Its the end of the first term of my first clinical year at Newastle University. Been exciting to get on the wards for the first time. Experience a close to full length day with nurses, junior doctors, core trainees and consultants in a variety of wards and departments. Different places, different people, different ward-based cultures.
And now as the Christmas break begins, its also a time to catch-up on society events planning - Academic Medicine Society, Haematology-Oncology Society and Emergency Medicine Society.
Each of these three societies have three distinct cultures.
Academic Medicine - A highly commited society committee with growing experience. A flexible President keen to empower other committee members.
Haematology-Oncology - A new society with lots of clinical year members. An easy-going President happy to support the plans of other committee members.
Emergency Medicine - An empire of a society that put on patient-based simulations every fortnight. A passionate committee that previously included later clinical year students now features many highly committed pre-clinical and early clinical students.
As a consequence of being involved in some societies and cultures is the importance of understanding your role. Your role as a leader and as a team player. Being able to switch mindset between the two in orderto meet the challenges of each society. In an aging society, cultivating enthusiasm. In a society with lots of new members, encouraging interaction. In a large powerful society, navigating sub-cultures within the society. These are all fluid challenges that require continued commitment.
Tuesday, 17 December 2019
Wednesday, 30 October 2019
9 Days in the Life
Its Reading Week! In seven years of university, never had anyhting life this. So why not return home - kick back and relax and run over some people on Grand Theft Auto V! And once we're happy with that, how about a time to reflect.
Monday 21st October 2019:
Its MOSLER day. Our first ever Modified Objective Structured Long Examination Review - just as daunting as it sounds. But to take-away my nerves before my 11am timeslot, I decided to head to the base ward - Elderly Care. Asked the doctor if he was a foundation doctor? He was a core medical doctor. Lesson #1: Don't assume the training level of a doctor. After that shaky introduction, felt comfortable looking at patient notes, X-rays and blood results. Just remember structured frameworks and we'll be more fluent in reporting results.
11am. The time has come. Sprint upstairs to meet my patient and examiner. History was going strongly - a couple of repeated questions but more to help lock-in my differential diagnoses. Examination was about to kick-off before a member of the nursing team pops in to say 'We're ready for your ultrasound.' And lights out - MOSLER over. Examiner explains the examination findings and we're off for our debrief.
How did I do? Well, I whiffed completely on the patient diagnosis - only one symptom was present - shortness of breath worsening over four weeks. Asthma? Right-sided HF? But a core condition that could present in this way could be a sub-massive PE. That was the patient. Hard luck for my first MOSLER. Great learning experience to focus on the core presenting symptom and branch out from there. Consider conditions that need to be ruled out before steam-rolling your way to a finite diagnosis.
Tuesday 22nd October 2019:
More patient circuits! Myasthenia gravis.Transient Ischaemic Attack. Stroke. Eye diseases. Multiple sclerosis. All presented in ways you might expect but pleasing to pick up on these diseases - even if examiner questioning did prompt a slight re-ranking of differential diagnoses.
In the afternoon, headed back to the Elderly Care ward to spend more time improving my diagnostic, examination and clinical reasoning skills. Visited a patient with neutropenic sepsis - confirmed to AML after a MDT meeting. Patient was yet to be told but will be soon once acute symptoms subside. Timing is crucial.
Wednesday 23rd October 2019:
GP visit! Met a patient with an extensive history of being systematically unwell - shortness of breath, cramping abdominal pain, burning on urination, back pain moving to the flanks. Possible pyelonephritis, persistent STI, renal colic. Routine Bloods, Ultrasound, Chest X-Ray - all ordered for her as an outpatient. A complete constellation of symptoms - further confirming the diversity of how patients present.
Thursday 24th October 2019:
Simulations Day! 'Please take a history from this patient in AMU.' There must be a catch here. There's no way we're taking a history from a patient for a full simulation. Instantly when we walk in, it's a tonic-clonic seizure. Oxygen, start the clock, manage the airway, find protocols / IV lorazepam / PR diazepam / phone a relevant senior. Handled the emergency well. Credit to the team here - airway was so well-managed. Made my job as the end of the bed inspector fluid. Other stations were headache, stroke, meningococcal septicaemia - not too challenging overall.
Friday 25th October 2019:
Last day of Essentials Block! Clinical teaching fellows are excited because we're playing articulate. Of course, its articulating various types of eplileptic seizure. Great end to a great start to the 3rd year.
Saturday 26th October 2019:
Edinburgh University Oncology Society Conference Day! Only around 15 in attendance but presenters were highly engaging and informative. Midday - presented my poster on machine learning classification on patients with a high-risk of tumour relapse subtype of ALL. Went smoothly - zero questions. In the afternoon, time to present my work as an oral presentation. A key question - that must be expected with bioinformatics-based projects is - 'what is the principal focus of the project moving forward.' Afterwards, I find out I'm the only oral presenter - the other two pulled out. Perhaps they were ill? Perhaps I was the only presenter to submit as an oral presenter? Perhaps they saw my project title and were put off? Either way, I'm walking home with the Oral Presentation Winner prize with a celebratory KFC in hand.
Sunday 27th October 2019:
Night shift back in A&E Epsom as an HCA. After my last shift over December on the wards, its great to be back and see some familiar faces. Also great to have a full team available, the difference it makes made the night run very smoothly. Not too many patients but the patients were handled smoothly and effectively. Pleased with how my first night shift went - great practise for life as a junior doctor in two and half years time.
Monday 28th October 2019:
Recovery day. A well-earned roast for dinner.
Tuesday 29th October 2019:
News comes rolling in.
I am writing to let you know that the judges have now assessed the entries for this year’s Paola Domizio Undergraduate Essay Prize.
Could it be? My midnight four hour piece to win the essay prize?
Unfortunately, your essay has not been selected as the winner for this year’s competition.
Not too disappointing really. I knew the essay was a last minute job but I was happy with the output in that timeframe. Previous failures - missing expectations in January exams, NSAMR ambassador role in 2018 have been overcome. This will be one to return to.
Monday 21st October 2019:
Its MOSLER day. Our first ever Modified Objective Structured Long Examination Review - just as daunting as it sounds. But to take-away my nerves before my 11am timeslot, I decided to head to the base ward - Elderly Care. Asked the doctor if he was a foundation doctor? He was a core medical doctor. Lesson #1: Don't assume the training level of a doctor. After that shaky introduction, felt comfortable looking at patient notes, X-rays and blood results. Just remember structured frameworks and we'll be more fluent in reporting results.
11am. The time has come. Sprint upstairs to meet my patient and examiner. History was going strongly - a couple of repeated questions but more to help lock-in my differential diagnoses. Examination was about to kick-off before a member of the nursing team pops in to say 'We're ready for your ultrasound.' And lights out - MOSLER over. Examiner explains the examination findings and we're off for our debrief.
How did I do? Well, I whiffed completely on the patient diagnosis - only one symptom was present - shortness of breath worsening over four weeks. Asthma? Right-sided HF? But a core condition that could present in this way could be a sub-massive PE. That was the patient. Hard luck for my first MOSLER. Great learning experience to focus on the core presenting symptom and branch out from there. Consider conditions that need to be ruled out before steam-rolling your way to a finite diagnosis.
Tuesday 22nd October 2019:
More patient circuits! Myasthenia gravis.Transient Ischaemic Attack. Stroke. Eye diseases. Multiple sclerosis. All presented in ways you might expect but pleasing to pick up on these diseases - even if examiner questioning did prompt a slight re-ranking of differential diagnoses.
In the afternoon, headed back to the Elderly Care ward to spend more time improving my diagnostic, examination and clinical reasoning skills. Visited a patient with neutropenic sepsis - confirmed to AML after a MDT meeting. Patient was yet to be told but will be soon once acute symptoms subside. Timing is crucial.
Wednesday 23rd October 2019:
GP visit! Met a patient with an extensive history of being systematically unwell - shortness of breath, cramping abdominal pain, burning on urination, back pain moving to the flanks. Possible pyelonephritis, persistent STI, renal colic. Routine Bloods, Ultrasound, Chest X-Ray - all ordered for her as an outpatient. A complete constellation of symptoms - further confirming the diversity of how patients present.
Thursday 24th October 2019:
Simulations Day! 'Please take a history from this patient in AMU.' There must be a catch here. There's no way we're taking a history from a patient for a full simulation. Instantly when we walk in, it's a tonic-clonic seizure. Oxygen, start the clock, manage the airway, find protocols / IV lorazepam / PR diazepam / phone a relevant senior. Handled the emergency well. Credit to the team here - airway was so well-managed. Made my job as the end of the bed inspector fluid. Other stations were headache, stroke, meningococcal septicaemia - not too challenging overall.
Friday 25th October 2019:
Last day of Essentials Block! Clinical teaching fellows are excited because we're playing articulate. Of course, its articulating various types of eplileptic seizure. Great end to a great start to the 3rd year.
Saturday 26th October 2019:
Edinburgh University Oncology Society Conference Day! Only around 15 in attendance but presenters were highly engaging and informative. Midday - presented my poster on machine learning classification on patients with a high-risk of tumour relapse subtype of ALL. Went smoothly - zero questions. In the afternoon, time to present my work as an oral presentation. A key question - that must be expected with bioinformatics-based projects is - 'what is the principal focus of the project moving forward.' Afterwards, I find out I'm the only oral presenter - the other two pulled out. Perhaps they were ill? Perhaps I was the only presenter to submit as an oral presenter? Perhaps they saw my project title and were put off? Either way, I'm walking home with the Oral Presentation Winner prize with a celebratory KFC in hand.
Sunday 27th October 2019:
Night shift back in A&E Epsom as an HCA. After my last shift over December on the wards, its great to be back and see some familiar faces. Also great to have a full team available, the difference it makes made the night run very smoothly. Not too many patients but the patients were handled smoothly and effectively. Pleased with how my first night shift went - great practise for life as a junior doctor in two and half years time.
Monday 28th October 2019:
Recovery day. A well-earned roast for dinner.
Tuesday 29th October 2019:
News comes rolling in.
I am writing to let you know that the judges have now assessed the entries for this year’s Paola Domizio Undergraduate Essay Prize.
Could it be? My midnight four hour piece to win the essay prize?
Unfortunately, your essay has not been selected as the winner for this year’s competition.
Not too disappointing really. I knew the essay was a last minute job but I was happy with the output in that timeframe. Previous failures - missing expectations in January exams, NSAMR ambassador role in 2018 have been overcome. This will be one to return to.
Sunday, 6 October 2019
Week in the Life
Monday
Its Monday quiz time! Fared better than the GI quiz two weeks ago. Pleased with my performance. Skin condition management is still blurry. Will improve this soon!
Clinical skills in the afternoon features subcutaneous and intramuscular injections as well as a good old return to catheter preparation. Both were rather solid. Feeling better about my aseptic technique. Still one to practice on dummies rather than patients at this stage!
Midnight tonight is the deadline for the Pathology Society essay. With a bare-bones plan and grand total of 0 words, its time to sprint off to the Walton Library for any book inspiration (sadly none) before a downtown trip to the University Study Rooms with a bottle of Summer Fruits Oasis. The 1,000 word essay was complete 40 minutes before the deadline. This essay was really good practise for a change in my writing style - becoming more descriptive, fluent and easy to read. Avoiding hefty jargon and sticking to the expectations of what's being asked of you. This was a fulfilling essay to write. With more dedicated time, very assured I will be able to be really competitive in academic writing.
Tuesday
Patient circuit is lively. Knees, spines, hands, shoulders. My patient was extremely reticent but that provided me a really good challenge. Patient presented apparently asymptomatically with no real concerns. If you don't have rapport with someone, how do you respond? Looking back thinking about a clear opening question - please do tell me about your diagnosis / recent medical problem would help set the tone. If cancer, a question on any recent concerns about a diagnosis / medical condition that you may have?
This patient had metastatic cancer. Thinking openly, focusing the conversation precisely if off-target and assuming nothing. This was a great consultation in being fundamentally sound - not looking for a diagnosis but a picture.
Knee exam needs work. Simply explanation for this is just to practise patient movements.
Wednesday
Dermatology pictures in the GP! I thoroughly loved this - flicking through slideshow pictures of skin conditions - describing it and coming up with spot diagnoses. Very enjoyable.
Met a patient with eczema leading to persistent pain, itching and discomfort. Previous lines of treatment provided short-term respite but impacting his life, adding to stress. Certainly skin conditions have the capacity to make people feel extremely vulnerable and insecure but in this patient, just feel frustrated. Assessing the difference, managing expectations from a GP consultation is something I enjoyed from this. Perhaps providing a more optimistic tone through the dermatologist referral would help.
Sat in a multidisciplinary team meeting on end of life care of patients with cancer. The GP lead with a roundtable of caring nurses all were very succinct in their delivery, had clear expectations and clear direction provided by the GP made this meeting extremely slick. Is this an insight into MDTs? Highly enjoyable.
Thursday
Dermatology clinics and quizzes! This was also an occasion where going off-script on the pre-reading and looking at diseases through my own resources thoroughly helped me prepare for the slideshows and quizzes. I felt really prepared and comfortable to nail the quizzes. First round, I was explaining the condition far too slowly - did not anticipate the speed required. By the second round, I was flying through describing the conditions. With greater confidence, comes greater execution, comes greater speed.
Edinburgh Oncology Society accept my abstract (Summer Research Project in Machine Learning and AI) for an oral and poster presentation in October! My first time presenting and looking forward to it!
On Reddit, I spot an opportunity to apply for an FIA Sid Watkins Scholarship. With each of his two biographies on both bedside tables, this is a very exciting opportunity to throw my name at. What is extremely motivating is to see previous scholars perform so strongly and to see them making a real impact in their fields. Translating Machine Learning into biometric data / baseline quantitative concussion analysis possibly?
Canteen food of sausages, beans and bacon was a delightful mid-clinic reward!
Friday
SBA and WRISKE questions. Felt nervous for these SBA questions once again but performed well. Even in the tougher questions, I did feel fulfilling to know that I had previous notes on these areas. Everything is in the ballpark now.
WRISKE still requires more practice. Making sensible and logical adjustments to pain management, detecting and explaining X-ray key terms e.g. subchondral cysts and making sure details e.g. contact details and reports are correctly filled in.
KFC with the boys was a great reward
Saturday
Very relaxing Saturday back home. A trip to the Golf Range, Kingston, Lamb Schwarma, watching the footie (Milner with a last-minute penalty!) and a 15 minute run with a great home-made Lasagna. Little bit of casual GTA 5 and Strictly Come Dancing as well. A real transition phase in the life of me!
Sunday
More big news! I've been accepted as the NSAMR Ambassador for Newcastle for this academic year! Very, very fulfilling after being unsuccessful the year prior! What a difference a year makes - a few tweaks on the application and we're in business!
Only downside? NSAMR AGM date is the 26th October. When is the Edinburgh Oncology Conference. Yep, it's the same date. Will need some advice on this one.
Train back North. Spent an hour in King's Cross flicking through musculoskeletal arthritis notes. After grabbing the classic Smoked Ham and Emmental Cheese Boots Sandwich, its train time.
Back in Durham. Completed going through my Cardiovascular, Respiratory and GI core conditions for Monday's OSCE circuit! Little bit of examination preparation too. All set for tomorrow!
Its Monday quiz time! Fared better than the GI quiz two weeks ago. Pleased with my performance. Skin condition management is still blurry. Will improve this soon!
Clinical skills in the afternoon features subcutaneous and intramuscular injections as well as a good old return to catheter preparation. Both were rather solid. Feeling better about my aseptic technique. Still one to practice on dummies rather than patients at this stage!
Midnight tonight is the deadline for the Pathology Society essay. With a bare-bones plan and grand total of 0 words, its time to sprint off to the Walton Library for any book inspiration (sadly none) before a downtown trip to the University Study Rooms with a bottle of Summer Fruits Oasis. The 1,000 word essay was complete 40 minutes before the deadline. This essay was really good practise for a change in my writing style - becoming more descriptive, fluent and easy to read. Avoiding hefty jargon and sticking to the expectations of what's being asked of you. This was a fulfilling essay to write. With more dedicated time, very assured I will be able to be really competitive in academic writing.
Tuesday
Patient circuit is lively. Knees, spines, hands, shoulders. My patient was extremely reticent but that provided me a really good challenge. Patient presented apparently asymptomatically with no real concerns. If you don't have rapport with someone, how do you respond? Looking back thinking about a clear opening question - please do tell me about your diagnosis / recent medical problem would help set the tone. If cancer, a question on any recent concerns about a diagnosis / medical condition that you may have?
This patient had metastatic cancer. Thinking openly, focusing the conversation precisely if off-target and assuming nothing. This was a great consultation in being fundamentally sound - not looking for a diagnosis but a picture.
Knee exam needs work. Simply explanation for this is just to practise patient movements.
Wednesday
Dermatology pictures in the GP! I thoroughly loved this - flicking through slideshow pictures of skin conditions - describing it and coming up with spot diagnoses. Very enjoyable.
Met a patient with eczema leading to persistent pain, itching and discomfort. Previous lines of treatment provided short-term respite but impacting his life, adding to stress. Certainly skin conditions have the capacity to make people feel extremely vulnerable and insecure but in this patient, just feel frustrated. Assessing the difference, managing expectations from a GP consultation is something I enjoyed from this. Perhaps providing a more optimistic tone through the dermatologist referral would help.
Sat in a multidisciplinary team meeting on end of life care of patients with cancer. The GP lead with a roundtable of caring nurses all were very succinct in their delivery, had clear expectations and clear direction provided by the GP made this meeting extremely slick. Is this an insight into MDTs? Highly enjoyable.
Thursday
Dermatology clinics and quizzes! This was also an occasion where going off-script on the pre-reading and looking at diseases through my own resources thoroughly helped me prepare for the slideshows and quizzes. I felt really prepared and comfortable to nail the quizzes. First round, I was explaining the condition far too slowly - did not anticipate the speed required. By the second round, I was flying through describing the conditions. With greater confidence, comes greater execution, comes greater speed.
Edinburgh Oncology Society accept my abstract (Summer Research Project in Machine Learning and AI) for an oral and poster presentation in October! My first time presenting and looking forward to it!
On Reddit, I spot an opportunity to apply for an FIA Sid Watkins Scholarship. With each of his two biographies on both bedside tables, this is a very exciting opportunity to throw my name at. What is extremely motivating is to see previous scholars perform so strongly and to see them making a real impact in their fields. Translating Machine Learning into biometric data / baseline quantitative concussion analysis possibly?
Canteen food of sausages, beans and bacon was a delightful mid-clinic reward!
Friday
SBA and WRISKE questions. Felt nervous for these SBA questions once again but performed well. Even in the tougher questions, I did feel fulfilling to know that I had previous notes on these areas. Everything is in the ballpark now.
WRISKE still requires more practice. Making sensible and logical adjustments to pain management, detecting and explaining X-ray key terms e.g. subchondral cysts and making sure details e.g. contact details and reports are correctly filled in.
KFC with the boys was a great reward
Saturday
Very relaxing Saturday back home. A trip to the Golf Range, Kingston, Lamb Schwarma, watching the footie (Milner with a last-minute penalty!) and a 15 minute run with a great home-made Lasagna. Little bit of casual GTA 5 and Strictly Come Dancing as well. A real transition phase in the life of me!
Sunday
More big news! I've been accepted as the NSAMR Ambassador for Newcastle for this academic year! Very, very fulfilling after being unsuccessful the year prior! What a difference a year makes - a few tweaks on the application and we're in business!
Only downside? NSAMR AGM date is the 26th October. When is the Edinburgh Oncology Conference. Yep, it's the same date. Will need some advice on this one.
Train back North. Spent an hour in King's Cross flicking through musculoskeletal arthritis notes. After grabbing the classic Smoked Ham and Emmental Cheese Boots Sandwich, its train time.
Back in Durham. Completed going through my Cardiovascular, Respiratory and GI core conditions for Monday's OSCE circuit! Little bit of examination preparation too. All set for tomorrow!
Tuesday, 16 July 2019
Fear of Failure
We are officially two-thirds into this nine year projected voyage through university. That means just three years left to complete some goals. The next one - a first author publication.
Simply what a time to be doing some summer research. Navigating my through datasets, near identical in structure to when this journey began back in 2013-14. Since then, the methods to tackle the data are more developed and more methods are more available. Simply, more avenues of attack. More excitement. More expectation. More of a chance to finally convert this opportunity.
It all begins with an abstract and ends with a disclosure of conflicting interests. I have none.
Nine years at university with no first-author publication. That will not be me.
Simply what a time to be doing some summer research. Navigating my through datasets, near identical in structure to when this journey began back in 2013-14. Since then, the methods to tackle the data are more developed and more methods are more available. Simply, more avenues of attack. More excitement. More expectation. More of a chance to finally convert this opportunity.
It all begins with an abstract and ends with a disclosure of conflicting interests. I have none.
Nine years at university with no first-author publication. That will not be me.
Wednesday, 26 June 2019
Year 2 Results
Two weeks late but with a good reason!
Passed.
Ranked 234/422
10 OSCE Stations passed.
Great sight to see! New record highs in OSCE, SBA and Coursework has definitely been pleasing. A drop in SAP is possibly a reflection of a greater commitment to the SBA (weighted more).
A tough year. That is another takeaway. A rise from mid-pack to the top ranked students requires a real plan at the start of the year. A plan that is an evolution from the previous year. Learning this has been tough to take but I'm glad I've taken it.
Throughout the second half, I felt that this year was really about commitment. How badly do you want it. Across all my years at university, you really have to get out of bed every morning feeling like there is nowhere else I would rather be.
And for the reason why this is two weeks late:
After those long January mornings, hunger is running high. Late June and its a very mild Summer Evening. Summer Research Project is two weeks in. Lots of plots, lots of preparation and lots more to learn. This level of hunger really is very similar to my first Summer Research Project in Plymouth '13. Back then, I was a passenger - developing my project under the direct guidance of a supervisor. This time, I'm the driver - developing my project independently with assistance of supervisors. More responsibility. More devotion. More care required.
Seeing how badly things have fallen to rescuing my ranking is pleasing but more can definitely come.
For now, bed for an early start to prepare my data presentations!
Passed.
Ranked 234/422
10 OSCE Stations passed.
Great sight to see! New record highs in OSCE, SBA and Coursework has definitely been pleasing. A drop in SAP is possibly a reflection of a greater commitment to the SBA (weighted more).
A tough year. That is another takeaway. A rise from mid-pack to the top ranked students requires a real plan at the start of the year. A plan that is an evolution from the previous year. Learning this has been tough to take but I'm glad I've taken it.
Throughout the second half, I felt that this year was really about commitment. How badly do you want it. Across all my years at university, you really have to get out of bed every morning feeling like there is nowhere else I would rather be.
And for the reason why this is two weeks late:
After those long January mornings, hunger is running high. Late June and its a very mild Summer Evening. Summer Research Project is two weeks in. Lots of plots, lots of preparation and lots more to learn. This level of hunger really is very similar to my first Summer Research Project in Plymouth '13. Back then, I was a passenger - developing my project under the direct guidance of a supervisor. This time, I'm the driver - developing my project independently with assistance of supervisors. More responsibility. More devotion. More care required.
Seeing how badly things have fallen to rescuing my ranking is pleasing but more can definitely come.
For now, bed for an early start to prepare my data presentations!
Thursday, 16 May 2019
End of Y2
With sincere apologies for the delay, please find attached a letter outlining the outcome of your Research Scholarship application.
Brilliant. A pit of sheer despair in my stomach. I have to read a letter of rejection now. But....
The Panel was impressed with your application and consequently has decided to offer you a Research Scholarship for your project entitled: “Classification of Patients with Acute Lymphoblastic Leukaemia into Clinically Applicable Genetic Subgroups through Machine Learning Enabling Delivery of Precision Medicine”
The show goes on! For the first time since 2014, we have a Summer Research Scholarship!
Ever since those January results, it's been a really tough five months. A lot of pensive moments of:
- Is this as good as it gets for me? Am I just set out for clinical work? Can I be an academic oncologist? Am I good enough to be a research student again?
But you turn up to lectures each day, get your notes done. Take a quiet study room over a group study room. Practice your OSCEs nearly every day in Easter. Condense and synthesise your notes. Address your society commitments - Emergency Medicine and Academic Medicine (Conference went well!). Maybe, just maybe, your Summer Research Project application gets accepted. And lo and behold, we are back!
Its a bright sunny day in Newcastle - summer is truly here!
OSCEs have also just rounded-up and here are my uber-quick thoughts:
Day 1:
1/10 - Hand Exams
Felt fluid. Covered the major bases before failing to do a Phalen Test! Examiner said 'Well-done' at the end. What a jokester.
2/10 - Information-Giving to a Mother with a Child with Viral Ear Infection requesting Antibiotics
Quite straight-forward to explain that antibiotics aren't recommended at all for viral infections. Six minutes is a long time so easy to waffle (guilty!) but overall managed to address concerns of the patient's mother.
3/10 - Cranial Nerves (except Eyes + Ears) Exam
This is a tip. Assume the volunteer is a patient not healthy. Covered all the major nerve components and concluded the station. Job done? No, just before the end I asked the patient if her loss of smell was real. Turns out she was a patient. Oh dear.
4/10 - Lower Leg Swelling History
Covered this well as I could have (given my very open questions leading to lengthy verbose replies). A slightly too focused family history may cost me.
5/10 - Blood Pressure
The sound of Korotkoff sounds was simply music to my ears. Remember to write the date of the BP.
Day 2:
6/10 - Sexual History of Vaginal History
Empathy sensitivity and delivery critical with this one. Felt I covered those domains well (despite some slight day two first station nerves!).
7/10 - Breast Exam
Another highly sensitive station. I felt I covered this well.
8/10 - GI Exam
Time was tight for this one! Inspection was lengthy but comprehensive. It was a race to finish on time and I did not quite manage to squeeze in our post-examination recommendations. Good otherwise.
9/10 - Headache History
A lot of systemic symptoms to get through beyond the headache and general symptoms. Felt I managed the best I could. Oh yeah and listen to the patient. They'll tell you a lot more that may tick further boxes.
10/10 - CPR
With work on my oxygen delivery technique, I think we'll be okay with this one in the future.
And that wraps up second year! Results in just under a month. Clinical placements start next week in North Durham (lots of new people to meet!).
Even better days are still ahead!
Brilliant. A pit of sheer despair in my stomach. I have to read a letter of rejection now. But....
The Panel was impressed with your application and consequently has decided to offer you a Research Scholarship for your project entitled: “Classification of Patients with Acute Lymphoblastic Leukaemia into Clinically Applicable Genetic Subgroups through Machine Learning Enabling Delivery of Precision Medicine”
The show goes on! For the first time since 2014, we have a Summer Research Scholarship!
Ever since those January results, it's been a really tough five months. A lot of pensive moments of:
- Is this as good as it gets for me? Am I just set out for clinical work? Can I be an academic oncologist? Am I good enough to be a research student again?
But you turn up to lectures each day, get your notes done. Take a quiet study room over a group study room. Practice your OSCEs nearly every day in Easter. Condense and synthesise your notes. Address your society commitments - Emergency Medicine and Academic Medicine (Conference went well!). Maybe, just maybe, your Summer Research Project application gets accepted. And lo and behold, we are back!
Its a bright sunny day in Newcastle - summer is truly here!
OSCEs have also just rounded-up and here are my uber-quick thoughts:
Day 1:
1/10 - Hand Exams
Felt fluid. Covered the major bases before failing to do a Phalen Test! Examiner said 'Well-done' at the end. What a jokester.
2/10 - Information-Giving to a Mother with a Child with Viral Ear Infection requesting Antibiotics
Quite straight-forward to explain that antibiotics aren't recommended at all for viral infections. Six minutes is a long time so easy to waffle (guilty!) but overall managed to address concerns of the patient's mother.
3/10 - Cranial Nerves (except Eyes + Ears) Exam
This is a tip. Assume the volunteer is a patient not healthy. Covered all the major nerve components and concluded the station. Job done? No, just before the end I asked the patient if her loss of smell was real. Turns out she was a patient. Oh dear.
4/10 - Lower Leg Swelling History
Covered this well as I could have (given my very open questions leading to lengthy verbose replies). A slightly too focused family history may cost me.
5/10 - Blood Pressure
The sound of Korotkoff sounds was simply music to my ears. Remember to write the date of the BP.
Day 2:
6/10 - Sexual History of Vaginal History
Empathy sensitivity and delivery critical with this one. Felt I covered those domains well (despite some slight day two first station nerves!).
7/10 - Breast Exam
Another highly sensitive station. I felt I covered this well.
8/10 - GI Exam
Time was tight for this one! Inspection was lengthy but comprehensive. It was a race to finish on time and I did not quite manage to squeeze in our post-examination recommendations. Good otherwise.
9/10 - Headache History
A lot of systemic symptoms to get through beyond the headache and general symptoms. Felt I managed the best I could. Oh yeah and listen to the patient. They'll tell you a lot more that may tick further boxes.
10/10 - CPR
With work on my oxygen delivery technique, I think we'll be okay with this one in the future.
And that wraps up second year! Results in just under a month. Clinical placements start next week in North Durham (lots of new people to meet!).
Even better days are still ahead!
Monday, 4 February 2019
Two Weeks Later
The sun is out. Springtime in Newcastle has never seemingly looked so good in early February.
A relaxing weekend back home also included a trip back to Cambridge to visit the old stomping grounds - Wolfson Court. Sadly, it is in a early stage of disrepair after losing down just after we all left. Three of the Girton Boys are motoring on with PhDs, two are in employment and one is at Medical School (me). PhD students have the unique responsibility of supervising young undergraduate students. From this, it was insightful to appreciate that students can come up with perspectives that are different to the supervisor. These perspectives come from a deeper understanding of the topic area - not simply regurgitating slide material. Over the last five and a half years of university, I have been guilty of this. Taking material, revising material and synthesising material into a mental model or carefully crafted essay has been my staple. Taking a step back and thinking about the deeper reasons for why situations are occuring in the way in which they are is an area I have not particularly thought about - providing time for yourself.
Something to think about in the future.
A relaxing weekend back home also included a trip back to Cambridge to visit the old stomping grounds - Wolfson Court. Sadly, it is in a early stage of disrepair after losing down just after we all left. Three of the Girton Boys are motoring on with PhDs, two are in employment and one is at Medical School (me). PhD students have the unique responsibility of supervising young undergraduate students. From this, it was insightful to appreciate that students can come up with perspectives that are different to the supervisor. These perspectives come from a deeper understanding of the topic area - not simply regurgitating slide material. Over the last five and a half years of university, I have been guilty of this. Taking material, revising material and synthesising material into a mental model or carefully crafted essay has been my staple. Taking a step back and thinking about the deeper reasons for why situations are occuring in the way in which they are is an area I have not particularly thought about - providing time for yourself.
Something to think about in the future.
Monday, 21 January 2019
Highs and New Lows
New Year. New decisions.
Assignment 1: 89%
Short Answer Paper: 59% - 389th out of 421 students.
Single Best Answer Paper: 59% - 320th out of 419 students.
We're making real progress in coursework from first year. A huge improvement in coursework mark from thinking through feedback from last year's essay. This was a fulfilling mark as the key area I needed to improve in was clear:
- Critical analysis of papers by reflecting on limitations > broad over-arching review giving yourself an opportunity to give your own opinion.
Reflecting on Limitations.
My exam results have set new lows for my ranking within the cohort. Reflecting on limitations is crucial and after employing notes per learning outcome and flashcards with the aim of boosting my long-term retention of pre-clinical material, I have seen large drops in my Single Best Answer Paper mark. This is reflective of a huge shift (after my January exams last year) in my learning style from repetitive memorisation of models by writing and condensing during Biomedical Science to revising a series of key facts.
During both exams, I felt unable to draw upon experience of thinking through a problem I've not seen explicitly seen before because I had not learnt the material as a model but rather a fact. Learning material as model first rather than fact first is reflective of my learning style as an Abstract Learner. As someone who learns through experience and generating a visual model during my Biomedical Science days rather than someone who remembers concrete facts and builds knowledge through a series of defined principles, I have appreciated this much more now.
Knowing what it took to get here and understanding various learning methods and how they apply to my strengths has been vital. Focusing on my core learning skills will help me right the path I'm on.
For now: A Charity Pub Quiz to prepare for! [Very Abstract!]
Assignment 1: 89%
Short Answer Paper: 59% - 389th out of 421 students.
Single Best Answer Paper: 59% - 320th out of 419 students.
We're making real progress in coursework from first year. A huge improvement in coursework mark from thinking through feedback from last year's essay. This was a fulfilling mark as the key area I needed to improve in was clear:
- Critical analysis of papers by reflecting on limitations > broad over-arching review giving yourself an opportunity to give your own opinion.
Reflecting on Limitations.
My exam results have set new lows for my ranking within the cohort. Reflecting on limitations is crucial and after employing notes per learning outcome and flashcards with the aim of boosting my long-term retention of pre-clinical material, I have seen large drops in my Single Best Answer Paper mark. This is reflective of a huge shift (after my January exams last year) in my learning style from repetitive memorisation of models by writing and condensing during Biomedical Science to revising a series of key facts.
During both exams, I felt unable to draw upon experience of thinking through a problem I've not seen explicitly seen before because I had not learnt the material as a model but rather a fact. Learning material as model first rather than fact first is reflective of my learning style as an Abstract Learner. As someone who learns through experience and generating a visual model during my Biomedical Science days rather than someone who remembers concrete facts and builds knowledge through a series of defined principles, I have appreciated this much more now.
Knowing what it took to get here and understanding various learning methods and how they apply to my strengths has been vital. Focusing on my core learning skills will help me right the path I'm on.
For now: A Charity Pub Quiz to prepare for! [Very Abstract!]
Subscribe to:
Posts (Atom)