Well 2009 is now a little over 6 hours away and in common with my general state this year I made no plans for tonight and now end up with no actual evening as such. Most of my friends are quite apathetic for new year this year, with a large focus on 'staying in'; 'doing nothing'; 'got no money'; and 'meh'; when I surveyed them.
I have the car so could go to one of the gatherings I know are happening, but that involves going all the way down in Newcastle, or Reading, both of which are a long way. and would cost lots of patrol. I have my House series 3 from Christmas, a warm flat, lots of tea and wine, and a huge pile of ironing, so it could be that I have an interesting evening, unless I get a better offer by text soon. I also have a large street party and concert outside, which if I open the window I can hear perfectly, and should I want to, I could go to with the 2 free 'inconvenience' tickets I get from the organisers.
Looking ahead, 2009 should be a good year:- my last holiday as a student, elective, and SSM, my Child Health block and for the first time in (at least) 12 years......a summer with no exams!
Looking back 2008 was a year of some highs (passing 3rd year, my ICU SSM, my block at seaside hospital - including chicken sewing and fireworks, passing driving test, getting a Car, my Sister's wedding) and lows (death of close friends, death of grandfather).
I liked 2008, it was a good year, but I am looking forward to 2009 so much more.
Showing posts with label Elective. Show all posts
Showing posts with label Elective. Show all posts
Wednesday, December 31, 2008
Thursday, October 4, 2007
Starting the ball rolling
Today I had a meeting with the head of year 3. It was a quite unusual meeting. It started normally but then became unusual.
I was at the med school, at the correct time, having had lunch with butcher Boy and joined the mature students/post-grad club. I met the head of year and we went down to one of the interview rooms. She started off explaining about the year, and how my exam performance had been - the weak areas, but also my strengths (Atheroma & Cardiology) in the exam.
We then got onto the structure of the year - my not having to do SSM's, but that I had to do an OSCE in a formative manner. We then got onto the LCP (see here, here, here and here), which the Uni say I don't have to do. however, as much for my interest, and also to make life fair for my GP partner next year, I made the suggestion that I should do it, and submit it but my prior mark (B) would stand. The Head of Year then said that the Director of Clinical Skills had sugegsted that I could do a series of portfolio cases, for him to mark, as this would be good practice for 4th year, whilst not a repeat of the LCP I have already completed. This sounds like a better idea as I should get to cover a wider variety of topics (who knew the Uni ever listened / took ideas on board, or was even capable of thinking outside the box?). She suggested that I email the Director of Clinical Skills to establish a task / written guidelines.
I also raised my point about going to different hospitals / GP if possible this year. She said that she/ the administrator would see what they could do, but were making no promises.
Finally we moved onto summer electives next year. I asked that although i do not have to do an SSM or elective next summer, whether I would have Uni support for doing another elective, to fill in my summer and give me additional experience on wards etc. She said this seemed like a good idea, and to email herself, the SSM convenor and the Electives convenor as appropriate when I had a project in mind.
At this point the meeting got more odd. The Uni allowing me to suggest my own projects and assessments was unusual in itself, but then she asked what I knew about sound and why the system linking the 3 seminar rooms together didn't work... I kind of offered an idea, but ducked out of anything else. the system seems very odd and hardly fit for purpose!
She then apologised for not being able to answer an email I had sent her after the resit results, explaining that the Uni procedure insists that students transfer from Year Directors to Administration once they fall foul of the regulations. Apparently several academics feel it is ubfair, as that s when students are most in need of some support from year Directors etc. This was the most unusual bit, a Year Director daring to challenge the status quo in the med School, in fact she called herself a heretic for even suggesting it!
I was at the med school, at the correct time, having had lunch with butcher Boy and joined the mature students/post-grad club. I met the head of year and we went down to one of the interview rooms. She started off explaining about the year, and how my exam performance had been - the weak areas, but also my strengths (Atheroma & Cardiology) in the exam.
We then got onto the structure of the year - my not having to do SSM's, but that I had to do an OSCE in a formative manner. We then got onto the LCP (see here, here, here and here), which the Uni say I don't have to do. however, as much for my interest, and also to make life fair for my GP partner next year, I made the suggestion that I should do it, and submit it but my prior mark (B) would stand. The Head of Year then said that the Director of Clinical Skills had sugegsted that I could do a series of portfolio cases, for him to mark, as this would be good practice for 4th year, whilst not a repeat of the LCP I have already completed. This sounds like a better idea as I should get to cover a wider variety of topics (who knew the Uni ever listened / took ideas on board, or was even capable of thinking outside the box?). She suggested that I email the Director of Clinical Skills to establish a task / written guidelines.
I also raised my point about going to different hospitals / GP if possible this year. She said that she/ the administrator would see what they could do, but were making no promises.
Finally we moved onto summer electives next year. I asked that although i do not have to do an SSM or elective next summer, whether I would have Uni support for doing another elective, to fill in my summer and give me additional experience on wards etc. She said this seemed like a good idea, and to email herself, the SSM convenor and the Electives convenor as appropriate when I had a project in mind.
At this point the meeting got more odd. The Uni allowing me to suggest my own projects and assessments was unusual in itself, but then she asked what I knew about sound and why the system linking the 3 seminar rooms together didn't work... I kind of offered an idea, but ducked out of anything else. the system seems very odd and hardly fit for purpose!
She then apologised for not being able to answer an email I had sent her after the resit results, explaining that the Uni procedure insists that students transfer from Year Directors to Administration once they fall foul of the regulations. Apparently several academics feel it is ubfair, as that s when students are most in need of some support from year Directors etc. This was the most unusual bit, a Year Director daring to challenge the status quo in the med School, in fact she called herself a heretic for even suggesting it!
Wednesday, August 8, 2007
Elective - day 11
My final day in Anaesthetics came round very quickly. I was once again in plastic surgery.
The SpR who was looking after me today also had a trainee SpR with him. We went to see a few patients and do anaesthetic assessments - one lady had a suspected ejection systolic murmur (Aortic Stenosis) and she had to have an echo before her surgery.
The actual theatre list started at 10am, and because the plastic surgeon was otherwise occupied in the morning, our theatre was helping with the trauma list. So we had a haematoma evacuation to do, and a crushed finger repair. in both cases the patients had been in for a few days and so they already had venflons in, so I couldn't practice my technique.
My supervisor said that all the Anaesthatists I had been in theatre with had been pleased with my performance and said that they had enjoyed having me as a student. he wished me the best of luck in my exams, took the Elective assessment sheet off me and sent me home about 3!
The SpR who was looking after me today also had a trainee SpR with him. We went to see a few patients and do anaesthetic assessments - one lady had a suspected ejection systolic murmur (Aortic Stenosis) and she had to have an echo before her surgery.
The actual theatre list started at 10am, and because the plastic surgeon was otherwise occupied in the morning, our theatre was helping with the trauma list. So we had a haematoma evacuation to do, and a crushed finger repair. in both cases the patients had been in for a few days and so they already had venflons in, so I couldn't practice my technique.
My supervisor said that all the Anaesthatists I had been in theatre with had been pleased with my performance and said that they had enjoyed having me as a student. he wished me the best of luck in my exams, took the Elective assessment sheet off me and sent me home about 3!
Friday, August 3, 2007
Elective - days 9& 10
Day 9
Today I was in vascular surgery. The anaesthetic stuff went quite well and I got to do a couple of venflons and intubations.
One of the registrars also told me a really simple way to look at blood gases and pH and work out whether a patient had an acidosis or alkalosis and whether it is respiratory or metabolic. If is a very simple 4 step approach which no text book has but it works very well. All in all it was a useful way to spend the 3 hours of the second operation; during the first one we had gone over ECG patterns and the pyramid of analgesia.
Day 10
Today I was back in ICU. This entailed following a ward round which was very interesting, as in the case of 4 of the 6 patients, the doctors had no idea what was actually wrong with the patients, nor why some of their biochemistry was so disordered. i also spoke to the ICU staff about the possibility of doing an SSM there - I need to send an email this weekend!
There is one day of my elective left, next Tuesday, as I have the Wednesday off for revision for the exams on Thursday and Friday.
Today I was in vascular surgery. The anaesthetic stuff went quite well and I got to do a couple of venflons and intubations.
One of the registrars also told me a really simple way to look at blood gases and pH and work out whether a patient had an acidosis or alkalosis and whether it is respiratory or metabolic. If is a very simple 4 step approach which no text book has but it works very well. All in all it was a useful way to spend the 3 hours of the second operation; during the first one we had gone over ECG patterns and the pyramid of analgesia.
Day 10
Today I was back in ICU. This entailed following a ward round which was very interesting, as in the case of 4 of the 6 patients, the doctors had no idea what was actually wrong with the patients, nor why some of their biochemistry was so disordered. i also spoke to the ICU staff about the possibility of doing an SSM there - I need to send an email this weekend!
There is one day of my elective left, next Tuesday, as I have the Wednesday off for revision for the exams on Thursday and Friday.
Saturday, July 21, 2007
Elective - days 3 & 4
Day 3
Today I was in a cardiac theatre where they were replacing a regurgitant aortic valve and doing a bypass graft using the saphenous vein from the leg. It was scheduled to be a 4-5 hour operation. The patient came down to theatre about 8.35am, and was in by about 9am, fully hooked up to all the monitoring machines, this operation was unusual, in that because the surgeon was going to be operating on the heart, they would need to stop the patient's heart and use a heart-lung machine to bypass the lungs.
The operation seemed to go ok - I saw a bit but not all, but the surgeon was very snappy and quite aggressive towards the other staff.
Day 4
Today (well the morning) was spent in ICU - intensive care. It was a kind of whistle-stop tour, where I also met some of the other emd students, who have done a full elective in the ICU. They were showing me what the equipoment does and also how the monitoring is done. I liked the visit to ICU and might consider an SSM at ICU this coming year. one of the other students also gave me some contact details for doing neonatal ICU, which might be a nice alternative.
It was one of the consultant's birthdays, so we had cake and stuff. All in all ICU is much calmer and fun than I had thought it would be, and involves a lot of the kind of detective work of managing patients to dow ith monitoring and correcting their blood results etc. They also seem to have good team working between the SHOs and consultants.
Today I was in a cardiac theatre where they were replacing a regurgitant aortic valve and doing a bypass graft using the saphenous vein from the leg. It was scheduled to be a 4-5 hour operation. The patient came down to theatre about 8.35am, and was in by about 9am, fully hooked up to all the monitoring machines, this operation was unusual, in that because the surgeon was going to be operating on the heart, they would need to stop the patient's heart and use a heart-lung machine to bypass the lungs.
The operation seemed to go ok - I saw a bit but not all, but the surgeon was very snappy and quite aggressive towards the other staff.
Day 4
Today (well the morning) was spent in ICU - intensive care. It was a kind of whistle-stop tour, where I also met some of the other emd students, who have done a full elective in the ICU. They were showing me what the equipoment does and also how the monitoring is done. I liked the visit to ICU and might consider an SSM at ICU this coming year. one of the other students also gave me some contact details for doing neonatal ICU, which might be a nice alternative.
It was one of the consultant's birthdays, so we had cake and stuff. All in all ICU is much calmer and fun than I had thought it would be, and involves a lot of the kind of detective work of managing patients to dow ith monitoring and correcting their blood results etc. They also seem to have good team working between the SHOs and consultants.
Wednesday, July 18, 2007
Elective - day 2 (maternity)
Today was my first ever visit to a labour ward. I was there to see what the anaesthetists do, although I also got to see 2 C-sections as well. It's much more umm, well, eerr, brutal than I thought. However, either way, 2 7lb babies were born fit and healthy so it can't be bad for them.
I don't know if today was a slow baby day, or if it's normally quiet, but there were only 4 ladies required anaesthetic intervention - either for a C-section, or for epidurals, so I got 3 or 4 tutorials on different aspects of anaesthetics. I got to spend time with an SHO, SpR and Consultant and got to see their different styles but also the high degree of teamwork they have.
- The difference between a spinal and an epidural anaesthetic.
- What the things to look out for when anaesthetising someone who is fit, healthy and awake.
- How they manage a patient who has an 'allergy' to one of the commonly used drugs.
SHO Teaching & careers adviceThe SHO I was with for that part of the day was really helpful at explaining why these things are important and why it is good to pick them up as a medical student, and not wait til you are a JHO. She also explained some of the simpler things about anaesthetics and the anatomy of where the different needles go. She also gave some advice on why Anaesthetics is a good choice as a career and also how to manage your FY1 choices and accepting that you are an admin clerk and spend most of your time monitoring things, checking up on things or ordering test fro other departments, She also said about knowing the patients on you ward because more senior staff are off at clinics, research etc, and it is down to you to know who slept well or didn't, whose birthday it is, whose family members are away and haven't been to see them, and things like that which help you to explain things to the consultant. Also getting to know some patient history and circumstances is important.
Seeing tomorrows patientsIn the afternoon we were a bit quiet, so the SHO took me over to see the 2 patients who are being operated on and whose anaesthatist I am with tomorrow. Both are having heart surgery, so I had a look in their notes and noted the drugs they were on and went to see them so they would know who i was and why I would be in theatre tomorrow (if they care at that point!). Upon coming home and checking the drugs they are on, one patient is on Clopridogel, which is a drug which aims to prevent your blood clotting (an anti-platelet). The BNF and other textbooks recommend stopping it 7-14 days prior to surgery unless it is needed for anti-platelet reasons. So that case may be a little interesting anyway. When I went to meet that patient, who is having an aortic valve replacement, and potentially a CABG - the consent sheet and referral letter said different things! - I had a listen to her chest and the murmur was really loud and obviously diastolic. Even the SHO said it was one of the best she had heard.
Tuesday, July 17, 2007
Elective - day 1
Phew. Today went well - I found the place, with many police outside, which surprised me at first.
My supervisor is very helpful and helped me find scrubs etc and then get sorted. I got to see 3 operations , mostly plastic surgery today and I get to see a variety of different anaesthetic environments this week - Maternity, cardiac Surgery and ICU.
The SpR I spent a large chunk of the day with was very helpful, explaining what they monitored and how, and why some of the values were still normal, even though in an awake person they would be considered very high. he also explained the 3 main classes of drugs used, and how they affect the body and why they affect you and wear off at different rates. He also guided me through the many tubes and masks that are available and some of the situations in which you would use each one and why.
We also got to see a medical emergency. walking through recovery, one of the patients was gasping for breath and making groaning noises - Stridor - which is when the airway is obstructed or narrowed, and the patient can't get enough air into the lungs. this obviously makes them a bit panicky, since they are only just coming round from the operation anyway. The patient was given an injection of a steroid to reduce any inflammation that was blocking the airway, and also inhaled some adrenaline which would achieve the same effect, tough for a much shorter time. Because the cause of the patient's stridor was not known, he was wheeled back round into an anaesthetic room, and had a fibre-optic probe put down his nose to check that there was no obstruction.
Today I also got my access all areas hospital ID card and discovered that the hospital is truly a maze and that you can get from A to B via C,D or E and that the theatre corridor connects them all.
My supervisor is very helpful and helped me find scrubs etc and then get sorted. I got to see 3 operations , mostly plastic surgery today and I get to see a variety of different anaesthetic environments this week - Maternity, cardiac Surgery and ICU.
The SpR I spent a large chunk of the day with was very helpful, explaining what they monitored and how, and why some of the values were still normal, even though in an awake person they would be considered very high. he also explained the 3 main classes of drugs used, and how they affect the body and why they affect you and wear off at different rates. He also guided me through the many tubes and masks that are available and some of the situations in which you would use each one and why.
We also got to see a medical emergency. walking through recovery, one of the patients was gasping for breath and making groaning noises - Stridor - which is when the airway is obstructed or narrowed, and the patient can't get enough air into the lungs. this obviously makes them a bit panicky, since they are only just coming round from the operation anyway. The patient was given an injection of a steroid to reduce any inflammation that was blocking the airway, and also inhaled some adrenaline which would achieve the same effect, tough for a much shorter time. Because the cause of the patient's stridor was not known, he was wheeled back round into an anaesthetic room, and had a fibre-optic probe put down his nose to check that there was no obstruction.
Today I also got my access all areas hospital ID card and discovered that the hospital is truly a maze and that you can get from A to B via C,D or E and that the theatre corridor connects them all.
Elective - Day 0
Hmm night before elective and the nerves are kicking in
Oh well I find out what the world of Anaesthetics is like in 8 hours, and I still haven't sorted most of my to do list from yesterday yet.
- Can I find it?
- Will he remember?
- What do I do with money keys phone etc?
- What money will I need for lockers?
- What hours will I be doing?
- Where will I be working?
- Will i have time for revision?
- What do I need to take with me?
Oh well I find out what the world of Anaesthetics is like in 8 hours, and I still haven't sorted most of my to do list from yesterday yet.
Tuesday, July 3, 2007
Year 4/5 timetable
They have moved the exams!!!!
Finals will now be in February/March 2009. This apparently allows time for resits, extra learning and health issues to be cleared up. This is good, since there had been suggestions that resits were to be removed from the final year.
We now also get a "Preparation for Practice" block to learn about FY1 year, assessment etc. However to pay for it, we only get 3 SSM's in years 4/5 before finals, with a further one after the exams.
Each teaching block now starts with a one-day academic day on campus with communication skills and clinical teaching. The idea apparently is to avoid interupting the on-site teaching blocks.
These changes also means that 9apart from resits) our formal programme ends on 22 May 2009, to be followed by 4 weeks of PRHO shadowing and Resits.
So our timetable is now (all blocks are 4 weeks long):
- 3 Medical blocks
- 3 Surgery blocks
- 2 SSM before Finals
- 1 Psychological medicine
- 1 Obs / Gyn
- 1 Child Health
- 1 GP
- one week academic week (8-14 December 07)
- 4 week elective in summer 08
In final year we also get a 4 week Christmas holiday, and a 3 week one in 4th year.
The exact order of blocks is laid out in 10 cohorts, each of which has its advantages and its disadvantages in terms of block timings - such as starting with an SSM in September 07; having both SSMs either side of Christmas 07; starting with Obs&Gyn; having GP just before finals in winter 2009; etc.
Tuesday, June 19, 2007
A mixed up day
Well my week of interspersed good and bad news continued. This is post 100 on my blog (what do you mean you weren't counting?!?!!)
SSM Presentation
Today was the last day of my SSM (I know it's only Tuesday) and today was essay deadline and a presentation to do. In typical me style this year, I started wroiting my essay on the PC about 10pm last night. I had done some of the reading and a fair of thinking about the essay, but hadn't really decided which aspect of "Severe hearing impairment and its management" I was going to address.
SSM Essay
About 2am, it hit me like a flash - kaboom - and I wrote about the communication strategies which are available for deaf children. I won't bore you with all the details suffice to say that it was stuff that was new to me and hence made a hopefully good essay. I finished editing the essay and inserting references about 9am (and had had a 40mins sleep) and then started the presentation, which only took me about 45 minutes to write, since it was fairly basic text and I had most of the essay facts in my head.
SSM Result
We went in at 2pm and did our presentations, and handed the essay in, At the end of the presentations, the consultant had a few questions for us and then told us that we had passed the SSM!!!!!! The actual SSM grade does depend on what he thought of the essay and presentation though. And that was before he had even looked at our essays. He then asked us a few more questions about the best/worst aspects of the SSM, and what we would like more of if he runs it in the future, and then we were free!!!! Third year finished*
* except for the elective and resists
Wednesday's travels
In a very typical move, I forgot to return my Hospital Library books and so, tomorrow before I go to see the Head of Year 3 to discuss my exam performance and see where I went wrong, I hav eto go in the opposite direction to drop the library book off, thus I get no lie in!!! I also need to collect a letter from the Uni to my elective supervisor and then meet Little miss P for Hot Chocolate on her day off (she doesn't do coffee or tea!), then I am through to Edinburgh for the start of a 4 and a bit day extravaganza of techie stuff in Glasgow, interspersed with some work shifts and a party on Friday night.
So my blogging may be a wee bit haphazard until Monday.
But first i am off to celebrate Cott's being open til 1 through the festival by sampling the Addlestones with Butcher boy!
Wednesday's travelsIn a very typical move, I forgot to return my Hospital Library books and so, tomorrow before I go to see the Head of Year 3 to discuss my exam performance and see where I went wrong, I hav eto go in the opposite direction to drop the library book off, thus I get no lie in!!! I also need to collect a letter from the Uni to my elective supervisor and then meet Little miss P for Hot Chocolate on her day off (she doesn't do coffee or tea!), then I am through to Edinburgh for the start of a 4 and a bit day extravaganza of techie stuff in Glasgow, interspersed with some work shifts and a party on Friday night.
So my blogging may be a wee bit haphazard until Monday.
But first i am off to celebrate Cott's being open til 1 through the festival by sampling the Addlestones with Butcher boy!
Saturday, June 2, 2007
Elective (3)
I met with my Elective supervisor today. It starts in mid-July to mid-August, and has teh following aims & objectives.
My Summer Uniform?
- The elective will concentrate on peri-operative care of the patient
- It will focus on:
- physiological optimistaion;
- fluid balance,
- Analgesia
- Strategies to reduce morbidity in relation to surgery.
The idea is that in the first 2 weeks I will spend time visiting various areas of the Anaesthetic world, and can then focus down for 2 weeks on an area that interests me.
My Summer Uniform?
Wednesday, May 2, 2007
Elective update (2)
At last, after firing off lots of emails, I have an offer of an elective, working with an anaesthesia team - it is nearby, and I have met the supervisor when he was a PBL facilitator, The one fly in the drink is that he is on holiday the first 3 weeks of the elective block, so my summer holiday will be split into 3 weeks between SSM and elective, and 2 weeks after, This also means that the Year 3 exam resits are in the last week of my elective!
Friday, April 27, 2007
Elective update
I wrote to my erstwhile elective supervisor expressing my disappointment at not getting a place with them, and tried another couple of options who all said, we can't take you because of A, B or C - all of which are very valid reasons. So over the weekend I shall go back to reading the list of where people have gone in the past, and sending off a load of emails.
Thursday, April 26, 2007
Elective falls through
As part of our course we do junior and senior electives which take place after the end of years 3 and 4. Each is 4 weeks long. For various reasons both these elective periods happen at the exact same time of year, so there is certain competition as 500 students all want electives in the same 8 week period.
Basically my plans have fallen through. I emailed my potential supervisor in February and was told "Yeah. it is fine, we will email you nearer the time"; well we now need to send a form to the Med School Office proving that we have a supervisor etc. This needs to be in by 1st May to give them 8 weeks to check details etc before we start the electives at the end of June. I emailed my erstwhile supervisor on Tuesday and today got a reply from one of his colleagues saying that they already had a student working with them, and I should have made my application earlier than the end of April. So clearly they have had some internal communication issues(!) Maybe I should have pushed earlier, harder etc.
So now I have Friday and Monday to organise a replacement elective, around ******** - can't afford 4 weeks anywhere expensive, since this is viewed as outline the teaching time and thus not eligible for Student Loan / Student Support. Thus I need to be able to keep on my part-time job at weekends / evening as well as being on elective 8-5, since the mortgage and food bills won;t pay themselves.
So I need to find a specialty, supervisor and project within 96 hours, get agreement, get the form filled in and returned to Faculty and all this while writing two 2,000 word essays about community-hospital interactions in the management of a patient i have studied, and revising for the written papers, and the OSCE's.
Ain't life great, excuse me while I go for a long walk off a short pier!
Basically my plans have fallen through. I emailed my potential supervisor in February and was told "Yeah. it is fine, we will email you nearer the time"; well we now need to send a form to the Med School Office proving that we have a supervisor etc. This needs to be in by 1st May to give them 8 weeks to check details etc before we start the electives at the end of June. I emailed my erstwhile supervisor on Tuesday and today got a reply from one of his colleagues saying that they already had a student working with them, and I should have made my application earlier than the end of April. So clearly they have had some internal communication issues(!) Maybe I should have pushed earlier, harder etc.
So now I have Friday and Monday to organise a replacement elective, around ******** - can't afford 4 weeks anywhere expensive, since this is viewed as outline the teaching time and thus not eligible for Student Loan / Student Support. Thus I need to be able to keep on my part-time job at weekends / evening as well as being on elective 8-5, since the mortgage and food bills won;t pay themselves.
So I need to find a specialty, supervisor and project within 96 hours, get agreement, get the form filled in and returned to Faculty and all this while writing two 2,000 word essays about community-hospital interactions in the management of a patient i have studied, and revising for the written papers, and the OSCE's.
Ain't life great, excuse me while I go for a long walk off a short pier!
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