Friday 31 December 2010

New Years Resolutions

This year I'm going to keep it simples...

1. Pass my MBBS

2. Find something to smile about every day

3. Survive 5 months of FY1

Lily xXx


Wednesday 29 December 2010

Nauseating Realisation

I thought since I've chilled out all holiday so far (except a little bit of bar work), that I should probably spare a few moments to think of medicine. Not wanting to do something too stressful I decided to make a list of revision topics so that I can make a proper revision timetable.

My list of revision topics spans 17 pages.

I have until the beginning of May to write revision notes for and learn 17 pages worth of topics.

Bugger.

This isn't including OSCE (practical exam) revision.

Double bugger.

I got a Kindle for Xmas so I've got even more reason to be distracted.

Triple bugger.

On the plus side I've booked 4 different revision courses. My bank manager would probably argue when I say this is a positive thing.

I'm going to both the medicine and surgery days from the MDU and Ask Dr Clarke. These should not only fill me with knowledge, but give me a pile of extra notes to revise from too. Apparently they're also partially OSCE orientated, so it'll relieve me of the worry that I'm not going to have the time to revise for OSCE until after writtens.

I need to work out some kind of attainable revision timetable now. There's nothing worse than aiming too high with revision and then getting all disheartened and wanting to quit once I'm a day or two behind. I need to balance this with not aiming too low with revision and sauntering off to the pub after 10 minutes. Oh how I love the pub more than the library.

Lily xXx


Saturday 25 December 2010

Merry Christmas!

Merry Christmas everyone!

It's been a long time since I've posted. Technical and time difficulties among other stuff.

Regular posting will recommence in the new year!

Much love...

Lily xXx

Wednesday 8 December 2010

Location, Location, Location?!

No not the TV programme. Although I like that.

Foundation jobs.

Where to choose?

As anyone who follows me on Twitter (@studentdocdiary) will know, I got into my first choice foundation school. This is a HUGE foundation school, so I now have big thinking to do about which jobs to rank and where.

My family home and my uni home are both within the foundation school. This means I'd like to think I know a fair bit about the area. This isn't necessarily a good thing. I have a lot of preconceived prejudice about some areas.

I've seen one job I really like the look of. It's near my flat so I wouldn't have to move. It's got paeds in it (YAY!), but unfortunately it also has obs and gynae... the only thing that makes me want to faint! On the plus side the FY2 jobs linked to it are either at my home trust (where my Mum died) or in Crapsville. I might go an spend a day visiting Crapsville to see if it really is as bad as I think?!

Lily xXx

Woo Hoo!

Got my first choice foundation school!!

That is all.

Nightie night...

Lily xXx

Friday 3 December 2010

Feeling Festive

Again it's been over a week since I blogged. Sorry.

Partly this is due to the rubbish internet connection which frustrates me for hours each day, partly this is just because I am rubbish.

It's been a varied week.

I spent last weekend at home. Well what was left of the weekend after the exam on Saturday. It was surprisingly OK considering I had done no revision. Psych wasn't. I was asked to ilict the first rank symptoms of schizophrenia. Great if I had remembered thought insertion and withdrawl. Oops. I was also annoyed at the ECG station. The examiner was convinced that I had the pads in the wrong place and that v1 and v2 should be in the 2nd intercostal space. Wrong. It's the 4th. I stuck to my guns and was marked down, but then went and checked afterwards. Bloody cheeky cardiology SHO.

Had the results yesterday and I did OK. With no revision I passed all except 2 stations. I didn't pass them as well as I would have liked had I have done revision, but it's allowed me to breath a sigh of relief. I'm clearly not as rubbish as I could be and I can spend the next few months getting things perfected.

The rest of the weekend was spent drinking too many vodka's with the new boy and his mates, at a naked photo shoot (arty, not pornographic) and then battling through the snow back to placement.

I spend the first 2 days of the week ill in bed, and the second 2 working very hard indeed as we seemed to have so much snow no-one could get to work and the poor new fy1 was abandoned to look after over 30 patients on his own.

I have another exam today. Great. On pharmacy and prescribing. Even better. I'm actually dreading it....

Lily xXx

Thursday 25 November 2010

Diagnosing Death

It's strange to think of death as a diagnosis... but apparently it is. It's a diagnosis that I'm sure most people wouldn't like to be given, but each of us will be given one day.

Today I certified my first patient. It was a bit of a strange experience. For a start the patient had been dead 3 days. Although a fair few patients die on my geriatrics firm, they all seem to die out of hours so I've never been around when someone passed away. This meant as I went with the doctor to check whether or not a patient we needed to fill out a cremation form for had a pacemaker or not, the doctor let me run through diagnosing death.

To be quite honest I felt like a bit of a prat. I knew he was dead, the doctor knew he was dead, the mortician knew he was dead. He'd been in a fridge for 2 days! You'll be relieved to know there was neither a pulse or a heart beat.

Afterwards I got into a conversation about dead people. It's strange how as doctors (or even medical students) we get used to dead people. It's also strange that no matter how used you are to dead people, there's always the odd situation where handling it is that much different. Sometimes it's if you knew a patient well, other times it's when surrounded by the patient's family and sometimes you just can't put your finger on it.

Surprisingly the mortician wasn't as much of a weirdo as I'd imagined him to be. Someone who locks himself in a room with dead people all day lends themselves to getting a reputation. I'd almost imagined him to be some kind of social outcast who couldn't string a sentence together. He was a very nice man. If it wasn't for all the dead people in the fridges I'd be happy to go back and visit.

Lily xXx

Tuesday 23 November 2010

Treading Water

For once the reason I haven't blogged is not because I have nothing to say, but because I've been so busy! So busy in fact that I feel like I'm constantly running around doing stuff, but not really getting anywhere... especially with sign ups!

Regardless of that feeling I'm in a pretty chirpy mood. This may have something to do with the sunshine, or something to do with the fact Christmas is coming... but is more likely to do with the nice young man I've been spending my free time with. Enough about him for now... I'm sure I'll bore you all with lots of details at some other point, you probably want to know what else has been keeping me busy.

End of last week I spent some time in the admitting ward of the hospital I'm placed at. Clerking in patients, managing them and then attending the post take ward round. It's reminded me of why I want to be a doctor, even though it was geriatrics, it was pretty fun. There was a steep learning curve, mainly to do with ordering tests and bits and bobs but the other junior doctors and the nurses were all really helpful. I love seeing everyone work as a team, as seems to happen with this geriatrics firm and the nurses on all the wards.

At the end of a full day of clerking in patients I was exhausted. I didn't even know how I was going to get up to attend ward round the next morning. I'm glad I did though. All the hard work paid off. The notoriously difficult to please consultant not only complimented me on my hard work, but then went and showed me off to the other consultants as "the really hard-working medical student who clerked and managed more patients than the sho's"

Part of me wanted to die with embarrassment and the other part of me wanted to have a t-shirt printed with it written on in HUGE letters.

Annoyingly even with all this hard work I still haven't got that many sign ups compared to other people because I just don't have time to trawl the wards to get things observed. I'm hoping on my night shift this weekend (yes exam Saturday, night shift Sunday, social life... gone.) I'll be able to sweet talk some friendly nurses into helping me get some bits signed off. I really really really want at least 20/30 sign ups done this term.

Lily xXx

Monday 15 November 2010

Chugging Along

Sorry I've been a bit lax at blogging over the last week, but as I've really just been chugging along I didn't see much point in boring you with what I was having for breakfast (an apple today, sometimes musli... quite often mini rolls), or something equally as dull.

Today I changed placement. I am now doing geris. Those of you who've been reading this for a while will know that there is no love lost between geriatrics and myself.

In fact I detest it.

This is no critacism of geriatricians. In fact I really admire them. They have to be good general physicians, patient, able to work effectively within a multi disciplinary team, they have to see the bigger picture with regards to patient's social as well as medical needs and they have to deal with lots of really sad stuff. It's the sad stuff that gets me down. The nutty old people are OK.

First day has been OK. I've sorted out when I'm clerking for my case study. I did a few really scutty errands that have hopefully earned me some brownie points and I managed not to fall asleep. This was so mean feat as I was up pretty late last night with a friend.

During this week I'm also going to get to experience the acute admissions ward. I'm excited about being able to go back to clerking patients in properly and examining people. It will also help with revising for my mock OSCE I'm guessing. Not that I'm planning to do much work. Seriously... an exam on a Saturday 6 months before the real things. I'm still waiting for them to say they're having a laugh.

Lily xXx


Tuesday 9 November 2010

Making The Most of It...

I've been telling myself since summer that hardcore revision starts from January. That means that I have less than 2 months of revision-free time to enjoy!!

Although I'm stressing about sign ups (yes... I realise, I'm always stressing about little things for no particular reason!), and my elective poster (Hmmmm... probably should start that soon!), I'm also going to make the most of the next few weeks.

I have weddings, birthday parties and Christmas parties all lined up. Yay!!

What is not exciting is my impending mock practical exam. On a Saturday. 6 months before the real thing. Did I mention that it's on a Saturday? Unimpressed. So that'll be a 6-day week for me then. Fabulous.

Lily xXx

Friday 5 November 2010

Non-Stop

Yet again I've promised myself a weekend of relaxation and getting some work done, and yet again, by 3pm on Friday afternoon I have organised a weekend of complete madness. Fabulous.

As well as going to the middle of nowhere to watch fireworks tonight, I'm also planning to hit the nightclub. Then Saturday I am being offically "the-best-friend-in-the-whole-world". A friend of mine has nowhere to live for a short while and as my flat is completely empty I'm running the keys up to London for him. Haven't decided if I'm going to stay in London Saturday night, or if I'm going to go home, but either way I think it'll be a late night with a few drinks.

Sunday I'm going to be chillaxing and recovering.

What does everyone else have planned for this weekend?! Hope you all have a good one!

Lily xXx

Wednesday 3 November 2010

Smile and Smooze

I started this morning with the obligatory consultant ward round, followed by a cup of Earl Grey in the mess. As we haven't been on take for a few days our patient list is rapidly dwindling (thank goodness as it seems like half the firm is on annual leave). Because of this there weren't that many jobs to be done, so with my FY1s permission off I trotted to get some sign ups.

This year as well as sign ups for skills we have to perform there is a long list of different procedures we need to observe, so that we can better explain them to patients in the future. This is why I ended up trawling the hospital sweet talking pretty much every healthcare professional I came across.

Apparently us medical students have a reputation for being demanding, bolshy and rude. I'm aiming to turn that around. It is for this reason that I have perfected the smile and smooze.

The smile and smooze works best if you are genuinely a nice person. It is quite obvious if you're just putting it on.

The technique is simple. When asking if a different healthcare professional will show you something you have to be nice to them. Remember that explaining things to you will probably slow down their already busy day. I always start with introducing myself and giving a big smile. I then ask nicely about what I would like to do or see. It's important at this point to emphasize that they will be doing you a favour so timings are completely flexable. If they frown it's important to keep smiling. This disarms mean people so even they say yes. The smoozing then continues with a very big thank you once they've agreed to what you want.

To perfect the smooze when you return to observe the other healthcare professional at work, bring something for them. A sweetie pilfered from somewhere is enough. Then remember to say thank you at the end. A couple of comments on how interesting/difficult/skillful their job is also doesn't go amiss. Everyone likes to hear when they're doing a good job.

The smile and smooze has yet to fail me. Fingers crossed!

Lily xXx

Tuesday 2 November 2010

Muddled Head

I don't feel quite right today. I've had a headache since yesterday afternoon and my brain just feels all mixed up. I gave up on being in the hospital after ward round today and went for a nap, which hasn't really changed or improved matters.

I really don't want to be ill!! Noooo

I've been feeling too grotty to even add anything more to my Nanowrimo, which is a pathetic 772 words long.

Fingers crossed I'll wake up tomorrow feeling like a new person. I want to make a game plan to get more sign ups this week. I managed to get another 2 today... hurrah! Some of the sign ups we have are really stupid though, whereas others seem near impossible. "Watch a barium enema" - Well I would if the hospital trust I was at did them anymore.

I've decided to be sensible this weekend and give up partying to instead do my Elective Poster. No more last minute rushing around for me this year. No no no. This year I'm going to be organised and calm (or at least as calm as I can be with finals looming!).

Lily xXx

Monday 1 November 2010

A Week In The Life of a Final Year Medical Student - Friday

Sorry this is late... I had such a busy day on Friday that I just left my laptop and went home for the weekend to recover!

7am - Get up, get sorted out to go in to the hospital.

7.50am - Realise the other students on my firm are too hungover to come in. Consider going back to bed, but decide I might as well make the most of being the only student for the day so trek in.

8am - Get to the hospital. See the huuuuge list of patients. Wish I'd stayed in bed.

9.30am - As its so busy I get to write my first discharge completely on my own. Get it double checked by a doctor... one sign off in my log book!! Woo hooo!

9.45am - Ward round moved from the Clinical Decision Unit to the wards. We have a new SHO with us (borrowed from another firm), she's really lovely and keen for me to get lots of experience. She lets me write drug charts and double checks them. I'm glad I went to the prescribing sessions we had a couple of weeks ago. Sign off number two...

The ward round is huge so this takes all morning. I get to write in the notes, fill out more drug charts and even examine some patients.

1.01pm - The SHO and I rock up 1 minute late for a presentation we all have to attend because we're so busy. We were worried there would be no good left but I manage to get a nice combination of colslaw and a chocolate chip muffin.

2.10pm - Leave the talk and hot foot it to the wards to get jobs done.

2.15pm - Try my first ABG. I was so nervous that my hands were shaking. Surprisingly to me I got it. That means I have a 100% success rate so far! I then had to run the sample to the machine on the other side of the hospital and work out how to use it. Not fun and noone in A&E would show me. Eventually got it working and had to run the results back up to the ward,.

3.00pm - Go through all the patients on the list and work out what blood tests they need over the weekend and print out the forms on the right wards. This is the disadvantage of not being ward based. The advantage is all the free exercise.

3.40pm - Spent time chasing a haematology referral as they haven't made it clear if they want to take on the patient or not. Try and find out what we're supposed to be doing. Succeed only after actually turning up to the haem clinic and sitting outside the room.

4.20pm - Chat to microbiology on the phone about a couple of patients. Get drilled on antibiotics once the consultant realises he's speaking to a medical student. Realise that I have a lot to learn.

4.30pm - Run around 4 wards trying to find the FY1s to tell them about the microbiology results. Noone's answering bleeps!!

5.05pm - Finish for the day. Legs throbbing from walking around so much.

5.30pm - Get in the car home to visit my Dad. Wonder how I'll survive a night out...

Lily xXx

Thursday 28 October 2010

A Week In The Life of a Final Year Medical Student - Thursday

7.11am - Get woken up by other students getting up and clattering about. Silently curse them and try to make the most of my last 49 minutes in bed!

8.00am - Alarm goes off. Blergh. Shower, dress etc etc.

8.55am - Bump into "Team Gastro!" in the corridor. Good job as I didn't know we were starting with a radiology meeting, not ward round.

9.00am - Radiology meeting starts. See some interesting chest x-rays. Feel surprised and pleased that I seem to be able to read a simple x-ray. It's all clicking into place finally.

9.45am - Ward round starts. Today's consultant likes to ask lots of questions to test my knowledge. I like it because he's not that scary about it and always fills in the blanks I don't know. I'm always learning when he's around.

11.11am - Try twice to get a cannula in a man with bad veins. I seem to get them in and then... nothing. Call the FY1, she has the same problem. FY1 calls the reg who gets it first time... she is my new idol!

11.45am - Eat a slice of chocolate brownie made by the reg... she is definitely now my new favourite person. It's difficult not to hug her with joy!

12.05pm - Continue ward round seeing the last couple of patients.

12.35pm - Complete the worlds quickest discharge note. Team Gastro is on fire today!

12.45pm - Run to teaching. Get free sandwiches... YAY! Get homework... BOO!!

1.30pm - Walk to endoscopy with my consultant. Get grilled about my sign ups. Should mean I get a few in the next couple of weeks though.

1.35pm - Clerk and examine a patient in front of my FY1 for practice. Impress myself by actually hearing lung signs.

1.55pm - Find the room where the ERCPs and endoscopies are being done. I'd write out the full name for an ERCP but its soooo long that my fingers would fall out. Basically they put a little camera down to the bile duct, squirt contrast up it and see if the bile duct is blocked. Saw some gallstones being removed from the bile duct. Got a sign up! Woo hoo!!

3.45pm - Bleep my FY1 to find jobs to do. Get sent to the other side of the hospital to pick up a patient information leaflet for a procedure. Run back to the other side of the hospital to give the leaflet to the patient. End up sitting down for 10 minutes and explaining the procedure to the patient. Feel bad about not being able to tell her when she's going to be discharged as she really wants to get home.

4.15 - Fill out all the forms for sending ascitic fluid to the lab. Stuggle to write on the sample bottles. Seriously... biros are rubbish. What pen should I use?!

4.30 - Get told to go home as the FY1s are uber busy and there's nothing I can really do for them.

4.45 - Get back to the flat, iron a top for this evening.

5.00 - Do my homework from earlier... I'm such a good girl!!

5.45 - Write this blog post...

... It's mess night tonight so the plan is to cook some dinner, get dressed and then head off out for a few drinkies! Unfortunately my feet hurt so much I can't stand up, which is a flaw to my plan... but I could always crawl to the pub!

Lily xXx

Wednesday 27 October 2010

A Week In The Life of a Final Year Medical Student - Wednesday

8.00am - Get up. I like these lie-ins. Apparently I should make the most of them as its doubtful that I'll get them when I'm on a surgery rotation.

8.45am - Meet the others and trek in to the hospital in the rain. Start complaining about the weather/life.

9.00am - Try to start ward round but we're short almost the whole team.

9.10am - Start post-take ward round. Proud to say I remembered how to use the photocopier for patient lists. At least if I fail I can be a secretary.

10.45 - About 9 patients through the ward round, only another 6 or so to go. Get tasked with begging another consultant to add a patient to their gastroscopy list. Get grilled as the patient probably doesn't need an "urgent" gastroscopy medically, but he's been suffering symptoms some time. There's some debate within the team as to whether or not he's a malingerer. I feel bad judging patients, but it's all too easy to do.

11.30am First ward round done. Everyone splits up to tackle the rest of the patients.

11.35am Have a difficult moment when a codeine addicted patient asks for opiate based painkillers. Another "judging" moment. Is he drug seeking or is he in pain?! Leave this one to someone more senior to decide.

12.20pm Get asked to do a difficult cannula... check my watch and breathe a sign of relief as I realise I won't have time before teaching. Apologise and feel kind of guilty.

12.30pm Turn up for teaching.

12.45pm Get told teaching is cancelled.

12.50pm Have some nice salmon pasta in the restaurant. Food is so cheap outside of the London hospitals. Spend some time chatting to students I haven't met before. Suggest starting up a study group. I really need something to help me learn.

1.30pm Try bleeping fy1's... no response.

1.45pm Finally get hold of fy1's. Ask what they want us to do this afternoon and get told to do what we want as there aren't many jobs except chest drains. Each of the fy1's was having their first go at a drain today so we decided that hovering around them would probably make them much more nervous.

2.00pm Got home early again. Bit bored of this. Would like to do some stuff... I have major amounts of sign ups to do.

2.30pm After faffing about for half an hour get started on my Elective Poster.

4.30pm Realise I'm not at all artistic and my poster is going to look a mess. Sad times.

5.00pm Teaching from the junior doctors. It's all quite practical stuff on examination. To be honest I feel it's a bit basic and stuff I already know, but it can't hurt to have it drilled in a little more.

7.00pm Decide what to have to dinner. Also promise myself to read a couple of pages of the Oxford handbook tonight. I really need to get some plan for actually doing work. Must remember to watch the apprentice. (I'm having the other half of the packet of tortellini I opened the other night if anyone's curious!?)

Lily xXx

Tuesday 26 October 2010

A Week In The Life of a Final Year Medical Student - Tuesday

8.03am - Wake up. Panic. Alarm was supposed to go off 3 minutes ago. Thank heavens for my inner alarm.

8.07am - Out of the shower. Curse the cold weather. Curse infection control for not allowing us to wrap up in duvet covers on ward rounds. Apparently they come past the elbow. Pah.

8.40am - Face the bracing cold. Half run all the way to the hospital.

8.55am - Impress the FY1's by actually remembering that we're meeting in the mess and being early. Have a "team gastro" moment. Eat a few custard creams for breakfast before I see how long the patient list is and lose my appetite.

9.00am - Try to hide under the sofa in the mess when I realise it's just us and the FY1's doing the ward round this morning.

9.01am - Reluctantly attempt to start the ward round. Even the hospital is freezing.

9.10am - Clinic cancelled so an SpR is free to ward round with us. Phew!! Very busy ward round, but had a couple of nice moments where we got to break good news for a change. It's nice to be able to help people. Makes up for all the grumpy shouty patients.

12.30pm - Grab a sandwich, overhear that Grand Rounds are cancelled this week.

12.45pm - Break the good news about Grand Rounds to my FY1... woo hoo! No presentations!

1.30pm - Get a stonking headache so trek all the way to Boots for paracetamol and sudafed.

2.30pm - Go to bed feeling really guilty that I'm not on the wards.

5.00pm - Wake up and still feely pooey so drive to see some family for TLC.

9.30pm - Realise I should go home and get some more sleep for tomorrow so I'm back on form and can make up for lost time. Get petrol on the way and end up covering the cut in petrol. Nice. Then lose control of the car on black ice. I feel grateful to be alive! Drive home uber slowly to avoid skidding off the road if I hit any more black ice.

10.30pm - Get into bed and write this blog post.

Lily xXx

Monday 25 October 2010

A Week In The Life of a Final Year Medical Student - Monday

7.01 am - Frantically try to turn off the alarm in a sleepy haze... panic about waking up everyone else.

7.02 am - Run to the shower just in case anyone else has an early start too. This is the problem with sharing 1 shower between 5 girls. On the plus side its always warm and so lovely and powerful.

7.45 am - Meet up with the other 2 students on my firm and take the 10 minute stroll to the hospital. Freeze in the process as all the 3rd years have used up all the lockers so I can't take a coat in. To make matters worse they actually live on site. Cheeky buggers!

7.55 am - Track down my firm in A&E and battle with the photocopier so we all have patient lists. Scramble frantically in my bag to find the photocopier code. Mental note to put it in my iPhone. I love my iPhone.

8.00 am - Start the post-take ward round in A&E. There's about 25 patients scattered between the clinical decision unit and all the wards in the hospital. So we don't have loads of jobs after the looong ward round (don't forget we also have to round our 17 inpatients after the post-take ward round), we take it in turns to get bloods which need to be done. It's tricky in a new hospital when spread over loads of wards as I'm never sure where all the equipment is. It's also frustrating having to write blood bottles by hand. Is there some trick to it that I haven't grasped? A special pen?! Help!

We also take it in turns to write in the notes, report ECGs, report imaging and comment on differential diagnoses.

12.37 pm - Have a cup of tea in the mess.

12.39 pm - Smirk as FY1s are told they're doing a grand round on Friday.

12.40 pm - Stop smirking as they delegate to us medical students.

12.41 pm - Comfort eat. 2 Custard creams. Consider crying into cup of tea.

12.50 pm - Hunt down patient notes. Get to them just before the ward clerk is sending them to coding... SCORE!

12.55 pm - Help FY1's with updating blood results in notes and discharges.

1.45 pm - Hunt down consultant to get signatures for some complicated tests and give the results of tests he wanted. Smile as he's so lovely and explains everything.

2.15 pm - Negotiate with less friendly ward clerk for a different set of patient notes. She promises she'll have them tomorrow. We'll see.

2.30 pm - Eat a cheese sandwich.

2.45 pm - Find FY1s and offer to help with any jobs. Thankfully they're not too busy so I head back to my room to start looking up bits for my presentation.

3.00 pm - Have a cup of fruit tea, check Twitter and Facebook... feel guilty about not doing work.

3.20 pm - Go on a wiki-fari when searching background info for presentation. Don't get very far but read lots of interesting medical stuff.

4.10 pm - Have a cup of green tea with apple and pear. Decide to nibble on some salad as teaching is going to go on late tonight. Nothing worse than rumbling during teaching. Also nothing worse than having to pee every 5 minutes, so make this my last cup of tea before teaching. Decide to chillax and watch an episode of Ugly Betty before my brain explodes.

5.45 pm - Head back to the hospital. Brrrr... still cold!

6.00 pm - Teaching from the FY1s.

6.03 pm - Die inside.

6.07 pm - Wake up again when they've stopped talking about how scary finals are. Actually find the teaching really useful and practical.

7.17 pm - Get embarrassed by tummy rumbling.

7.50 pm - Throw tortellini in a pot of water and wolf it down in hunger. Then eat too much cake and feel bad for the cake binge. Gossip while eating and end up not attempting work for an hour.

8.50 pm - Open powerpoint.

8.51 pm - Abandon work for writing this and then plan to watch the new episode of Desperate Housewives. Then work. I promise!

Lily xXx

Friday 22 October 2010

Weekend!

Finally it's the weekend. My first weekend on this placement... and you know what that means... oh yes... party time!

Although last night was party time too...

...and I think Saturday is also party time.

In our defence we're celebrating FPAS forms being submitted. Woo hoo!! It's also our last weekend of major freedom before we all start actually knuckling down. Lots to learn, lots of sign ups to get. I'm also really looking forward to my post-night-out brunch. Going out for fried goodness is the law after a big night out.

Diet starts Monday... right?!

Lily xXx

Thursday 21 October 2010

Nerve Wracking

I did it.

I submitted FPAS.

I read through the questions a million times, but I'm still worried that I've done something on the form wrong. At least now I can put it behind me... or at least I can once my adrenaline buzz has died down.

Everyone on placement is discussing their questions. In fact right now I can overhear 2 people talking about them. It's not good for my nerves. I keep worrying that everyone's are better than mine. I think I'm going to have to hide until December to avoid discussion about these sodding questions.

My next step is to get my presentation about my elective done, and to start hammering out log book sign ups. Apparently a lot of universities don't use the logbook method. Lucky sods. We've been banned from having FY1's sign our books now... making it pretty difficult!!

Lily xXx

Tuesday 19 October 2010

Drafting... Done!

So I've finished the first draft of all my FPAS questions. Just need to give them a read through for grammar, spelling and sense and then I can send them off. I'm a little bit stressed because I don't feel my answers are that strong (particularly the last two), but there is very little I can do about that as no matter how much I try to rewrite them, they don't get any better.

This means that once the form is done I can concentrate on getting really stuck into my new placement. The FY doctors and registrars on my "super firm" seem really lovely and keen to let me do as much or as little as I feel I need to. This year its definitely about doing as much as I can.

Hopefully next week I'll get to recap some clinical skills I've forgotten and maybe even learn some new ones. I'm itching to try an ABG on a real patient. I also really want to try passing an NG tube, but I'm not sure where I'll get the opportunity.

I'm also hoping to do another "week in the life of..." series of posts next week or the week after to give everyone a taste of what it's like being a final year medic.

Lily xXx

Sunday 17 October 2010

Distractions

The lure of an evening at home and then the stress of having to move into placement accommodation means that I'm current only at 3/5 FPAS questions completed. Fingers crossed I can do the other 2 this evening, read over them tomorrow and submit them either tomorrow or on Tuesday... a fair bit before Friday's deadline.

My room in hospital accommodation is typically grim. It looks rather like something has died and then been splattered all over my room. I think it's where someone has had posters up.

Unusually for me I have unpacked completely and it's looking rather tidy. That's the only thing really making the place liveable. The water tastes funny too... ewwies. I'll be buying bottled water tomorrow then.

In unrelated news I bought a sparkly dress this weekend which is rather lovely, so shall be looking for an occasion to wear it. I also got some furry lined slipper socks... Mmmmm. Fantastic now that the chilly weather is setting in.

Lily xXx

Friday 15 October 2010

Two out of Five Ain't Bad

So, I've done 2 out of the 5 white space questions. Part of me feels like I need to celebrate doing 2 of them and the other part of me is screaming "Noooo... SHUT UP! Do the other questions you moron!"

Having a really bad cold isn't helping. I'm sure my inability to breath properly means I'm hypoxic. I was actually panting for breath on the train yesterday... everyone must have thought I was a complete freak! My fingers are also too cold to type efficiently.

Moan moan moan... I know. It's boring.

Moving into placement accommodation on Sunday. Apparently it has free wi-fi. I'll believe it when I see it.

Pretty excited but also scared. There are so many hoops to jump through and log books to sign before I even start thinking about exams at the end of this year. I'm wondering if I should already have a revision plan started? Exams are in May. Advice from those more organised than I would be greatly appreciated!!!

Lily xXx

Thursday 14 October 2010

Slowly, Slowly...

Painfully, bit by bit, I'm getting closer to doing these blinking FPAS questions. I've sat down, I've brainstormed and I've come up with some ideas. Nothing fully written out, not even a first draft, but a nice list of useful bullet points of cases and learning points I got from them.

These questions are really succeeding to make me feel completely inadequate. What personal achievements do I have? Why do they all sound so stupid? Why don't I have publications, presentations, motivation?!

Non-medic friends and family are always exclaiming that I must be clever and I must be so proud of what I've achieved, but these questions have really made me pick myself to parts. It's not a nice feeling and to be honest I can't wait until they've been handed in.

I've heard of quite a few people who've already submitted theirs. Does this mean they've been working their socks off? Are their applications amazing? Have they just rushed it because they don't care? Do they have so many things to write about that they found it so easy it was done in a couple of hours?

Deadline is in just over a week so I might stop moaning about them by then. It's going to be tough to put the application to the back of my mind until the 8th of December when jobs are allocated.

Lily xXx

Tuesday 12 October 2010

Popular Questions

So it looks like the simple act of posting up the FPAS questions has caused me to get an insane number of hits, well and insane number for this little blog anyway.

I wonder what people are hoping to find when searching? For some it will just be curiosity and wanting to look at the questions. For others it may be advice on answering the questions. Part of me wonders whether some people are out looking directly for ideas. I'm not sure how well that would be tolerated if plagiarism issues come up for some applicants? Apparently 2 applicants were excluded from the application process last year. I wonder what they did afterwards?

Having paniced and got myself into a state over my lack of personal achievements last last, I decided to pick up the knitting and leave the questions for a few hours. I'm so glad I did. Looking at them with fresh eyes this morning they aren't so horrible. Don't get me wrong, they aren't nice. But they aren't awful either.

Hopefully by bedtime tonight I'll have drafted an answer to the first question, and that should get me started. On a roll so to speak. I want to have the application done by Sunday night as I don't want it hanging over me while I start placement next week. I'm not sure how realistic that is?! Question for last years lot... how long did it take you to complete the application?!

Lily xXx

Monday 11 October 2010

The Dreaded Questions

Today was the day that final year medics in the UK were both dreading and anticipating. The release of the "white-space questions" for the foundation job application process. Lots of people have been asking what they are, so here you go...
2. Effective team working can have a significant impact on the quality of the patient experience.

* Describe a clinical case you have observed where there has been a multi-disciplinary approach to discharge planning. Describe how the interactions between the multi-disciplinary team impacted on the quality of the patient’s care. What have you learned from this experience about effective multi-disciplinary team working and how will you put this into practice as a foundation doctor?


3. Learning happens in a variety of contexts, some of which are opportunistic and some of which are planned.

* Describe a clinical situation which provided you with an opportunistic learning experience. What approach did you take to consolidate and extend this learning? Compare this approach to how you may follow up a planned learning experience. How will you use these experiences of learning to improve the quality of teaching others?


4. Being able to prioritise tasks is an integral competence of a practising doctor and may be challenged by many factors.

* You are the only foundation doctor on a busy surgical ward, and you feel under pressure to complete the tasks expected of you. A foundation doctor from another surgical team asks if you will hold their bleep for the second time this week as they want to go to theatre to observe an operation. What would your initial response be to your colleague? What factors would influence this response? If you had to hold the bleep, how would you prioritise the tasks? What additional learning needs does this situation highlight for you?


5. Communicating information to patients can be a complex undertaking.

* Describe a clinical consultation that you have observed where the specific cultural, social or family circumstances of the patient posed additional challenges. Identify the techniques used within this consultation that contributed to this patient’s experience. What other approaches could have been used in this situation? What did you learn from this which you can apply to your future clinical practice?


6. Essential attributes of a foundation doctor are the ability to deal effectively with pressure and the ability to prioritise
tasks.

* Describe two different personal achievements to demonstrate that you possess both of these qualities, relating each achievement to a single attribute. For each attribute, give one specific example of how your achievement can contribute towards improving your performance as a foundation doctor.


I'm not going to share my answers until after the application procedure is over. This is to avoid any potential plagiarism issues. It's safe to be said that I am bricking it though. Personal achievements? Is getting through med school not a sodding achievement enough for you people?! Seriously. I've achieved nothing, so this question is worrying me.

I think a bottle of vino to lubricate the thinking process is needed...

Lily xXx

Friday 8 October 2010

Getting in the Groove

After my initial panic at the start of the week, followed by complete mental brokenness, I think I'm back on form.

I've enjoyed some of the lectures we've had this week, but overall I'm glad I'm not still in my preclinical years. Clinics are definitely where the fun is. We've had a strange bunch of lectures. Mainly covering basics and trying to teach us how not to actively kill our patients in 9 months time. One lecture however was a little strange. It was all about coping mechanisms doctors have. Basically we all deny everything, act like hypochondriacs, shag anyone who moves and make really awful jokes about it all. This means we're going to ruin our own lives and probably commit suicide. Great then.

I'm itching to get back on the wards. I want to clerk patients, I want to formulate management plans, I want to follow the junior doctors around hoping to gain all their knowledge by osmosis. Mostly I want to start honing my practical skills and revising everything I need to know for finals. It feels like the last sprint now, so I want to give it my all.

Lily xXx

Wednesday 6 October 2010

World's Most Annoying Man

It's been a while since I had a proper rant. Now I'm thoroughly Londonised again (read: stressed out) I think ranting is what I'll do best.

Today I want to rant about people that I don't think should be allowed to pass medicine. Well one person in particular.

Just for a moment think of the qualities you'd want in a doctor. As well as knowing their medical stuff if you're like me you'd want someone responsible and caring with a certain degree of matureness. Not a complete dickhead.

Unfortunately it was my pleasure (NOT!) too spend an entire day of lectures sitting in front of the Worlds-Most-Annoying-Man. I'd heard about him in passing before. It turns out that I'm not the only one he irritates. Apparently he's arrogant and tries to shag all the nurses and doctors. I was willing to just laugh that off as boyishness. Until yesterday.

He spent a whole day of lectures talking. Not just "what did you watch last night on TV?" chatter, but rude and obnoxious comments. "Ha ha ha ha... it's not only needlesticks that give you AIDS" during our occy health talk (rich coming from the man who's reported to have started a chlamydia epidemic last year....). Wolf whistling and singing songs at female lecturers as they came in (not big or clever), and generally trying (and failing to be funny).

Seriously. Can you be struck off for being a dickhead? I really hope so. If not I really pity his patients!!

Lily xXx

Monday 4 October 2010

Broken

This is how I feel after the first day of every year.

Completely, utterly and irreparably broken.

Strangely this is quite a good feeling. Nice, satisfying exhaustion and fear.

It's amazing how just one day of lectures can be so draining. Especially when those lectures are all on admin things.

Seems like today the uni has just been reminding us what's expected of us and that no matter how hard we work there aren't enough jobs for us all at the end of this year. Oops. I'd have found it more upsetting if I didn't feel a little sorry for the foundation programme lady who came to talk to us and was practically laughed out of the lecture theatre. Temporary insanity occurs when you tell 500 people who've been studying 5 years that they might not have a job at the end of it.

I've been given a log book full of skills to get signed up in the next 9 months. It looks far too thick to get it all done. I'm at the denial stage of things where I don't want to look at it in detail quite yet lest it give me some kind of nervous breakdown. For me the next few weeks are going to be completely concentrating on foundation applications.

Once I've beaten jet-lag that is.

Until then I'd quite like a slave to unpack, clean my flat, cook me dinner, rub my aching feet, take lecture notes and brush my hair. Applications via email. No weirdos.

Lily xXx

Sunday 3 October 2010

So It Begins...

This time tomorrow I'll be popping on my shoes, grabbing my coat and slinging my handbag over my shoulder, leaving my flat for a late start at uni. The first day of the new academic year.

As per usual I've left everything to the last minute.

I'm still at my Dad's, haven't done my washing for elective and haven't sorted anything out for tomorrow. I need to go to the supermarket and drive all the way back to London.

All my procrastination has been Foundation Application based. I've been reading the rough guide and trying to make some decisions. Where should I apply? I've also been thinking about the white space questions. Although applications open tomorrow we don't get to find out the questions until the 11th. That gives us less than a fortnight... eep!

Lily xXx

Thursday 30 September 2010

Love At First Sight

From the moment I stepped of the plane I knew that I was in love with Samoa.

But now I'm back in the real world. Final year starts on Monday, along with the opening of the foundation application. It's going to be a busy and tough academic year.

So as I have a couple of days left before it starts I'll use the time to daydream about Samoa and reflect on the amazing time I had.

I can't pretend that it was a taxing elective placement. It was incredibly laid back, but even with that I felt I've learnt something. I encountered diseased like rheumatic fever and typhoid that I haven't seen at home and I practised my auscultation skills, hearing lots of interesting chest crackles.

What has been more valuable than the medicine, are the life experiences. I conquered my fear of water slides by sliding off mini waterfalls, and my fear of swimming under water by snorkelling in coral with shoals of tropical fish. I've climbed craters in rainforests, driven down dirt tracks and slept in a thatched hut during a tropical rain storm.

I have memories that I'll smile about for the rest of my life. It's also given me a chance to chill out and relax... something I've really needed after this year. I'm going to be starting term in a very good mood. That is if I get over the jet lag and don't chew off my own legs to stop the itching from the mozzie bites!

Tomorrow I'm doing my favourite part of the new academic year ritual. Buying stationary. I shall be walking around all the local bookshops sniffing notepads and caressing nice pencils and pens. Mmmmmm. Joy.

Life is good!

Lily xXx

Monday 13 September 2010

A Quick Update

So... not only am I getting to grips with the hospital (working hard... 1.5hrs a day!!) but I'm also getting to grips with tanning... who'd have thought a ginge could get so brown?!

I spent the weekend sleeping in a wooden hut on a paradise-like beach!!

I'm also learning first-hand what a lot of mozzie bites at one point feel like, tonight I am bathing in deet... I'd like to see the little buggers chew through that... but I think somehow I'll still end up even more bitten.

I'm not sure how I'm going to adjust to getting back to life in the UK in a fortnight. Strange to think that in 2 weeks and a day I'll be back on my way home to be a 5th year! eep!!!

On a side note the foundation programme people have said there won't be enough jobs this time!! Unimpressed... now job applications are seeming much more daunting.

Lily xXx

Monday 6 September 2010

Doing Some Work

I had my first morning in the hospital today. A short morning, but I've learnt a lot none-the less.

I've decided to tag along with paediatrics. Tomorrow I'm going to a clinic full of rheumatic fever patients, so I need to learn a little about that, but today it was mainly jaundice and pneumonia. The doctor I went on ward round with was a fantastic teacher, even though he'd already been working over 24 hours!!

Now I'm off to get some fresh coconuts. Apparently the coconut water inside is naturally lightly carbonated. Om nom nom!!! Can't wait... I'm going to come back a lot fatter!!

Lily xXx

Friday 3 September 2010

Talofa!!!

I have arrived in Samoa and it is paradise on Earth.

I cannot believe how beautiful it is here, not to mention how warm.

Can't say I've got any medicine done yet, but we all know how I can be a little work-shy at times. I have however conquered my fear of waterslides on some rocks which slide into beautiful pools of water surrounded by tropical trees.

I probably won't be blogging much as firstly I'll be having too much fun and secondly t'internet is a little pricey. I will however fill you all in when I'm back, and who knows I might post again at some point.

Lily xXx

Monday 30 August 2010

Hayfever Attacks

Today has been a hayfever hell day for me. I have sneezed so much that I'm quite surprised that my brain hasn't come out of my nose, or my eyeballs popped out of their sockets.

Not only have I spent all morning looking like I've been crying, I almost did cry when I spent the whole of my lunch in a lovely beer garden sneezing so much that I could hardly eat. Thankfully I made up for it with apple crumble after dinner... nom noms!

I'm now trying to pack for elective (yes, I know I'm leaving it last minute), and I seem to be disturbing dust on everything so the sneezing has started again.

At this rate they won't let me on the plane as they'll think that I'm highly contagious.

It still hasn't hit me that I only have 2 sleeps until I'm off to the South Pacific... that is if I ever actually manage to pack a bag!!

I'm sure that once I go the next year will be a whirlwind.

Less than a week after getting back FY1 applications open. It's also back to uni and off to another placement. 8 weeks of actually working with an FY1 as a real part of the team. Then it'll be Christmas, when I'm guessing I should probably start revising for finals as rumour has it that cramming is a bad move.

It's strange to think that in less than a year, if I pass all my exams, I'll be working as a doctor. It's also more than a little scary!

Lily xXx

Tuesday 24 August 2010

Welcome to England

I was interrupted from deciding between a kitkat or a bag of crispies at the petrol station by the sound of our radio... "emergency call in your car for you".

All thoughts of snacks were forgotten as we bundled back into the carbulance.

"Patient shot with pellet gun"

Can't be too bad can it? Oh well, it says red call.... off we go.

About 6.5 minutes later we turn into the road.

2 police cars, 3 police vans, numerous teenagers locked in the back of one. All seems a bit much for what we presumed was a drunken accident with a pellet gun. No time to ask right now, we just make our way to the patient.

The patient is sitting on the side of the road. He doesn't speak more than a few words of English, nor do his friends. He's clearly distressed, in pain and struggling for breath. His friend is on the phone to someone from home howling inconsolably the shock and panic in his eyes.

They were playing a game of cards after work. They're only in England for a few days. Shame their overriding memory of English people will be the chavs who hid in the bushes with an air rifle trying to shoot them in the heads, succeeding in shooting one of them in the right hand side of his chest.

We took one look at the patient. He had a big pellet wound to the right of his sternal edge at around nipple height. No exit wound. You could feel the surgical emphysema, but otherwise, apart from breathless, the patient seemed stable.

We couldn't very well tie him to the roof of our car and take him into the hospital so we called for a truck. The nearest one was 20 mins away on lights. Bugger. Even with him being stable now we didn't fancy sitting there for 20 minutes with a pellet rattling around somewhere in his lung, next to his heart.

We had an idea. We were only 3 minutes away from a hospital and there was a pretty police van. That would do!

After a little sweet talking the police let us pile in to the van. I felt sorry for them, they looked nothing but panicked as we fiddled with O2 canisters and cut the patient free of his clothes. I think they were glad to be rid of us after the 3 minutes.

When we got to hospital and handed over the patient in one piece I realised something. My curse of the observer had gone and instead I'd got the drama I'd be hoping for. Should be careful what I wish for.

Lily xXx

Monday 23 August 2010

First Placement Over :-(

The first part of my elective is done.

I'll probably never get to ride in an ambulance as an observer again, and I'm very much hoping I won't have to ride in one as a patient either. Not that I don't think they're wonderful. They are. But still... I'd rather not get ill/injured.

I'm going to really miss it.

Everyone was so friendly and lovely to me. The banter was great. The patients were partially interesting, partially horrifying, partially frustrating... but all part of a great learning experience.

What I won't miss however is sitting around for 3 hours with no jobs, going to take a bite into a sandwich... getting a job before I've even sunk my teeth in and then not stopping until 45 minutes after we were supposed to be at home.

I've learnt some valuable things I'll never forget.

1. Listen to paramedics doing handovers. They met the patient before anyone in the hospital.

2. Coffee is not a luxury, it is like petrol for people. For this reason nice ambulance people should be given cups of coffee at every opportunity.

3. Paramedics have loooooong shifts, have to sit in a van with smelly patients and deal with grumpy and abusive people. I should be thankful I'm not locked in a van with all of my patients.

4. "Foxtrot Oscar" ... my favourite technical term of the placement.

Now this placement is done I'm finally getting excited about part 2 of my elective which is a week away from now. I spent a small fortune (well a large fortune to me), on suntan lotion and mozzie repellent. Tomorrow I'm driving back to London to sort out all the bits and bobs I need from my flat. Soooooo exciting.

I always forget to pack something obscure yet important though. Any tips about what to pack for a beachy elective in the South Pacific?!

Lily xXx

Thursday 19 August 2010

Good Luck!

Just a quick post to wish everyone picking up their A-level results today good luck.

Congratulations if you got the grades you wanted. If you didn't try not to get too down, there's a silver lining to every cloud and you'd be amazed at the opportunities life throws your way.

It seems like only a few months ago that I was picking up my results and in fact it was 5 years ago. I remember the nerves, staying up all night refreshing UCAS track and crying when my results came in. I even asked those sitting around me if "accepted" meant that I'd got in.

If you got your results today go out and celebrate. Have a nice lunch, perhaps dinner, maybe even a few drinks with your friends. I'll be toasting you all this evening with a big glass of vino!

Lily xXx

Monday 16 August 2010

Car Problems

I think my car is cursed... or maybe just broken beyond repair.

I've already spent over £200 having the silencer-thingie on my exhaust changed because it was about to drop off, the break disks and pads changed because the whole car shook when breaking and the dashboard light fixed...

The dashboard light is broken again. That means when driving at night I have no idea what speed I'm going or if I have any petrol. It also makes the inside of the car all dark and scary. The air vents have also started spluttering like I have a squirrel with bronchitis hiding in them. This wouldn't surprise me.

Looks like I'll be spending more pennies getting to the root of this dashboard light problem.

Ho hum!

Lily xXx

Sunday 15 August 2010

Time Management

Even though I'm doing a lot fewer hours than I do while I'm at uni, I've somehow got worse at managing my time.

I never know what day, date or time it is. I keep leaving chores and important things to do until the last minute... I'm turning into a scatterbrain.

I have no idea where the time is going. I certainly don't think I'm socialising more than normal. The only thing I can think of is that I'm being repeatedly kidnapped by aliens and thus losing hours out of each day.

Lily xXx

Tuesday 10 August 2010

Day or Night or Night or Day?

Working nights confuses me.

Staying up doesn't seem to be much of a problem, but later knowing what day of the week it is or time of the day really seems to puzzle me. Even my usually chronologically perfect tummy is getting confused. Is it lunch? breakfast? snack time?

This week I have a bizarre night shift, day off, day shift, day off and night shift timetable. I think I'm just going to have to live off Cadbury's chocolate mini-rolls until my tummy knows what meal it's expecting.

Next week, my last week of placement with the lovely ambulance people, seems like it's going to be spent mostly in control. From the day I've already spent in control I have a lot of respect for the people who work there.

Then I'll be frantically preparing myself for Samoa, and I'll hopefully get a chance to write a couple of posts about some of the jobs I've been on and the things I've seen over the last month.

Lily xXx

Monday 9 August 2010

Packing and Choosing

I've always been a light packer. Going above my luggage allowance has never been a worry for me. That is before I had to pack for a whole month away.

I just don't know what to take. I keep trying to make lists, but it just seems never ending.

Because I am both a worrier and a catastrophiser I'll have to pack a first aid kit and small pharmacy worth of drugs. Then because I am hoping to make the most of the beaches and waterfalls I need to decide how many bikini's I need. How many pairs of linen trousers or smart skirts for the hospital? What shoes should I take for in the hospital? ARGH!

At this rate I'm going to take a bikini, some flip flops, a sarong and my steth. Done.

Lily xXx

Thursday 5 August 2010

Scary Month

Some might think October is the scariest month being that it's the month of Halloween, for others it might be September when the new school year and all it's uncertainties begin.

For many many people it's August. The scariest month of all.

Scary for GCSE results, scary for A-level results and scary for FY1 doctors who are starting their first jobs as doctors this week.

Good luck to everyone who's feeling the nerves this August for whatever reason. I hope all of you waiting for exam results do amazingly, and I hope that those starting work in hospitals this week don't get too nervous. You know you can do it!

Lily xXx

Monday 2 August 2010

Ramblings

It's hard to know what to write about at the moment. I don't want to tell all about this part of my elective just yet as I fancy writing up the highlights once it's all done, rather than dribs and drabs as they happen.

Without giving too much away I can say that I'm really enjoying myself. Even the shockingly early mornings and 12 hour shifts aren't dampening my mood.

What has dampened my mood however is the injury I accidentally gave myself on Saturday night. I was helping my Dad cook and realised that the bits he was frying were burning. I picked up a pair of tongs to turn the food over and before I even got the tongs close a huge splat of burning oil jumped out of the pan and bit me.

I now have huge blobs of deep partial thickness burns all up my arm. It looks horrible and the night it happened was so painful I spent a lot of the evening in tears. Thankfully the burns are pretty numb now. Fingers crossed they won't scar too much... I wonder if bio-oil would help?!


Lily xXx

Wednesday 28 July 2010

Crummy Handovers

I started my elective on Monday morning, and so far it has been fantastic! I've spent the last 2 days with a lovely critical care paramedic and a paramedic who've gone above and beyond to make me feel welcome and to teach me stuff.

We haven't been that busy, but we have had some interesting jobs that I'm sure I'll mention in the future. However the most important thing that I've learnt so far is about a good handover.

A good handover seems to be a mysterious thing for ambulance crews. This isn't their fault.

Over the past few days I've witnessed many incidents of nurses and doctors not really listening or not allowing paramedics to handover properly.

A prime example of this was yesterday. We brought in a lady with a serious neurological condition. We did this because we witnessed her change conciousness levels, black out and switch between aggressive and just simply away with the faeries. To put it into context one minute she'd be thrashing around, shouting abuse and trying to get out of the ambulance, the next she'd be slumped and not even flinch while having a wide bore cannula shoved in her arm.

Turns out she'd self discharged against medical advice the day before. She'd also been aggressive towards the hospital staff. As you can imagine they weren't happy bunnies. In fact, the hospital staff were so rude while handing over that the patient tried to get up and leave. Great. Making her more aggressive. They then kept interrupting while not listening. The handover could have been 30 seconds long and if they'd have listened they'd have understood that we'd seen some worrying clinical signs. Annoyingly it took us about 4 minutes to get someone to listen to these clinical signs because they were too busy interrupting and basically saying that they didn't want the patient because the patient had been trouble before.

So next time you're in a&e listening to a handover, do just that. Listen. You might learn something new about the patient even if you've known them before.

Once you've listened and got the full story, then start asking questions or making comments. If you do so before you just look stupid and grumpy.

Lily xXx

Friday 23 July 2010

Bye-Bye...

No not me. I'm staying here for until the end of next month.

Facebook is filled with everyone's status updates. "Flying in 3 hours" or "Just landed in Tanzania". It's exciting just reading it.

I hope everyone has a safe journey and an amazing time. I know that I can't wait until I'm jetting off on a plane to Samoa! I'm also already looking forward to coming home and seeing everyone's pictures and hearing their stories from elective. Thank goodness we're all in London for the first couple of weeks after we get back.

If there's one piece of advice I can give to everyone is pack a spare pair of pants and t-shirt in your hand luggage. It's bound to go missing if you don't!

Lily xXx

Sunday 18 July 2010

Time Flies

This time next week will be the night before my elective starts.

That means that this time last week will be my last night of "real" holiday before 5th year. Something tells me that elective should be even better than having holiday time though.

Over this week I've got lots planned. The first part of the week will be taken up helping a friend revise for her OSCE exams and dinner with a friend before they jet off to America. The middle part cooking an amazing meal for my Dad's birthday. Then the weekend at Farnborough Air Show with my Dad and some of his friends. It will really be non-stop.

The first 4 weeks of my elective are still in drizzly, windy and recently gloomy England. I'm spending time with an ambulance service. Soooooo excited. Fingers crossed early next week the guy who's organised it for me will email me with what I'm doing and where to go. I also need to ask him what I should wear. Sounds like a pointless girly question... but really... What should I wear?!

I then have a week to recover from the excitement and long days of the ambulance service before I have to hop on a plane for 25 hours. Well 2 planes actually, and 3 of those hours are at an airport. Then I'll be landing in Samoa. It sounds cheeky but I'm hoping that Samoa will be quite laid back. I definitely want to learn medical things, but I also want to get a chance to explore the islands and the culture. I haven't really decided what to pack yet except 4 bikinis, a couple of pairs of linen trousers and a pile of T-shirts.

Lily xXx

Saturday 17 July 2010

Finally a Final Year

It's official, I passed my OSCE!

That now means that I'm a final year medic.

On one hand it doesn't feel like I've been at university for 5 years, on the other hand I'm starting to get a little fed up of student living.

It's incredibly scary to think that I have 1 year left at university. 1 year left living near the vast majority of my friends, 1 year left where we have relatively little responsibility, 1 year until I am expected to know what I'm doing...

By the time I get back from elective I have a sneaky suspicion that it will all zoom by in a flash. There will be foundation applications, then christmas, then we find out jobs, then easter, then exams, then graduation.... then the real world starts!

I am planning to celebrate today by cleaning my flat. I am so rock 'n roll.

Lily xXx

Thursday 15 July 2010

Graduate Tax

Another thing for us students to moan about.

I can't quite decide whether I think graduate tax would be a good or a bad thing. On one hand the money for universities has to come from somewhere, on the other hand it would be nice not to be paying out for university all the time.

What really bothers me about paying for university is the fact that for the next 10 + years of my life I'm pretty much tied to the NHS. So I'm paying lots of money, to learn how to do a job, to then work for a government organisation.

This isn't too bad in itself.

What makes this bad is the fact that I'm starting to feel hard done by. I have more than 1 friend who hasn't gone to university and has had a baby. Now that these friends are single parents to young children they can't afford childcare so instead stay home on benefits. These friends live in nicer houses and flats than me, can afford sky TV and seem to spend a couple of nights a week either getting takeaways or out drinking.

I feel that I'm being penalised for wanting to do a job that will help people. If I'd decided to have a baby and stay home I could be curling up on my new sofa, watching sky on my 37" TV.

I know it's controversial to say this, and I'm sure that there are people on benefits who not only deserve them, but spend them wisely... but the more people I talk to the less that seems true.

I'd be happy to pay a graduate tax if I didn't see other people get handouts without having to put any effort into life.

Perhaps if the government only gave benefits to those who needed it, and then made sure they weren't giving money out to be spent on sky TV and nights out clubbing, then they'd have more money for education.

Lily xXx

Monday 12 July 2010

What to do?!

I had to pop to the shops today in my revision break.

I was wandering past the place where madsadgirl and I often go for a cup of tea when I noticed something. Someone had collapsed on the floor and was surrounded by people trying to help.

I slowed down and thought "hmmm... maybe I should go and help..."

I walked over to the entrance next to where the lady was collapsed and was told by a security guard to go away as the situation was under control. There seemed to be a fair few people helping so I left.

Now I feel incredibly guilty.

Should I have pushed a little bit more? Insisted I was a medical student so I could help. I certainly know my basic life support and emergency management very well after this week's revision.

Do I realistically know more than your average first aider? Had anyone there even done a first aid course?

I'm 100% positive that if this happened in a year's time and I was officially a doctor I would have barged in to help regardless of what the shopping centre's security staff thought. Maybe I should have a little more confidence in my abilities now?

All in all I hope that the lady had just fainted with the heat and is now back on form, sipping a cup of tea and nursing her bruises from falling down.

Lily xXx

Wednesday 7 July 2010

Temptations

For the first time ever I have my OSCE towards the end of the 2 weeks of OSCE exams. In the past I've always had my exams near the beginning.

This leaves me with a moral dilemma.

Should I ask people who've already done the exam what they've had? The majority of my year group seem to think this is definitely the way forward. I'm not so sure.

Firstly there's guilt. How would I feel getting a mark that I know might only be better than a friend's because I was more prepared for a certain station?

Secondly, OSCEs change. surely over the space of 2 weeks they will change the stations they examine us on. We're lucky to pretty much know every station that is going to come up, so regardless of what a friend has had I'm still going to have to make sure I'm safe and learn every station just in case in come up.

Thirdly, what if I get myself in a muddle? It's all too easy to listen to what other people found in exams. "My patient had a kidney transplant..." Would this make me just go into an abdo exam focusing on looking for a transplanted kidney? Would I forget to check other things? What if it wasn't the person with the kidney after all? Surely if I just examined properly I would be able to find out what's wrong for myself.

So because of this I am going to buck the trend and avoid everyone who's already done their exams talking about it. I don't want to know the stations and I don't want to know what patients they had. I'm just going to spend my time learning what to do for the stations and making sure I do it properly.

Lily xXx

Monday 5 July 2010

Surprise, Surprise

Believe it or not, admin messed up again.

I have a feeling this is starting to turn me into a bitter person.

On the plus side when written exam results were due out on Friday, although we didn't get our marks they did let us know whether or not we passed or failed. I passed thank goodness!

Fingers crossed today I shall get to find out my actual mark.

The uni has also claimed that next years GP placements are being released today. I'm a little miffed as due to being short on time they've missed a whole stage of ranking placements. Originally we were supposed to rank the areas of London, then we'd get allocated an area and we could rank much smaller areas within that large area. As it stands I've pretty much chosen an area which is about 1/4 of London. I could end up with a pretty big commute next year.

I'm finding it very hard to concentrate on OSCE revision. I have a week to go... Does anyone have any tips on the best way to revise OSCEs?! Tomorrow I'm meeting up with a friend to practice some examinations, but otherwise I'm pretty much reading the book and taking histories off Teddy C.

Lily xXx

Thursday 1 July 2010

Levels of Panic

Going into uni in the run up to practical exams always raises my panic levels.

It seems that the vast majority of people are hysterical about them.

What I don't understand is why?

Yes they're nerve wracking, yes there is a small chance we might fail... surely getting hysterical just makes this all worse.

We're lucky in the way that we're told quite specifically what we can expect, yet people still ask stupid questions.

"Do I have to take the pulse in a cardio exam?" ... erm, well yes.

"Should I do a PR once I've done this child's abdo exam" ... have you ever PRed an actual patient in an OSCE. No. Do what you did last time and say "to complete my exam I would like to examine the hernial orifices, do a PR and get a urine dipstick."

"Will they test me on this really obscure minor bit of a limb exam? OMG.... If I miss it am I going to fail?" .... no, they've just said that nothing is instant fail.

"I know you said nothing is instant fail, but if we fail XYZ is THAT instant fail?"

ARGH!

The next person to ask a stupid question is liable to get headbutted by me.

My other pet hate at the moment are those people who say how amazing being last in the OSCEs is as they'll know all the stations. We already know what we're being examined on. Just learn it all. Doesn't matter if your friend a week ago said they had gout/heart failure/cerebral palsy... it could change. Stop trying to guess things and just learn the stuff.

Less than 2 weeks to go now. Thank goodness.

Lily xXx

Monday 28 June 2010

Halfway There

Finishing an exam when you still have more to do is such a confusing feeling. Part of me wants to run around in circles and celebrate and the other part thinks "meh, not another bloody exam after this one... just. can't. take. it. any. more."

On the plus side I am halfway through exams now, and all the way through my written exams. I'm so bad as gauging how I've done in exams. I should find out the result of this pretty soon though. Apparently before my OSCE in a fortnight.

It stuns me how the university administration get away with being so useless.

In most companies if you consistantly missed targets and deadlines people would be sacked. It just isn't acceptable. However at uni its the norm. Results are rarely out on time. Placements are never out on time, neither are allocations to special study components... which also always seem to get messed up somehow. Last term I was told I hadn't got any of my shortlisted topics and given a new list to pick from, which included my top 5 choices. Something clearly went wrong there.

If I thought everyone would do it, I would suggest that the whole year boycotted something to show them how unacceptable it is. How would they feel if we turned up at OSCEs 3 days late because we were pretty busy otherwise?

Any bets on when I'll actually get my results? Also taking bets for when placement details for next year are released. They were originally due weeks ago, then the deadline got moved to last Friday and they're still not out. Pfft.

Lily xXx

Sunday 27 June 2010

Hot Hot Heat

This time of the year is probably the one time that you can tell I'm not British.

I actually like this hot weather.

Although it's been too warm to sleep properly and I've been getting all sticky and sweaty, I love this weather.

Yesterday I spent a large amount of time in a beautiful park, sitting under a tree revising. Even when walking through the grotty bit of London I live in, I couldn't stop smiling. I even managed to pretend for a while that I was on holiday somewhere warm and nice.

I have a written exam tomorrow, and then in a fortnight I have my OSCE. Fingers crossed this warm weather lasts until after my exams.

Lily xXx

Wednesday 23 June 2010

Drained

Sorry about the lack of posts.

Revision and essays mean I am mentally drained. I can't think about anything to blog about.

Hopefully I'll be back on form soon.

Lily xXx

Saturday 19 June 2010

"Mad Skillz"

Apparently this is what young people now call things they are good at. I wonder whether that makes me old for just not getting why, or in fact cooler than they are.

Although I'm a fairly confident person, I tend not to be arrogant and don't usually blow my own trumpet. There is one exception to this. Cooking.

I am pretty good at cooking.

I've loved cooking ever since I was old enough to help my parents in the kitchen. I was a toddler when I first discovered my love of mixing things with my hands, about 5 when I realised I could eat the whole herb garden in one sitting and about 7 when I really got involved with actually chopping and cooking.

I think because I've had years of practice I don't often think about what I cook, I just seem to put things together and they taste nice. This makes me feel lucky because apparently it doesn't always work like that for other people.

Last night I made lovely pepperonata on ciabatta with the most delicious goats cheese I've ever eaten, followed by really good sausage, crushed potatoes and onion gravy. Om nom nom!

Although this is all very tasty I'm now starting to feel I don't push myself enough in the kitchen. It's surely not good enough to be a really good cook, I should be aiming to be an AMAZING cook. Yes. I did mean to put that in capitals.

I've decided that now I have a fancy camera so can take pics of what I'm cooking I'm going to start up a food blog on the side. Something to encourage me to try cooking things outside of my comfort zone, improving my presentation and improving my food photography skills.

The problem is, I can't think of a name for it.

Any ideas?!

Lily xXx

P.S. Yes, I still have an essay to do, and revision... blah blah blah.

Thursday 17 June 2010

Revision Hot Spots

I can never decide the best place to revise.

Bed always seems like a good option, but I usually end up falling asleep. I've decided to save bed for early morning "reading" revision, when I can read some notes in bed with breakfast but nothing more or I sleep all day.

My flat is nice and quiet for revision, but I get distracted by the internet and watching 4od. They have this amazing program called Pussies Galore, which isn't porn, it's a program about crazy cat people. I love it and watch it whenever I'm bored, along with cook yourself thin.

The library seems like a sensible place to revise. Then again I spend 45mins getting there and 45mins getting back. It's really noisy. I also tend to see people I know and then 5 min coffee breaks turn into afternoons in Starbucks.

When it's sunny I like to go to the park and revise in the sunshine, but I soon end up distracted and day dreaming.

I think I need some kind of personal trainer for revision to stand behind me and shout at me whenever I distract myself.

Lily xXx

Tuesday 15 June 2010

Catch Up

Once I get on a roll with work it would be a bad thing to stop myself, and stop the flow. This means I always have a lot of catching up to do after a couple of days hard work. I have lots of washing, washing up and catching up with blogs.

My presentation went OK, except for the time when I had to massively blow my nose in the middle of it because it was running rather unattractively. We got amazing free sandiwches during the presentations from my fav sandwich shop. There are more presentations next week that I'm going to watch just to get the free sandwiches.

Talking of freebies, I know its unethical, but a friend of mine went to conference last week and sent me a massive package of amazing free stuff from drug companies. I've figured it's OK to use it all as I have no idea what any of them are. There is even a pedometer with a heart rate monitor and calorie counter, as well as a stress ball, some USB sticks, pens, pads and my very own purple tourniquet!

As I worked hard for the last couple of days I allowed myself a blissful lie in this morning, so I should really get my bottom into gear and have a shower and get dressed if I want to make it in for the clinic I have timetabled. It would be much nicer to just stay in bed though!

Lily xXx

Friday 11 June 2010

More Presentation Tips

So we all came up with good presentation tips last time, but I forgot 2 vital ones.

1. Have some vague clue of what you're talking about.

2. Don't "misplace" your USB stick.

Unfortunately I seem not to be able to follow my own advice and had to run into town this morning after disocovering at 9pm last night that I didn't have a USB stick, I'm also faffing about my lack of knowledge in the presentation topic. Oops.

At least it'll all be over with by this afternoon!

Lily xXx

Thursday 10 June 2010

Grotty McGrottbag

This should be my new name.

I'm feeling a bit under the weather so I'm all yukky. My throat is croaky, my head hurts, my nose is a constant stream of greenish gunge and I am radiating heat like a little heat lamp.

I've always felt short changed when I get a sore throat. I had my tonsils out when I was 8. It was sold to me as "You'll never get a sore throat again." Now that was complete cow poop.

Granted my sore throats aren't as bad, but talk about misleading a child! It just seems that before when I'd get tonsilitis, I now get either laryngitis or a chest infection. Thankfully at the moment I seem to just have white spots over my tonsil-stumps.

I have a big important presentation tomorrow so I hope at least the runny nose and sore throat clear up a bit, otherwise not only will I be a nightmare to watch but I'll also be an infection risk.

I wish I knew who'd given me this. Probably someone on the train coughing in my face. I'm starting to feel that people should be given tissues as they get on public transport. I might start wearing a mask... I've seen a surprising number of people doing it.

Lily xXx

Wednesday 9 June 2010

The Countdown...

If my maths is right (which it probably isn't if I'm going to be honest...), it's less than 3 weeks until my written exam! Eep! In fact this time in 3 weeks I will probably be revising like a little loon for my OSCE.

I was really upset because my OSCE is on the last date it could be over a 9 day OSCE stretch of exams to fit the whole year in. I'm now breathing a sigh of relief as I get a week more revision than some of my friends, which considering this huge essay I have do is pretty good.

I'm hoping the weather will be poo this weekend so I'm not tempted to go and sit outside. Although it's allowed to be sunny for OSCE revision time as I think sitting the park taking an imaginary history off my imaginary friend might be quite nice.

I have a presentation on Friday. I really should be getting on with it. I think it's going to require a fair amount of blaggage so I hope I don't look like a complete prat. Thankfully over half my group are also presenting that day and I'm pretty near the start so I'm sure everyone will be too busy panicing to notice if I do.

Lily xXx

Sunday 6 June 2010

Say Cheese...

This isn't a post about cheese. However I do like cheese, my favourites at the moment are roquefort and reblochon. Om nom nom. I'm also partial to a good cheese fondue.

This is a post about my new camera. My canon powershot G10.

In a word it is amazing.

I'm not used to having anything more than a simple point-and-shoot digital camera, so being able to take proper photos and change settings is amazing.

Lucky for me a friend of mine has a similar camera so has been showing me how to use some of the functions. I'm trying to think of the best times to take the camera out to practice taking photos. In all honesty I just want to leave all my work to one side and spend a week playing with the camera.

I have a presentation to do on Friday and I think I'm going to reward myself by hopefully baking a cake at a friends house (and taking photos of it!). I might also have a trek around London to take some nice photos. Does anyone have any recommendations of places which are particularly good for photography around London?

Lily xXx

Thursday 3 June 2010

Chuffing Hell...

... I've decided that keeping the foul language especially in blog post titles to a minimum is probably best. It's the only phrase I can use to describe how frazzled I feel.

I'm so busy at the moment I feel like I'm going to have to sleep solidly through 5th year to make up for this term. Fortunately (or unfortunately for my grades....) it's not all study.

I went to see Les Mis last night with a friend and adored it. I knew most of the songs already so thought I'd like it. My love of all things musical and all things french also helped. Hugo the ferret was named after Victor Hugo infact. I'd also still consider calling a child this, even though I also gave the name to a hairy smelly mustaelid.

I thought this term would be packed full of half days. Not so. I'm going to dash through a bit of work now to make up for the fact I was in dermatology all morning learning very little. Thankfully paeds was much better than that and I learnt a lot about paediatric heart problems. This HAS to be a good thing for exams. Once I've got some work done and had a shower I'm off to a friend's flat for pancakes... mmmmmmmmmmmmmmmm!

Anyway I better get on, can't keep the pancakes... no wait I mean friend... waiting!

Lily xXx

P.S. Thinking of getting a hair cut this weekend. Any suggestions for practical, easy to maintain nice hair styles for someone with really thick wavy hair?!

Tuesday 1 June 2010

More Lessons

Today as well as learning a whole host of medical things I also learnt a few more valuable life lessons.

1. My shoes aren't waterproof

2. My coat isn't waterproof

3. My bag isn't waterproof

4. London rain tastes funny

Once I've dried off I need to get the energy to do some work. I thought the next 3 weeks would be relaxed clinic-wise and I could get loads of work done but I've just had a whole host of extra tutorials thrown in. I'd be more pleased if they weren't all at random times meaning I'll be hanging around pointlessly lots and lots. Grrrr.

Lily xXx

Monday 31 May 2010

No Burn Out

It seems that nearly ever time I go to write this blog I'm moaning about my lack of motivation. I'm hoping that for this academic year at least I won't be doing it again.

It's getting towards the sprint at the end of the year now. The most dangerous time for either total lack of motivation or complete burn out. I'm hoping to stay in the middle and get neither of these.

I have 3 weeks left of placement, a week of revision, presentations and deadlines, written exams, a fortnight off and then practical exams. Apart from feeling a little overwhelmed at everything I have to do, I'm trying to make myself an anti-burn-out plan.

Maybe stupidly I have a lot of social stuff lined up in the next couple of weeks too, so I'm really going to be juggling work and play.

Wish me luck!

Lily xXx

Sunday 30 May 2010

AMAZING weekend.




I think the capital letters say it all.


So far I have had an amazing weekend.


Friday I celebrated my birthday. It was all a bit upsetting at first when I got stuck in a traffic jam for 3 hours on the way home, but I managed to while away the time playing Trivial Pursuit with some nice randomers. Thank you randomers for cheering up the traffic jam :)


I then got home, had a delicious dinner cooked by my Dad and met my friends for drinks. Unfortunately drinks meant I control myself when it came to making the most out of my birthday present from my Dad. The worlds best camera.


It's a Canon Powershot G10. It's breathtakingly fab.


Saturday was a friend of mine's Hen Night. We went to see Legally Blonde the musical. You'd expect it to be completely awful, but it was brilliant. Light humoured, witty, funny and entertaining. Much better than I expected, although to be honest I'm not sure what I expected. After that we went to the ice bar. I made sure I got my money's worth and ate half of my ice glass after I'd finished my drink. We then wrapped up the evening by hopping in our limo home... luxury.
I think I'm going to need to sleep the rest of the day to recover!
Lily xXx


Thursday 27 May 2010

Kylie's Birthday

In just over an hour it's Kylie Minogue's birthday....

... it's also mine!!

23!!

I've been out for dinner with the girls tonight, and after uni I'm having lunch with madsadgirl and then I'm off home for dinner with my Dad and drinks with my home friends. Hurrah!

I'm planning to take my spangly new laptop home with me for the weekend to do some work, so hopefully I can blog a little update on my celebrations.

Lily xXx

Wednesday 26 May 2010

Tweet Tweet!

So I've decided to give Twitter a go. I'm already a facebook addict, so what is one more internet addiction?

If you want to see the pointless minutae of my day, and hear the strange things travelling through my head then follow me. I'm "studentdocdiary".

Also if you're on Twitter let me know as it doesn't look that fun a thing to do if you're not following people.

Lily xXx

P.S. Yes I should be doing work rather than making Twitter accounts, but shhhhhhhhh!

Tuesday 25 May 2010

I Got Sunshine

I love the sunny weather. Things never seem to be able to get me down as much when the sun is shining. Along with feeling happier, somehow the sunshine makes me more motivated. It's probably because I know that if I get my work done I can do and sit outdoors and enjoy synthesizing a little vitamin D.

I met the deadline I had last week, so now I've got to try and keep up the momentum so that I can keep hitting deadlines. I've also got 7 sign ups in my log book. As well as all of this I've prepared the next 3 out of 4 presentations I have to give this academic year.

Hopefully now less is hanging over my head I can chill out a bit and lose the stress spots I've sprouted. I'm even taking the time to read a novel which I started in the sunshine over the weekend. I'm also piling in the fruit in and veg in preparation for exam stress... although my now gurgling tummy has told me that maybe I've eaten too much veg!!

Lily xXx

Friday 21 May 2010

Sitting Pretty

I was on the train yesterday. I got on at an earlier station than normal so I got a seat and gladly got comfy in it. We pulled into the next station and a pretty large group of people piled on. I was happily reading my newspaper when out of the corner of my eye I noticed the man opposite me looking up worridly every 30 seconds or so behind me. Being the nosey person I am I turned around and saw a lady with a baby bump. It was a pretty tidy little baby bump and hidden by her coat mostly, but there was no doubting it with the way she cupped one hand under it and rubbed it with her other hand.

Without thinking I automatically sprung out of my seat, tapped the lady on the arm, apologised for not noticing that she was behind me and offered her my seat. She deserved it, I can't imagine carrying around a baby belly is very comfortable. It's tough enough carrying around my pizza belly.

There were two points to this that really annoyed me. Firstly that the man opposite me had clearly clocked her but didn't offer her his seat. This was probably because I was a couple of inches closer, but the simple fact is he saw her. In fact all the people sitting down were around me, and at the next stop I had to actually ask one of the men to give up their seat for an old lady who was struggling to keep upright. Where are their manners?

Second point. The pregnant woman was clearly in discomfort and was really relieved when she got to sit down. Why didn't she just ask someone? She was wearing quite a baggy coat and if she hadn't have been so slim otherwise I would have probably just thought she was tubby. TFL are giving out great "baby on board" badges for mums-to-be, but sometimes I think if people just asked it would be easier. Same for older people. I know they shouldn't have to, but if the general public don't have the manners to offer a seat, then why stand, struggle and complain about it later when just asking would do?

This isn't the first time I've been on a train and noticed that everyone either has their back to a pregnant lady, or is busy reading a book or the Metro. They aren't not offering seats often because they don't want to, but simply because they haven't noticed. I know if I am ever pregnant and I want a seat, I'll be a little bit cheeky and ask someone.

Lily xXx