The end is nigh

That's it, that's done. My final Uni sign off is done, and following a 2hr lecture tomorrow and a drinks reception and after handing in my P for p workbook, full time Uni will be over, finished. As I left hospital today, the radio station played some Sinatra:

"And now the end is near; And so I face the final curtain
My friend I'll say it clear; I'll state my case of which I'm certain

I've lived a life that's full; I traveled each and every highway
And more, much more than this; I did it my way

Regrets I've had a few; But then again too few to mention
I did what I had to do; And saw it through without exemption

I planned each charted course; Each careful step along the byway
And more, much more than this; I did it my way

Yes there were times I'm sure you knew; When I bit off more than I could chew
But through it all when there was doubt; I ate it up and spit it out, I faced it all
And I stood tall and did it my way"

So now i head on towards my last long summer of work, weddings, holidays, fun, friends, and academic presentations and writing up papers containing some of my research from SSM's and electives.

Mum's big birthday

The day that my exams finished was Mum's big Birthday celebration weekend away - her birthday having been mid exam period!

We headed up into the wilds of Scotland and stayed at a very nice hotel with minimal phone reception and a nice spa sauna place as well as a nice restaurant, great grounds and even a giant chess set!
Evenings after dinner were spent sat by a roaring fire playing board games. It was a great end to exams!

The main highlight of the Saturday was quad biking - dressing in hi vis suits, wellies, goggles and crash helmets....followed by an afternoon of swimming in the pool and using the gym and a nice tasty dinner.

Sunday was a nice massage and then lunch before heading home for a sleep prior to heading down to Cornwall; see previous posts

Cornwall

March involved a nice week break down in Cornwall with Mum & Dad

Sorry!

Apologies for the 2 month absence.

News.....
1. I passed my finals
2. I start as a Doctor in August
3. We were doing preparation for practice lectures which redefine the word dull.
4. I spent 3 weeks on a GI medicine ward as a junior FY1 type role.
5. I have spent evenings and weekends doing all the things I didn't have time to do between September and the end of exams....seeing friends, doing some work, seeing films, going to comedy shows etc.

Anyway more detailed updates will follow soon :)

Goodies

After butcher boy doing me a favour yesterday, he emailed yesterday - I suppose it saves him having to do any real work, and asked if I was free to help with a short trip to Costco today to buy exciting supplies.

We also took his flatmate, who used to work with us all in the days of supermarket land and is now working in another branch of the public services. The summary:

• huge tin of pretzels,
• lots of juice
• random foodstuffs
• and of course tasty pizza and coke in the canteen whilst we divide the bill

All in all a good Saturday morning.

The Will to carry on

It seems I am a hard person to get hold of.......last Summer - Augusty time, I drafted my will and poewer of attorney, as advised by the solicitor when I bought my flat in 2004. Anyway, having gotten round to it, I have at various times since been on Bute, busy, and studying, so it was today before the completed Will and I coincided for a signing. Now I just have to get a doctor to sign to say that I am of relatively sound mind, and get my sister to sign the Power of Attorney and it's all go.....

Opticians at 11 as well.

Because the will guy, and Butcher boy as the witness of my signature on the will, were coming round at 9am today, after yesterdays OSCE, I spent some time tidying the flat - well tidying as in putting all notes in a big pile; and hoovering and mopping the floors, doing all the dishes and wiping the benches, and moving anything to big / annoying / strange to be tidied easily, into the bedroom, which now looks like the storage yard for a junk shop.... Can't decide if I am running out of room, or just running out of sensible storage ideas. There is a big yellow storage place not far away.... I wonder......

Scores and next year

Well, last week the UKFPO published the jobs online. I got my 6th choice - moral don't choose popular choices because with a mediocre score you should not aim too high! So next year I shall be in Glasgow and Lanarkshire. I thus spent the end of the week ranking in order the 18 individual rotations (this is the 3rd or 4th level of ranking to get a job!) and thus know that I will be doing a combination of medicine and surgery and very little else.....

Then later in the week they published the scores breakdown for our questions (each section scores out of ten points:
1 - List previous degrees, papers, posters etc - 8 points

2 - Describe a case from your clinical experience that you have observed in the first 24 hours from hospital admission. How did members of different professional teams interact and how did this contribute to effective patient care? What did you learn from this that will influence your future practice as a new doctor? (200 words) - 8 points

3 - Describe a case from your clinical experience that you have observed in the first 24 hours from hospital admission. How did members of different professional teams interact and how did this contribute to effective patient care? What did you learn from this that will influence your future practice as a new doctor? - 4 points

During a ward round on an ICU placement, a consultant was teaching me about ventilator function and the various modes available for use in a patient with pneumonia. The consultant organised a tutorial where, having established my background knowledge of respiratory anatomy and physiology, he used diagrams and patient scenarios and asked me to explain the pathophysiology of each patient, and choose a method of ventilation, justifying my choice. I found this tutorial approach very helpful.
As a middle grade doctor, I could be called upon to explain some of the clinical features of a disease, such as diabetes mellitus, to some junior colleagues. I would adopt the above approach with the colleague in a one-to-one situation and start by establishing the level of the colleague’s understanding of the relevant disease. From this, I would then lead them through any areas of poor understanding, before reviewing a number of selected cases so they can see why the disease leads to the presented clinical features, and the effect these have on a patient’s life. Finally I would present them with new cases to establish their understanding after the teaching, reviewing their answers with them.

4 - You are one of two foundation doctors on a ward round. The registrar identifies a minor error made by your colleague and makes inappropriate critical comments in front of the patient and the healthcare team. Your colleague is visibly distressed. What actions would you take and how would you prioritise these? What actions do you believe your colleague should take in relation to these comments? How might you address a minor error made by a more junior colleague in the future? - 10 points

As this is a difficult situation, taking place in a semi-public arena and involving a senior colleague, I would ask my distressed colleague if they were alright to continue or if they needed some time out to compose themselves. Before moving on I would reassure the patient regarding the minor error, and would check that the ward round notes were written up correctly, such that patient care was not adversely affected by this incident. After the ward round, I would approach the registrar and politely suggest that whilst errors need to be corrected, they should consider how they present their comments in front of patients.
My colleague should discuss this error with the registrar in order to learn from it, and request the registrar to discuss any failings with them privately rather than in front of others.
Were I to be the registrar, I would correct the error to ensure patient safety and good treatment. After the ward round I would discuss the matter in private with the foundation doctor explaining why the error could have caused problems. I would offer appropriate help e.g. individual training or tutorial to improve their understanding and prevent recurrence of the error.

5 - Describe one example from your medical training when you received feedback on an aspect of your performance. Explain how that feedback altered your subsequent practice. How will you use this experience to develop a specific aspect of your foundation training?- 6 points

Having observed the procedure several times, I was, under supervision, taking my first blood for culture, using aseptic technique. My setup was less than ideal. I contaminated equipment and had to replace it and start afresh. The supervisor took me aside and discussed the problem, emphasising the need for thorough preparation. They suggested that I plan carefully, listing the equipment required and checking I had collect it all prior to starting. They also demonstrated techniques for putting on sterile gloves without contaminating them. Overnight I read up the procedure and consulted the local protocol. The following day, the registrar asked me to repeat the procedure on another patient. I referred to my notes and the protocol, collected the required equipment, double checked it, and completed the procedure successfully without wastage or contamination.
I adopted this approach of observation, pre-reading, reference to local protocols and making notes for common procedures in this and subsequent placements, and have found that it increased my confidence and success at performing procedures. In foundation training I would continue with this approach to new procedures, consulting textbooks, familiarising myself with local protocols and carefully observing senior colleagues practice and amending my notes accordingly.

6 - At times, the patient and the medical team have different ideas on the management of the patient’s illness, because of personal, social or cultural views held by the patient. Describe a clinical case where you have observed this. Identify the factors that contributed to these differing views. Why is it important to understand these differences in your practice as a foundation doctor? - 4 points

The summary of this is that I am rubbish at questions I work hard on and quite good at ones I drafted once.

Interestingly, due to an academic score of 34 (repeat a year) I made my academic score almost with part 1 which brought me to the same score as many of the academically gifted members of my year who did not have a degree. Thus the scoring discrepancy, and thus the first choice is jobs is based on ability to answer those questions.

The questions for 2009-10 were quite different to previous years and I am not sure if that helped or hindered.

Oh and as a PS - I know what to do if someone shouts at me - I got 10/10 above for that!

Theoretically half way

The written exams were Thursday & Friday and featured a bizarre selection of questions old and new - STI's, testicular masses, febrile convulsions, pelvic fractures, postural hypotension, hair loss, and more.

The Short Notes were again unusual - the ethics one being absed around adults with incapacity and the rights of relatives with 'welfare guardianship' rights; the public health one related to smoking prevalence.

Either way they are now both finishged and OSCE revision starts in earnest tomorrow!

The hoodies are gathering

I am surrounded by hoodies, most of whom look as if they'd happily receive a hug......though not from David Cameron.

Yes, on level 5 of the Study area in the med school, the buzz of tension mixed with the swish of pages turning, the click of keyboards and the hum of the aircon is stifling conversations. The neat piles of empty coffee cups, M&S sandwich boxes, salad tubs and fruit salad trays are growing near the bin, and the dress code is heading from normal to comfy and homely - started with hoodies and jeans, now slippers are creeping in.

The earphones are in, and a selection of online music sources, podcasts etc are providing the soundtrack to our lives. Yes, we're heading through exam season, and as we all struggle with the same past papers, and identifying which antibiotics cause cholestatic jaundice; and debate the answer to mock EMQ 1.8 from the XX past paper etc, we are heading towards a camaraderie - those of us who choose to revise here and developing something of a bunker mentality/ blitz spirit.

And when it all comes down to it, we are all in it together.

Wish us luck!

Pivotal month?

Far be it from me to declare any month as more important than it's colleagues, but.... Feb 2010 is pretty important to me - career-wise at least.

Finals
These pretty much fill February - writtens w/c 8th and OSCE w/c 22nd & 1st Mar. Nuff said - they decide if I graduate, if I have resits etc etc etc. This means that much of the rest of the month is built around revision.

Last Med Student Block
.........................Hopefully! This should be signed off tomorrow, again hopefully with a 10/10 pass. The coursework is all uploaded so everything on that side of things looks ok.

Programme details
Hopefully I find out which programme I will be on next year for Fy1 jobs. This is step 2 of the 3 stage 'find me a job' process. Step one assigned me to Scotland Foundation School, and Step 2 will allocate me (hopefully) to one of my top ten choices of programme (or I go into 2b where I have to re preference the remaining vacancies).

Much of the above is tentative and 'hopefully' and just to tempt fate I am planning as if I will pass!!

The last thing we needed.....

It seems that someone from my year at Uni has posted somewhere on t'interweb that they have seen the 2010 finals paper.

This seems to have sent faculty chasing their own tail in circles with panic, and thus we have received an email saying that they will now be re-writing the exam paper to ensure no unfair advantage etc whilst saying that they think it unlikely that anyone has actually seen the paper.

Whether re writing means merely swapping the title page on the 'main' and 'resit' papers or long evenings of feverish activity in the admin end of the Med School as well as the library end is to be seen.

After all, all we need at 16 days to go was another minor panic!

Catching up a bit

After my SSM at DEPCAT hospital (see here) I wrote up the results of my project, and we submitted it to a scientific meeting. Due to my SSM being in Intensive Care stuff, this means that most of the other posters were written by senior registrars, researchers and consultants.

I was thus quite lucky to be one of the 50 chosen to be assessed in the poster competition at a conference in St Andrews yesterday. This did necessitate an early start, but was a really interesting day with some very interesting lectures on H1N1 and the medical responses to it, and then some research presentations from across Scotland - it was also a chance to catch up with staff I had met on SSM and elective over the past 2 years. This networking surely can't be a bad thing when I get to ST applications in 2012!

However back to earth with a bump, and sat revising in the (boiling hot) library of one of the hospitals, and wondering whether my tiredness despite 7 hours sleep is in anyway related to lack of vegetables and fruit in my diet at the moment.

Being in SL in the evening doing past papers and revision does tend to make you a snack food addict - subway, greggs, ready meals, coffee, tea, irn bru, crisps, chocolate ....and hospital food is not much better - the average sandwich contains a bit of lettuce!

The joys of online shopping

3 call centres, 25 minutes and 3 regional accents later I have discovered that my new vacuum (Samsung) is in East Kilbride at the depot as they could not deliver on Thursday as my road was closed. I thus have to go to EK one day this week between 9-5 or 9-12 on Saturday.

Call centres
1. Sainsburys direct - Belfast - amusing irishman and loud colleagues - I could hear the guy next to him talking to a woman ordering a washing machine for SK11 postcode
2. HDNL - Liverpool - very friendly girl, who because their computers were slow, had a 10 minute chat in broad Scouse with me about life and the world and what had I done for new year. her name was Emma.
3. HDNL - East Kilbride - blooming heck, tech them about customer service, the guy belched whilst on the phone.

Resolved to make a resolution?

Psychologists at the University of Hertfordshire say it is quite normal for nine out ten of us to give up giving up/cutting down/working out in the first few days of January. Those who do keep on keeping on never make it past 77 days anyway, according to the insurer PruHealth (‘Death of the Diet Day’ is March 18, if you’re looking to pencil dinner dates in to your new dairy). But those who don’t bother at all end up healthier, mentally, as they avoid feelings of failure and worthlessness, according to the charity Mind.

Source

Hmmm 5 weeks of work and 4 weeks of exams takes me to just shy of the new years resolution deadline which does imply that any resolutions related to studying may outlast the exam season!

5 star hotels

This next few months will yet again see me visiting some fancy hotels - working, Uni Graduation, Uni Conference, Mum's Birthday, Weddings and such like.
This is the location of the conference in January and it looke very nice, but I worry that it will eb cold and dark when I arrive and likewise when I leave and for all I see of the facilities, woe could have helf it in the old Ruchill hospital.

This is allegedly the location of the 2010 Grad Ball. Looks rather nice and I hope we get fireworks like that, but I fear that they may cost more than the ball will. We were discussing the other day the issue of having to pay now for a Graduation Ball when we an unsure of passing let alone Graduating in July!

End of the year!

Hmm we appear to have arrived at the last day of 2009 all of a sudden. I must complain, no-one told me this would happen. Only yesterday term was finishing for Christmas (ok so technically it was 18th December), but this leaves me now with a major issue of trying to complete all the tasks I promised / am obliged to complete by the end of the year.

The main task are registering for a conference in January and completing the text for a poster for said Conference so we can send the poster to the printers and get it printed in time. I have technically been onto this since June but not really done much about it.

Subsiduary tasks include going to the bank and tidying my flat. Then comes the big decision of the day - Edinburgh, Study Landscape or my flat for new year?

The end of the year is also the Queen's New Years Honours list. For the first time in a wee while, I don;t know anyone on the list, though in second year I was a research subject for a trial for which one of the lead authors got a gong! In previous years, Uni lecturers, Scout Leaders, ex-colleagues, Charity people and even people at Mum & Dad's church have received a gong of one level or another.

It does make me wonder how many of the class of 2010 will be OBE / MBE / Sir / Lord before retirement.

My flat on tv

Story of a christmas in pictures

Sleep

Hmmm couldn't get to sleep last night

Possibilities include
a) not burned sufficient calories / done enough exercise. Unsure how this works, but trying to get to sleep after lazy days is harder.
b) finals fear - not feeling particularly fearful as yet, but it is building.

So at 5.30 I gave up trying to sleep and have a large cup of 'Taylors of Harrogate Lazy Sunday' coffee at a fairly strong level and am contemplating my day.

Either way, I should sleep very well tonight ahead of my trip down to Newcastle on Thursday complete with Thermos flask and camera for the snowdrifts, tailbacks,m jacknived lorries and 'christmas roadtrip' film scenes from airplane, home alone etc.

WINTER 2009