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.

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?

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

PBL - A Problem Best Left

She stands in the shower, the warm water dripping down her face. At least now, nobody can see that she's crying. She gets out of the shower, shivers as her feet hit the cold tiles. She wraps herself in her towel and sits on the edge of the bath. As she looks down at her scarred legs she feels that deep lonely ache in the pit of her stomach. She hastily pulls on her clothes and leaves the bathroom. She scrabbles around for her books and pens and throws them in a bag. She turns on her hairdryer to drown out the noise of the students talking noisily and happily in the street. She picks up her bag, pulls on her boots and walks out of the door. Today is just going to be the same. She gets to her seminar group 5 minutes early. She gets out her notes and takes her seat, saying nothing but a polite hello. There's no point saying anything else any more. She feels unappreciated and disliked by the group. As the discussion begins, she is frequently talked over and ignored, and even put down by other members of the group. This isn't what this should be like. This should be enjoyable, and sociable, but instead, she gives in and sits in silence. She sits, and just hopes that soon it will end. She leaves, only to go to her lecture, and sit and cry silent tears, hoping that nobody can see.

This is my attempt at trying to express what PBL days are like for me this year. It's a constant struggled with my group and I dread the days. My tutor has been fantastic, and a great help and support, but I just don't feel valued, and I don't feel like my presence is even noticed. I guess, this is just the way it's going to be.