Where am I now?

To anyone out there still with this blog on their reading list..

Hi there! I fell off the blogging wagon a good few year back and its been a long old while since I posted... But heres a quick upshot of where my life has taken me:

1. I'm now a paediatric trainee with a few years experience under my belt.  Remarkably this means I stuck to the speciality I thought I would be interested in right back when I started medical school which is probably pretty unusual.  I do love paediatrics itself and the kids crack me up (although occasionally some of the parents send me nuts - a fairly typical paediatrics problem!) but the current state of the NHS, our new job contract and challenges of the "modernising medical careers" pathway certainly add a degree of stress to things.
2. Personal life is pretty good! I got my first house and got married last year plus got a couple of lovable but crazy cats!  
3. Husband is also a paediatric trainee which is an interesting and unusual dynamic - good side is we can empathise with each other about all things paediatrics and revise for exams together but bad side is because we are exactly the same grade we have to compete against each other for jobs in the area we want.  The upshot of this is that for our next job rotation husband has my dream St3 job whereas Ive been lumbered with a 1.5hr one way commute (as I said, joys of modernising medical careers type training plus an oversized + underorganised deanery).  Still the secret to a good marriage is not seeing each other right??
4. I'm considering sub specialising in neonates which is an area I never ever thought I'd be interested in until my last job which was tertiary neonates and I absolutely loved. 
5. Passed my last proper exam this year so have got my paediatric membership now - Halfadoc is all grown up!

Thats the brief upshot for now , hopefully I'll post more soon before busyness of life makes me fall of the blogging wagon again...

Halfadoc xxx

Unpublished elective posts: My first solo ward round!

Unpublished elective posts part one

Foreword
A few years ago I published posts from my medical school elective in Tanzania whilst I was out there (see 2011 around september time in archives).  I used to write them in the evenings on my PDA and then publish them as and when I was able to get access to a computer.  As my elective was in a very rural village this was quite sporadic - the hospital did have one computer but being the only computer for a hospital of 120+ patients it was frequently in use and even when you could get access to it (usually late in the evenings if you could find the key to the computers room) the internet could be outpaced by carrier pigeons and power cuts were very frequent meaning I often lost blog posts and emails halfway through trying to send.

The upshot of this is that there are several partial or fully written blog posts lurking on my computer that I never published.  Its difficult now to publish the partially written ones as the me that would complete them now already feels like a remarkably different person to the wide-eyed enthusiastic fourth year medical student who was getting frustrated by the level of care given at the hospital and the memories of that frustration have already begun to fade.   But, I will try and slowly publish these posts and stay as true to the thoughts I had at that time because my elective remains my most enlightening medical experience and so the most worth blogging about in my opinion.   I will say with each post whether it has been partially written in recent times so you can decide for yourselves how accurate to my experiences at that time the blogs are.  I won't delete bits of the blogs however much they make me cringe now!

My first solo ward round! (minor additions to first paragraph only)

5.10.11

Accidentally ended up finshing up a male ward round by myself today because the clinical officer had to go to opd and asked me to see the last few patients.   Pretty strange having two nursing students plus 1 qualified nurse following me and pushing the notes trolley; I am used to being the ward round follower or notes trolley pusher!  This entourage was definitely useful though in terms of taking a history when I do not speak swahili! This translation service wasn't completely useful however as clearly there are boundaries out here that we wouldn't feel were appropriate within a medical setting in England.  For example the nursing students refused to translate "When were your bowels last open" and giggled at the very suggestion.  Unfortunately this question wasn't really something I could charades-style act out...

In total it was only a few patients that I had to see on my own, but think I did manage them correctly and even noticed that a patient who appears to have had a stroke secondary to hypertension has not actually received his prescribed antihypertensives for the last 3 days, something which has not been noticed in the last 3 ward rounds! So feel pretty proud of myself really, maybe I will make a doctor yet!

Rest of day was pretty full of responsibility as well.  In maternity ward there was a patient in the labour room with poor progress of labour who was on an oxytocin drip which was supposed to be given at an increased speed every half an hour, however despite the fact that there was 3 midwives about plus an insane number of student nurses, every time I popped into the labour room from ward rounds the increase in speed would be massively overdue and still not done! So had to do it myself as well as go on two ward rounds - multitasking skills!

While I waited for the doctor to come and review this patient after the oxytocin had failed to increase the strength of her contractions, I watched the nursing students being taught how to perform a vaginal examination of a pregnant woman.  Craziest teaching of a pv exam that I have ever seen!About 20 students all round one patients bed whilst the teacher performed an examination this intimate examination on her! Poor patient! Talk about intimidating! Also some of the smaller girls standing at the back clearly couldn't see so I'm not sure how much they learnt from the experience. Very, very different to how this is taught in England!

The examination - there are two pregnant ladies within this corner - the one that is being examined and one nearer the camera that students are leaning over in order to see the examination

Halfadoc x

The unwritten rules of being a junior doctor/ 25+things you wished you knew before becoming a doctor

Well I thought it was about time that I did a junior doctor version of my post about things you wished you knew before starting medical school ( http://halfadoctor.blogspot.co.uk/2012/06/80-things-you-wish-you-knew-before-you.html ) so here goes:

1. (And this is the most important) Never say the "q" word. The q word is the dirtiest swear word of the medical world. In the rare event your day is "Quiet" DO NOT SAY IT!! If you do utter the word then be prepared to be blamed by all staff when seemingly every patient on the ward becomes deeply unwell.

2. When referring a patient you can prepare your referral as much as you like and still guarantee the senior you are discussing with will ask that one aspect you forgot to look up such as the all important serum-rhubarb level.

3. Crash bleeps like to go off when you are in the middle of a procedure or breaking bad news

4. Crash bleeps like to get cancelled as soon as you arrive at the correct location having run from the opposite end of the hospital.

5. As per above "crash call cardio" is an excellent way of getting your recommended exercise.

6. The patients you get called to see with low urine outputs/ poor oral intake will probably have drunk and/or peed substantially more than you have during your on call shift.

7. You will have to make some truely awful referrals/ investigation requests at the recommendation of senior doctors (surgeons I'm looking at you) and by the end of your fy1 year you could probably make a decent second hand car salesman after the amount of shit you have been peddling to other specialities all year.

8. For the above the words "my consultant would like" absolves you from blame for crap referrals.

9. You will get blamed and/or shouted at for the crap referrals anyway.

10. A great ward sister/ charge nurse who likes you will make your rotation survivable. Doubly so if said nurse is also an avid ward baker.

11. You will just be finding your feet in a speciality when you rotate to the next one. Return to go, do not pick up 200.

12. The most difficult to bleed patient will also be the one who needs daily/ twice daily bloods.

13. You won't have to do a female catheter until there's a patient that none of the nurses can catheterised and then suddenly you are expected to be the expert...

14. If you are a female doctor then in spite of your stethoscope neck adornment and totally different dress code you will get called nurse by patients 85% of the time.

15. To misquote pirates of the Caribbean: Your finish times are more like a guideline...

16. However late after your shift it is if you are on the ward you will still be considered fair game by other staff for more jobs.

17. As soon as you have qualified (if not as soon as you have started medical school) be prepared to be accosted by nurses/HCAs/cleaners/catering staff/ friends/ family/ the cousin of the great great granddaughter the lady who lives 3 houses away requested you look at and instantly treat their rash.

18. All rashes look the same to an FY1

19. The treatment for most rashes is emollients and/or steroids anyway.

20. You will develop a robust stomach that cannot be touched by indigestion. This is because you will strengthen it by consuming a lot of your lunches either whilst fast walking between wards or while typing a discharge summary with one hand and eating with the other.

21. If you start reviewing a patient whilst eating lunch however you may have gone too far.

22. Most of your friends will be doctors.

23. You will spend a lot of your social time discussing medicine with other doctors.

24. On the rare occasion you manage to venture away from the medical crowd for socialising please see point 17. You will still find yourself discussing medicine...

25. Scrubs are lifesavers when laundry day came and went about a month ago.

26.  You will find a pair of comfy shoes and wear them to pieces as the thought of breaking in new shoes on the wards is unthinkable.  (In my case I wore my shoes until there was decent sized holes in the soles.  I only threw them away when I stepped in a patients vomit...)

27.  You will develop a creepy habit of staring at people with bulging veins and thinking "phwoarrr how easy would it be to cannulate that!"

28. Your patients will rarely have such veins.


I will add more "rules" as I think of them

Dr Halfadoc x

Rubbish Handovers

Doctors are often slated for their terrible handovers between shifts.  Whilst nurses have a rigid formal handovers at every shift change, we have formal handovers between SOME shifts but informal between others (for example the day doctor may bleep the twilight doctor with something that is yet to happen such as blood coming back, this is often quite haphazard. The twilight doctor will then formally handover at the end of their shift in a sit down meeting to the team of doctors on overnight including senior doctors.  I've noticed Often the very minimal change of sitting down and having someone senior present improves the quality of the handover and how much information is given.  However the twilight doctor may be handing over stuff from the day teams list so their handover will be limited by what the day team originally told them.)

Here's a handover I recieved this weekend:

Night shift doctor :  Oh and Mr Y hasn't had his xray yet.
Me: What is the xray for?
Night doctor: Not sure
Me: ... What type of xray
Night doctor: Oh erm Chest xray.
Me: Ok can I have his hospital number
Night doctors: (Has this and gives it to me but only after I ask)

I later hunt down Mr Y's request form purely so that I can find out why he is having one.  At this point I discover its not  a chest xray but a lower leg (fairly different ends of the body!) and he is having for the potentially very serious issue of ?osteomyelitis (infection of the bone). So I was very glad I looked!

I received this handover at a formal type handover so perhaps sitting down doesn't always solve "medical-chinese-whispers" after all.  In summary, we as profession do need to work on our handovers.  (This example is the worst I can think of but there are plenty of other slightly rubbish ones).  This weekend has reminded me about the importance of trying to both handover well and make sure I ask the right questions of those handing over to me so that I know what is going on.  Geeky though it is I recommend all those reading this try to remember to do their handovers in a formulalic way such as the "SBAR" system.

Happy handing over!!

Halfadoc x

Bedside manner anecdote part 1

Me attempting to calm down very angry and aggressive patient: (About 4th attempt at explaining to the patient that she has had an intracranial haemorrhage which is why she needs to be in hospital and that she needs to calm down (stop punching us!) so we can examine her) So the reason you are in hospital is because you became unwell at home so your husband has brought you in, your brain scan has shown you have had a bleed on your brain.  Do you understand this?

Angry patient: Well you dont even have a bleedin' brain!

Well played patient, well played.

The reality of life as an FY1

So I'm now in my tenth month as a foundation year doctor working at one of the busiest hospitals in the country (great job picking there Halfadoc!) . I'm not going to apologise for having thoroughly neglected my poor blog even thought its something I never intended to happen and gives me the occasional sharp guilt pang before I forget about it again (probably due to being distracted by remembering another of the 1 000 000 life tasks I have forgotten to do).

The reality of life as a junior doctor is that at points of the rota I am so busy, so tired that I scarcely can summon the energy to do the bare essentials of eating and washing before I go to bed.  This isn't deliberate hyperbole and I do not think it is that far from the truth at times.  It isn't the entirety of life as a junior doctor either but when on the "easy" rota shifts you often find you need to spend your slightly increased spare time catching up on the washing you neglected during busier patterns, attending own health/dental appointments, paying bills, hoop jumping for the dreaded e portfolio (an online method of assessing Junior doctors  using a series of tasks that are about as useful as the labours of hercules) paying in ash cash cheques (not all chores are bad!) etc etc.  The remaining spare time not surprisingly you often feel like spending as selfishly as possible ;). I used to be reasonably keen at playing sports (albeit in a lazy halfhearted kind of way).This year I have attended exactly one training session and one competition - in which I came second to last in, I guess the lack of training has caught up with me.    So that is why my blog has been neglected badly enough that if it were a patient in the NHS it would probably have gain a DNAR (do not resuscitate) form by now.

So is it all bad?
No. But you have days/weeks when it feels that way.

However there are moments that bring you back and make it feel worthwhile again and here are a few examples to stop this post sounding all doom and gloom:

• Mrs Jenson, the lovely old lady who recently submitted to me cannulating her with a stiff upper lip that all too few of the patients have and afterwards thanked me for doing what is after all a painful procedure (though not as painful as some patients suggest) and gave me a handful of her chocolates as thanks.  She wouldn't take no for an answer and I was very grateful for her as that handful of chocolates was in fact the total of my lunch for that 12.5 hour shift.
• Mrs Smith, I met this lady whilst they were in the surgical high dependency unit where I was the sole junior doctor for a nerve wracking few weeks.  She was there throughout my time and had a really rough time of it.  She'd had a surgery to remove a bowel tumour which had left her with a stoma.  Unfortunately the stoma wasn't working and she had a condition called Ileus which basically means her remaining bowel had gone on strike.  This is very common after bowel surgery but this poor lady had it worst than most.  She was in high dependency for weeks, required a repeat operation after a leak from where she her bowel had been joined up at which point she developed prolonged ileus yet again.   She was very ill and very low in mood and yet in spite of this had her relatives bring in regular chocolates for the ward staff and once even summoned me over and gave me a box of chocolates and said it was just for me for the help I had given her (naturally I did share it with the nurses as I had certainly nicked theirs to keep me going through skipped lunches).  She also used to say "god bless you " to me on a regular basis which as an atheist made me feel a bit guilty but I appreciated the kind sentiment.  This lovely lady fortunately did go home shortly after I left the unit.
• The adrenaline rush of a crash call and amazing feeling when the patient DOES regain an output.
• A thank you from a healthy patient who is going home.
• Pay day.  I didn't do medicine for the money and theres a lot of better, easier ways of earning the same or more and definetly earning more per an hour.  However when times are tough and you barely can keep going at least it is a day to focus on.

(As ever all names/ details have been changed.)

Lately I've been re reading Max Pembertons junior doctor book and realising what an accurate portrayal it really is of life as a junior doctor. I read it before medical school, and I thought I understood what he was saying and what being a junior doctor would/could be like, but I'm now not sure you can until you are really there.   I don't think even medical school fully made me realise what it would be like.  I particularly however liked this quote from his book: "I was never naive enough to think that medicine would be a bed of roses, I just never realised there'd be so many nettles" 

For this weekend however this fy1 is enjoying the sunshine safe in the knowledge of impending annual leave and the e portfolio finally being handed in.

Till next time,

Halfadoc x

My first week on call

On the 12th day on call,
The hospital sent to me:

12 thousand bleeps,
11 nurses insisting,
10 BM's a-leaping*,
9 drug charts completing,
8 NOFs a-breaking **,
7 TTOs for writing,
6 bowels delaying,
5 arterial gases,
4 calling pts,
3 stolen pens,
2 D.T's***,
And cake with a KFC!

(Numbers may be altered for comic affect...)

*BMs = blood sugars
**Neck of femur - common and bad fracture in old people.
***delirium tremens - occur when alcoholic s are withdrawing

Dr Halfadoc xx

Quotes from my first week and a bit as a junior doctor..

Quotes from my first week and a bit as a junior doctor..

Well its been an eventful and exhausting week and a bit as a "proper" junior doctor.  There's so many anecdotes and stories I could tell you about that I don't know which one to focus on, instead I thought I would share a few quotes to give you a flavour of how the week has been.  As ever please remember none of these quotes/descriptions are entirely accurate so if you think you recognise yourself or a relative, you almost certainly don't...  All of these quotes however are versions of things said to me during my first week or so of work.

Patient: You're a doctor?!? I thought you were a work experience student! (this was the response of the second patient I said "I'm one of the doctors" too, the first one simply said I looked to young to be a doctor)

Gentleman that I'm trying to put a cannula in: Don't worry, just have a try. (firstly isn't it my job to tell him not to worry - clearly need to work on calm expressions! Secondly I'd actually got it in by this point and was just sticking it down..)

Consultant: "And this is wrong.... and this is terrible....and this drug needs to be stopped...and why hasn't this been done...." "I'll forgive you this time as your new but.." - None of the aforementioned mistakes were my own management plan, they were the more senior juniors but I get it, prinicipal role of the FY1 doctor is to be the whipping boy for everyone else's errors. 

Lovely senior nurse: Did you write [plan I had scribed but at instructions of FY]?  Mr [above consultant] is on the warpath about [minor mistake by FY2 in plan] but don't worry I told him you weren't on the ward.
Be nice to the nurses and they will look after you!

Disgruntled patient: What an earth am I paying for the nhs for?!

More "senior" junior doctor friend: Do you want me to lie and say it will get better?
                 Me: Yes please!

FY2 + nurse: Halfadoc, go tell Mr Z that his investigation has been cancelled today so he has been nil by mouth for nothing.  Again, FY1 = everyones whipping boy/ person to be given the most disheartening tasks.

FY2: Make sure you test his anal tone.

Conversation overheard between FY2 and ortho surgeon: Lucky you having to keep testing Mr Y's anal tone.  FY2: Nah I'm getting the FY1 to do it haha.

Consultant grilling me: Come on, this is simple!

Younger patient who I have stayed several hours late for to try and ensure his treatment gets finally started that evening: Do you have kids? [No] Then you can't understand.

Lifesaver ward pharmacists: Did you mean to do x/y/z? [Always no].
Lifesaver ward pharmacists: Would you like to add x/y/z? [Always yes]

FY1 colleague on another awful-paedics ward: We've got to make sure we go to lunch together so its not so lonely and so we can discuss problems.
          Day 8: We finally go to lunch at same time but only because there is a compulsory lunchtime teaching.

Lovely senior nurse:  Here I baked some cake, have a piece.
I repeat: Be nice to the nurses and they will look after you!

Still, 10 days till pay day! Swings and roundabouts etc!  Hope thats given anyone considering medicine a realistic idea about the glamourous first days of being a junior doctor.  And to end on an appriopriate quote: 

Dr Halfadoc  x

First day of shadowing

So its finally here - I now have a hospital ID badge that says I am an fy1 doctor and a graduation present of a pink
Stethoscope saying Dr Halfadoc* around my neck. And yes, I feel like a massive fraud at the moment - kind of like a 14 year old playing dress up!

We've had all our induction talks - which seemed to me intent on scaring us senseless and informing us we would hate our lives for at least the first 6 weeks. I've also learnt that my first rotation orthopaedics is nicknamed awful-paedics here which sounds ... pleasant! But now for my first actual day on the wards, I ll let you know how it goes!

Dr Halfadoctor xx

*it may not say exactly that on it ;)

Half a doctor no more!

Half a doctor!! FINALS PASSED :D

Well I've just had a lovely couple of weeks holiday after some truly horrible finals (which ended with at least the positive news that I got my first choice F1 and F2 jobs) but most importantly have now found out I PASSED! I have no idea how but I don't plan on questioning it!
So I'll be back soon to catch up on actual posts but  I guess this blog will need a change in title in the very near future! I'll try and post some finals tips too from things I learnt the hard way, in the mean time here's a link back to my free revision source post which I have updated a bit more as these sites and resources definitely helped me to get through: http://halfadoctor.blogspot.co.uk/2012/10/the-best-free-medical-finals-revision.html

Much love,

Dr Halfadoctor!

My scariest blonde moment yet...

Finals are this week. THIS WEEK.  With that in mind read on...

So I discovered this evening that I've had a five year blonde moment where I had no idea that the thymus and thyroid were different things... I genuinely thought that all the t-cell regulation (to do with the immune system) stuff the thymus does was just another function of the thyroid...

Massive fail. Massive massive fail. So yeah wish me luck for the next few weeks!! (Short post because clearly I have revision to be doing!)

(In my defence a quick google tells me I'm not the only person to get confused here but I'm betting the asker of the below links question wasn't taking med school finals in under 100 hrs time :/ ) http://wiki.answers.com/Q/Are_the_thyroid_and_the_thymus_the_same_thing

Junior Doctor application screw up

Those of you who have been following the news may know that this week there's been yet another screw up with Junior doctor job applications.  Unfortunately for me, I'm now in the cohort that has been affected.  Heres a news article that summarises it all: http://www.guardian.co.uk/society/2013/feb/27/medical-students-job-offers-exam

But basically what happened was:
This Monday: We all found out what deanery we had been allocated for our F1 and F2 jobs.   This allocation is based on our score out of 100: 50 points come from educational scores e.g. ranking within the medical school, having publications, having extra degrees etc and 50 points come from the "SJT exam" - a multi-guess "choose the most appropriate action" ethicalish type exam (its a bit of a joke of an exam anyway and I doubt it really shows who will be the better doctor but that's another issue entirely).  Anyway on Monday I got my first choice and was over the moon!  Spent quite a significant amount of time on Monday evening starting to rank my job options.

Tuesday evening (after our medical schools were shut so we couldn't even get advice):  We receive an email from FPAS (the organisation responsible for allocating our jobs) telling us that they had detected an error in the marking of the SJT and will be remarking a subset of papers (this has since been changed to EVERYONES papers) and so will have to reallocate jobs too and we are to consider Mondays allocations as no longer correct.  There wasn't actually an apology anywhere in the first email..

We've had more emails since and basically it seems like the main issue is the scanners of the electronic sheets had failed to detected rubbed out answers properly leading to some people having "too many responses" recorded for certain questions and so gaining no marks.  However there is another issue that they have not yet told us as they have admitted our marks can go up or down...Furthermore they have admitted to detecting another error in the week prior to job allocations but are claiming that was an isolated error... What a shambles!
So now with finals mere weeks away we have the stress of waiting again and then when deaneries are reallocated those at my medical school will be forced with picking actual jobs (you have to rank 100 odd actual jobs) right amongst our finals time.  Ideal!

Hope other fifth years are bearing up under the strain ok!

Halfadoc xx

 
A Wikipedia screen grab after the screwup - see second paragraph! Click on picture to see it :)
 
 

Not my blonde moment

Not my blonde moment

Firstly I'm sorry for being v.quiet on the blog front for a long while - final year is proving to be tough: Long days on the wards, teaching in the evenings and then the feeling that every spare moment I have should be spent revising...

Still finals will be finished in 3 months time hopefully provided I don't have any retakes *Touches everything wooden in sight*; so then I will try and catch up telling you tales of my fifth year because ironically along with being one of the busiest, its been one of the most worth blogging about!

Anyway today's post is not actually my story but a close friends which I thought was too good to share...

So this happened when my friend "B" was in her 3rd year.  She was due to watch angiography for the first time (angiography involves putting a small tube into one of your blood vessels and passing it up to the heart and then adding contrast.  This allows xrays to be taken of the small vessels of the heart to see if there is any narrowing or clots.  It is usually done if the patient has had a heart attack or suspected angina.)  Because of the xrays involved, medical staff have to wear heavy protective clothing or the regular exposure they get would cause them health risks.  Medical students also have to wear this clothing if they have to be present in such procedures.

Now the problem was than B hadn't ever been shown how to put on this clothing (to be honest, its pretty self explanatory though...) and nor had she seen people wearing it before.  One of the parts of the clothing is a thyroid guard which is basically like a kind of bib as shown below.  However poor B didn't know this so just put it on how she assumed it was meant to go.... .... Still I hear VISORS are making a comeback!


Apparently the consultant cracked up every time he saw her from then on!


Halfadoc x

P.s B has made it to fifth year with the rest of us and now knows when and when not to go for the 90's raver visor look!

2 prison guards, 1 patient, 1 pair of handcuffs, 1 nurse, 1 cannula, NO PRESSURE

2 prison guards, 1 patient, 1 pair of handcuffs, 1 nurse, 1 cannula, NO PRESSURE

I've come along a lot in the last few weeks at my clinical procedures.  I've improved from wanting to hide in the nearest supply closet at the suggestion of cannulating a patient to actually feeling pretty confident I can pop it in provided the patient is not completely shut down/ older than time itself (for those non medical personnel not in the know, a cannula is basically a tube you put into a vein so that you can give IV drugs/fluids through it, it usually stays in there a few days).

Those of you who are observant and have been following my blog regularly  might have realised I have only ever blogged about successfully getting a cannula in ONCE, that would be because until a few weeks ago I had in fact only got a cannula in ONCE (yes, I am a final year and yes I realise this is bad) which was on my elective over a year ago and then only under guidance from a midwife.  Still after a few weeks on surgery and 1 in ITU I'm finally more at the level a fifth year should be at and have now done quite a few, but heres the story of my first two sucessful patients.....

1 week old with a MELONoma (sorry I doctored the word a bit...) he was a bit fruity... (yes yes brother, I stole your joke, I'd vancouver reference you but this blogs anon so tough luck :P)

Ok, this patient was a mango.  The nurses mango to be precise (I think she ate it afterwards and all :S).  He made good practise for how to hold and insert cannulas though, very forgiving and very patient, so I think I owe my first actual successful unassisted cannula to him.  Here he is in all his cannulated glory:

Incidentally don't try and flush saline into a cannulated mango, it WILL squirt out and hit your reg in the face. Opps :/.

The patient in handcuffs
So off I went to cannulate my first actual patient here at the suggestion of mango-nurse, and she came with me so she could sign off my cannulation skill box if I managed / take over if I did not. All fine so far, till I get the patient who turns out to be handcuffed to a prison guard with another one watching... So my cannulation attempt will in fact have 8 eyes on it, excellent, no pressure... IS IT ME OR IS IT SUDDENLY REALLY HOT IN HERE?!

Furthermore the vein I like the look of is partially being covered by the handcuff, I try to pull the handcuff down a bit (wondering as I do if thats even allowed or if a prison guard is about to yell at me) but it gets caught on the wrist bone so I assume its meant to not go any further and give up tugging and try to work around the handcuff when the patient impatiently tugs it down for me, opps, good start.

But anyway long story short, I did get the cannula in first time (yay) but I did also give the bed a bit of a blood splattering which mango-nurse was less keen about, never mind, win some lose some.

But yes, not the first unassisted cannulation experience I was expecting!

Halfadoc x

Things can only get bettttter....

October 2012:  This last week and a bit started off so badly, with everything seeming to go wrong leaving me very fed up with medicine and my own disorganisation, fortunately I'm glad to say a week on and everything is already seeming a lot less stressful!  The main two items of stress are below, not the only ones by far, but the straws that broke the camels back I suppose because without them it all seems so much more manageable again :).

I've gone from having fits of rage that someone had taken my stethoscope from SAU where I had accidently left it over night (my stethoscope is by no means top of the range but its still £60 that I really can't afford to waste right now) to having my faith in humanity restored by someone responding to my "MISSING STETHOSCOPE" posters and getting it back to me.  It had been missing for 3 weeks and I leave this hospital in a week so I thought it was a gonna but had been paranoidly eying up all stethoscopes of the same colour to try and see if my name was engraved on them.  Its probably for the best that its turned up now, because staring at all those doctors' chests was probably a little creepy....

Furthermore I was having a major fit of rage at myself and a big panic about the fact I could not find my intercalated degree certificate and it is foundation job application time - if I couldn't get a replacement one by the 19th then my intercalated year would be a waste of time in the sense that I wouldn't get any points for it on my job application - I couldn't believe that I had successfully put things such as my Duckling Swimming Award certificate in a well organised folder but had no idea where the most important certificate I currently had was! Major fail!  I organised to get a replacement (another £26.50) and begged the admin lady to push it through faster than the 3 weeks quoted when sods law, 2 hrs after I had paid, my parents find my certificate at home. Doh!!  However the very kind admin lady arranged a refund for me even though my certificate had already been printed - what a gem! So once again faith in humanity restored :)

But at least I alway know where my duckling awards are, I mean WHO knows when someone may ask me to show proof of having earnt that...

Its also been a good week in that I've spent it in ITU which has been VERY interesting, plus I'm finally getting good at blood taking and cannulating - the doctors on this ward have actually commented that I'm very good! Now thats a change! 

The best FREE medical finals revision sources

Right, so this is going to be an ongoing resource that I will add to as I go along , but I figure finals are a problem that is best shared so it would be nice to have a list that all students can look at and add to in order to save us all doing the same research.  Please comment if you know of other sources and I will add them to the list :) (and steal your suggests for my own revision as well ;D).

Free Podcasts - good for revising on the go

• http://saran.podomatic.com/ - easy to download, work straight away with windows media player.  I've not listened to them yet so I'll let you know what they are like soon (downloaded them for a long car drive!).
• http://www.podmedics.com/ - not free but you can get a free 7 day trial.  So I guess you can liberate as many resources as possible during that time....And of course then sign up for the website if you like them...
• There is a free podmedics podcast app with quite a few downloadable podcasts which are pretty good if you have an iphone

Non downloadable presentations/ podcasts (streaming only)

• "Feather does finals"- Meant to be really really good, been recommended by lots of people.

Youtube videos! (for those all important examinations you never learnt to do!):

• Series of OCSE videos by manchester uni -  v. useful! (and thats as a non biased non Manchester student ;D) 
• Another ocse video series - not as many as above one, but good for thyroid!
• Varicose veins ocse video - this one is great for varicose veins examination, finally made sense to me! (There is also a few more ocse videos if you click on the uploader name)

Websites

• geekymedics.com - looks really good from what I have looked at so far :)
• http://almostadoctor.co.uk - really useful notes and sectioned in a very easy to use way.
• www.askdoctorclarke.com - the courses and that aren't free but you can sign up to the website for free and theres a fair bit of revision material there 
• http://passmed.co.uk/index.html - bit variable, has links to other free sites but lots of them are out of date (have been looking through for working ones!).  Some info on the site itself though.

....More to come!

Blonde Medic Moment 3: A lethal pocket dial

Blonde Medic Moment 3: A lethal pocket dial

September 2012: Ok this has got to be potentially one of my most embarrassing medical moments to date, and it literally happened about 30 minutes ago so this is hot off the press as it were....

So to set the scene:
Was just having a quick chat to my friend in his hospital accommodation about the surgical firm that he has just finished on and I have just started on.  The conversation was mostly about the F1 but also about the surgical team and our opinions of surgery in general...

Embarrassing topics we covered included

• My friend having a crush on the F1
• How the F1 is often late and seems pretty laidback (we weren't berating this, just commenting on it and saying that he doesn't seem any more keen on surgery than we are)
• How neither of us are particularly keen on surgery at all and would prefer to spend time doing private study as it is probably more useful that the often waiting about style of surgery.
• How my friend also had a bit of a crush on the registrar......

And other topics of conversation best not discussed here as my mother sometimes reads this blog...(Kidding mum)

Anyway I had a brief chat to someone else (nothing incriminating, just general banter) on my way back to my accomadation and then when straight back...  When I sat down I realised my phone had been pocket dialing the F1 for 3 whole potentially incriminating minutes... ..... Chances are I was safe and he wouldn't have heard anything beyond the later banter/ me walking, but that is waaaay too close for my comfort :/ .  Fingers crossed he didn't hear anything (especially as my friend would also be embarrassed) but what on earth were the chances of my phone picking that particular moment to dial the F1?! I swear these things could only happen to me!


Anyway I hope the thought of how much I am cringing now brings some enjoyment to your day at any rate! Trying hard to keep blogging reasonably regulary but fifth year is eating me alive and there are so many things I plan on blogging about that just don't make it to my blog.  If there's anything in particular anyone would like to hear more about please do comment below and I will try and focus on those areas for a bit! 

Halfadoc x

Blonde medic moment 2!

Blonde medic moment 2!

Time for another short blonde moment post! Okay this moment is made blonde by the fact it has occured recently and so has occurred whilst I am a final year and really should know better....

Consultant Surgeon (Lets call him Mr Stereotype for definitely no reason connected to his personality being a bit stereotypical of a surgeon...): Why is the Gallbladder important?

Me: It makes bile?

Mr Stereotype: Errrrm no, it doesn't make bile....

So why is it important??

Smart Student: It makes mucus

Mr Stereotype: Well Yes, but no, its important because removing it is paying for my children's private education.

And probably pays for his monday, tuesday and wednesday games of golf too (maybe he does  kidney stones for the thursday and friday games)

First Week of Final Year - Eeeeek!

First Week of Final Year - Eeeeek!
End of August 2012:

Well, I've officially made it to final year, how scary is that?! I'm living in hospital accommodation for the next 8 weeks but actually on my 4 week GP placement first of all which is about 10 miles away from my hospital accommodation. Living in hospital accomodation is proving to be quite an odd experience so far, I'm in a flat of 4 which is quite plush in that it has two showers, one with a loo in the bathroom plus a separate toilet as well. It also has double beds! Luxury! But on the downside its exceedingly quiet - am yet to meet one of the four health professionals I am living with (only one of these is another student) and have seen one of the others only very briefly, no internet there yet either! How will my social life survive ;D (it will probably actually be good for my academic life as long as it doesn't continue too long, no facebook!)

Its quite weird being able to literally see the hospital from my window, I don't think I'd like living here on a permanent basis whilst working in the hospital very much, it would seems quite clautrophobic and I expect it would feel like you never really got to escape from your working life. Even now it feels a bit of a continual reminder that I should be working and that finals are starting to loom...

As once described in scrubs: The hospital can be a monster that takes over your life, I could see this being doubly the case if you lived in hospital accomadation permanently!

Starting on GP in someways this feels a bit like a lack of progression from fourth year which had quite a few GP visits but in other ways it is really quite different. For one thing I have my very own shiny consulting room which is literally mine and mine only to use for the next 4 weeks which is pretty exciting! I've been told I can decorate with pictures, bring a radio in... etc. Unfortunately not sure my "suicide bunnies" poster is quite appriopriate so I've decided to keep it plain and professional! So far I've only used it a few times to see patients before they see the doctor but hopefully I should use it more and more as time goes on.

Another change for this year is that as I am there for a solid 4 weeks rather than just the odd afternoon I am already starting to feel like more of a team member rather than occasional visitor which is really nice :)

Thats all for now - going to try and keep posts shorter and sweeter otherwise I have no hope of managing to post reasonably regulary whilst keeping up with final year, which already I am finding ever so slightly stressful...

Halfadoc xx

How to apply to medical school without losing your mind

Hi guys, sorry I've fallen off the blogsphere a bit, its been a busy few months full of finishing fourth year and the fun of exams*  combined with summer fun such as volunteering as a games maker at the olympics and earning my last pennies from my part time job before I quit it in order to dedicate my time to giving myself and my wonderful lack of medical knowledge the best chance of scrapping through finals in about 9 months times (eeek eeekk eeeeek!!! This absolutely terrifies me!!)

The good news is I'm all passed on fourth year and so now do hold the terrifying title of Final year medical student.A week and a bit till I start back :o.  Start taking your vitamin tablets cause its looking like I could actually pull off this medical student business **! 

But anyway: Blogging.  I'll catch you up on some of my latest medical exploits soon, but I figured its that time of year when AS students have all got their results and are working on their applications... Well I always intended this blog to be something that would help current applicants but it has occurred to be that I've not really shared that much of my "wisdom" about the application  process, so without further adieu:

General advice

Personal statement – concentrate  more on what you gained from a few key pieces of work experience/ volunteer work than just listing all the things you have done.  Spend time working on your opening line, you want to get their attention and make your personal statement stand out.

Interview – Best advice is to be enthusiastic and to be yourself.  Read a good newspaper on the day of your interview and the few days leading up to it (often  there are questions on current medical issues).  Re read your personal statement –look for bits where you may not have expanded much as these may be the areas the interviewers ask you more about.  Think about what you might want to say for some key questions eg “Why medicine” and “How do you deal with stress” but don’t script answers too much because it will sound fake.

Look on forums before your interview – some people put up what they got asked at recent interviews at particular med schools and the questions often don’t change much.

What if you don’t get in? This is in my opinion my most important bit of advice: Gap year and reapply!! Lots of gap year students get in esp if you do something useful with your time on your gap year that you can talk about at interview.   Get feedback from unis that rejected you so you can improve next time.

Phone, fax and email medical schools on results day – some medical place do very occasionally come up at clearing! A girl in my year got into keele despite not having applied there originally because she both phoned and emailed them her results + personal statement on results day and they offered her an interview – have heard of this happening to a few people at keele. 

 Seriously, the grad route is always a possibility but as you have to pay your own tuition fees for second degree (so thats £9000 upfront, no loan, per a year) this really should be your plan C not plan B, gap year gap year gap year!! 

Websites

Current medical student blogs e.g. www.halfadoctor.blogspot.com obviously :p, but seriously theres some very interesting reads on the blogroll at the right of my main page

http://www.wanttobeadoctor.co.uk/main.php (by Leeds WAMS, but lots of general advice and example interview questions)

www.newmediamedicine.com (a forum for medical applicants and current medical students) and/or www.thestudentroom.co.uk then just go to the medicine pages.

Tomorrow’s doctors document: http://www.gmc-uk.org/education/undergraduate/undergraduate_policy/tomorrows_doctors.asp - this is apparently what medical schools want you to be like but I've got to admit its a bit wishy-washy and I only ever skim read it, whoopsy.

Books

Bedside Stories: Confessions of a Junior Doctor (Paperback)
by Michael Foxton

In Stitches: The Highs and Lows of Life as an AandE Doctor (Paperback)
by Nick Edwards

Trust Me, I'm a (Junior) Doctor (Paperback)   (and all other Max pemberton books, all good reads!)
by Max Pemberton

So none of this is by any means exhaustive, but I hope it helps a little.  Any of questions about applying that you have, please feel free to comment below and I will try and get back to you :).  Also I forgot to mention, how do you apply without losing your mind?? Well, I'm afraid I never discovered that one but I hope you enjoy the compulsion to constantly check your UCAS for changes more than I did ;) 

Halfadoc x

*Mainly a very annoying GP exam which combined genuine medical knowledge with rote learning/reciting type aspects about things such as the "WONCA tree" - google it if your interested but I don't advise bothering, for starters theres absolutely no connection to any chocolate factory ;D
** Don't take too many, that's just as bad.