I'm A Medical Student Get Me Out Of Here

[imamedicalstudent]

In 30 Years Time...

Technology fascinates me, maybe its because I've grown up with it but I've always felt affectionately towards it. In some ways it fascinates me more than life itself, what is a few billion years of evolution compared with with the technological advances of the last 30-50-100 years? Sure evolution is pretty dam clever but the technological revolution which allows me to type this and instantly have potentially millions (or, more realistically, about 30 - I can dream...) of readers is simply staggering...

read the rest of this post here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

"There is a 3:38 in Bay 5"

Having spent a few days in A&E, it is already immediately obvious what the most important thing is. You might think, or hope it would be the patients but sadly it isn't. Wouldn't you think that in 2008 the central focus of care in the A&E department would be the patient? It isn't the nurses fault, nor the doctors, both of whom work very hard to ensure patient's receive the best care possible but whilst they're doing so, there is something more important on their minds. What can be more important than the patients I hear you cry with horror? I'm sure most of you have guessed by now; the 4 hour target.

read the rest of this post here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

A Vision of Revision

I've spent this weekend camped in a lecture theatre at a finals lecture course, not only that, I paid for the privilege. At £95 a weekend, its not cheap, especially when there is one for surgery and one for medicine. I guess whether or not they're worth it is a personal opinion, perhaps sitting at home reading a book would be just as effective and £95 cheaper for some people. A few thousand students each year attend one of the finals revision courses run by companies like the MDU so there must be something about them that makes them popular, perhaps its the misguided vision that attending such a course is a one-way ticket to finals success. I'm not as naive to think that and if anything this weekend has made me more scared than I was before....

read the rest of this post here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

What Next?

I'm not usually an ill person, sure I get the occasional bout of man flu once or twice a year but other than that I'm usually quite healthy. That was until this year, I've been ill almost constantly since before Christmas with one thing or another.

This weekend I was struck with a mysterious vomiting bug! It only lasted about 36 hours or so but I'm still feeling the effects now. Vomiting is not fun, especially when there is nothing left to bring up apart from tiny amounts of water that you've managed to drink to keep you hydrated.

I'm thoroughly fed up of being ill, it is quite literally, driving me insane!

What is wrong with me?



Post your diagnosis here:
http://www.blogger.com/comment.g?blo...2&isPopup=true

[imamedicalstudent]

Reacting to Unexpected Situations

I've been in A&E for a couple of weeks now and you can never predict who or what is going to come through the door next. It could pretty much be anyone from any background with anything wrong with them, you can't foresee every possible situation you might have to deal with.

What happens when its not something clinically relevant but it surprises you nonetheless. For example, what if a patient, during the middle of a consultation says something unexpected. What if they go on a 5 minute racist rant about the state of 'our' country? How do you react to something like that? Particularly as a medical student but even as a doctor or nurse. You can't possibly sit there and agree, at the same time you can't really challenge the persons views, that isn't what you're there for. So, do you just sit there politely and let them rant until they can rant not more? Do you look at your shoes, at the patient, at the wall? Do you make your excuses and leave? Is there a difference if your patient is a 30 years old or 90? Male? Female? What about afterwards when you have to present the case to a senior and the only seniors around are of a different race? Do you warn them of the patients beliefs? Do you pretend you'd not heard anything? Do you go for an early lunch?

Being a doctor is about much more than dealing with clinical situations.



Click here and leave a comment if you wish:
http://www.blogger.com/comment.g?blo...1&isPopup=true

[imamedicalstudent]

Vein Hunter

I'm a vein hunter, no, not an assassin of vain people (as much as I'd love that) but a pursuer of veins. My time in A+E has turned me into some sort of sadistic predator. My chosen weapon, a venepuncture needle, I stalk, like a cheetah hunting zebra, just waiting for the chance to pounce. Every patient a potential victim, but each with their own particular characteristics. The young man with magnificent engorged vessels entwining his arm. It would be almost too easy to swipe two bottles, that is until he begins to whimper in desperation, "I don't like needles", but it's too late I think, as the blood begins to flow and I reassure him; "almost done". The middle aged man with similarly bulging veins, barely even flinches as my weapon penetrates his flesh with the greatest of ease. But these examples are like feeding meat to a crocodile, it is too easy, where is the fun, the challenge, the adventure...

"Go and bleed the lady in 9" - my heart flickers, slightly nervous knowing that the 86 year old's veins are likely to be hidden like ninjas in the night. This is more like it I think to myself as I cleanse my hands in a ritualistic sacrifice of bacteria. I assemble my weapon and approach, pausing briefly to introduce myself, a mere interruption to what lies ahead. I strap on my tourniquet and begin to look for a potential victim. Like rabbits hidden in a burrow there is nothing, not even the scent of prey. I ask the patient to squeeze their hand and gently feel my way around, still nothing. Am I to fail at the first hurdle? I retrace my steps, carefully examining for the hint of blood streaming through a vein, hidden deep. YESSS! What's that, invisible to the eye and barely palpable, the mere hint of a vein? My fingers tell me its exact position and I load the needle. It is time.

Majestically, I recheck the vein, I panic as momentarily it's gone, but no, there it is. Oblivious to the world around me, I almost fail to hear the elderly lady announce "the district nurses always have trouble, they can never find any blood" - this just encourages me! I get into position, needle poised, "sharp scratch" I announce as I ease forward through the skin. With practice you can feel the needle puncture the vein, you think it's there. You ease back the syringe plunger and without delay a gush of red pours into the tube. You've hit the jackpot, first time too, perfect - but its not over yet. You've got to change the tubes, keep the needle perfectly positioned and finally, withdraw the needle. All in all a triumph, a perfect hit, another victim.

It's become a game, no longer challenged by the simplest of veins, only the difficult ones give the same satisfaction, the same feeling of achievement, the same buzz. I'm a vein hunter!


Post a juicy comment here: http://imamedicalstudentgetmeoutofhe...in-hunter.html

[imamedicalstudent]

A Fitting End

Contrary to the title of this post, it isn't a story about rectal diazepam.

Tomorrow heralds the start of my final 4 week hospital placement: lower GI surgery. Rather fittingly, this is the same as my first ever clinical placement at the start of 3rd year (I wonder if the consultant will recognise me?). I wonder how much I've learnt and how far I've progressed in that time? Hopefully quite significantly! How much time I'm actually going to be able to devote to this placement I'm not entirely sure as I have an ever-growing list of other things to attend. I hope to spent most of the time with the F1 (fingers crossed that they'll be friendly and helpful, although its all change next week anyway as the F1s rotate).

The fact that this is my final placement means a couple of things: the first and most important thing is that finals are just 6 weeks away, secondly, in seven weeks it'll all be over one way or another, thirdly, that I have 4 PBL sessions left EVER and finally, that in 6 weeks I will hopefully never have to set foot in a certain city ever again!

To be perfectly honest, I wish finals were tomorrow. I just want to do them and get them out of the way. Sure 6 weeks is a long time and I've still got lots to learn, never mind revise but I'm awfully fed up of just waiting for these exams to come.

This weekend I attended the medicine version of the revision course I wrote about 2 weeks ago. It was a completely different style to the surgical one in that it concentrated on exam technique more than knowledge but it was useful nevertheless.


read other posts here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

Surgical Consult

Without a doubt I want to be a surgeon. There is nothing else in medicine that inspires me like surgery. I realise that medicine and surgery might be considered separate entities but you get the idea. Medical specialties just don't press my buttons, I much prefer the blood and guts (particularly relevant to lower GI which I'm doing at the moment) world of surgery. Surgery has the tools and gadgets which I enjoy playing with so much, it requires focused attention to detail with which I'm slightly obsessed.

I spent the morning (and most of the afternoon) elbow deep in bowels, I realise this might not be everybody's cup of tea but I was fascinated. Even when not scrubbed up I can quite happily just sit (standing and watching gets ever so slightly tedious) and watch. I learnt today that my back muscles are going to need some work if I'm to fulfil my ambition. The other thing that I'll have to work on is my anatomy, I've said this before and I really resent not being taught any useful anatomy. I suppose I shouldn't be surprised, we've not really been taught anything, I had to go elsewhere (and pay) to learn how to suture, God knows what else we've missed out on. If I go on and pass finals, I'm determined not to waste my last ever summer and in between much computer game playage, I will learn some anatomy.

I don't know which surgical specialty appeals most at this stage, although I've always had a soft spot for orthopaedics. To be honest, I'm not really bothered, as long as I get to cut people up (when they're still alive I should add) I'd be happy.

Who knows whether I've got what it takes but with little else that inspires me I'm determined to try my bestest.



read the rest here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

The Student Becomes the Master

(I wish)

This week a friend and I took it upon ourselves to teach the 4th years. It is approaching the end of the year and therefore exam time for everyone. Thursday afternoon a group of about 15 or so 4th years assembled themselves in the skills lab to be taught obs and gynae for OSCEs. I was taken a little by surprise and consequently hadn't prepared. I ended up going over breast exam, pelvic exam and pregnant abdo exam all from memory. I think it turned out quite well, although who knows what the students thought, it was also very useful revision for me as I learnt things from them too. As you'd expect, they were more interested in what stations had come up previously and any hints and tips for the exam. I tried to emphasise the important things and even collected a list of email addresses to send round some resources.

Today I was slightly more prepared in that I'd read what I was supposed to be doing and prepared handouts. At half 12 there was hardly anyone there but 5 minutes later a group of 20 or so had appeared expecting to learn about orthopaedics and neurology. We split them into two and I took half to 'teach' them cranial nerve examination and neurological examination of limbs. My cranial nerve exam was a bit rusty but again I hope they found it useful, certainly they seemed quite pleased with the handouts which out to make up for any gaps in what we'd taught. In the end we ran out of time so I didn't get chance to go through everything with the second group and by now I'd run out of handouts but lovely person that I am, I took all their email addresses and promptly sent a copy to those who'd missed out.

And so, the students had become the masters. Albeit masters in the very loosest sense of the word. It was more going through the examinations together and pointing out where each other had gone wrong. Nevertheless, teaching this was and a sparkly certificate I shall get. Not only was it good revision for me, I enjoyed the experience. It was refreshing, if rather more difficult than I thought it'd be, to teach other people. The students were quite willing to learn and I wasn't short of volunteers which made things easier. I've never really been a position where people are expecting me to teach them and I did quite enjoy the whole thing, I just hope it was useful for them. I can certainly see why people are obsessed with feedback forms, having done these sessions I can see how difficult it is to assess how useful a session is.

Oh well, I'm sure they at least found the handouts useful.

I look forward to being able to do some more teaching in the future. Apart from surgery, medical education is another interest and I hope to be able to pursue that further.


Leave a comment here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/

[imamedicalstudent]

Random Musings For a Sunday Morning

- This year it was my turn to pick the winner of the Grand National. (About bloody time too I've not won owt for years). As comply or die romped home I was cheering at the TV, as I tend to do when I get a little overexcited. I was very pleased indeed to collect the best part of £100 of winnings.

- Bring back winter! At least on those dark, cold, dreary mornings, you can lie in quite happily and sleep until your heart is content. I was really looking forward to a lie in this weekend but on both days we've been awake well before 8. Its ridiculous, I've not had a lie in for weeks! It doesn't help when you have curtains that may as well not even be there they lot so much light through. It feels like daytime but its so early and I just want a lie in now and again! Is it really too much to ask?

- We're hopefully going to Glastonbury this June. It'll be the last time we get such an open opportunity to go so we thought we'd better make the most of it.

- Pancakes for breakfast. Yum Yum Yum. Now if only I had someone to deliver my Sunday Times...


Leave a comment and read other posts here:
http://imamedicalstudentgetmeoutofhere.blogspot.com/