What a Ridiculous Exam

- If you're going to insist on asking us a load of microbiology questions, please tell us in advance so we can learn it. Alternatively, you could, you know, actually teach us something rather than making us do it all ourselves in PBHell.

- If pt x has so and so wrong with them, my 'initial management' would probably include the answers a, b and e. Please don't make me guess what Dr Jones wanted as the correct answer, based on how he was feeling when he wrote the question, when all 3 are potentially correct.

- To all of those studying a PBL course, unsure what exactly you need to know, the answer is everything. Yes, absolutely every last possible detail of every conceivable thing. You must know every textbook inside out and be prepared to answer questions on everything.

- I've done this exam 5 times now, and this time was by far the hardest in my opinion. At least most people seem to have found it rather difficult.

- I pity the poor 1st years who did the same exam, they must have literally had to guess all but a couple of questions.

- I've got a headache.

- OSCE tomorrow.

- Onwards and upwards

Close To The End

3 years of life in hospital as a medical student hopefully came to an end today. Shitters

Exams Monday, Tuesday, Friday next week. Shitters

Then its all over. Shitters.

Results 1 month later (don't even get me started on that). Shitters

Argh shitters!

The next update will probably be Tuesday after my OSCE. See you then

Blogging Revision

Ok, so I'm not supposed to be blogging because I'm supposed to be revising but I had a wonderful thought - what if I combined the two?

What better way to revise ethics and consent than to discuss it. It's a grey area without a yes or no answer. It is more a matter of common sense and opinion so I'm asking for your opinions on the following scenarios:

1) You are the SHO on an upper GI surgery firm, you are told to explain a diagnosis of gastric cancer and start to consent a schizophrenic patient for surgery.

2) You are a new GP partner in a GP surgery seeing a woman who is going in for a elective operation, and she doesn't want the people in the hospital to know about her Hep C status... it turns out that she thinks if the hospital knows about her Hep C status, her social worker would find out and not let her to see her daughter.

3) A husband slept with prostitute in Thailand on business trip. Wife is unaware but attends GP with sore throat & demands to know what’s wrong with husband & wants same treatment.

So, how might you approach the above situations, go on, leave a comment and help with my revision.

Shingles Mingles

So missbliss has shingles, poor her, everyone who has had it seems to have oodles of sympathy. Unfortunately, nobody seems to be quite sure whether or not I've had chicken pox. I thought I had and was merrily poking her rash before she went to the doctors, but it seems that I might have just made up me having chicken pox as a child. I guess we'll find out in about 14 days or so (the incubation period) right before my finals start. Wahey.

On the plus side, the football rocked my socks. And so I've got the champions league final (no legs involved missbliss) after exams.

piss off!

I don't seek out the most remote and quietest place in the library for you to come and sit on the table next to me and spend 10 minutes talking to your 'bro' on your mobile. Prick. Kindly piss the hell off!

They Think Its All Over....

Well it very nearly almost is. I finished my last clinical placement on Friday. This signifies a couple of things, firstly that I'm supposed to know everything that I could possibly need to function as a doctor and secondly that finals are in 2 weeks.

2 weeks tomorrow, my first exam, then 2 more, spread out over the rest of the week and that is it. I'm free...at least for a month until results.

As a result of this, I'm not going to be writing, or reading blogs much over the next 3 weeks. Well that is the plan anyway. I know I've already mentioned my upcoming exams plenty of times and thanks to all those of you who've wished me luck.

Best of luck to all those readers who are also sitting exams as we come towards the end of another year.

A Dream Becomes Reality - But Not In A Good Way

How many people have dreamt about being a hero at the scene of an accident? For the majority it will remain just a dream, one in which they are cool, calm, confident and heroic. For others, this dream becomes real, but the reality of the situation is somewhat different to the heroic dream.

This afternoon we went for a drive in the countryside, the sun was shining and we were merrily winding our way around the country roads. Up ahead, over the brow of a hill I noticed an accident, it soon became clear that it was quite serious. There was a distinct lack of emergency services, I was faced with a decision, should I stop or carry on? Despite having little to offer I decided to stop, I pulled over, just beyond the accident. My heart began to race, I hadn't paid much attention to the scene as I was pulling over so I didn't really know how serious things were. The accident had obviously happened barely a minute before we passed and a couple of other people were already on the phone to the emergency services.

As I approached, I realised this wasn't just a shunt, it was a high speed, head-on collision involving two cars (car 1 with one man in, car 2 with two women). Metalwork was strewn across the carriageway and the cars were in quite a state. I approached what I initially thought was a police woman talking to an obviously distraught and injured passenger. I introduced myself as a final year medical student and asked if there was anything I could do. It wasn't until afterwards that I realised that she was just a smartly dressed passer-by.

As a final year medical student I've not exactly got a wealth of experience of medicine, let alone in pre-hospital care. I'm not afraid to admit that I was terrified, realistically, what could I do? No experience, no equipment, no nice doctor telling me exactly what to do, absolutely no idea what I was doing. Not only that, all my brain could think was "Oh SHIT!" So not exactly the cool, calm, confident hero?! I went to the driver's window of car 2, the driver was slumped, she was barely breathing. I tried to introduce myself but she was barely, if at all conscious. The only thing I could think of was ABC (Airway + c-spine, Breathing, Circulation), she was obviously trapped and severely injured, I tried to assess her pulse, I couldn't convince myself that she even had one. I tried the back door so I could get in to stabilise her head and neck but it was stuck. I was focused on trying to assess ABC it wasn't till later that I noticed (actually missbliss pointed it out) her other arm was broken so badly it was bent in 3 places. Eventually a policeman who'd arrived managed to get into the back and to stabilise her head, but by this point she looked terribly grey. I'm no expert, I'm not even a novice, but something inside me thought she was probably exsanguinating internally.

By this point the only emergency services on scene were the police, I moved on to the driver of car 1, he was the better of the 3 casualties, although he was still trapped inside his vehicle. Again I introduced myself and briefly assessed him, he was alert, although completely disorientated. I tried to reassure him as much as I could, his neck was painful, so I was doing my best to make sure he kept his head still. By now the scene had become littered with firemen, although they were concentrating on the other car so I stayed with the man in car 1 talking to him, although he couldn't remember anything at all.

Eventually the ambulance arrived, I explained who I was and one of the paramedics asked me to stay with the man I'd been talking to until the other ambulance arrived. I could hear the emergency service working frantically behind me to free the women in the other car. I kept being as reassuring as I could and after what seemed like days the other ambulance arrived, I briefly explained what I knew and what the man in car 1 had told me about his condition. Finally I took a step back to look at the carnage.

Despite the carnage, the whole scene was rather calm and quiet. It is impossible to describe but certainly the reality is completely different to anything you could ever dream or see on TV. As I stood there talking to one of the witnesses, he asked who I was and I explained. "Coming towards your exams eh? You'll soon have a different title then won't ya?" he said. The reality is that if I pass these exams he's right, I won't be a final year medical student, I'll be a doctor. My worry then is that people will expect things of me in such a scenario. It was clear to me that there are no heroes in a situation like that, it takes a real team effort by everyone involved. Without that, things wouldn't get done, and people would die. I don't know what happened to the casualties today, indeed I may never know but I really hope that everyone involved is ok, and my thoughts are with them and their families.

Finally, and not that I've ever had anything but respect for paramedics and the emergency services but after today, I've got a whole new admiration for the work they do. It is one thing being the doctor in A+E surrounded by all their equipment and a team of nurses on the receiving end of an ill patient, but a paramedic, first on the scene to something like this. They really do deserve a great deal of respect!

As for exams, they're a walk in the park compared to this. Reality is so much more terrifying.

It was so difficult to even begin to write about today's events, I'm not even sure I should have. I know I had little to offer and I don't think anything would have been different if I hadn't stopped, but I'm glad I did, and if I'm ever in that situation again, I hope I'll be a little more confident that I can do something, even if it amounts to little more than nothing.