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.

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!!

Back in Business

Sorry guys - the blog went private so I could make a few tweaks and changes to the site and comments.

Change number 1:

You need to be signed in to make a comment - no more of this anonymous slagging me off business. If you're going to insult me, at least be man (or woman) enough to admit who you are instead of this cowardly hiding behind a keyboard.

Change number 2:

All comments are being moderated. Didn't want to do it but, as people continue to use the comments of my blog to try and put me down and give me a bad reputation, it has to happen. Sorry but I no longer have a choice about this.

Change number 3:

The top of my blog now states its exact purpose. It may sound selfish, but really, this is my diary, and whilst I'm happy for people to comment and ask me stuff, I will answer eventually, but it is for me ultimately, and on here, I'm putting myself first for a change.

Change number 4:

My contact details are now down the side of the blog, with a link to my twitter page.

Change number 5:

The big image of me is gone - just didn't like having it there. Instead is a wonderful picture of an air ambulance that I believe is in Austria. Clicking on it takes you to the source.

Some Advice

This is a question I was asked a few weeks ago, via my formspring page. I thought it might help those students starting 6th Form, or about to start thinking about the dreaded UCAS (University and College Application System).

As a second year student, what advice would you give to anyone considering the same career path that you have chosen?

Think VERY carefully about whether this is REALLY what you want to do - you will be devoting your entire life to this degree for 5 years. You will lose your social life, and it will be hard to make and keep friends. Discuss it with your adults, your tutors, your friends, your family, ask questions to people like me who have already been through this (I'm happy to answer emails from anyone about this - dysdiadochokinesia@hotmail.com). It is hard, physically, emotionally and mentally.

It's a rewarding career but if it's not right for you, it will wear you down. Also - pick the right type of degree for you. PBL doesn't suit everyone, nor does a traditional course, nor a course with clinical placements from the word go.

Get lots of experience - being a doctor isn't glamorous like on Casualty or ER, it's hard graft and very demanding, and can often be very unglamorous - particularly when you're examining stool samples or putting maggots into leg ulcers! It's incredibly demanding, tiring and stressful. It can be upsetting, it can make you angry, get you frustrated. You'll experience more emotions in your first few weeks of clinical placements than you ever thought possible. It's a lot of hard work, and won't be much like you expected it to be. Do some work as a healthcare assistant or something in a hospital, do lots of shadowing.

If you're serious about it, go on lots of open days, ask current students about the courses and what they think about them, work hard at your A levels and GCSEs, and pick the right subjects for the courses you have in mind - DO your research. If you don't think you're going to get the grades, look at Access to Medicine courses, or Medical Schools that offer lower grades depending on what school you're at, or Medical Degrees with a Foundation Year.

Do lots of practice interviews, find out what they're like at the universities you've applied to - they vary a lot. For example, UEA is an OSCE style interview, whereas St George's University in London is a traditional interview with 3 consultants and a medical student firing questions at you.

But ultimately, do what YOU want, and what you think is going to make YOU happiest.

Good Luck

Future HEMS Doctor?

When I joined Twitter, I started out as MedStudentFaye. That's me, that's who I am and what I am. Plain and simple. I soon realised thought, that I wasn't happy just being me. I wanted to aim higher. I wasn't happy just being mediocre or average. So, I became FutureHEMSDoc, in order to give myself something to aim for. However, this year, I've been doubting myself. A LOT. I haven't been at all happy at UEA, that's no secret. The course isn't really right for me and I haven't made many real friends at all on my course, or even at UEA in general. I feel isolated and alone a lot of the time, despite having a wonderful boyfriend (NorfolkDocToBe) but he's usually up in Manchester, but at the moment he's the other side of the world. I love him to pieces but him being so far away is currently very unhelpful! I don't at all begrudge him the opportunity he has in Australia, and am really pleased he's enjoying himself and travelling and learning a bit more about himself and what he wants to do as he advances in his medical career. He's made for medicine. I'm not so sure that I am.

I've had several lengthy discussions with many of my good friends on twitter about all of this - mostly Mark Glencorse and his lovely wife Sandra, as well as iMedicFF (who has put up with me crying far too much!) who have been fantastic in helping me decide what is best for me, and what I should do. (Thank you guys! Really appreciate all the lengthy conversations - I know I'm a pain in the butt, but you've helped me out a hell of a lot). But in the end, no matter how much I discuss this with people, it is MY decision. I changed my twitter name so there was no pressure on myself to be FutureHEMSDoc, but at the end of the day, I wouldn't be me if I didn't push myself. For now, I'm going to work as hard as I can at this medical degree, because I'm not one for giving up. If I pass the year, I'll carry on and work until I get to where I want to be. I'm not particularly bright, and I'm not popular or happy on this degree, but once I'm qualified, I can do so much with it, and I just can't waste that opportunity. I've got this far, and I couldn't forgive myself if I threw that away. If I fail the year, at least I gave it a go and did my best, but I'll then go and be a paramedic. I'd be happy in that job, I know I would. I love every single aspect of it, even the paperwork and the picking up drunks on a Saturday night, but I think I'd always feel like I lost the opportunity to do more. I'm not at all putting down paramedics and what they do - the VAST majority of those that I've met have been fantastic people, highly skilled and far better than I would ever be at that job, but as a doctor, I could do many more different things, and maybe even change the way a few things work for the better.

As I said in my first post, I'm stubborn, opinionated and I care a hell of a lot. Because of that I'm going to do my best whatever I do. I'm going to keep going out observing with paramedics as much as possible (if you're a paramedic or tech who wants an observer, give me a shout!! I'd love to go out with as many different people as possible). I'm going to keep working as an HCA in my hospital, and I'm going to speak to ambulance services about student paramedic jobs, and look into paramedic science degrees, because I'm still a little unsure.

I'm crying as I write this, not because I think I'm making the wrong decision, but because I think, for now, I'm making the right one for me, even if the world seems to be passing me by because of it, and because I've put a lot of people through my crying and worrying and stressing over all of this.

To everyone who has helped me with this decision, including those who I haven't mentioned by name: Thank You. You don't know how much help and support you've been. Honestly, you don't.

To everyone who has put me down and told me I can't do this, and told me to quit and that I'm useless and  a waste of space, and that I'll be a rubbish doctor: I'm going to prove you wrong. You may put me down, and say awful things to me, but it's just making me stronger. I'm going to FIGHT until I have nothing left.And I'm going to do what's right for ME.

Guest Post - How To Deal With Meeting A Person With Depression

This guest post was written by madsadgirl originally. It's another fantastic piece of writing, about those like me living with depression. You can read her blog here:

http://madsadgirl.blogspot.com/

How To Deal With Meeting A Person With Depression

It is a sad fact of life but the majority of people in this country feel very uncomfortable about the subject of mental illness. What makes it worse is that a significant proportion of the population are likely to suffer from the most common form of mental illness, depression, at some point in their lives, yet that particular illness still carries a serious stigma with it.

The problem for the sufferer of depression is that it can be a very debilitating illness, but to the majority of non-sufferers that you meet you show no signs of having anything wrong with you. There are no tell-tale spots or rash, you have no stitches, bandages or plaster cast, and you don't require sticks, crutches, or a walking frame to get around. You can be, however, very seriously ill indeed and yet there are no outward signs that would be obvious to those that you meet. So short of carrying a bell or clapper like the lepers of long ago, or wearing a notice around your neck proclaiming "I have depression; treat me carefully" most people would not realise that there is anything wrong with your health.

I don't know how depression manifests itself in other people, I can only describe what I feel, but my depression is not only something that affects the way that I feel about things, it also has some very definite symptoms that I feel physically. When it is at its worst, depression makes me feel as though my head and body are not connected to each other. My body feels numb, like the numbness that you feel in your lip after having an injection at the dentist's, and my head has a woolly feeling with a tendency to feel very light-headed as though I have drunk alcohol on an empty stomach. All of this is combined with an overwhelming desire to cry, though I have no idea what I am crying about, it is just something that I have to do.

So these are the physical symptoms that I feel, which in themselves may not seem like much, but are nonetheless capable of lowering my mental state to a level even lower than it is already. I find it impossible to concentrate; reading becomes something that is unbelievably difficult. I have always loved reading, and half an hour with a good book before I lay down to sleep was the perfect end to the day. Now I find that I have to read the same page repeatedly to stand any chance of understanding what I have read. I have always been shy, but depression makes it incredibly difficult to interact with people that I do not know. Social functions become trials that can cause anxiety to build up days in advance, and small talk something to be avoided because you are likely to become tongue-tied while attempting to have the simplest conversation.

When somebody asks you "How are you?" you answer automatically "Fine" although you aren't really. You answer like this because you know that they really don't want to know that it took a monumental effort to get out of bed, that getting yourself to this stage in the day has been a war against irrational feelings, and that if they ask you anything else you are likely to burst into tears. You hate it when they say "Smile, things could be worse" when you know that there is nothing that could make you feel worse than you do at that particular moment and and smiling is the last thing on your mind because you are finding it almost impossible to just exist. If you were to answer the "How are you?" question truthfully, the questioner would become embarrassed and not know how to further the conversation because they would find it difficult to deal with someone with a mental illness.

Mental illness is something that happens to people. They don't ask for it, and they most certainly would prefer not to have it. Unfortunately, while the medical profession has made incredible advances in the treatment of many of the diseases and injuries that affect us physically, diseases of the brain are not so easy to treat. While we are very similar physically, we are all unique mentally; that is what makes it so difficult to 'cure' mental illnesses.

The next time that you meet someone who suffers from depression, please remember that they are a human being just like you, they don't want to feel the way that they do, and that you can't catch what they have got through contact with them. But most of all, remember that they don't like being stigmatized because they have a mental illness. Remember that; because at some time in the future the person with depression could be you. 

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.

Why Emergency Medicine?

Emergency medicine is really popular as a career choice. Mostly because a lot of medical students appear to have the misguided idea that A&E is all trauma and cardiac arrests and life saving.A proper adrenaline fuelled career. It might surprise you to know that medicine wasn't actually my first choice of career. I wanted to be a paramedic. I hate being in one place, I like the challenge of not knowing what I'm going to see next, and I've dealt with my fair share of drunk people whilst first aiding at concerts. That seemed my ideal career, however, I was encouraged to aim higher academically so I applied for medicine. By some miracle, I got two offers and accepted my place at UEA. By some other miracle, I then got the grades to actually start studying medicine.

So far we've studied rheumatology and orthopaedics, and haematology and dermatology. I loved orthopaedics but it involved far too much time in theatres for my liking. I found rheumatology and haematology very interesting but not practical enough. As for dermatology, I will say no more than Yuk. At the moment I'm about to start a cardiology placement, including vascular surgery and stroke medicine. I find cardiology highly interesting, but the long term management and surgery doesn't interest me as much as the immediate issues cardiac conditions can present. I like to live in the here and now and think on my feet.

So, in answer to the question, Why Emergency Medicine? Because I honestly can't see myself doing anything else. I love the thrill of not knowing what's coming next. I like management of simple conditions as well as complex cases. I like the here and now and  I like to see what I do making a visible difference to the patient if it's possible. I work well in a team, I'll happily pitch in with the mess and vomit and lifting and carrying, and I make a good round of cups of tea at the end of a busy shift. I guess I just can't see myself doing anything else and I really don't see that changing. I'm determined to get to where I want and to be good at it. 

Even if that means living in the library and having no social life for the next three and half years...

Ill. Again.

For those of you who know me, I have the world's worst immune system. Not a quality you want in a possible future doctor, and in an auxiliary nurse I know. I've been ill on and off for the last week, until tonight when I felt absolutely horrific and was in huge amounts of pain. I'm not brilliant at looking after myself when I'm stressed and this time I'm no different, but this time, I've had a lot more to think about, and there are people I've needed and wanted to look out for, so in order to do that, I ignored my illness.


Turns out, I'm bloody unlucky anyway. I have a chest infection and a kidney infection. Double whammy. What joy!! Anywho..... bedtime. I feel like crap.