbliss*) 'Sociology as Applied to Medicine' is one of the many wonders now listed on Amazon, I bought that eagerly during my first week at medical school, (yes I was naive) I might have opened it once in the last 4 and half years....oops.

c) Volunteering as a 'model' for the 4th Year OSCEs - at £20 a pop, a few sessions of that will help no end (not to mention it being an excuse to get out of PBL!)

So I'm sure you're all wondering what it is that I splashed my non-existent (at present) cash on, well I could do a cal and not tell you but I'm not that mean, besides, you'd never guess in a million years.

It looks like a laptop, and is in fact a laptop, but its small, about the size of an A5 writing pad, and only 900g in weight. The Asus eee PC, is my favourite new gadget. Unfortunately the operating system is based on Linux which means its completely different to Windows but I'm slowly getting used to it and it can do just about everything that I would ask of it. Its not meant as a main PC but at £200, this exceptionally portable, sturdy and generally cool gadget can be slipped into my bag to be used to surf the web on the move, check emails, write blog posts and most other stuff your £500-1000 laptops can do.

Ok, ok, so you might not be quite as excited as I am because I am a bit of a geek but still, I'd recommend these to anyone. Few things are quite as exciting as waiting for a new gadget to be delivered - so much so that I actually looked forward to PBL this week because I knew that after it, I'd get to play with my new toy. Woo

p.s. Check out the reallm for more PBL tales.

Bringing the Islands to Life

Now we've settled into our new flat and got the Internet up and running we've been able to upload some of our Solomon Island videos to youtube. Hope you enjoy them:

Taking off after stopping to re-fuel

Driving through a local village on the island

An English lesson Solomon Island style

Solomon Island children playing down by the sea

Playing volleyball in the evening with a load of local children.

(yes ladies and gentlemen, that's me - do excuse the odd clothing arrangement)

Custom dancing the night before we left, AMAZING!

Evening in paradise

There you have it, a few videos which I hope bring to life some of our amazing experiences. It makes both of us really happy to look at the videos and pictures but at the same time, its quite sad because we both miss it tremendously!

A few random thoughts

OK, So I should actually be in theatre at the moment but the surgeon has disappeared and I'm fed up of playing 'hunt the surgeon'! I've been sat here for 10 or 15 minutes thinking what shall I do, various options occurred to me and I even started a 70 question meme but it was going rather slowly and I was a bit bored so here are just a few of my random thoughts.

1. - Everyone seems to be particularly excited about Christmas this year, despite the fact that it's still 46? days or so away whispers of Christmas are everywhere. Its probably like this every year but I've never noticed such a buzz before.

2. - There was disappointment among my fellow students this week as news filtered out that we'd no longer be getting free coffee during PBL/lectures. Must be a cost-cutting exercise, although rumours are that it'll be back when the new building is ready (which is already 4-5 months behind schedule, I'll be surprised if I ever see it open whilst I'm here) Personally this news didn't bother me one little bit, I never drink coffee or tea so its a complete waste of money as far as I'm concerned. I'd much rather have my share in biscuits, sadly this doesn't seem to be allowed. My PBL tutor accused me of being a Mormon this week because I didn't drink any caffeine, I told him I just get my caffeine from other sources!

3. - Facebook is turning us into a nation of freaks. I registered on facebook in its very early days but its grown incomprehensibly since then. Almost everyone between the age of 17 and 23+ is on it, and you're seen as some kind of freak if you're not. Or maybe its 'cool' to shun this social networking phenomenon. No doubt about it, it is a useful tool which makes life easy for example sharing pictures and keeping in contact with far-away friends but at the same time it can be a real problem. Facebook 'stalking' everyone you've ever known is almost mandatory these days, and I can't help feeling a great deal of trouble is going to come of it. I'm not even going to mention all the ridiculous third party applications that have been added in recent months, they're almost enough to drive you insane. I'm fed up of being 'bitten' by someone using a vampire application or being invited to the "my little toe is bigger than your nipple" society. Get a grip people!

4. - If you're wrong, just admit it!

5. - IKEA is amazing, I love walking around, I love looking at the stuff, I love picking the flat-packs out of the warehouse, I love trying to cram the flat packs into the car, I love putting the flat-pack stuff together and I love standing back and admiring my new TV stand, bookcases, drawers and various other IKEA goodies.

6. - I'm a geek, but you know what? I don't really care what anyone else thinks.

7. - I'm hungry, time to get some food and go back to theatre. What a strange post.

It is done!

After many minutes staring at the 'submit' button I finally plucked up the courage (after checking everything just once more) to click it and that was it! Not even an "are you sure you wish to submit" With one click it was done, off into cyberspace to be scored by someone who knows nothing about me other than the answers to 7 questions!

9th January is the day we find out our Foundation School allocation - bring it on.

Future Surgeons – Surgical Skills course

Last Friday, I went to the Royal College of Surgeons in Edinburgh to attend a surgical skills course for medicals students. It was great fun and very useful – especially considering my useless excuse for a medical school have refused to bother teaching us about things such as suturing (quite strange given that its on the competency list on the foundation application – but never mind)

Credit must go to HospitalPhoenix for recommending it, unfortunately he wasn’t there as one of the tutors. I would have quite enjoyed racing him against the clock stacking sugar cubes and fastening cable ties laparoscopically (bloody difficult!) I was also disappointed to see that the Angry Medic didn’t turn up despite his name being on the list of participants (I hope everything is ok in angry’s world!)

So anyway, the course itself, it’s called something like: ‘Future Surgeons: Key Skills’ and is intended as a basic surgical skills course for medical students. There were about 20 or so of us there, mainly from Scotland but also a few from other areas of the UK including one from London who had come a very long way!

What made it so good was probably the tutors, they we’re all fairly old but rather proud of their combined 200 years of experience. They were all very friendly and very good teachers. The lead guy, a retired orthopod was hilarious; he was a comedy genius and a good teacher too.

It was very interactive and an excellent environment to learn things in with a number of experienced tutors roaming around to answer questions and help out. I really enjoyed the whole thing and despite having to make some urgent phone calls at lunchtime to sort out moving into our flat the next day, the whole thing was very relaxing.

Am I a future surgeon? Who knows, I'd quite like to be but whether I'll cut it in that cut-throat, competitive world only time will tell. *Goes off to actually learn some anatomy*

Missbliss wrote here about our very long and stressful moving day on Saturday, we're still unpacking and are slowly settling in albeit with a couple of teething problems.

Foundation Application Update coming soon to either here or the real little medic.

Medics on a Train!

I’m currently on a train to Edinburgh to attend a surgical skills course for medical students; fortunately by the wonders of modern technology I was able to reserve a seat with a plug socket for my laptop. Sadly, I wasn’t able to reserve all 4 sears so when I got on, someone was sat in my seat. Anyway, I finally managed to get myself sat down but as there was someone next to me I had very little space so I sat reading my gadget magazine (ok so I’m a geek) waiting patiently for the other person to disembark.

I soon realised that the woman next to me, who’s toe I had stood on and almost destroyed when sitting down, was in a deep conversation with the lady at the other side of the table. Now, not that I’m nosy or anything but I soon realised they were talking about doctors, not only were they talking about doctors they were quite openly slagging them off. For some reason I found this absolutely hilarious. I listened attentively for 10 to 15 minutes or so, whilst pretending to drool over the latest gadgets in my magazine.

I could barely contain myself as such wonders as “they’re [doctors] all very very arrogant” and “you either get one of those – just out of medical school types who barely look 18, or an arrogant consultant who won’t listen to you” came flooding out. At this point, I decided it might be quite funny if I got out something medic-y. I happened to have the details of my surgical skills course so pulled it out of my bag and slapped it triumphantly right in the middle of the table. Almost immediately the conversation stopped and the look on their faces was a picture. For the next 10 minutes or so they continued to babble about this and that although there was no more slagging off doctors.

Now I don’t know if this was right, or if it was wrong, but they were really giving doctors a hard time and rather than butt in and stand up for them, I thought the subtle approach would be more amusing.

Anyway, the lady, who also had a ridiculous amount of rubbish which she failed to remove from my side of the table until she departed, has now left the train leaving me free to type blog posts/work on my foundation application/play football manager or all of the above. Actually, my foundation application is just about finished, missbliss is has spent ages trying to delete the 100+ extra words I had written for each question and it’ll be ready to submit well before next Friday’s deadline.

p.s. Writing on a train is strange, every so often the person next to me takes a drink and perhaps, just maybe, takes a sly peek at what I’m up to – in which case, Hello! I don’t really know if he’s reading this or not, but either way, I thought it would be amusing to type this just so he knows that I know, if he is reading that is.