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.

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.

What are we supposed to do?

As medical students, sometimes we encounter situations we are not at all expecting, and that we struggle to deal with because it's not something we've yet covered in our training. We then don't get the opportunity to later discuss how best we should have dealt with the situation, so when it comes to the next time around (which inevitably, there WILL be a next time) we have very little idea what we should do, what we're supposed to do. Thing is, I just can't work out how to change this. It needs to change. We can't be left feeling like this every time we encounter situations like this.

Ideas on a postcard please.

Alternatively you can email me or DM me.

Oh Balls...

OSCE went very very badly. I will almost certainly have a resit in the summer. Balls.

Hardest Decision

So, I'm a week on, and nothing much has changed. I'm home for Easter and hating it. Family life is difficult and I don't fit back in anymore. To top it off, the boyfriend is in Australia so I can't even talk to him all that much because of the time difference (Time zones suck!!). I'm quite lonely here and all I want to do is sleep.


I'm having a real rethink about my life at the moment. I'm not really happy in medical school and I really don't know if it's the right thing for me. I always wanted to be a paramedic, but my school refused to send off the UCAS form with Paramedic Science on it, or write me a reference for a student paramedic position. My parents refused to support me in that career, and I knew that nursing and midwifery weren't for me, so I decided to just go for it and apply for medicine. I didn't think I'd get offers, let alone get the grades, but I did, even if it was by the skin of my teeth. 


Since then I've been struggling with everything at medical school, aside from the practical things. The science is way beyond what I can cope with without doing stupid amounts of work. I no longer have a social life and the stress is having an impact on my health. I love the practical stuff, and fast paced patient turnaround, but other than that, there is very little keeping me here. I haven't made many friends, I don't go out or even dance anymore (I used to be a dancer on the university Dancesport team) and I just don't see a reason why to carry on. I keep scraping through exams other than the practical ones and I'm just not enjoying much of it at all.


I'm thinking about leaving it all and going to be a paramedic. It's what I wanted to do in the first place and I think it's really where my heart's at but I just don't know. My parents would hate me for it, I don't think my boyfriend would really be all too happy about it and I just don't know. I can't decide. I've agonised over it, shed plenty of tears and lost a lot of sleep over it. It's a very difficult decision but one I will have to make soon enough.

Little Blip and Nightmares

Apologies for my little blip last week. I still feel like crap, but normal blogging has now returned. (But related to that, I would love if you would let me know that you're reading, either via Twitter or a comment or email. Anything really! Would love feedback on the blog, and requests for things you want me to post about).


As those of you who have been reading the blog back will know, I have a really keen interest in Emergency Medicine. I love anything adrenaline fuelled and fast paced, and I even love treating the minor injuries and drunks etc in A&E (although I much prefer "real" medicine, I love it all!). This means that a lot of the cardiovascular medicine I'm studying at the moment is of great interest to me. I enjoyed my defibrillator training, teaching on arrhythmias and ECGs, teaching on MIs, teaching on AAAs. All of it I find really interesting, and geared towards the medicine I like and want as a future career. So, why am I having recurrent nightmares about being involved in my first cardiac arrest?


I've seen cardiac arrests before, but not been actively involved other than fetching and carrying. I've seen my first in hospital death, and yes it affected me, and I was upset by it, but it's the nature of this job that people will die sometimes. We all have to die eventually. What I don't understand is why I keep waking up from this nightmare panicking, and why throughout the dream I am absolutely petrified.


The nightmare starts with me following a consultant on a ward round. We go to a patient behind a curtain, and find them unconscious. Then begins the resuscitation protocol. I know exactly what happens, I've seen it before, I've been trained to deal with it. Yet, in the nightmare, when the consultant asks me to start compressions and to then start the defibrillation protocols, I freeze and panic, and see the patient slipping away before me. I get pushed out of the way, see a failing resuscitation attempt before me, hear in the distance the consultant ask if everyone agrees to stop and call the time of death. This is the point where I wake up. I wake up panicking and breathing far too quickly, and absolutely petrified.


I couldn't do anything, I couldn't move, I couldn't get myself to do what I've been trained to. I doubt in real life it'll be like this, because often, when I'm stressed then that intrinsic knowledge kicks in and I move and do what needs doing. I don't understand why I'm having these nightmares, because it shouldn't happen like that, and the likelihood is that, as a medical student,  probably won't be involved in an active resuscitation attempt for some time. But yet, that niggle is always at the back of my mind every time I'm in the hospital. I don't know why, and I hope this nightmare will go because I'm exhausted from waking up every night at least once. I guess I'll just have to beat this panic out of my subconscious.


As a weird aside, according to my housemate, I've been sleep talking. Mostly having conversations with my boyfriend apparently. Maybe this is all my stress? It's creepy, that's for sure!! Just hope I don't start sleepwalking!

A Little Dilemma

At my medical school, we learn clinical skills from year one. This year, I have so far been taught to take blood from patients and to cannulate them. However, I was taught to do these on a plastic arm. Those of you who are familiar with these "practice arms" will know that they just don't feel like a real vein on a real arm on a real person. 


My dilemma is this: However much you practice on a fake arm, it doesn't feel anything like the real thing. Cannulating your first patient, or performing your first venepuncture is absolutely terrifying and if you've never done it on a real person before, the chances are you might not manage it. If a patient asks you whether you've done it before, what do you say? "Yes, but not on a real person"? We're not allowed to practise on each other, and so we get no practice on real arms before we do it on real patients. I want to pose two questions to you.

1. If a patient asks you "Have you done this before?" and you've only done it on a plastic arm, what would you say?
2. Do you think medical students should be allowed to practise on each other, and what is your reasoning behind your answer?

I'd love to know what you think!! Leave me your comments and I'll try to answer them all.