Sunday Doctors

[sundaydoctors]

OSCEs are Objective Structured Clinical Examinations. What makes them so hard to revise for, though, is that rarely do they fill their remit of being either objective or structured. Until Robodoc is successfully assembled to mark your jittery six and a half minute delivery of bad news to an actor or of a catheter to plastic genitalia, then they will not be marked obectively. And it's medical school, so let's face it they won't be structured. I'm not even sure if it's us that are meant to be structured or the exam. Either way, it ain't.

So after a month or so of sporadic trips to the special room with boobs on straps that can be hung off all varieties of medical student to be examined by another, I still feel suprisingly unprepared. I didn't get much sympathy from my junior medical student housemate either.

"You'll breeze through it, it's basically summer holiday for you now" she says whilst proving my point exceptionally trying to assemble a pedestal fan (UK chaos, nearing 30 degrees). In true british, or human, style the instructions were cast aside like a mild insult. There were several metal cylinders that were meant to slot into each other and a range of bolts for the edges splayed across the lounge .
I lay on the couch observing and considered helping her, "This is a lot like that video they showed us in second year with that girl trying to assemble a bassoon. She clearly had no bloody idea. Then they showed us a video of a bassoon player assembling one. Anyway point being we'd look like the first one in our OSCEs if we don't practice, and clearly neither of us have touched a bassoon"

My favourite parts of the last 2 days of sessions focused on the OSCEs (aimed to reassure):
"Just don't leave it too late. Ignore that bit, it's too late already"
"You won't break down mid-exam. It has happened just once or twice over the last four or five years"- a lie. An opthalmologist made me burst into tears five minutes in last year and I'll be dammed if he meant me.
"You won't pass if you make the children cry. If they make you cry? I don't know"

There is a small part of me that loves the first bit where ten or so of us are shut in a room waiting for the gun to fire for the start. The terror is so palpable you can't help having an odd feeling of amusement. Then when I look at Sweaty Stevens in the corner I enjoy it that bit more knowing that he is even more terrified by my face beaming back.

[sundaydoctors]

[Before I go on I will say that I am not just an incredible cynic. I often find medical school highly enjoyable, it just happens that most entertaining times are usually thanks to irony]

They say you always remember your first patient. This is not true. Well at least not for me. Most of mine were either unrousable, unwilling or just too incredible old to have a two-way conversation with.

As we begin our 'clinics' we are divided into small tribes and nudged out to large hospitals across London. Then to the wards to begin the game of the Make Your Own Medical Education Up game. No more nice spoonfuls of knowledge from lectures, we are to go and 'clerk' some poor sickly people, which basically meant asking them what was wrong with them and why, then not being able to help them at all with anything (for example why the nurse hadn't come back to change the dressing/catheter/bed like she said she would last week).

The first stage of the game is to get into the ward. Fortunately they let us chose a partner (mine is M) to bring along at all times, and this is probably the sole reason we have both got so far. Our sad little faces look through the big doors to the wards for 5 minutes or so then paw at the card swipe on the side of the door. No cards for us, that would be too easy. Then myself and my partner debate pressing the buzzer for another 5 minutes. Just about to press it and someone comes out of the door. Success.

Then to stage 2, the Notes Game. We spend half an hour flicking through the notes, thinnest ones first (less things to talk about), looking busy. Or at least we think so, everyone else probably thinks we're morons. Our junior doctor wants us to 'present' a patient each to them, and we've got 10 minutes or so left. So we select the youngest and least ill sounding patient and stride confidently to their bed for stage 3.

M: "How was yours?"
Me: "Asleep. Yours?"
M: "Couldn't find him"

We report our failure back to junior doctor, but this is the least of our worries. Because of course we were allocated to the winner of the most -stereotypical-magnificantly-petrifying-female-consultant award. I'm sure there's some competition for that too.

It is a true case of Laugh or Cry. We both did a bit of each. There were lot of Tubeculosis patients in the area, so I probably clerked more TB patients than anything else on that rotation. I remember being halfway through taking a patient fresh from A&E's cough and night sweats history when they sputtered onto my arm and I realised it was probably time to put a mask on.

My favourite moment in that term was near the end. We had just finished a HDU (high dependency unit) ward round with our consultant and she stopped, turned to face our group of 6, who recoiled instantly and did anything to avaoid eye contact. She had a very good knack of stopping very briskly, turning and firing questions on cystic fibrosis or just fire at us.

She says, "I went to the (some operatic horse thing) show the other evening. It was simply wonderful. Have any of you been?"

We looked at her in utter bemusement. Convinced she was bluffing, none of us said a word. We just stared back wondering what just happened. She looked back oddly at us, huffed and then stormed off.