Electives

As part of medical training in the UK, students are required to go on what we call an "Elective" in either their 3rd/4th/5th year of training. The purpose of this is to experience medicine and medical education that is different to what you've already learned on your course. For most students, this means experiencing healthcare systems abroad. For me, it means seeing and being part of different healthcare systems in different populations and settings within the UK.

For the first 4 weeks of my elective, I chose to spend time with London Ambulance Service (LAS). What I saw and experienced was INCREDIBLY valuable. I could far better appreciate the different challenges the paramedics and ambulance technicians etc face prior to transporting patients to hospital. It's really changed my outlook. Sadly though, due to a series of unfortunately timed and unexpected events, my placement with LAS hasn't been able to continue beyond the first 5 shifts I had observing a paramedic. Everyone I've spoken to has really been helpful and tried to be accommodating, but sadly the placement has had to end.

This, has left me in a sticky situation. I need a total of 8 weeks signed off to be able to carry on into my 5th and final year of medical school. Currently, I only have 10 days signed off. The second 4 weeks of my elective is arranged and looks to be really interesting, so that's all sorted, but the missing 2 and a half weeks of sign off sheets is a tad frustrating. The medical school have been helpful so far, but it remains to be seen as to how I'm going to rectify all this. I most likely will have to undertake yet another placement during my summer holiday (Which I'm really rather upset about - I passed all my exams so had a summer free of work and resits. Oh, I don't think I'd said. I PASSED!!!! WOOOOOOP!!!).

Elective is supposed to be a fantastic learning experience and really enjoyable. I wish mine had stayed that way. It's safe to say I'm exceptionally grumpy and fed up at the moment about it. I genuinely want to learn - I love learning and I don't think I'd have stayed in medicine if I didn't. Being bored with very little to do during the week (because the friends I have in London are working/at university) is really frustrating, and being able to do nothing to rectify the no placement situation is frustrating too. So, to cheer me up, if you've been on a medical school elective, tell me about it! What was good, where did you go, what did you learn, did you find anything particularly difficult or have any problems? If I can't learn from my own experiences, it'd be great to hear about some of your experiences too. Ping me an email at futurehemsdoc (at) gmail (dot) com and tell me about your elective!

I live with jerks....

I have just been woken by a fire alarm, caused by the flat upstairs. I have an exam this morning. Might stand outside the upstairs flat's door with a very loud alarm at 7.30.

Dear Grandad

Dear Grandad,

It's been just over a year since you died and I've missed you every day since. Last weekend you would have had your 90th birthday, and I wished I could have shown you how far I've come in the last year. You would be so proud of me. I'd like to think somewhere you still are proud of me.

I'm finally starting to find my place in this world, and becoming comfortable with the person I am. I'm starting to become the confident young woman you knew I could be, and I'm well on my way to being a doctor now. You were so FIERCELY proud of me for that. For how hard I work, how much I wanted this, and how much I was willing to give up to get to where I want to be. I only wish I had spent more time with you before you died. To tell you more often how much I loved you. I know you knew that, but I wish I'd said it.

It's taken me a while to write this. Not because it's been difficult, just because I have so much to say to you. I want to thank you for being so proud of me. It's the only reason I've kept going this year, and the only reason I will keep going until I'm a doctor.

Thank you for everything,

Your granddaughter,

Truffle

Learning and Teaching

At my medical school, we're taught in a variety of ways. Traditional lectures, dissection, prosection, but also newer ways of teaching "Problem Based Learning", interactive seminars, teaching ward rounds, "structured patient teaching" and regular primary and secondary care (GP surgery and hospital) placements from your first year of study. Everyone has ways they learn best, and ways that aren't necessarily the best for them. Personally, I hate lectures. Often I feel they're "Death by PowerPoint" and it's quite easy to switch off in a warm, dark, comfy lecture theatre. Even easier to switch off when the lecturer turns up 10 minutes late, doesn't know what the lecture is supposed to be on, or what year of study you are (things that are rather important to know in my opinion!).

Recently, we've been timetabled some seminars, which are given by 2 different lecturers on alternating weeks. One lecturer is truly fantastic. He makes you think, hates PowerPoint, and obviously really enjoys teaching. The second sees the seminars as an opportunity to talk AT us, and show off how much he knows. Not something that is particularly helpful. I love learning, really I do, I wouldn't be at university if I didn't. But I have to be taught in an engaging way before I enjoy learning. Teaching is an important part of medicine - we're taught mainly by practising clinicians and other healthcare professionals, who see the stuff they teach us. This is unbelievably valuable and a fantastic learning opportunity for us as students.

Because of fantastic teaching, I myself find teaching other students valuable as a way of revising, and also I find it enjoyable - the look on someone's face when they finally understand something they've been struggling with is great when you've helped them reach that level of understanding. This has, however, left me thinking. I want to carry on teaching, and I've had fantastic feedback about my style of teaching. Should I look for more opportunities to teach as a student? I just don't know if my knowledge is good enough.

Careers

Now I've made it to my 4th year of study, there's a lot of talk about career pathways. I've always been dead set on prehospital/critical care, and love anaesthetics as a speciality. However, I've just finished a rotation on Obstetrics and Gynaecology - a speciality I had convinced myself I'd hate - and loved EVERY minute of it. The SHOs (junior doctors) were incredibly enthusiastic, willing to teach, and happy to have me involved with clinical skills. They've made me a lot more comfortable in my abilities as a medical student (for example, I am MUCH less nervous taking bloods from patients now), and this is the first placement I've felt truly happy on. I was treated like part of the team by everyone, midwives and doctors alike, and was comfortable in my role. I was given a lot more responsibility on this placement (still with supervision) and really enjoyed the experience. I actually felt like I was benefitting patient care. This has reminded why I went into medicine, and reminded just how close I am to finishing Medical School.

I think I could honestly see myself as an obstetrician in the future. The career has everything - a mix of surgery and medicine, it's hands on from an early stage, has good job prospects, has emergencies to deal with on a regular basis and the uncertainty of not knowing what you'll see next. Seeing myself in a career I thought I'd hate is bonkers, but this is what you get for staying open minded! It's a good job I am open minded about specialities, I think, because otherwise I could end up in a career I truly hate.

To the wonderful SHOs: Thank you. Thank you for making me confident in my skills and for helping me find my feet. I can't repay you for that.

To the consultants: Thank you so much for being enthusiastic about your speciality and willing to take the time to speak to and teach students. It was noticed and very much appreciated.

To the midwives: Thank you for not conforming to the stereotype, and being truly lovely to everybody - and thank you for the opportunity to deliver a baby. This was truly special and something I shall never forget.

To the patients: Thank you for letting me be involved in your care, and helping me learn and become a better medical student. I truly enjoyed getting to know you and your families, and helping you welcome your new babies to the world. Thank you particularly to the lady who let me deliver her baby. It was a wonderful experience to be involved in, and I won't forget you and your family. Congratulations on the birth your beautiful baby.

I made it!

I made it. I actually survived 3rd year. I've passed all my assessments, and all my end of year exams (including the OSCE where I was continually attacked by a wasp!) and I've survived. I'm finally a 4th year.

This year has been horrific, looking back. My grandfather died, my grandmother has been in and out of hospital very ill too, I've had surgery for a very stupid injury, and suffered a lot of ill health as a consequence; and I've had a bit of a decline in my mobility. Of all of that, losing my grandad just before my 21st birthday was definitely the worst part of the year. And although passing the year is a great achievement, it makes it all the more real that my grandad will never see me graduate. He was immensely proud of me, and what I do, and I wish he was here to see my finally happy and truly loving my degree and chosen career.

Having an entirely free summer is giving me time to reflect on the year and how it went. I think the best description has to be rocky. A bit like being on a boat in a storm, that's only just passed. But even with all the difficulties, I've done well in all my exams, I've become a lot more settled, and I've become more confident and happy. I've also made some truly fantastic friends this year. One of whom is a junior doctor, without whom I probably wouldn't have passed the year, or stayed sane. So, a BIG thank you for being an amazing friend this year goes to Natalie, a very lovely person and a fantastic F2 Doctor.

This year has definitely made me a stronger person, and I think things can only get better from this point. I'm much more open to the possibility of several careers in medicine, including paediatrics, anaesthetics, intensive care, as well as my still very strong love of A&E and Pre-Hospital medicine. I'm completely at home in the hospital now, and really loving my placements. I've realised even more this year how much of a privilege it is to see patients, and to all of you who let medical students see you, thank you, it really is SO valuable.

Next year I have much to look forward to. Rotations in Obstetrics and Gynaecology, Paediatrics, and my elective, a new PBL group and a chance to meet new people, and I honestly can't wait to get back. But, for now, I'm going to kick back and enjoy my summer. I won't get many more holidays like this, so I'm going to do my best to make the most of it!!

Truffle

x

Exams

First of this year's exams starts on Wednesday. I'm stressed out of my mind and fed up of not leaving my room, have tons of revision to do and it would have to be beautiful weather outside. Determined to do really well this year and do my Grandad proud.

Sorry!

Yes, I'm alive. I've neglected blogging for a while for several reasons. I'm totally swamped with work, we had a death in the family and I also landed myself in hospital. Again. Thankfully this time it was only for 4 days, but it did involve some fairly big surgery as it was for a nasty fracture with some complications. Yes, I'm an idiot for fracturing a bone. We have finally hit Easter holidays now though, so I'm catching up on rest, my social life and some work that I missed due to recuperation time for the broken bone. Safe to say due to impending doom (exams) I won't be blogging much now until August, but I do promise to stay around on the blog a bit more, and currently am welcoming suggestions for things you want me to blog about, so leave a suggestion in the comments box or email me and let me know!

Invisible

In the last week or so, I've had to face up to the reality of being told that I, a medical student, an intelligent, stubborn, arsey young woman, am disabled. I'm not disabled in a stereotypical way. I'm not in a wheelchair, or deaf or blind. I don't have a walking stick or a guide dog. I have a complex medical condition. It affects my mobility in a way that most people can't see. It affects my vision in an undetectable (to most people) way. I can't walk far, or do things that are seen as normal. I can't easily cook myself a meal from scratch any more. I can't often read my textbooks with much ease. I can't write my own name or get out of bed some days. But I look almost completely normal. I have an invisible disabilty. I'm treated the same as everyone else because they can't see what's wrong. Some days, I love this. On days like today when I'm in excruciating pain and quite frankly want to hide under my duvet and cry, all I want is a shoulder to cry on and an offer of small help, but because it's invisible, so am I.

Dear Father Christmas

Dear Father Christmas,

I've tried to be good this year. I've made some new friends, attempted to make peace with some I fell out with, and made an effort to keep in touch with old friends along the way. I've looked after my grandad when he's been ill, I carried out the promises I made to him and visited my grandma and passed my exams. I've tried to be nice to my sisters, even they've made me want to tear my hair out, and I've helped my mother when she's asked for it. I've worked hard and got the marks I've deserved, and I'm finally accepting my health problems.

So, in return, please may I have:

• Some extra spoons - they'll be needed in the New Year
• Some help with this awful Student Finance screw up
• A couple of friends at University - being alone is so hard sometimes
• Some extra space in my brain for all the stuff I need to know
• New ways of learning things that works for me and sticks - I'm struggling
• And some acceptance from friends, colleagues, the medical school and my family of my illness and of me as a person.

Thank you for reading this, whether you can fulfil it or not.

Truffle

xx

To Do List

1. Learn to do 2 new clinical skills according to university procedures (2 days before we're assessed on them in an OSCE)
2. Write up 14 patient case studies with background to the disease and reflection on the case
3. Read, understand and evaluate 12-20 research papers
4. Write a research protocol with references for above papers
5. Read, understand and perform a meta-analysis of 3 more (different) research papers
6. Write a presentation on said meta-anlysis
7. Pass my OSCE on Wednesday
8. Write a 2-4 page piece of work on medical treatments and therapy for Multiple Sclerosis including the mechanism of action of any drugs I mention and write about supportive therapy, and current research into treatments for multiple sclerosis
9. Have a social life
10. Make some friends
11. Go to 7 hours of dance lessons and rehearsals a week (minimum)
12. Not dislocate too many joints
13. Keep on top of my medication
14. Email my personal advisor again
15. Email the Disability Coordinator at the Dean of Student's office
16. Meet with my personal advisor
17. Meet with the Disability Coordinator again
18. Photocopy all my hospital appointment letters for the medical school
19. Check the post at least twice a week (it's delivered to the post room/medical school)
20. Go to my hospital appointments
21. Go to my GP appointment
22. Go to lectures
23. Learn some medicine
24. Not burn out and fall to pieces
25. Maybe have a Christmas holiday
26. Earn some money
27. Keep on top of all my medications so I don't have to have any time off
28. Keep in contact with home to find out how my grandad is
29. Ring the hospital and try and speak to my grandad

Still Here

I'm still alive, I have lost a chunk of my sight, and am being sent for all manner of investigations into my eyes, joints, skin and heart, including seeing a geneticist, so everything's a bit crazy. I'm also on a clinical placement at the moment so learning lots in a very short space of time with long days, all whilst trying to maintain a social life and enter dance competitions that I'm probably not well enough to do. Tough times but I'm still here and still keeping going. Normal blogging will resume soon! I'm still on twitter and still check my emails regularly - let me know if you have any ideas for things you want me to blog about, or if you just want to get to know me better

Back soon!

Truffle

xx

What do you see?

After my last post, I had comments on twitter saying that I was insulting people whose eyesight really was failing as I can obviously manage to do clinical skills with no problem, and that if I couldn't I'd be a danger to my patients. I was a little hurt by these comments, because until you've experienced what it's like to have sight like mine, it's difficult to appreciate the challenges I face with it.

I manage to do clinical skills fine because I adapt as I learn the new skills and find a way to do them that works for me. As a child I learned to hold a pencil different to other children because I couldn't coordinate the pencil well enough to write the "normal" way. My handwriting was still dreadful but it worked for me. If you learn a new skill, you don't necessarily do it exactly the way it was taught - you make adaptations that work for you, and that applies to everyone, whether you have difficulties with sight, hearing, understanding, mobility, etc or not. Most of what I described in my last post are things I don't actually think about from day to day any more, because they're completely normal for me. It's just when I move house and change environments, particularly to somewhere I don't know, that I have to think and adapt what I do. I've recently moved to live on campus and I've already learned that I need to adapt to the new surroundings. Already today I've burned myself on the grill twice because it's high up on the wall and the grill tray comes out at an angle that's difficult for me to see. I've walked into walls because the corridors are narrower than I'm used to at home. It's frustrating, but in another week or so there won't be those problems any more because I'll have adapted and they'll become normal adaptations which require little or no thought.

A perfect example of problems in new situations was whilst out with a friend today. We were in one of those gadget type shops with lots of electronic toys that run around and fly etc. One of the shop assistants was flying a miniature helicopter. It was black with a blue light on it but because of the speed it was moving and the colour and size it was, I just didn't see it and nearly walked into it head on. A toy like that can do a surprising amount of damage to a person's face, it will at least sting for an hour or so if the blades catch you - trust me on that one! I didn't see it mainly because it was on my left hand side. If I'd have been somewhere I'd known to take extra care, I'd have been looking left more often by swapping control of my eyes and forcing my brain to use my left eye - just like I do when I'm driving. Small adaptations that just make me and other people safer.

Essentially what I'm saying is, I don't claim to be anything i'm not. I just make do with what I have. I'm grateful for the sight I do have and want to protect and preserve that for as long as possible. I'm not trying to make out things are worse than they are, I'm not trying to get pity or sympathy. I don't want that. I just want a little understanding, because outwardly, i just look like a clumsy twit. I look "normal". I conform to society. If you look at a photograph of me, you can't tell there's anything wrong. You might pick up that I have a squint (I hate that word by the way. I squint when I look at the sun. So does everyone! It doesn't mean my eye looks like it does - that's amblyopia if you want to call it something medical, or a lazy eye if you don't). I don't make a big thing of it. I don't like drawing attention to it - people comment on it enough as it is without me pointing it out! But if people ask why I do something differently then I explain. Just because outwardly everything seems fine, doesn't mean that I'm not struggling.

So, my question to you, what do you see when you look at me? Do you see a girl who is quite frankly struggling, or do you see the outwardly bubbly "normal" person, or do you see a moany whingey whiney person? Yeah I complain about it from time to time, but wouldn't you? I'm only human after all.

Eyes...

Anyone who knows me, will know that my eyesight is, quite frankly, horrific. I've worn glasses since I was 3 and had a patch that failed to correct a squint for two years when I was 4. I have poor spatial awareness and depth perception. I can see about 10centimetres (4 inches) from my face without my glasses. At the moment there are very limited options for contact lenses for me so I can't wear them currently because my prescription is so high. I cried the first time I wore contact lenses because I'd never seen myself in a mirror without glasses before.

Simple things are difficult for me because of my eyesight, so I'm going to attempt to describe an average day at university in order to explain just how difficult things are, because it's things people take for granted that I struggle with from day to day.

So, I wake up. First thing I have to do is find my glasses. Mostly this involves a lot of groping around. There's no point turning on the light yet because it won't help me see the glasses. Once I've found them (it usually takes about 10 minutes) the lights go on and I get up for a shower.

Showering is, well, fun. I have to make sure that my shampoo bottle is a different colour from my conditioner bottle and different again from my shower gel. I also have to have brightly coloured razors so that I can find them all. If my shampoo and conditioner look similar then I have no idea which is which until I pour them out. Glasses steam up in the shower so I can't see anything even if I do keep them on.

Once I'm showered I then get the fun of putting make up on. I have to have a mirror really close so I can see to do my eye makeup and then wait for it to dry before my glasses go back on. Putting in earrings I've learned to do by feel now so that's no issue. By this point I've usually fallen over or spilled something at least once. I'm permanently bruised from stupid accidents. Getting dressed means I don't wear anything with fiddly straps or buttons because I can't see to do them properly and my coordination isn't good enough to do them up based on feel alone.

Breakfast is again interesting. If I have cereal, it's a given that I will spill the milk. If I have toast, I'll struggle to get it out the toaster, cos where the toast is and where my brain thinks it is and thinks my hand is in relation to it are two very different things. Coffee is needed at this time in the morning and I'll miss the cup putting sugar in and spill it en route back to my room.

I pack my bag with my laptop, a textbook, notepad, highlighters, a ruler and pens and head off to lectures. When I get to the lecture theatre, I hold on to the railings/chairs as I walk downstairs cos I fall over a lot as I fail to judge how steep/deep stairs are. Once I'm settled in my seat (near the front so I can see the lecturer clearly), I fire up the laptop and download the powerpoint for the lecture. If I don't, I can't read it on the projector. At this point I usually have to enlarge the text and change the colours to make it easier to read. I follow through the lecture, making notes by hand, then immediately type them up afterwards - my handwriting is so bad because of my sight that if I don't type it up then I have no idea what it says a few hours later.

Lunch is the same as breakfast and I knock stuff over, fall over and spill things. Occasionally I miss my own mouth with food or drink which makes a right mess.

If I have a placement then things are even harder because a lot of the clinical skills we use I have to shut my eyes and use feel or shut one eye or the other to adjust for my sight and make sure I know exactly where my hands are.

Dinner is just as difficult as lunch and breakfast. I usually try and run before dinner, but if it's even just drizzling I generally don't because rain on my glasses means I really can't see.

If I'm doing group work then I type everything up with a coloured background so I can see the text better, then convert it back before I send it to the group. I have to edit all of the group's work so I can read it properly on screen usually as people aren't considerate when I tell them that I can't read certain things, and I can't afford to print off 30 odd pages of work a week.

These are just a few of the things I struggle with. If I told you all of them then we'd be here forever. The point in me telling you this is because I've been offered Phakic Intraocular Lens Implantation Sugery. Paid for privately by my dad. I want to leap at the chance but the risk of me losing my sight is high. Laser surgery isn't an option so this is my chance at as close to 20:20 vision as I'm ever going to get. But I'm petrified. I lose my sight, my career is over. Question is, do I take the risk?

Getting Left Behind and Vanishing...

It's been a little over a month since I last blogged, and it's not been the best of months which is why I've not been blogging, although I'm still around on twitter. My grandad's been really ill and has been in and out of hospital and generally a big worry for me. My sisters got A level and GCSE results. No idea how my sister's A levels went and I don't dare ask but my baby sister did fantastically in her GCSEs so I'm really proud of her. I've come back to university for a couple of weeks because I've had some clinical placement hours to make up from when I was ill and things were strained at home because my mum's been so stressed.

It's generally been quite lonely because my friends I had at home have all moved on and the few friends I have at university have been home for the summer. I kind of feel like everyone is moving on and leaving me behind. I'm still the same shy, insecure person I was when I was at school. I'm still permanently doubting myself and my abilities, and it feels like life is passing me by and that I'm missing out on things that should be normal for someone my age, like going out with friends and just actually enjoying university life.

I also feel like i'm being left behind in terms of the blogging world too. I used to have a really fab blog but now, it seems like it's pointless. I have little motivation to write because I get little back from this blog now. The number of comments have dwindled and I just don't think it's worth the effort any more. It seems more successful and popular blogs have more popular people behind them and they're streaks ahead of me. Let's face it, who wants to read this when you can read blogs by people like Mark Glencorse and Stuart Gray? I guess I'm just going to have to decide whether I want to even blog any more, because quite frankly, it just doesn't seem worth it, and too many people keep trying to shoot me down and stop me blogging.

Home Alone

So, exams are over, my housemates have already moved out (and left me loads of crap) and I've had a stomach bug. So the packing frenzy begins tonight for when my mum turns up in the morning. PANIC!!!!!!!!!!!!!!!

1 more to go...

Title says it all really. One more exam until I am FREEEEEEEEEEEEE!!!!!!!!!!!!!!!!!!!

Countdown to the End of Term!

One Exam done. 2 more to go.

The OSCE for my last unit of study went actually okay. I now have one more OSCE to get through and the written exam and possibly one resit of an Analytical Review of a Research paper but who knows?! Time to get my arse in gear and do some revsion!!

USA Medical Student Day

Over in the states it is currently still July 1st which apparently (according to MedicDani) is Medical Student day there. So, this post was her idea and nudging me towards getting some fantastic advice from all of you hopefully! What I'd love would be for you to tweet @ me or to leave in the comments box or to email me is your piece of advice for brand new medical students, or students starting placements or junior doctors about to start their first jobs, or advice for medical professionals in general. Just one piece of advice is all I ask!

Here's Dani's piece of advice:

Befriend the nurses and the aides. We will be your best friends or your worst enemies and we have more power with the surgeons than you think. We decide whether to like you or not based on your first day, so the only staff to fear on day one is the Nurses and aides.

Looking forward to reading all of your pieces of advice!!

1 sheep, 2 sheep, 3 sheep....

It seems I've become an insomniac. I haven't slept properly since last Tuesday. I'm currently surviving on 1-3 hours a night. 3 is good. Very good. It's making me feel horrific, I'm having horrible dreams, it's not doing me any favours healthwise (I have apparently some strange viral infection that is playing games with my heart rate and making me feel generally rather bizarre.). I want to go running, in the hope that it'll burn me out, but I can't risk it with my lungs being as rubbish as they are. All I want is sleep and I just can't get it. Any ideas for things to help? Sleeping tablets aren't working (prescribed ones. I have two types and neither seem to be doing anything.) neither are hot baths, lavender oil, milky drinks. Suggestions needed!! I need some sleep! I have an exam on Monday and my stress levels are even higher cos I'm not sleeping.