Old Enough To Be Your Doctor?

The only reservation I ever have about university (apart from the atrocious error of judgment in choosing this particular one) is that I was too young when I started. I was barely 18 (only by a couple of days) when I started the 5 year journey of university. I've always been one of the youngest in my year and I’ve always wondered what would have been different if I’d been in the year below. Children's lives are defined by their school year group and there can be up to a year between students in the same groups. I started school at the age of 4 although I was allowed to fall asleep in the corner in the afternoons whilst the older children were kept awake! I wonder how long it takes for the August babies to catch up with their September friends - is there even anything to catch up? I'd say so - 1 year is a long time when you're 4 or 5! I always enjoyed being one of the youngest in my year at school, especially when it became clear that I was cleverer than many of those around me (how arrogant is that for a child?!)

Anyway, back to topic. I started university and was among the youngest around, in fact, I’ve never met anyone younger than me in my year - although statistically there must be some people younger than me (don't Scottish school years differ anyway?). I was surrounded by people who'd taken gap years and traveled the world, people who'd already done other degrees or people who already had entirely different careers but fancied a change. I was mature for my age, but compared to the people around me, was still relatively immature. I'd toyed with the idea of a gap year but for various reasons decided against it, I wonder now if it would have made any difference to my time at university. I don't regret not doing so, I just wonder what would have been different. Fortunately we've had the chance to do some traveling and it was great, I’m hungry for more.

I remember thinking when I started that I'd still be one of the youngest in the year group 5 years later when we all became doctors. Now that prospect is getting ridiculously close. Others around me have done intercalated years, resit years, or were just older when they started. So come August (pending finals) I’ll probably be one of the youngest out there, there is a high probability that I’ll be the youngest in the SW deanery what with 6yr courses, intercalation etc etc. Personally I think that’s quite cool, I’m not sure the patients will though. I think I look about my age so I’m certain I’ll get plenty of comments about being too young to be a doctor, behind my back mostly I expect. It doesn't bother me, they're probably right. Who would you want to be treated by? The 35 year old doctor who spent 10 years as an accountant before deciding on a career in medicine or fresh faced me who'll still be 22.

"How cool are dictaphones?" "stop", "new paragraph"

Today I had my first surgery at my GP placement. This means that I've got patients of my own, real...live...patients! I have my own room, my own computer, my own sign on the door, my own button on the computer to send in my own patients and all sorts of other cool stuff which I'll come onto later.

Throughout the last couple of years at other gp's I've always been able to see patients on my own before they see the GP but not to the extent that I can now. Now I have my own surgeries built into the computer system and the receptionists book patients in to see me... they must all be stark raving bonkers.

Anyway, it was great fun. That feeling I had from my elective where I felt like I was actually being a doctor came flooding back, although fortunately for the patients I'm still heavily supervised. My GP supervisor has slots in her surgery to come and check on me, make sure I'm not going to kill anyone and sign any prescriptions etc etc.

This morning I had 5xhalf hour slots - so the patients are actually getting a good deal, they get to spend 3 times as much time with me as they do with the doctor. Although most appointments don't tend to take that long, by the time I've worked out how the computer works and written up the histories (hopefully without referring them accidental for a vasectomy.) that half hour is soon gone. My first patient this morning was 40 minutes early, he must have been excited to see me.

It was an odd morning actually, 3 of my 5 patients went away with referrals to the hospital - 2 under the 2 week rule for the same thing. This of course meant that I had to do the referral letters - or more precisely I had to dictate them! This was by far the highlight of the morning, I'd always wanted to play with a dictaphone and dictate my own letters - it was unbelievably cool. So cool in fact that it took me about 40 minutes to dictate my 3 letters because I kept changing my mind about what I wanted to say and I kept recording over myself by accident. I used to sit in clinics and listen to consultants dictate their letters adding all sorts of weird and wonderful phrases wondering when I'd get my hands on a dictaphone. I kept my letters very professional - I dread to think what the consultants will think of them when they get them though - I'm sure I probably filled them with useless information about entirely irrelevant things but not to worry. Ok, I'll stop now, maybe I'm slightly too over-excited by this dictaphone thing, after all - referrals aren't generally that good for the patients.

Anyway, I didn't kill anyone, and even managed to come up with decent management plans. I really enjoyed myself, hopefully I didn't scare the patients too much.

Afternoon surgery starts at 4pm this afternoon, is it really bad that I hope somebody needs referring so I can dictate another letter?

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!)

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.