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Larbert, Scotland, United Kingdom

Tuesday, February 26, 2008

Clinical teaching

I seem to have reached Tuesday without me realising somehow that the week had started. Anyway. Monday was my usual hospital then PBL day.

We turned up at the hospital in bright sunshine (this becomes important later), and went to the room. No one came down to teach us, so we waited a bit then called the subdeans secretary. She told half of us to go to each of two wards. Two of us went up to the Cardiology, where we met a very friendly FY1 and a stressed out FY2 - the Consultant being in Egypt!

The two of them were doing the ward round on their own, so we followed bits of the ward round and stayed to see 'interesting' patients where there were some.

These included a man who had had a dissection of the aorta, and thought he was having a heart attack because of the pain, but the big teaching hospital had sent him home because his ECG was normal, only for him to re-present with breathing problems and cough 10 days later, and a trans-oesophageal Echo to show he had dissected his aorta. Hew as then rushed in for an emergency valve replacement and aortic surgery.

We also got to examine the visual fields of a man who had a stroke last year, and had a complete loss of vision to his right, although everything else about his eyesight was fine, and he didn't think he'd be a danger on the roads if they gave him his driving licence back. He is one of the many characters in the hospital, and indeed some of them are such good raconteurs they should write a book.

The FY1 was very nice, and invited us to go back whenever we wanted to see patients! They also gave us a good going over of reading ECG's and how to spot which artery is affected, and the patterns of LBBB and RBBB.

By this point the rain was very heavy, and it has continued to pour with rain for the past 30odd hours, including all through my driving lesson, and today the rain was joined by very strong winds. There was much discussion in PBl about how bad the weather was.

Tuesday morning saw a whistle stop tour of the mental state examination and how to do a psychiatric history and examination, in a session lasting 2h30. It was very rushed and a touch stressful, trying to get the concepts and their symptoms clear in your head. I was sat with shermanator, which is goo, because he thinks of lots of questions after most teaching sessions, and in our attempts to answer them for him, it makes you think more about the subject and you can cobble together a good argument - good exam practice, even if we talk in large concepts and not the minutiae that the medical school like in exams!

Tuesday afternoon was supposed to be an FRS on alcohol, but I remember it well from 2007, and since I was feeling crap, nauseous and tired, I came home and had an afternoon nap.

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