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Scrubs and Pubs

Graduand

I woke up to the sound of my alarm after a paltry 5 hours sleep. Tempted to snooze I grabbed my phone, but then I remembered...

"Today is graduation day! My final day as a student. Should probably get up then..."

Getting ready was a sleepy blur. As per usual my hair would not behave itself, so I gave up the fight. I managed to squeeze on a packed rush hour train. I was more flustered than excited. The flustering continued as picking up tickets and gowns was as stressful as being in Ikea on a bank holiday. Once I'd picked everything up I was glad for the sunshine and the chance to stand outside and meet my Dad.

My Dad is officially the sweetest Dad in the world.

OK, I know I'm biased, but when I tell you why I think you'll agree. Not only did he turn up with a smart new haircut, there was also something a lot more special. He was wearing the (hideously awful) tie I made him at school when I was 11. I almost burst into tears. He's even proud of my dubious foray into fashion.

The next hour was spent mainly showing off our parents and trying to stop them wandering off before heading towards the Cathedral to graduate.

I'm not sure what I expected from the ceremony, but I loved it. I love the ritual of the robes. I love the academic staff's different costumes. I even loved the addresses made by various people from uni. This was probably helped by the fact that they were all quite short and sweet.

Before I knew it the time had come...

PANIC!!

What if I fell over? I am notoriously clumsy.

With an incredible level of concentration I put one foot after the other, trying not to stumble. The couple of students before me went past in a blur. Then it was my turn...

Step, smile, shake hands, a few more steps, smile, simultaneously shake hands and take scroll and step off the stage...

continued at Scrubs and Pubs (my new blog as a junior doctor)

Graduation Ball

What a magical evening. An evening made even better by the fact that although there was copious amounts of champagne and wine flowing, I managed to moderate myself and spend the whole evening sober enough to enjoy every moment.

I might be biased because I'm currently on a graduation-high, but this ball was fantastic.

The evening started with champagne at the fountain outside one of our teaching hospitals, overlooking the River Thames. To add to the atmosphere there was a jazz band playing, and it gave everyone the perfect opportunity to catch up and drool over all of our beautiful dresses.

Felt a bit like naughty school children for a while as a big group photo was taken and the photographers did lots of shouting at us, but that was all soon forgotten when a fleet of Routemaster Double Decker Red Buses turned up to transport us to the hotel. Once we reached the hotel we were ushered through to another champagne reception, this time with a string quartet.

After an hour of drinking more champagne, my feet were really hurting in my heels, so I was glad that they called us through to dinner. We enjoyed our tasty 3 course meal, while listening to a harpist... it was all very sophisticated.

To end the sophistication we all took to the dance floor to have a good old boogie to songs from the last 6 years.

All in all a fabulous night.

I'm now off to get bits ready for graduation tomorrow as I'm off for a sneaky drink or two tonight! Yay!

Lily xXx

End of an Era

I've been thinking for a couple of days that I should write something deep and meaningful to end this blog. I'm getting closer and closer to graduation day now, and therefore closer to switching to my new blog, so I feel that I should probably stop thinking about being deep and meaningful and just write something before it's too late.

It's graduation ball today, and graduation itself on Friday. Even though these are looming and I got my results a week ago, it still hasn't really sunk in. I'm sure the reality of being a doctor won't sink in until I actually start work at the end of July.

There is a little shadow over all these end of degree celebrations though. A lot of people in my year group are having to resit the year this year. 37 in fact. A fair few of them are friends or at least mates of mine. I think the strangest thing will be if they get sent as medical students to the hospital I'm working in.

I've spent the week mulling over how quickly the last 6 years have passed. It only seems like it was a few months ago that my Dad was driving me to halls and I felt so nervous I thought I was going to puke all over the dashboard. A lot has happened in the last 6 years though, and hopefully I've managed to learn a lot of stuff. I also hope that I don't forget it all over the next couple of weeks before I start work.

So sorry that I haven't written anything deep and meaningful, but I think that's because there is so much flying around in my mind at the moment. That and this heat is melting my brain.

Hopefully I'll have time to give you a little graduation ball update tomorrow, but for now I'm off to try and make myself look acceptable.

Lily xXx

I Passed!!!

Sorry it took me so long to post this, but I was busy putting plan A into action and drinking lots of champagne!

Hurrah!

Lily xXx

Tomorrow!

AARRRGGGHHHH!

Results day tomorrow.

This is plan A:

Get up and let plumber in to fix shower.

Find out results at midday online.

Pass.

Get champagne.

Go to campus

Indulge in champagne.

Celebrate my socks off.

This is plan B:

Get up and let plumber in to fix shower.

Find out results at midday online.

Fail.

Get gin.

Take gin to bed.

Cry.

I hope tomorrow will be plan A

Lily xXx

Plans

I've managed to fill up this week until results, all in an effort to not thing too much about exams.

Sunday I cooked for my Dad and then hopped back in the car to London. I spent my evening drinking beer and talking lots and lots. Lucky for me I got a lovely lie-in to start my Monday. The day was mostly spent trawling London to find the shoes I want for graduation. After navigating past a swarm of angry bees (yes, really...) on Regent St, I finally found them. Beautiful beautiful beautiful dark red patent leather shoes.

The rest of the time before results is filled with little bits which I find insanely exciting, but probably mundane to most people.

Tomorrow I'm having a new oven delivered. I haven't had a working oven in my flat for about a year. This means baking cakes and pizza... noms! Then on Wednesday I'm going to chill out with a friend and keep her company at her hospital appt. The evening will be topped off with popping out for dinner and hopefully a few drinks to aid the fretful sleep before results...

On a slight tangent I was asked if I was a Miss or a Mrs over the weekend while buying a new car tyre, I wanted to say Dr sooooo much!

Lily xXx

Making Plans

I am completely rubbish at organising my life. If I didn't get the occasional kick up the bum I'd pretty much just coast through life without doing much.

I have about 5 weeks of holiday time left. I need to make the most of them. I have results day in 6 days, grad ball on the 29th of June and graduation on the 1st of July. I'm also spending a few days in Paris with my Dad later on in July. Otherwise I have diddly-squat planned. I realise I have a flat to pack up and move out of, but I really should be making plans otherwise to make the most of summer.

This is where all the nice people who read my blog are going to come in useful. If any of you can think of a nice way to spend a few days, that isn't extortionately expensive but also doesn't involve a tent comment and let me know.

I've also been busy making the new blog look half decent. Tell me what you think?!

Lily xXx

1 week to go...

This time next week I will know whether or not I passed my exams and therefore whether or not I start work as a doctor on August 2nd.

On the surface I always seem calm about exams. I can even offer the voice of reason. I know that there's no point panicking once the exam is done... there's nothing I can do now. That doesn't mean that I'm not having nightmares about it though. I haven't slept properly in about a week and it's only going to get worse over the next week.

Strangely I'm also getting panicked about other random things. Mainly fashion based. I have graduation ball and graduation to get outfits for. I've found a lovely dress for the ball, but now I have to find something for actual graduation... and shoes. I need to find shoes. I also possibly need to get a hair cut.

I guess if dresses and haircuts are the biggest of my worries, then life is OK!

Lily xXx

Whiling Away Time

At the moment my life just seems to be a countdown to results. It's only 10 days to go. So as not to completely waste the 3 weeks by stressing out, I've been trying to make myself busy.

eBay has become my biggest new obsession. If it stand's still long enough I'll probably try to sell it... better watch out Dad! Unfortunately this does mean that I have to take 10 parcels to the post-office this morning. If the people who bought them pay for them, I have another trip of 5 parcels tomorrow, and potentially lots more on Wednesday too.

I also ventured into a gym for the first time in years. This gym was perfect. It was small, relatively quiet, not full of posers, had a huge pool and best of all it had a sauna and jacuzzi. Excitingly it also had a shower that squirts at you from all directions. It's clearly the little things that make me happy, and that's one of them. Apparently they also do a 10% NHS discount on membership, so I think that's the gym I'll join once I'm home.

To top off my luxury free-time I've been cleaning out both my flat in anticipation to move out and my Dad's flat in anticipation to move in. Not perhaps the fun laid back holiday I dreamed of, but strangely satisfying in it's own way.

This week I have boring grown-up paperwork things to do, but also hopefully lots of fun to be had!

Lily xXx

Save Graduate Entry Medicine!

A couple of days ago I got a nice email from a young man called Chris (well I presume he's young... you never know with these graduate types :-p) asking me if I minded mentioning a bit about the campaign to save graduate entry medicine.

I myself came straight from A-levels to medicine, but I have a great admiration for graduate medics. On the whole they're lovely and they seem so much more motivated, organised and able to study than many of the undergraduates (like me...). In fact only a week or two ago in the pub I was having a big conversation with undergraduate medics about how we felt that medicine should perhaps be a graduate-only subject.

That however is a discussion for another day...

This campaign is basically highlighting that with the new increased tuition fees and potential for the NHS bursary to be removed, most graduates seeking to do medicine will simply be unable to afford it. This will mean lots of people who would make fabulous doctors not reaching their potential, which quite simply isn't fair. All this just because they can't stump up big lumps of cash up front.

I'd harp on about it, but these guys do it a lot better so visit their facebook page, sign their petition, see how the BMA supports them and follow them on twitter @saveGEM

Good luck guys... I really hope that something is done about this.

Lily xXx

Diazepam Daze

I would have let you all know yesterday that I don't have to do the extension exam, only I was in a bit of a diazepam-fuelled daze. This means one of 3 things.

1. I could have passed everything.

2. I may have failed writtens, but passed OSCE.

3. I may have failed writtens and failed OSCE.

I'm hoping for choice number 1.

Dr Grumble asked if it was true that 80 people failed. Well no. It was 75... so close to 80.

I'm sure most of those will have been borderline though, and may very well pass the extension exam... otherwise there is going to a be a bit of a shortage of junior doctors.

Anyway... some of you might be interested as to why I have suddenly developed a taste for benzos...

I pulled my back out. There I was moving heavy furniture around all day with no problem, then I bent over and next thing I was in so much pain I couldn't move. I stayed propped up against a wall for 20 minutes and then gave in and called my Dad to help. In the end I ended up taking 5mg of diazepam at about 4.30pm which relieved things just enough for me to hobble around, I took another 5mg at 11pm before I went to bed... that ruined me.

I slept for 13 hrs. I then got into the shower wearing my PJs. Lathered up with shower gel. Reached for my towel. Tried to dry myself with my towel under the still running shower. Realised something was wrong. Felt stupid.

I then got dressed and went to find my Dad.

I'd put my clothes on inside out.

Safe to say I didn't try anything too complex after that!

Lily xXx

Final OSCE

So I did it and I survived.

It's strange to think that this OSCE could be the last exam I sit as a medical student. I'll find out on Monday if I need to sit the extension exam to improve my mark or not.

Although 21 stations, each 7.5 minutes seems really long, in the actual OSCE the time flew by. It was over in what seemed like minutes, although it was actually hours.

I thought I'd give a quick run through of the stations for those who are interested...

1. Precription chart for COPD... it was so hard to fit this in the time.

2. Cerebellar exam.

3. Advice about hospital discharge, wound care and antibiotics.

4. Surgical history, possibly an ileus.

5. Breaking bad news, telling a lady who was trying for a baby that she isn't pregnant.

6. Choosing the drug and setting up a nebuliser.

7. Prescribing for cellulitis.

8. Brief history and examining a lady with the fake strap on boobs.

9. An alcohol history.

10. CVS exam.

11. Dermatology history and exam.

12. Medical history, possibly heart failure.

13. Setting up a syringe pump (minus the actual syringe driver).

14. Respiratory exam.

15. Abdominal exam.

16. Giving advice about osteoporosis.

17. Explaining a laprascopic nephrectomy.

18. Informing a nurse that a patient wishes to complain about them.

and 3 rest stations

The examination stations all had so many signs, which meant that it was hard to fit them into the time given. I also find the plastic strap on boobs so offputting!!

Anyway I am off to nurse my hangover...

Lily xXx

OMG... OSCE

I don't usually swear on here...

Fuck.

I have never been this scared before an exam. For some reason I've got it into my head that I'm not prepared even though I have passed both my Mock OSCEs. I've been to revision weekends, I've practised on friends and I've even read the books.

I still can't remember everything in cranial nerves.

I get my knickers in a twist during cerebellar exams.

I have forgotten all my special joint tests.

I have no skills.

I've forgotten all the facts for explaining.

Fabulous.

It's just so scary that after 6 years of hard work there is a possibility this could be the last exam. Working seems even more scary than doing these exams.

On the plus side by just after 5pm tomorrow I should be finished.

I'll have definitely earned a drink or two.

Lily xXx

Birthday Girl

If there's something which is going to ruin a birthday, it's having finals looming just ahead.

Yesterday was my birthday, and instead of waking up with a bit of a headache after a night enjoying myself, I was in bed by midnight. I've woken up with a huge sense of panic instead. I didn't do ANY work yesterday and my OSCE is on Thursday.

Until now I've been calm about OCSE. I've had the view that as long as I turned up during the year I'd be fine. I know how to examine, I know how to take histories and I can do most skills (just about...). I always said the only think that buggered people up was nerves and panic. Now I have nerves and panic.

I'm also really worried about our prescribing stations. The nice thing about them is that they don't have an examiner, but there's so much to remember to prescribe.

My OSCE is 21 stations long and each station is 7.5 minutes. This makes the whole thing like some kind of marathon. I'll probably die of exhaustion before I get to the end.

On a lighter note today I'm going to Ping Pong for FREE dim sum. They have an offer that if you turn up in your PJs with a teddy you get a free meal and a free cocktail. Hurrah!!

Lily xXx

Written Finals.

I wanted to write a post about my written finals, but they were so traumatic that part of me thinks that I'd be better just blocking them out of my memory completely.

The first exam was as I expected. The single best answer questions were pretty tough. It's always hard to pick the "best" answer, when more than 1 may be right. The second part, which was extended matching was pretty easy... and I'm hoping I'll have made up marks on this part.

After the exam I thought about revising more, but the thought of going over all the stuff I'd got wrong in that exam wasn't a happy thought, so I trotted off to Selfridge's and bought myself a lovely carrot cupcake. I then spent the evening chilling out.

The second exam was HORRID!! I thought the single best answer questions were a bit easier than the day before, but the extended matching were soooo hard. One question asked us the life expectancy of a boy born in Zambia in 2000. No idea. There was also a huge question on antibiotics and another haematology one, both of which left me so muddled. Blergh.

Fingers crossed I'll have done enough to scrape a pass.

As most people who know me would expect I went out after the exam and got completely sloshed. Apparently a bottle of wine is not a substitute for dinner. Who'd have thought?! I spent the next day in bed recovering, except for a little outing to get breakfast. Today was spent having lunch and coffee with a really good friend I haven't seen in ages... and then tomorrow OSCE revision starts in earnest.

Also... it's my birthday in 6 days!

Lily xXx

Calm Before The Storm

This time in 48 hrs I'll have finished my written finals and will hopefully be enjoying a cool, alcoholic drink with a couple of friends. All probably exhausted from the mental marathon we'll have endured.

It's strange to think that if I pass these exams they will be the last written exams I will sit as a medical student and that I will be 2/3 of my way to finishing finals. I think I'm calmer than I've been for any other set of end of year exams.

There are 2 possible reasons for this.

Reason 1. I have turned up to uni for 6 years, I have done a moderate amount of revision and I have finally come to the realisation that having done the above I will probably pass. I'm not aiming for a distinction or to get an amazing score. I just want to pass.

Reason 2. I have completely lost it. Later the reality of the situation will hit me and I'll have to be dragged from under my bed tomorrow morning kicking and screaming.

I hope it's more reason 1 than reason 2.

I'm off to try and relax for the rest of the evening, which is easier said than done. I'll probably cook some dinner, watch some TV, pack my bag for tomorrow and hopefully be in bed nice and early.

Before the exam I'm grabbing breakfast with a few friends from uni. It's always a good way to calm down before an exam... just as long as they don't start talking about all the stuff that they know and I don't. If that happens I'm going to stick my fingers in my ears and sing "lalalalalala" until we're sitting in that exam hall.

Good luck to everyone else sitting exams at the moment, whether they be GCSEs, Alevels or uni exams. Lets hope we all pass!!

Lily xXx

Exam Flu

It's even more virulent than man-flu. The dreaded exam flu.

Yesterday I had a headache and sniffles, by the time I went to bed I had some achyness and today I just feel like poop. I also have a temperature of 38.6.

This would only happen to me less than 48 hours before my first exam.

I've decided that this illness is due to mental weakness more than anything else, so I'm going to man-up (once I've had a bit of a moan). I'm taking paracetamol and decongestants. I'm drinking lots of fluids and I'm even breaking evidence-based medicine and doing everything else I can think of. Vitamin C tables, chicken noodle soup... you name it, I'm willing to try it so I don't feel like this on exam day.

Lily xXx

3 Days to Go...

It doesn't quite seem real, but my written finals are this week! I've got to the point where I'm so bored with revision, that to be quite honest I can't wait until Thursday and Friday just to get the bloody things out of the way. There's actually something quite soothing about sitting in an exam hall full of people all quietly ticking boxes on an answer sheet.

I know this is a little bit soppy but I wanted to say a big thanks to everyone who's wished me good luck (on here, on twitter and in real life). It feels nice to know that other people have faith in me, and it gives me a little faith in myself.

Also a big thank you to everyone who's read my blog over the last 3 years. I still find it strange to think that people actually read what I write. It makes me smile so much when people applying for medicine tell me that they're reading the blog and it's getting them all excited about medical school. It makes up for the fact that I'm jealous of all the fun they'll have over the next few years as they get into medical school, make new friends, learn new stuff... it really is awesome. I just hope the brilliant side of medical school has actually come across because we all know I like the occasional grumble...

On a related side note, once I graduate, I'll be starting a new blog...

scrubsandpubs.blogspot.com

So add it to your blog-reader in advance. Also... if anyone is good at making title banners or generally making things look nice, and you fancy giving me a hand please get in touch!

Lily xXx

Mini-Breakdown

It was bound to happen. What would finals be without a bit of drama?! Too easy... that's what!

Those of you who've read the blog for over a year will know about my ex. For those of you who haven't a quick summary. I was dating someone, we moved in together, we got engaged, he left, I was sad, the end. It took me months and months until I really got over the sadness, but over the last few months I can truly say that I've been really happy. In fact I even started to think that a little bit of heartbreak is a good life experience.

Last night the ex decided to tell me he still loved me and wanted to get back with me. I'll go no further than to say the conversation was drama-laden. I think in normal circumstances I would have just brushed it off and not let it stress me out. Along with the stress of exams, family stuff and that I really just lost it last night. For some reason I just couldn't stop crying.

A pep-talk later and the tears stopped, which was good, but I just couldn't sleep. 5am this morning I was sitting in my kitchen watching the sunrise, and only then did I get to sleep... for a whole 3 hours.

I was really tired and more than a little weepy this morning, but got taken out for a lovely breakfast and had a cuddle with someone special which definitely made me feel better. In fact I think that once I graduate I'll be prescribing cuddles for all my patients. Cuddles really do cure a lot of things. A nap also helped and I managed to get back on track.

Spent the afternoon in a cafe revising. It's only in the last 2 days that I've realised I actually get a lot of work done sitting in a cafe, more than even in the library. Would have been nice if I would have realised that earlier in my 6 years of university.

I've also been shown some amazing revision lecture videos from a lecturer at St Barts, you can find them if you Google "Feather does Finals". Each video is 2.5+ hrs long, and there are 8 videos so I wish that I'd found them earlier, but I'll fit the 6 I haven't watched into the next 4 days of revision somehow.

4 days until first written exam and I'm back on track. Thank goodness!!

Lily xXx

Sleep Monster

I keep trying to revise at home and failing miserably. I turn into some kind of sleep monster. I end up setting my alarm for 8 and then snoozing until 9. After that I get up, have some brekkie and then make the same awful mistake every morning... I pick up my notes and get back into bed.

Who does that?!

Then before I know it, I've read a couple of pages, and then I wake up an hour later face first in my notes. After that it's lunchtime and then I repeat the process.

Part of me wishes written exams were this Thursday and Friday instead of next, then at least I might be able to stay awake a little.

I'm going to go for a little walk to the supermarket to get some washing powder, which will hopefully wake me up enough to actually absorb some information. Failing that I'm going to eat a whole jar of instant coffee with a spoon.

Lily xXx

Library Days

Now that clinics are finished my life has evolved into the dull but comfortable revision routine I probably need to pass exams.

As much as I moan about it (and ask my friends... I moan a lot), I tend to enjoy this last bit of pre-exam revision. It means I can sit myself in the library, put something soothing on my iPod and slowly chug through notes.

Unfortunately my library calm was somewhat ruined by a couple at it on the desk next to me. There were far too many sloppy smoochy noises for my liking and I'm about 87% sure they probably had sex at some point while in that library. I wish my eyes could unsee the things I saw.

Worryingly I'm still not sure I'm revising the right stuff, but something must be useful as I've done 2 mock exams and I got 70% on one of them and 76% on the other. I'd be pretty chuffed if I could do that in the real thing.

In an effort to be a normal person (well as normal as I'll ever be), I'm also trying to still have a bit of a life over exams. I'm spending my revision breaks having coffee with friends, tomorrow night I'm cooking for my ex-flatmate and on Friday I'm meeting up with someone off Twitter once I've tackled a morning of revision. I'm also really enjoying spending time with some non-student friends. I've even been calm enough to indulge in a cheeky few drinks on 2 nights this week (already!!). That's definitely something that can only be enjoyed when not with people panicking about exams.

The only big downer is that I'm starting to get a bit upset about the thought of leaving London. I know I'll only be an hour away, but it's not the same as being just down the road.

Lily xXx

Last Day

This is it.

Today I had my last day of clinical placement as a medical student (... as long as I pass exams).

It was a bit of an anticlimax.

I got up, strolled to the hospital and for once found scrubs in a reasonable size. We then had an incredibly long ward round and before I knew it the consultant was saying we might as well have lunch and take the afternoon off.

It hasn't really hit me that it's over yet.

No more clinical placements as a student, no more lectures as a student, no more tutorials as a student. Just exams.

Exams.

PANIC!!

Not really... I'm (trying to be) not the panicking type. First written exam 2 weeks tomorrow. That's 2 weeks of revision left, and then a further fortnight until my OSCE. Plenty time if I knuckle down.

On a side note I shall be wasting tomorrow trying to collect my logbook from the administrator here, and then driving to London. My afternoon will be spent queuing at the council offices for a new electronic door fob and then queuing to vote. After all that I'm going to drive all the way back down to Kent for a couple of days. Crazy busy day.

My own fault for mysteriously losing my keys and forgetting to register for postal voting though.

Lily xXx

Inappropriate

Don't worry this isn't going to be some confession-post. As far as I'm aware inappropriateness is not something I suffer from. Nor (for once) is this a ranty post about someone else being inappropriate.

ITU has just got me thinking about dark humour.

All the medics I know make really inappropriate jokes all the time. I guess it's our way of coping with the sad things...

Today we had possibly the most amusingly inappropriate incident I've seen on ITU yet.

To set the scene, we're in a quiet corner of ITU. The patient has been there for some time and is stable, slowly edging towards a possibly recovery. For a bit of entertainment the nurse has the radio playing. We take off our aprons, wash our hands and we're just about to leave when a new song starts...

"Don't leave me this wayyyy... I can't survive..."

Cue all of us blustering out of the room holding our collective breaths trying not to giggle.

I really hope that people don't take offence at medic humour. I guess the Amateur Transplants have yet to be hunted down and vilified for their songs. I however need to resist the urge to sing them to myself in ITU.

Oops.

Lily xXx

All Engines Are Go

It's finally happened. I've got that pre-exam burst of energy that leads to serious progress.

Today was unbelievably productive.

I was in the hospital by 8am this morning, for my first day on ITU. Ward round was much more interesting than most as the other student and I had to examine EVERY patient on the ward round. Brilliant practice for OSCEs as well as being a sure fire way to make sure we weren't sleep walking the round.

I got my final 2 clinical skills sign ups on ITU too. What a relief. I now just need my attendance sign ups and some of the junior doctor's signatures co-signed by a more senior doctor.

As well as getting those bits done I got to watch an FY1 put in a perfect central line (under supervision obviously). I have no idea how she stayed so calm with 2 medical students watching her. She insists she was nervous and sweaty, but as far as any of us could she, she was awesome. I just hope I can have the same level of calm next year.

I left the hospital just before 6pm. To be honest there was a fair bit of waiting around to get those sign ups I needed, but it was worth it.

When I got home I threw a lasagne in the oven (judge me for eating a ready meal only when you see how rubbish our little hosp accom kitchen is...), had a bit of a gossip and then decided to continue the productivity.

I spent 20 mins reading some dermatology notes, something I've not covered much so far in revision. Then I got bored of reading (short attention span), so I did a mock written exam the university has made available on our intranet.

Much to my surprise I got 76% overall in the exam. This has made me so happy. I'm clearly learning something. It also means I can tone down the writtens revision a tad and really get onto the OSCE revision.

Tonight I'm going to continue to ride this wave of productivity by reading some communications OSCE stations notes. I'm also going to keep my fingers crossed that tomorrow will be as productive.

Lily xXx

Focus

Something I always lack in exams is focus. I just can't concentrate on one particular thing for any length of time. Even if I'm revising it's in little bursts flitting from one topic to another.

This weekend has been so beautiful that it has been particularly hard to focus on revision. The glorious weather has meant lots of sitting over looking the sea with my Dad and my friends from home. In fact saying no to a trip to the beach today was one of the hardest things I've had to do in some time. Although I'm a firm believer in time off from revision, I would have got nervous taking a second day in a row off. I did have yesterday off though, but wasted most of it asleep in the sunshine.

I did get a bit of practical revision however, when my friend came off his bicycle and managed to tear through the skin on his calf with the gear wheel thingy. I put my 6 years of medical education to the test with a pile of gauze, some warm water and some TCP. I learnt that oil is particularly hard to get out of wounds.

Today's revision has been on testicular cancers and leukaemia. Hope fully before bedtime I'll have revised myelomas and lymphomas too. Then if I cover anaemias and clotting issues tomorrow I should pretty much have haematology for finals covered. I do worry that I'll have just forgotten it all in a month though. I also worry that all this worrying is taking up valuable brain power.

My other worry is my revision belly. I have really piled on the pounds over this revision period so far. I must remember that preparing and eating snacks is not the best form of procrastination.

Also kit kats are not a food group apparently. This is upsetting.

One more worry... I smashed a mirror by accident. EEK!! Does this mean I'll get 7 years bad luck?! How could I do this just before finals?! HOW?!

Lily xXx

Slip, Slap, Slop

It's that time of year again...

Summer time!!

Which means revision time too unfortunately, although who can deny that revision is much more fun when you can sit in the sunshine and do some reading?

I have spent this morning in the sunshine, smothered in suntan lotion, reading some revision books and even having a sneaky nap. I feel pretty good for it. However I am getting to that point where I am in intense panic about finals.

I don't feel like I'm doing enough work. I also don't think I'm learning the right stuff. I wish I was psychic and could guess what was going to come up in the exams.

I guess all I can do for now is plod along with reading stuff, and enjoy sitting in the sunshine.

Although I'm in a state of inner panic I'm not going to let it send me insane. I'm going to follow the advice of Dr Dark from the MDU revision course and remember that if I don't chill out, that will affect my marks as badly as if I wasn't doing any work. Everything in moderation.

Part of this moderation is cocktails this evening. Mmmmm...

Lily xXx

1 Month to Go

The last 6 years have flown by. It honestly seems like only the other day when I was starting university, and now the end of it is staring me in the face.

I can't believe I only have a month until written exams start. It's scary scary stuff. I feel nowhere near ready enough, but I'm worried that I'm not doing enough and the right type of revision. Every time I learn something a little niggly bit in the back of my head tells me that I'm learning the wrong stuff.

In fact this finals obsession is completely taking over my mind. I'm even having nightmares.

In a strange way I wish that finals were next week and that I could just get them out of the way.

On the plus side I've not allowed my social life to go completely to shreds. I'm still trying to enjoy a couple of glasses of wine in the sunshine every now and then. It always seems to cruel the way exams always seem to be when the weather is at it's best.

Lily xXx

MOSCE

I never thought there would come a day where I actively volunteered to do extra exams. I didn't bank on finals scaring me quite so much. As soon as I was offered the opportunity I signed up for a mock OSCE, or a mosce... which I think just trips off the tongue beautifully.

It was weird doing communication skills stations with the junior doctors we work with, but also very useful. They also went to the trouble of finding us proper patients to examine, with signs and everything. I was baffled by Mr Dexotracardia as I couldn't feel an apex beat on either side. At one point I was just considering saying that he didn't have a heart.

In a way it's made me relax a little more. I now know that I can take a history, examine and explain things. In fact I could probably scrape a pass, so over the next 6 weeks I can work on boosting my confidence and fine tuning things so I go from being OK to being good. It also means I'll feel less bad about taking my birthday off in the run up to exams.

Now I just have to motivate to revise over this week off!

Lily xXx

Prescribing

Apparently prescribing is something that junior doctors do very badly.

I guess there are lots of reasons for this, but a lot of it boils down to teaching. At my medical school we're lucky to have some formal teaching, although not much. When learning it on the wards, it's all too easy to pick up bad habits of older colleagues, without even realising it's not good practice.

On the weekend I was told that in one Foundation School over 40% of Foundation Doctors are on remedial supervision due to prescribing errors. I'm not sure how accurate that is as it seems like a pretty high number, but it's scary. The GMC published information that said when they investigated, prescription errors were at around 10% in junior doctors, luckily most of these were intercepted by pharmacists.

It's also really confusing that prescription charts vary from trust to trust. My favourite ones so far had a really nice special prescription sheet for infusions, allowing you to write any extra special instructions.

I've also heard the rumour that a national prescribing exam could be appearing soon. Even though it's an extra hoop to jump through surely it can only be a good thing.

Anyway, today I'm frantically revising for my mock OSCE. There are prescribing stations in our OSCEs. We have 7 minutes and we're given a BNF, but there's not really enough time to look things up, so instead I'm memorising treatment regimes for common things. I'm pretty good at knowing which drugs to give, but I've never really paid that much attention to all the doses... I've always taken it for granted that I can look it up in the BNF. Tomorrow however, I am going to be a walking BNF.

Looking forward to having a week off for Easter next week. Granted I'll be revising and stuff, but it'll be nice to not have the hospital looming over me. Fingers crossed the weather will perk up again so that I can spend the week revising in the sunshine and eating ice creams... Mmmmm!

Lily xXx

Relaxation, Revision... Blah blah blah..

So I've been a bit naughty this weekend.

Don't worry I'm not about to go into some epic overshare, I mean about revision. I went to the MDU medicine revision weekend, which was awesome. Otherwise, I've taken a long weekend off and not really done much else work-wise.

I'm placating myself with something the lecturer said.

"If you guys just went on a 4 week holiday before your exams and didn't pick up another textbook, you'd probably do better"

Such is the power of relaxing.

I'm hoping that he's not pulling my leg. I really really needed this chilled out weekend though. It was completely lovely, even if I did spend Sunday morning more than a little hungover.

I need to start hardcore OSCE revision this week. I have a mock OSCE on Thursday, which should be interesting and exhausting...

Lily xXx

Ouchies!

Everyone who knows me, knows that I''m not the most active of people. I must have been the only child at school who hated PE and would have always rather read a book than run around. In fact the only exercise I ever enjoyed was dancing, cycling and horse riding.

As it's getting closer and closer to exams I'm spending more of my time sat on my ample bottom, and less of my time standing up and walking around. I reckoned that this might be why I've been feeling so stressed out... pent up energy perhaps?!

I decided to remedy this, I was going to go for a run. I've been putting off this run for a couple of days, but today the sun was out and someone told me about a lovely trail through the forest. I tugged on my trainers, squeezed into some lycra and I was off...

The trail was lovely. I enjoyed about the first 500m of it. Then the pain set in. Not chest pain, which I often get if I forget my inhaler, not calf pain from weak oxygen-hungry muscles but hip pain?!

I've officially turned into a Granny.

I somehow developed what felt like a trapped nerve in my hip. It was excruciating.

I've decided this is all some higher sign that cross country is not the sport for me. I wish there was a fun, painless and cheap way to get fit! *sigh*

Lily xXx

Boozing

I've given up alcohol for lent, in fact as I hadn't drunk for a bit before lent it's now been over 5 weeks since I had an alcoholic drink. It really hasn't bothered me as much as I thought it would. After a week or two, when everyone stopped taking the piss out of me, having a diet coke or a lemonade in the pub has just been normal for me. Luckily it's also proven that I'm as much fun sober as when drunk... I just get all the giggles and none of the hangovers. Bliss.

So yeah, this post isn't about me boozing, its about other people boozing.

I recently spend a weekend night shift with the London Ambulance Service on one of their booze buses. It was eye opening. For a start I knew people got so drunk they peed themselves (yes... that is you rugby boys...), but I didn't realise people got so drunk they shat themselves. That is a whole lot of drunk.

I saw three amazing things...

1. Inco pads on the seats of the bus. Why don't people do this for their children in cars too?!

2. Making a wearable sick-bag out of a clinical waste bag. I might have to adopt this again for children getting car sick in cars.

3. A paramedic getting a grey cannula in, it took her about 5 seconds and was completely perfect. It makes me ashamed of my faffing to get a blue in.

It's also really put me off binge drinking. I, like most people of my generation, have spent more than the occasional Saturday downing jaegerbombs and then spending the next morning cuddling the loo, vomming it all up. I'm now petrified that one day I'll end up so drunk I'll have to be picked up by a booze bus, very embarassing.

As a completely unrelated aside... the estate agent stood me up on Thursday. He just didn't turn up with the clients, so I almost went into renal failure for no good reason. I was not impressed. He also always gets my name wrong. Stupid man.

Another unrelated little ramble... revision. I no likey. I'm finding it hard to concentrate and nothing is going in. Short of doing onexamination questions I just can't focus on anything else long enough. I think I'm going to have to hide my very distracting Kindle.

Lily xXx

Waiting Around

Usually I'd moan about being kept waiting around on the wards or at outpatient clinics. It seems that waiting around is destined to become a big part of my life. Now I'm being left waiting around at home. By the estate agents.

Selling a home is stressful to say the least, especially when you're as adverse to housework as I am. I rushed back to London today to make sure the house was dust-free and as clean as possible before the viewing this evening. I really want to sell/rent it out. I hoovered the whole thing, cleaned all the kitchen surfaces, cleaned the bathroom and scrubbed the kitchen floor. I smell so badly of bleach right now that I'm probably in danger of toxic chemical inhalation levels.

The estate agent was supposed to be here 15 mins ago.

It's not as if I have any massive plans to go out tonight. In fact I'm cooking dinner for a friend later. My main problem is kind of embarassing.

I need to pee.

I need to pee really really badly.

I think I'm currently in danger of putting myself into renal failure. However I can't go until the estate agent arrives because it would be awful if him and the potential buyer walked into the flat as I was in the loo. I'm not sure why I'm so bothered about this but I am.

Lily xXx

The End is in Sight

I don't really have much useful to say. I've had some bad news over the last week which has thrown me off course a little bit. I need to focus on the fact that I'm so near the end of medical school that I can't let anything spook me and ruin my chances of failing.

On a lighter note, I worked out that because of bank holidays, I have less than 20 days of actual placement left, which is scary. I think it's 19 more mornings that I will turn up in the hospital as a medical student. Clearly this is only if I pass, if not I have 19 days + 1 year.

I'm finally getting there with sign ups too. I have 3 left to get in my log book and an attendance one at the end of the rotation. The relief is extreme, its nice not to have to constantly be on the prowl for sign ups.

I know I should be revising more, but I keep getting distracted with ideas of what I'm going to do with my time off after exams. I'm thinking of travelling Europe with a friend, I'm definitely having a weekend in Paris with my Dad... but that still leaves me with a couple of weeks to fill. I really want to make the most of the last long holiday I'll probably ever have.

Lily xXx

Night Shift

There are a couple of frustrating things about being a medical student. Firstly it seems like there are always loads of other students around, so you have to fight to actually get any experience. Secondly, whenever there aren't a whole hoard of students it always ends up that nothing happens so you stand around like a spare part wasting time.

Both of these things annoy me beyond belief.

As one of our sign ups for the term we have to do a night shift. The good thing about nights is that there are definitely less students around. The bad thing is that usually nothing happens and you end up being a spare part, or just kipping in the mess.

Not on my night shift.

It was a surgical night on call with the fy1, he warned me it had otherwise been dull all week. To be honest I was just pleased with the chance to wear scrubs and trainers... ultimate comfort wear.

Somehow (for once...) I ended up lucky.

The evening started off pretty typically. Catching up on the days jobs, mainly chasing blood results. I then got the chance to clerk in and examine a patient. Sounds dull, but I enjoy it. I also got to formulate the management plan and write the drug chart... great practice not only for OSCE but life as an FY1 too.

After that there was a trauma call. A drunk driver in a car crash. Thankfully she'd only hurt herself. Unlucky for her she's fractured some vertebrae, ribs and a limb. Silly silly lady. Things could have been much worse.

We then had a patient who had potentially perforated after an operation. I tried taking bloods with a needle and syringe for the first time, I've always used butterflies. Turns out I was worried about nothing... needle and syringe is easier and faster!

I learnt how to be polite, but assertive with other healthcare professionals, and that giving away mini chocolate bars gets you much further than anything else. I practised all my examinations, history taking, blood taking, ABGs, management plans, writing drug charts and even got to have a go at a catheter.

In fact in 1 night shift I did more than I've done on 3 weeks of day shifts.

I think I'll be doing more nights.

Lily xXx

Finding The Words

Those of you who've been reading the blog recently will remember my post about the young patient with cancer, and how concerned I was that no-one had told him anything.

As far as I was aware, from the notes and from what the consultant said, he'd been told his diagnosis last week. He seemed a bit more upset and agitated, but was in a lot more pain. I thought, considering everything, he was taking this bad news pretty well...

Then today I was involved in a conversation with the palliative care team, his nurse on the ward, the FY1 and I. Turns out he'd only been partially told.

I felt sick.

He'd been told that there was shadowing in his imaging, and that this was being further investigated. So really he had no idea. The doctor never explicitly used the word "cancer". The consultant was adamant that the patient knew what he implied. The rest of us weren't so sure.

It was left down to the palliative care team to go over to him and break the news properly, making sure he understood everything.

I've always thought it's important to say things as they are. Words like cancer and death are scary, but it's only fair that the patient knows what's happening. Or at least that's my opinion.

I know that when my Mum was dying in hospital it was a long time before we were told she had cancer and was dying. In fact it was only a couple of weeks before she died. I have no doubt that the team caring for her were aware long before us. Probably like my team they were waiting for histology and a proper management plan. Surely though, for someone with obvious mets, it's important to at least tell them that they have cancer.

I can't help but think that if we had a bit more knowledge about my Mum having cancer that she might have had the chance to die in a hospice, which is a lot nicer than a hospital. I also think it would have been a lot kinder on my Dad and I if we'd been told more and prepared a little more for things.

I just wish I was a bit more influential in the team so that I could help this family a little with what is clearly going to be a difficult time.

I don't think histology or the finer points of management matter that much to patients or relatives. What matters is knowing a realistic prognosis and the major options for the future. Home, hospital or hospice care? Saying goodbye to loved ones. Getting affairs in order. Sorting out finances and wills.

I'd like to know what other people think, or situations other people have been in? What would you do if you were the consultant?!

Lily xXx

Looking Lazy?!

Time management is becoming a big part of this last rotation. Evidently as I have finals I need to spend a while revising for writtens and a while examining patients each day. I also have to show up to see my firm.

At the moment I'm trying to strike some kind of compromise. I'm turning up at 8, going on ward round, hanging around until lunchtime to do jobs and then buggering off to study. I hope they don't think I'm just being lazy.

I also still have sign ups to get. One of them is a sign up for breaking bad news, something we're not allowed to actually do to real patients by most doctors. A few friends have had theirs signed off by doing role play with doctors, but thus-far I haven't been that lucky. Argh.

Lily xXx

Student Beans

So I did an interview for Student Beans...

I think this is the closest I'll ever get to feeling famous, and it feels pretty good. I'd like to apologise to the poor person who's face they've shoved on the interview as we all clearly know I'm anonymous (and ginger...)

It's slightly disheartening that in a few days they can make a better looking banner for the interview than I could make for my blog in 3 years. Clever peoples...

Lily xXx

Bad Timing?

It's not often I blog about something serious, but this is something that's really been playing on my mind.

There's a patient in the hospital I'm in, who is relatively young and has very aggressive metastatic cancer. He's been an inpatient for a week and no-one has told him. No-one has even given him a clue to his diagnosis.

I feel really uncomfortable about this.

The CT he had showed all these lesions, and further tests have been carried out. The reason I've been given for no-one on the team breaking the bad news is that they feel he's the kind of patient who won't respond well to being told half the story, so they want to wait until histology is back and the multidisciplinary team have made a treatment decision.

I don't agree.

I think we should at least tell him that there are suspicious looking lesions on his scan, that the tests we've done so far are specifically to look at these lesions and to find out what they are, and that until the whole team have discussed it we can't give him much more information. Then at least any bad news won't be totally out of the blue.

I have a sinking feeling that no-one is telling him, as no-one wants to be the one to tell this patient the devastating news. I think the doctors are all just waiting for the specialist nurse to come along with the results and tell him.

It's awful. If this cancer is as aggressive as we think it is then the guy mightn't have that long left and will probably want to spend as much time with his partner and kids as possible. With the extra time he may be able to organise care at home or in a hospice, or even a last family holiday before he is too sick to go anywhere.

Every time I see him I want to cry and scream with frustration as he has no idea.

I'm dreading ward round tomorrow. Part of me hope's he's been told, even though I think he'll be fuming with us for withholding information. The other part of me doesn't want that confrontation.

I can't stop thinking about it.

Lily xXx

Referred Panic

I went into ward round this morning. Did the usual... scribbled in the notes, smiled at the patients, checked the obs charts, made sure the nurses witnessed me alcohol-gelling my hands until they almost dissolved and made the right tutting noises at everything the registrar tutted at.

I thought I was doing well.

After ward round the (exceptionally lovely) surgical registrar came to the mess, put the kettle on and made us all some toast. Then we got to chatting. Firstly we chatted about the general madness of patients being on antibiotics too long because no-one thinks when they check the drug chart. Secondly we chatted about how stupid hospital politics are, trying to make us send home dying patients. Then we talked about finals.

I just casually dropped it into the conversation that my finals are in 2 months and 3 days. The registrar was stunned... "Go... go now and study! In fact don't spend much time on the wards... study study study!!" The panic in his voice made me jump a little.

This has got me into a panic. I still have sign ups to get and yet I have a lot of actual studying to do. I'm only averaging 63% at onexamination questions and I've realised I've forgotten all the basic science I ever knew. I had to draw and relearn about kidney nephrons and how diuretics work today. That's really basic first year stuff.

This week certainly hasn't been as productive for sign ups. I got 7 last week... this week so far I've got 1. Tomorrow I'm aiming to get another 1, at a push 2 and ideally I'd get one on Friday too. I don't think it's through lack of effort, I just think I've got the easy ones done now and the last few I have left are a little more complex.

I also need to find out when my consultant is next on call so I can clerk a patient in and get my case study done. Hopefully next week.

I'm not sure why I get these recurrent bouts of panic. I guess it's because I'm so close to the end and I'm just worried that something small will trip me up.

Lily xXx

Scut Work

I know I shouldn't moan. I'm really lucky, I'm doing the course I want, I've got as far as final years, I have amazing friends etc etc. Even though I know this I'm going to have a big moan right now...

It's traditional that med students do the "scut work", basically the jobs no-one else wants to do. For me this splits into educational scut and useless scut. Educational scut includes things like taking blood from 5 different patients in a row. It's not particularly interesting, but at least I'm honing my blood taking skills. Stuff like helping nurses with enemas, setting up fluids, collecting stool samples are all also scut in my mind, but useful as I'm learning how basic clinical skills are done.

Today however I got landed with useless scut. Discharge notifications and referral letters. I think a certain amount of discharge notifications and referral letters are useful to write, as it's a big part of being an FY1, however being pimped out to another team when I'd done all jobs and writing 3 discharge notifications and 3 referral letters on top of the ones I'd done for my firm was so frustrating. To make it worse their med student was putting in cannulas and doing bloods, two bits of scut that I want to do lots of to get some practice.

It's tough as at the start of the rotation we're told not to let people take the piss with getting us to do all the paperwork. An hour or so a day is seen as the maximum for us as we really need to either be consolidating our clinical skills or we need to be studying for our finals.

It's just pissed me off that 90% of my morning was wasted.

I've also pissed myself off by wasting 2 hrs this afternoon napping.

Lily xXx

Awesome

I've started saying "awesome" all the time. I'm now saying it so much I'm even annoying myself.

I'd love to know who started me off with this annoying habit.

"MR X needs a new cannula." "...awesome"

"Can you write the discharge summary for this patient?" "yeah... awesome"

"These free sandwiches are stale." "Really?! ...awesome"

Next time I say it I'm going to slap myself.

Lily xXx

On Fire

...thankfully not literally. Although my boiler currently sounds like it's about to explode.

I just wanted a little boast.

Even though I've been pretty ill this week I've got 7 sign ups! That leaves me with only 10 left to do. Feeling much more chilled out now that I've got a big chunk of them done.

Unfortunately I can't say my revision has been as successful. I've been scaring myself with onexamination questions, which are brilliant, but show that I have a lot of weak areas. I'm lucky enough to have an amazing FY1 who's quizzing me and teaching me all the time... Apart from this I'm not really sure how to revise. I'm trying to make mini revision cards of stuff I should know by heart when I answer a question wrong or find a weakness. I'm also trying to read the Oxford Handbook and Surgical Talk.

How else can I revise for writtens guys?!

Lily xXx

The Final Hurdle

I've started my last placement before finals. It seems like the last hurdle before the exams and hopefully qualifying.

I've got off to a bit of a pants start, having to take today off as I practically put myself into acute renal failure, by leaving a kidney infection untreated. Bad move. Except for that though, it's going well.

The accommodation is standard hospital accomm. It's neither exceptionally good, nor bad. We all have a large-ish single room with desk, bed, wardrobe etc. There's then a bathroom shared by the 5 of us in each flat. What is weird is that they've split up my clinical partner and I, so I've hardly seen her all week.

My firm for the first 4 weeks is interesting. I have no consultant, so need to find someone else to sign my book and case study. Otherwise the FY1s are lovely, and the registrars, although seeming a little gruff at times, also seem nice. Nice for surgeons anyway.

Yesterday before I ended up so sick I couldn't work I also managed to do something that was worrying me. Take bloods successfully... first time! Because I've been at GP since Xmas, I was worried that I'd have forgotten how. Very glad that I've got the first blood under my belt. Now I need to get the first cannula of the year and I'll be happy.

Some of you will also be aware of how worried I am about log book sign ups. Not including my case study or educational contract I had 15 left to do this term... I've done 5 already. Big relief. Unfortunately they were 5 easy ones. Hoping to shadow an fy1 on nights next week and maybe get another couple of sign ups there. Would also be useful to get my case study done then as it's when we're on call.

Anyway I'm off back to bed. Hoping a day of sleeping will have me well enough for the wards tomorrow.

Lily xXx

Om nom nom...

Those of you who know me in real life will be well aware of how much I love my food. I spend hours cooking and am known as a bit of a cookery dragon. No-one dares to interfere. My wooden spoon is sacred.

Strangely when I'm away on placement I just can't bring myself to get the same joy out of cooking. Pokey, dark, cramped kitchens full of other people and strange equipment don't really do it for me. This gets me kind of down.

I'm dreading my 8 weeks of living on chocolate mini rolls and tortellini. So I'm just warning you, if I'm grumpy its nothing to do with you, its the dull food.

Lily xXx

HELP!

I'm feeling soooo stressed out...

Being in lectures for a week has made me realise "ARGH!!!! FINALS!!!". This was made infinitely worse from a talk by an FY1 who opened her lecture with "This time last year I'd read all of Kumar and Clarke, could recite each page of the Oxford Handbook... and just didn't know where to go from there" ... Seriously. Fuck off. If I've got to that stage by finals I'll be laughing. She made me feel sick.

I'm also freaking out about sign ups. I've got an 8 week placement left and a hell of a lot of sign ups left to get, including hard stuff like "breaking bad news" that no-one will let us do, and no-one will sign up for doing a role play. Meh.

My final stressage is my flat. I'm either going to sell it or rent it out. This is really making my head want to explode. It sounds like a minor thing, but it means keeping the flat clean. I am so untidy, so this is such an effort. On an amusing note I single handedly tiled the bathroom floor with lino tiles... go me!!

Anyway I should probably go and actually pack for my next placement at another DGH. I'm moving in on Sunday night. It's strange but I've got to the point where guessing what hospital accommodation is like fills me with joy. I think this is because I've stayed in so many dives now that nothing bothers me, I just see the funny side...

Lily xXx

Save Our NHS

I'm sure that I'm not the only one who is aghast at the proposed NHS reforms. In fact most days it seems to be the topic du jour on twitter and has us all ranting...

http://saveournhs.org

Go to this website and sign the petition. It might make a difference...

Lily xXx

Goodbye GPland

Tomorrow is my last day in GP land. I'll be a little sad to see it go, but I feel it's time.

I've learnt so much, not only information-wise, but also in communication skills. I'm so much more confident with history taking, bad news breaking and dealing with grumpy patients. It's also been the first time I've felt like I'm managing my own patients. I know that deep down, my GP has the final say, but as I get to present the management plan to him and get on with it, it's strengthening my confidence no end.

The bad thing is that I think I've had complete skill atrophy while in GPland. Someone came in needing bloods and I tried and didn't get it first time so the GP had a go, and he got it. He hasn't taken blood in 10 years. I am a failure. Oops.

On the plus side I passed my last special study module on Wednesday. Hurrah!

Lily xXx

Selfish Post

I was going to make my next post about Ask Dr Clarke Surgery, but I've changed my mind because I need to exercise "le rantage", something that I save especially for blogging as my friends get fed up of all the real life rants.

Starting with good stuff... I found out my FY1 placements. I'm doing paeds/general (breast) surgery/geris. This is awesome as I get to do paeds. Even the idea of having to do geri's can't get me down. The hospital I'm at is pretty close to home, so I'll probably end up living with my Dad for a little while at least. I'm not sure my liver can handle that amount of vino.

My FY2 is in an obscure place I used to live as a young child. I'm going to embrace it and be happy as it gives me a chance to go somewhere were I know no-one any more and make lots of new friends. Deep down I think I'd rather be in London.

Because, hopefully, I wont be a student doctor anymore after this summer I've also been thinking about a new blog to start. @trufflethebendy on twitter suggested Scrubs and Pubs. I like this a lot. So this is what it will be. Struggling with making a good layout etc... so if anyone is computer-minded and wants to help, get in touch. If you're super organised you can start to follow it now at scrubsandpubs.blogspot.com, but no actual posts will go up until July... when I graduate and actually become a doctor.

Also, as I'm no longer based in London I need to move. This is where "le rantage" will start.

Firstly this means a massive clean out of the flat. I'm a hoarder. I don't find clearing out easy. In fact I love living in clutter. The thought is stressing me out.

Secondly, estate agents. I probably don't need to say more than that for you to understand my pain, but I will. Talked to 2 estate agents. One says I won't be able to sell it but will be able to rent it, the other says I won't be able to rent it but will be able to sell it. This all makes my head hurt. I just want to sell the sodding flat and move "down saaauf". They're also really slimey. I'm being visited by 2 estate agents next Thursday... I'm going to suggest they strip to their boxers, wrestle each other in my living room while covered in jam, and the winner gets my custom.

Lily xXx

Ask Dr Clarke: Medicine for Finals

Generally I'm a selfish blogger. I write what I want to write, because I can. Occasionally though I think about writing something useful. This is one of those moments.

When I was thinking about what revision weekends to go to for finals I was really stuck because not that many people have reviewed them. Luckily for me there are a host of helpful people on twitter who helped me out, but this is my attempt at helping others out with a little review of my own.

Ask Dr Clarke has a great reputation. In London it also has a great venue... BMA house. I arrived there nice and early, about 8.20 and was surprisingly faced by table after table of coffee and tea... free!! I know I paid a lot to go on the course so it wasn't strictly free, but still, I wasn't expecting it. As we registered we also got a book of revision notes and a hat pin with a red and white end to test visual fields. I never had one of these before. I was disproportionately excited.

As a little aside the book of notes is fantastic. It has lots of bullet point notes, diagrams and extra notes for things that aren't covered in the course. The course aims to cover the 3 types of learners; visual, auditory or kinaesthetic. I've always been a kinaesthetic learner, but I find that learning in all 3 ways really helps cement things in my mind.

The day is split into topics. Each starts with a little quiz, so you can identify the areas you have strengths or weaknesses. This is really useful as I always end up revising the topics I'm comfortable with as it makes me feel better, which isn't useful. This really showed me where I need to do more work (cardiology and renal!!) and where I could probably relax my revision a little (endocrinology is my mastermind subject!!).

Key ideas were reinforced through repetition, singing (for heart sounds) and doing dances. Sounds cheesy, but it was awesome. Dr Clarke himself is also a really engaging speaker.

As many of you know my tummy rules my mind, so the inclusion of lunch was also much appreciated. Everyone got a cute little lunch bag, with a choice of sandwich, bottle of water, apple, bag of crisps and kit kat. Om nom nom...

Kit-kats are my favourites (along with Toblerones, Choc Orange and Mini Rolls), just in case anyone ever fancies treating me...

I'll write about the surgery revision course soon.

Lily xXx

Inspiring Kids

Inspiring might be going a little far, and I guess they were teenagers not kids... but I'd really like to tell you about the day I spent teaching local teenagers more about jobs in healthcare.

To set the scene, my university is based in an area with many inner city poorly achieving schools and lots of knife and gang crime. Because of this we teamed up with a local school and set about educating the children about jobs in healthcare. Hopefully this will open their eyes to some interesting jobs they may not have known about or considered.

After changing into scrub tops and listening to a talk on knife crime the excitement started. During the morning they split into groups and rotated around stations run by different people. There was BLS, ultrasound, occupational therapy and cannulation/blood taking. I got to teach the cannulation station which was awesome practice for me on the fake arms. It was also one-on-one so as well as being encouraging and fun for the kids it gave me a chance to answer lots of questions on hospitals and medical school.

The afternoon got a little more complex. We moved onto high tech simulations of emergency situations, which got all the kids very very excited. As well as this we had laprascopic surgery simulation, which even I was excited to have a play with.

During the afternoon I had to teach suturing. I'm not very good. Not only was I panicing as half the kids didn't listen and looked as if they were going to gouge each others eyes out with needles, I really don't have much skill myself. Luckily a very nice surgeon saw my struggle and sat down and taught me properly. He even went as far as teaching me a mattress stitch. I was so surprised that he didn't shout at me for holding my forceps like some kind of backwards monkey. Apparently there is such a thing as a nice surgeon.

Overall it was a really fun day for me, I just hope the kids found it as fun. I have to admit I was exhausted afterwards though... I envy their energy.

Lily xXx

Riding The Wave

The wave of motivation is approaching the shore, and I am riding high upon it.

Not only have I finished my SSM essay, started the presentation and attended 10+ hr days at placement but I'm getting on top of the extracurriculars. I've finished my fastbleep article (but failed to submit it because basic technology is clearly beyond me), I've read 2 books, bought and read some of a surgery textbook.

As well as all the stuff I've already done, since I'm on a roll, I'm going to keep up the momentum.

Tomorrow I'm spending all day at a simulation/lecture day introducing secondary school children to jobs in healthcare. I'm only a little bit scared by the fact it starts with a lecture on knife crime and then I'm left with them and sharps.

Friday I have another full day at placement. At lunch I'm going to look at what I have left of the prep work for Ask Dr Clarke's revision weekend and finish that off. Friday night will be early to bed because then I'm off to spend 2 days asking Dr Clarke (so to speak) and learning lots (hopefully). I then have 2 days of GP, and on Wednesday a course on travel health with some practice nurses. It all sounds like good fun and I'm excited.

... I will admit that I'm looking forward to my day off next Thursday though!!

Ooooh, and before I forget... I find out my FY1 job on the 15th. Exciting stuff too. I guess it's good to keep busy beforehand to make the time pass quickly.

Lily xXx

Searching for Blogs

I've just finished my essay... hurrah!! Although I still have an awful lot to do, as work never seems to end, I've earned the right to a little more procrastination before I begin my next project.

Procrastination comes in no better form than reading blogs...

I follow lots of awesome blogs, but I think now is time to start following a few more.

If you write a blog I don't follow, or know a blog I might like please leave me the address as a comment

Thanks everyone!

Lily xXx

Tik Tok...

I can't get the song Tik Tok by Ke$ha out of my head. I don't particularly like it, although I do LOVE her hair in the video. I also don't see why she has to use a silly $ sign in her name. Madness. I thought writing this down would help get the song out of my head... but its not really working.

The reason I have this song in my head is a little abstract.

I can't stop thinking about how quickly time is ticking by.

I've only got 3 weeks of this placement left. I feel like I've hardly begun.

I'm well over half way through the year.

4 months until exams are over.

6 months until jobs start.

ARGH!

Lily xXx

Motivation Vs Procrastination

As always procrastination is winning. I think it helps that I have a very untidy flat and as soon as I tidy something up, I get it messy again. Means I always have cleaning to do. I'm also thinking of using a supermarket trip as a big procrastination idea... and if I can get my car started I can drive to the big supermarket next to the cinema and then I can go and see a film too.

I really do need to get some motivation this weekend though. The plan is to have a 1st draft of my 1000 word special study module essay by Sunday, as well as typing up the notes I've made for my Fastbleep article.

If I do that I know I'll feel really good about myself.

So why can't I get started?

Lily xXx

Privilege

Every now and then it dawns on me how lucky I am.

I turn up at clinics, on the wards and on house visits and time and time again patients allow me to be part of massive emotional times in their lives. They most of the time the patients gain nothing extra from me being there. I'm sure for some people it even makes things more difficult, uncomfortable or embarrassing... but still they let me stay so I can learn.

Although I always thank patients I'm not sure they realise how seriously I mean it.

So thank you everyone for letting me be part of your lives. Thank you for helping me learn.

Lily xXx

Little Miss Extracurricular

They say it's never too late to start something... So I'm picking my penultimate term at medical school to start really getting involved in things that will not only sound impressive, but that I really think I'll enjoy.

I'm writing an article for Fastbleep, an amazing new resource for notes for medical students. I'm excited because not only is it a chance to help add to a brilliant website, but it's going to be a great way for me to revise a topic.

As well as writing some notes for a website I'm also helping teach some med students face to face. It's nothing too taxing... I'm going to be helping teach some OSCE stations to 3rd years. Again a chance for me to give something back while giving myself a chance to revise.

To top it all off I'm also taking part in a day at our new simulation suite teaching school kids some healthcare skills and getting them interested in careers within the NHS.

In fact just reading all this bits gets me excited, but also exhausted. It feels kind of nice to be giving something back... maybe I'll do it more often.

Lily xXx

Cultured Weekend

Some of you will be confused and some of you will be impressed by the fact that today I'm indulging in even more culture.

As if Cirque Du Soleil on Wednesday wasn't enough, today I am going to the Tate. Again. I went just before Xmas too. That makes me properly cultured.

But don't worry... I'll still be indulging in a fishbowl of cocktail later... I haven't changed that much!

This in theory is my last weekend of freedom before revision starts. Although I said that about Xmas. I really need to get some motivation and knuckle down unless I want to be resitting 5th year and to be honest, that does not appeal.

Also I need to rant. The postman came again today and didn't bother knocking, just left one of those "you weren't in to receive your parcel" notes. I was in!!! Grrrr. To make it worse the parcel had the dress that I want to wear tonight.... boo hoo!! :(

Lily xXx

Totem - Cirque Du Soleil

This is a little unusual for me. Usually I prattle on about life and med school. Today I am going to attempt a kind of review of the Cirque Du Soleil show I saw last night. Or at least review it in a Lily-style.

Last night I went to Totem at the Royal Albert Hall with a friend. Our first issue was finding a pub or somewhere to eat nearby. Seriously. It is like a desert when it comes to drinking spots. It's practically on the Imperial campus... do they not drink? Is this why they're so clever?!

Anyway, we got into the Royal Albert Hall, took our seats up the top and looked down at the giant turtle that looked like the stage. I like turtles, so this was good.

The show started with a man in a sparkly leotard being dangled from the ceiling like a giant human disco ball. This was amazing. In fact when I'm a billionaire I'm going to have a human disco ball in my living room.

I also liked the men dressed as lizards on the trampolines with the bars. And I loved the trapeze artists. I was strangely fascinated and petrified at the same time by everything else. These acrobats must be superhuman. I can't begin to imagine the hard work that goes into conditioning their bodies. It's amazing. I was amazed.

It was the second time I saw Cirque du Soleil and it was even better than the first. I now want to see the other 20 shows they have...

Lily xXx

Chaos In GP-land.

Manic does not describe my morning.

GP-land broke into complete chaos and mayhem today.

When I arrived at 8.50 there was a queue of patients outside. Why wasn't the surgery open? Turns out the receptionist hadn't turned up.

Friday saw the receptionist and myself have a falling out. I was seeing a patient who had miscarried recently. The receptionist stormed in mid consultation and began shouting at the patient. Turns out the patient had wanted to make a complaint about not being seen soon enough and asked another patient for the receptionists name and had a grumble. The receptionist was shouting "If you want to know my name you ask me to my face, don't go talking about me behind my back"

Totally unprofessional. Totally inappropriate.

The patient was pretty upset, the receptionist was asked to leave the room. Afterwards the receptionist was told by the GP she was in the wrong after having a bit of a clash with me over the whole thing. I was mortified by her carry on.

Anyway, back to today. The receptionist wasn't there this morning. I think she was sulking.

After we let in a disgruntled bunch of half frozen patients the GP and I realised we had a problem. The receptionist had the keys to the consulting room. 20 minutes later and we found a spare set. Our problems still weren't over...

Today was "the-big-change day". We were changing computer system. Not good when noo-one has an idea what they're doing. We could barely turn the system on, let alone enter patient info or print a prescription. We reverted to writing all the consultations by hand. Cheating, but we would have been there for months otherwise.

Thankfully we spent a 3 hr lunch break learning how to use the system and by the afternoon we could just about cope.

Tomorrow I have to use the new computer on my own. Eek!!

( On the subject of professionalism there is a research project happening at the moment looking into medical student experiences of professionalism within healthcare. There's a questionnaire you can fill by clicking the link... http://is.gd/Qhv9kg )

Lily xXx

My GP Tutor....

... is the best GP in the world. Fact.

This is evidence based medicine. My evidence being that at least 80% of the patients that I see at the GP surgery tell me that he is the best GP in the world. They also bring him so many chocolates that even when all the other staff have taken home a box there's still a box for me to have.

Being at medical school is not just about learning facts from books, it's about learning how to be a good doctor. I guess we do this from watching bad doctors and avoiding what they do, while seeking out good doctors and trying to emulate what makes them a good doctor. For this reason I thought I'd list the things that make my GP tutor, the-best-GP-in-the-world.

1. He's been a GP at 1 practice for over 30 years. Because of this he knows lots of little things about his patients and always makes them feel cared for by asking after relatives and past medical problems.

2. He never makes a patient feel like a timewaster.

3. When a patient cries, he knows what to do. He doesn't just sit there awkwardly like some people. He offers tissues and tells them its OK to cry.

4. He cares for his palliative patients. He'll do home visits after surgery hours so he's not rushed and can sit with the family for half an hour or more to answer their questions and just be there. He also will sometimes just sit there holding a very sick patients hand so the relatives have time to go and make a cup of tea.

5. He is frank and open with patients. "Am I going to die doc?" ... "Probably not today, but there comes a time when all of us have to die".

6. He doesn't panic. Prime example a lady who is 38 weeks pregnant came into the surgery. Her BP was over 160/110. On questioning she hadn't felt her baby move in over 24 hrs. We couldn't find a foetal heartbeat. Mum started to panic. I was quietly panicing. He was calmly reassuring the woman, phoning the hospital and organising child care for her younger child. Thankfully the baby was OK, but I was so impressed with the way he didn't fuss and took control of the situation right down to phoning the patients mother to pick up the younger child from the GP surgery.

I'm sure like any doctor he has his bad days, and I'm sure he makes his mistakes, but I hope that once I'm practising my patient's feel that I'm as good a doctor as he is.

Lily xXx

Ranking.... Done.

Finished

Fin

Finito

Now I can get on with doing some work/cleaning my hovel of a flat and put FY1 out of my mind until Feb 15th. It's going to be a big day as I'll find out whether or not I need to sell my flat. Scary times.

Also been thinking, Since I won't be a student any more I'll have to start a new blog too... So many changes.

Lily xXx

Ranking Foundation Jobs.

What a chore.

I have 271 jobs to rank. I haven't done that well on my fpas application (well enough to just scrape into a popular foundation school, but no better), I have to rank ALL the jobs. By them telling me this I'm presuming that they're saying "rank all the jobs but realistically you're getting one of the bottom 50".

This doesn't bother me so much. I've got a job in the foundation school of my choice. So what if it has the dreaded geriatric rotation in it? I'll survive. I'm also not that bothered where I go within the foundation school, I'm sure that even if I have to move away I'll make new friends. I moved away to go to uni and it was the best thing I've ever done. My thinking is that FY1 will be more about the opportunities I seize and the attitude with which I tackle things.

This said I'm still stressing about ranking. I ranked the jobs by numbering them, with a pen, on the prospectus. All the paeds jobs first, then everything else in order of location ( - geriatric jobs) and then everything else that has geri's in it last. Fairly simple. Oh no. Now it's come to putting it on the computer its really complicated. I can either type in the massively long code for each job, then search it, and then select the job to rank or I can search by hospital or speciality and pick the jobs from a list to rank. This would be simple if the prospectus told us the hospital, it doesn't it tells us the trust. It would also be nice if the website told us the FY2 linked trust, which is doesn't. Wasting so much time cross referencing things.

The fun is I'll have to do this all over again next year to choose FY2 jobs. Joy.

Lily xXx

*Shudder*

So far in GP-land I've had to face my biggest body-part fear in medicine. There's one thing that is guaranteed to make me squirm. People would be surprised to know that this isn't the long hours that freak me out, nor is it the rectal exams or the babies having a pee mid 6-week check...

...it's belly buttons.

Especially outies.

How do outies even happen? Innies are pretty gross too though. They're all deep and grotty looking. I've even seen people with seemingly flat belly buttons. Usually on well toned young men. They freak me out too, the flat belly buttons that is, not the young men. I'm rather fond of those.

I have to go and psych myself up for another day of abdo exams and getting close to belly-buttons. *shudders*

Lily xXx

Biscuit-Chicken-Egg Theory

At new year I promised to write this theory.

It's my special theory on nationality. Unfortunately for me as it's quite abstract (...yes that means crazy), everyone is always either confused or wetting themselves laughing half way through my explanation.

To set the scene. People always talk about what nationality I am. I'm not British, even though I was born in London I'm not automatically entitled to British nationality. I would have to apply for it. My parents have both lived in the UK for some time but are EU nationals from other countries. For arguments sake lets say Germany and Spain (it's not actually these countries). This means that I'm allowed passports from both of these countries. I get upset because when I say I'm either Spanish or German people argue with me and say that I'm not really. But I'm not British either. So what am I?

Anyway the theory...

If you put a chicken in the oven and it laid an egg, when the egg hatched would it be another little chicken or would it be a biscuit?

It would be a chicken.

And there in lies the answer. You are what your parents were. Even though the oven normally would be the birth place of biscuits if a chicken gave birth there, it would still be a chicken.

This makes me a chicken and all of you lot biscuits.

More philosophy of Lily at some other point.

Lily xXx

Variety is the Spice of Life

I've just finished the end of my second day of my GP placement. I had an early start, a late finish but a very nice gap in which I got to go home in the afternoon.

I'm enjoying GP a lot more that I thought I would. In fact, to be perfectly honest, I was dreading it a bit. It's such a relief after seeing lots of inpatients with similar problems to see a big variety of patients of all different ages, races and backgrounds with a huge mixture of different problems. It's also lovely to see the relationship the GP has with many of his patients. He repeatedly pointed out patients older than I am that he has known since birth. One patient even bought him a bottle of wine to say thanks for his treatment, it was lovely to see.

Although I'm enjoying it a lot I still don't think it's the career for me. I don't like the fact that tests aren't right at your fingertips and I don't like the rude demanding patients who insist on sick notes or antibiotics.

I was also petrified by the number of people who came in with flu. I haven't had time to get my flu jab yet so I tried to hold my breath every time one of them came in. Needless to say holding your breath for 8-9 minutes is a little difficult so I may have breathed in some flu germs... nooooooo!!

Lily xXx

P.S I've discovered a new thingy called "graze" online, where you can order boxes of yummy and relatively healthy treats which fit through your letter box. For lazy people like me this is ideal. It's like the take-away of the snack world. I have a code for a free box if anyone wants to try...

QGXK196 ... input it on www.graze.com if you fancy trying it.96

New Year, New Placement.

Today was another start to a new placement. It sometimes feels as if I'm on a merry-go-round of placements. On the plus side, all this moving between placements, hospitals, departments and specialities means that I'm getting less and less bothered with change.

I've always been a bit of a change-hating control freak. Because of this my first day of new placement is usually filled with dread. Today my only dread was about finding the GP surgery. I must finally be used to all this moving around.

My first day was pretty chilled out. I didn't have to arrive until 10. When I got there I was introduced to the very friendly GP and automatically given a cup of tea by the even friendlier receptionist. I think I could get to like this place.

The morning was spent sitting in on a clinic. It was nice to see lots of young people after my time in geriatrics. I got to spend time with baby checks, vaccinations, lots of people with colds and sinusitis and some more long standing problems.

After clinic I went on a home visit with the GP to see a lady with an enormous leg ulcer. It didn't smell too bad, like many ulcers I've seen, but it was HUGE. It must have taken up 1/3rd of the surface area of her calf. She's had it for a very long time and is now running out of treatment options. Although she was unwilling last year, she's now going to try maggots. I've heard about maggots being used to eat the dead flesh out of ulcers to help healing but have never seen it. I'm pretty excited. I'm going to ask the district nurse if I can tag along to see what happens. I really hope it works as the lady was so lovely (not that I'd wish a poorly healing leg ulcer on someone who was horrid).

I got to go home early today which was nice. Unfortunately I had 2 sad phone calls in the afternoon with varying amounts of bad news, one of which I'll blog about once I've had a chance to cool down. Dreading the amount of housework I have to do and I have to start revision... eep!!

Lily xXx