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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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