Wednesday 31 October 2007

Halloween

Wishing you all a very scary Halloween!!!




The lanterns that missbliss and I made

Tuesday 30 October 2007

Great Start to the Week!

My last post was about how busy this week was going to be, and I wasn't wrong! Unfortunately I seem to have caught a rather virulent strain of man-flu. My head feels like its in a vice, my sinuses feel like they are being infused with molten lava, my nose is streaming like Niagara falls and my throat feels like its being attacked by an army of miniature samurai! That being said, I feel like shit which makes doing things a real pain in the arse!

Yesterday I had to hand in my elective report;
6am - I got up, showered, dressed and made dam sure I had 2 copies of my elective report and a copy on CD
6:30am - Left the house to drive the 60 miles to the medical school building
7:30am - feeling like shit, and only half way through the journey I made an emergency stop at a motorway services for a crunchie!
8:30am - finally arrived having spent the best part of 2 hours driving and was amazed that I could find a parking space
8:45am - went to computer cluster to check my emails and waste some time before reception opened so I could hand my report in
8:59am - set off on the short walk across the foyer to hand in my report
8:59:30am - am startled by a loud cry of "OHHHHH SHIT!" coming from right in the middle of the foyer
8:59:35am - realise that people are looking my way and that the cry of "OHHH SHIT" came from me. My brain is running a bit behind because of my man-flu
8:59:40am - I've only gone and forgotten my elective supervisor assessment form which also needs to be handed in today!!!! ARGHHHHHHHH! I blame man-flu!
9:00am - Have just about stopped myself from crying in the middle of the foyer and go in to hand in my report.
9:01am - I apologise to the friendly man on the desk for forgetting my form, he has NO idea what I'm talking about and writes me out a receipt for my report.
9:05am - Right, what am I going to do, this form HAS to be in today and is supposed to be in by 12:00 on the dot.
9:10am - Get back to the car, there is only one thing for it, I'll have to drive home and get it.
10:30am - Arrive back home after driving 60 miles back - man-flu is now making me feel even worse! Realise that if I drive back to the medical school I probably won't be able to make the deadline.
10:35am - Phone medical school to ask if I can fax it over as its only a form. Unfortunately the woman I speak to has no idea what-so-ever and isn't very helpful!
10:40am - I decide faxing it is the only thing I can do so I write a letter and email the man in-charge (who is conveniently on holiday today)
11:00am - Get to Staples and pay £2 (cheaper than the £15 it would have cost in petrol) to fax my form over with a request to email me confirmation of receipt
11:30am - Go home and die.

5:00pm - still no confirmation email, great, they've either not got it or haven't bothered to email me back to let me know. God knows what will happen now, will they fail me for being late (even though my report was in time), will it not matter at all? Who knows, one thing is for sure, it won't be simple!

On the plus side, Between dying and 5:00pm I did manage to fill in some of the foundation application form which went live yesterday. I also managed to plan the answers to the sacred 7 questions.

Today my man-flu is even worse, I feel like shit. I need to get better quickly in order to keep up with my busy week.

Sunday 28 October 2007

so much to do, so little time

I knew things were going to be busy when we returned from our trip but busy is probably an understatement!

I have finally finished my elective report, it is pretty good now even if I do say so myself. My blog actually proved useful as rereading some of my posts whilst away helped with the content of my report. It was supposed to be 3500 words but that simply isn't enough so it ended up at 3700 which is still a ridiculously small amount considering everything that happened. I don't think I've done it justice but I've done the best I possibly could have. Much credit must go to missbliss for her help. Now I just have to hand the dam thing in which is going to be a pain in the arse as it has to be handed into the medical school not my hospital. I'll look forward to me 100 mile, each way, commute on Monday.

I thought about putting a copy of my report up on the net but since the university seem to have stepped up their assault on plagiarism it'll have to wait for a while. I wouldn't want to be accused of stealing someone else's report and making up 2 months of my life now would I? If you're desperate to read it then drop me an email.

That's one thing I can cross off on my ever expanding list of things to do. I can also cross off finding a flat as we've found one! Although finding somewhere to live adds about 60 different things to my to-do list. Particularly as its unfurnished so we're going to be sleeping on the floor. IKEA here we come!

My first week back in hospital was both eventful and uneventful, you can read about it here at the real little medic (email me for an invite if you want).

Next week promises to be busier than ever! We're moving into our flat next Saturday, I'm going on a surgical skills course in Edinburgh next Friday and there is the small matter of the foundation application form which I've yet to really study in detail! Expect to here more about that next week (if I get time to blog that is!)

I'm also planning a post about some of the crazy things people have googled only to end up at my blog. At the moment its mostly about the foundation programme application form as I've written about the questions but there have been some gems just recently and I'm sure it would be worth sharing them.

Finally, this is my 100th post, so I'd just like to say a quick thanks to all the readers and commenters out there who make blogging a bit more interesting!

Thursday 25 October 2007

Elective Report

I'm currently writing my elective report which is supposed to be 3500 words. Now I'd have no problem just rattling off 3500 words describing my elective but I want to try and do it some form of justice but its just so difficult.

I thought my elective report would be easy. It is supposed to be in an informative but fairly clinical style but my elective was about so much more than that. Not only do I have to cut out so much but its hard to make things sound real and interesting.

I know my report will probably be ok, but I wanted it to be more than that.

I seem to have lost all my creative writing juices (not that I had that many to start with) - bloody worrying considering the foundation application form goes online next week!!!!!!!!!!!!!!!1

Arghhh its driving me insane!

Monday 22 October 2007

The 7 Questions...

You may or may not have already seen the Foundation Programme 2008 application form, either way, here is my breakdown of the questions.

Question 1
Maximum points available: 5 points Limit: 250 words
List your educational achievements


Hmmm, this is the only question which I have no chance of scoring well on. In the notes that accompany the form it states that the marks are available for other degrees or publications in peer-reviewed journals. Now I have neither, when it comes to academic achievements I'm an above average student, but there isn't much that stands me out from anyone else who is above average academically. I do have a couple of things I could put down, however they've not actually happened yet so they'd be pending achievements. So anyway, I don't like this question much at all.

Question 2
Maximum points available: 8 points Limit: 150 words
Give one example of a non-academic achievement explaining both the significance to you and the relevance to foundation training.


Not a very difficult question most people have at least some kind of non-academic achievements. My problem here will be picking something which fits the question and I'm able to explore the significance to myself and foundation training.

Question 3
Maximum points available: 8 points Limit: 150 words
Describe one example (not necessarily clinical) relevant to your medical training where you have felt personally under pressure and/or challenged. What did you do to manage this and what did you learn from this experience that will be relevant to your foundation training?


I have a couple of potential answers to this question. One is rather controversial, another doesn't look particularly favourable towards me but I could reflect very well on it and the others are just a bit boring so I don't really know.

Question 4
Maximum points available: 8 points Limit: 150 words
Describe one example from your undergraduate medical training of your ability to prioritise tasks and information from any clinical or education area. What was the outcome, what have you learned and how will you apply this to foundation training?


I'm not keen on this question either. Surely the entire medical course is about prioritising tasks and information? It will be hard to pick out something original. The explanation and reflection will be the easier aspect of this question in my opinion.

Question 5
Maximum points available: 8 points Limit: 150 words
Describe one example from your own clinical experience that has increased your understanding of the importance of team working. What was your role and contribution to the team? What have you learned and how will you apply this to foundation training?

I was worried this question would come up but I think I've come up with a good situation now which I should be able to work with to get a decent answer to this question. Maybe I should use PBL! haha


Question 6
Maximum points available: 8 points Limit: 150 words
Describe one example of a recent clinical situation where you demonstrated appropriate professional behaviour. What did you do and what have you learned? How will you apply this to foundation training?

Again I have a potentially controversial idea for an answer to this question. I think brushing up on GMC good practice guidelines will be important for this form and this question in particular.


Question 7
Maximum points available: 10 points Limit: 250 words
Compare and contrast the care pathways you have observed or two different patients with similar clinical problems. To what extent did each pathway take the individual needs of the patient into account? What have you learned from these patients that will be relevant to your foundation training?

From the very little talk I've seen on the application form as yet, this seems to be the question which most people dislike the most. Personally I rather like it, I do think it is a bit of a strange question but I like it because I think I have a good example to use which will make interesting reading, be easy to reflect upon and will hopefully score well.

So, overall I'm fairly happy with the form, it could have been much much worse in my opinion. I don't think the system is a great way of doing things but it was always going to happen this way and you just need to think about how you'll be able to answer the questions. Good luck to anyone applying for foundation posts this year and stay tuned to hear how my application goes.

Tuesday 16 October 2007

So where have we been for the past 3 months?


Blogs we wrote on the island
2007 Elective round up
Well, The Little Medic and I did a little world travelling (Thailand, Australia, Fiji, Los Angeles) but the main part of our trip was a 2 month stint in the town of Lata, on Nendo island, in the Temotu Province of the Solomon Islands.

The Solomon islands are situated between Australia and Papua New Guinea. It takes around 4 hours to travel to the Solomon Islands by air from Brisbane/Fiji. The flight takes you to Honiara, the capital. From the capital it takes 3 hours by two-propellor plane to reach the island we are on, or 3 days by boat. The province we were in is so isolated that the Solomon Island government often leaves it off official maps of the country. It is one of the most remote places on earth.

The main island of Temotu province is called Nendo in the local language and Santa Cruz by most other people. The main island has a hospital and a school. It can take up to 12 hours by boat to reach Nendo from the islands that lie even further out. One of the outer lying islands in the Temotu province is Anuta - you may have seen it on Bruce Parry's recent episode of 'TRIBE' (we only found this out on our return). While we were on Nendo, I taught in the school while The Little Medic completed his elective at the hospital. It is safe to say there are few facilities in the hospital and almost none in the school. There is one doctor for the entire province of 20,000 people who are spread over a huge area of ocean. TLM saw a lot of medicine, a lot of surgery and he really learnt a great deal from the experience. Stuff the namby-pamby useless British medical schools, this was almost like an old-fashioned apprenticeship with all 1-on-1 attention from the doctor who has to specialise in everything. I taught with only a piece of chalk and my imagination and story-telling. I realised how ungrateful we are in England for our medical and education services. The experience made me re-consider teaching in England, but more of that another time.

We can't really explain what it was like to live there, in a place with no running water or electricity, no television or radio and scant contact with the outside world. It was amazing and here are some of the things we did:
  • climbed a 100m (approx) waterfall with no equipment
  • trekked through jungle/rainforest

  • swam in shark-infested water
  • waded through crocodile-infested rivers

  • saw genuine (not put on for tourists!) custom traditions/dances

  • survived high seas in the Pacific Ocean in a 5 metre boat - the waves were at least 4 or 5 metres high and were slapping onto and into the boat (which had no life jackets)

  • slept in leaf houses
  • saw group mourning and wailing women (very moving and sad)
  • lived without electricity

  • saw a lunar eclipse

  • acclimatised to a humidity of 94%

  • ate taro, breadfruit, cassava, giant clam and all other sorts of weird and protected foods (when not eating rice and taiyo [tuna])

  • lived in close proximity to an active volcano

  • fished in the South Pacific (caught Barracuda!)

  • washed in half a bucket of rainwater every day for two months (surprisingly refreshing)

  • beheaded, gutted and fileted whole fish bought for the equivalent of 50p

  • swam in lagoons and jungle pools

  • leant how to communicate 1) in pidgin 2) with eyebrows

  • taught classes of 50+ in a tiny leaf hut

  • practised medicine and surgery with almost no facilities

  • had two earthquakes - one 6.7 and another 7.2 (close to epicentre both times: 20 miles and 70 miles)

  • lived in constant danger of cyclones and tsunamis

  • SURVIVED and had a fantastic time!

Instead of me trying to explain the experience, I'll let the pictures do the talking (but I'll help with a few subtitles!):

We ended up over the rainbow... awwwwwww (twee!)



The plane - a scary ride but a surprisingly smooth landing



Solomon style living had its advantages


A very Little Medic far out on the reef



The beguiling sea, pretending to be serene and harmless


A village with its leaf houses



Tinakula volcano - formed from a burning baby according to custom story (as I found out from my class)


Local wildlife



Local food




Custom dancers



Paradise



Crafting a canoe (can take 6 months)


Outside my classroom



Inside my classroom




Goodbyeeee! Lookim Uifela comeback soon!

Goodbye Lata, we miss you!

Monday 15 October 2007

Tales From a Tiny Island

I promised more tales from the Solomon Islands and more tales you shall have in this and future posts. In a couple of days when I've sorted out all the pictures I'll hopefully be able to upload a few of those.

So, I last left you with the tale of our jungle trek, if you read the post you'll know what a nightmare it was! After that, I did eventually just about forgive the doctor and life carried on as normal. When I say normal I mean in Solomon Island terms... so bucket showers, nothing happening on time etc etc.

We'd been there a while now and had settled into a routine, there wasn't much at all to do. We amused ourselves by playing vollyball with the local children, reading books, playing cards or strolling down by the beach and swimming in the lovely warm South Pacific (keeping a close eye out for the apparently dangerous sea snakes). My work at the hospital was as laid back as ever, with ward rounds in the morning every other day or so and surgery the other mornings. By now I was assisting in whatever procedures were the order of the day (the vast majority of which were tubal ligations but we did have the occasional hernia repair).

There was another emergency cesarean section during my last week in which I took the role of comforting the patient, holding her hand as she trembled with fear, in between, monitoring the patients pulse, blood pressure, hanging up drips and giving drugs. Talk about multi-tasking! Once again things turned out very well, there are remarkably few complications during birth out there which is good considering they'd be rather serious!

Surgery was made rather difficult due to the fact that the pulse oximiter cable broke. So whilst we were still anaesthetising everyone with ketamine, we now had no other way of monitoring their breathing and O2 sats other than watching them to make sure they were breathing. (The cable has a whole story of its own about how it will be almost impossible to replace, just like everything else - i'll tell you about that in a future post). Not only that but the hospital was now ridiculously low on supplies, drugs were running low, we'd run out of diazapam which meant when anaesthetising with ketamine, every other patient either screamed or shook like crazy. Its not easy to do a procedure when the patient is screaming his head off with bad dreams and shaking like a plate of jelly in an earthquake! There was hardly any gauze left which made dressings and surgery quite difficult, various other medications had run out or were running out rapidly. Why was it so bad? Well, all the medication has to come by ship, a ship had come, unfortunately the person who was supposed to be responsible for putting the medication on the ship had got drunk and forgot (A very regular occurrence in all walks of Solomon Life).

The ship that came brought only a few barrels of plane fuel which left us rather worried. There were constant promises of more fuel coming but a Solomon Island promise is about as much use as a life jacket made of lead. As each day passed we got more and more worried and eventually it was decided that we should try and get an earlier flight. I sorted this out with the Solomon Airlines man who 3 days later decided to tell me that it wasn't actually possible. With some phone calls and a lot of wrangling they squeezed us onto a supposedly full flight and were were to leave slightly early.

The day before we were due to leave, I finally got chance to deliver my presentation on diabetes to the hospital staff. I enjoyed it, although I'm not sure how much they understood. I tried to make it nice and simple but I'm still not sure whether they were nodding in agreement or just out of politeness. Following my presentation I thanked them all for having me, I felt quite sad to be leaving. The wonderful Solomon people continued their friendliness by providing a goodbye lunch for missbliss and me which was a nice touch. That night, there happened to be a custom dance going on in a local village. We were very lucky that it was happening on our last night (they only do a couple each year), and that we were able to go. It was an incredible experience, to see such a custom in its completely traditional style (i.e. not just for tourists). More about that with the pictures...

And with that, it was time for us to leave (although I didn't for one minute expect the plane to come), I was extraordinarily surprised when it did turn up and after a couple of months on a paradise island which had become much like home we finally said our goodbyes and waved as we took off in the little plane to return to Honiara.

It was a sad day, but it didn't really hit us until the next day when we were sat having dinner in our hotel just how much we valued our time in Lata and how much we'd miss the island and its lifestyle. (more on that later too)

Bye Santa Cruz, we miss you.

Sunday 14 October 2007

As One Journey Comes To An End Another One Begins

Returning home brings a mountain of things to sort out, organise and do. One item on the list is a small thing called the foundation programme application!!!!! Yowsers. Probably the most important thing about 5th year (apart from finals but talk of those is henceforth banned.)

I quite enjoy blogging so you'll probably be able to follow my journey as I go about applying for my foundation 1 post, as long as I have enough time. Scary stuff indeed. Of course missbliss will be a valuable resource with her English knowledge to correct my poorly written rubbish.

I've had a brief browse of the net and flick around the blogsphere and I've not seen any mentions of foundation programme 2008 (FP 2008) applications yet which somewhat surprised me (although given that I've not spent much time online due to being on holiday I might just have missed it.)

On the 8th October, the 2008 application form was released to the world of waiting medical students. I've not seen MTAS written anywhere so I'm hoping they've moved away from being called MTAS due the what happened with ST applications.

I don't know what the general consensus about the application is but in my opinion it could have been much worse. There are questions I don't like but mostly I'm quite pleased and hopefully I'll be able to cook up a fairly decent application. I'm not sure whether or not I'm allowed to copy the questions to my blog and go through my opinions on each, but that will have to wait till I've got more time anyway.

There is also a story to come about my academic ranking which I found out by email from a friend whilst I was in the Solomon Islands. All I will say is that I'm fairly pleased with my ranking which should help with my application.

Finally for now, I've written a short post over at the real little medic take a look over there, if you need an invite drop me an email and I'll get back to you (although it might be in a week or so)

If you've seen anything in the blogsphere about the application form or other bloggers applying for FP 2008 please let me know either in a comment or by email to imamedicalstudentgetmeoutofhere[at]hotmail.co.uk.

Friday 12 October 2007

it comes to an end....

Sorry for the lack of updates the last few weeks, things have been very busy and Internet access difficult. There are many stories still to tell but I think these will have to wait but don't worry, for those interested, there will be more tales and even some pictures!

So anyway, where are we at... well, we've left Lata, in fact, we left a short while ago. Unfortunately we had to leave a couple of days early. This was mainly due to the fuel situation, a ship did come but only brought about 9 barrels worth (a bit useless when it takes 3-4 per flight) So anyway, there wasn't enough fuel for us to get on our original flight so we had to get on a slightly earlier one, it took some persuasion for them to let us on the supposedly full flight, but eventually they did. The day we left was rather sad, we'd both grown to live quite well with the simple lifestyle. It wouldn't be until the day after we'd left, whilst sat in our hotel enjoying a much needed steak that it would finally sink in that we'd left. The journey itself, back on the small plane, was rather hairy as it rained all the time. The first thing we did on arriving at our hotel was order a cheeseburger!

By some extraordinary luck, we managed to then re-arrange all our flights so we left Honiara the next day, bypassing Fiji but for a brief wait in the airport (where we were nearly offloaded), flying onto Los Angeles. From the back and beyond to one of the richest, most crazy places on Earth! We set up in a Hotel in LA and set about hiring a car, this turned out to be one of the scariest things of the whole trip (normally that probably wouldn't mean a lot but considering what we've been up to on this trip its saying something!). I've never driven an automatic, left hand drive car on the wrong side of the road before. I had a small tantrum where I strongly considered taking it back, with missbliss's encouragement, I fought on and with the addition of a sat-nav unit made excellent progress and now it feels just like normal!

So that's where we're at, our Solomon adventures are over and we're heading for home very shortly. Hopefully I'll keep my blog very busy over the next few months, there will be Solomon stories to tell not to mention the other million things to do when we get back which includes: being back at med school, applying for Foundation posts!!! (shitters), finding a house, catching up on things from the last couple of months and all sorts of other wonderful and interesting things.

Anyway, in the words of Warner Brothers, 'that's all folks'.