The End Of My Year As A Clinical Teaching Fellow

I’ve been telling everyone I know who is currently during their foundation training (FY1/FY2) and considering taking a year out after F2 to definitely do it. F3 allllllll the way!

This year for me has probably been my favourite year as a doctor, because I was very lucky to be able to create my dream job – combining ward work on AMU, with two days a week of medical student teaching, as well as working with the Improvement Team to help the Trust and medical school support ethnic minorities more. I even had half a day of study time a week for PGCert work that was fully funded as part of my role too, what an absolute dream!

Being a CTF has made me realise that I want a career that allows me to be as flexible as this year has been, and that is one of the many reasons why I want to be a GP, but a separate post on the next stage of my training will be coming soon…

I am so so grateful for the opportunities I’ve had this year, and I’m so proud of all we’ve achieved. Some highlights from this term:

• Launching a cookbook with contributions from staff to celebrate the diversity of our Trust, as well as support local businesses that sell the ingredients mentioned in the recipes. Proceeds from the cookbook will support the local hospital charity, and the aim going forward is for the cookbook to be included as part of a welcome pack for trainees who rotate to the Trust. Induction to a new role shouldn’t just be about the clinical aspects of it – new starters should also be welcomed to and introduced the local community.
• My Trust launching an online reporting system for racism, based on some of the experiences I shared.
• Saying goodbye to the students I’ve been teaching this year was sad, but I’m so so proud of how far my year 1s have come, and how much their confidence has grown with talking to patients. Definitely felt like a proud parent by the end!
• Passing my second PGCert assignment – YAY. Two modules down, one to go!
• Making progress with the two possible publications I’m working on with my supervisor and a professor at the university, hopefully more to come on this…
• Completing another quality improvement project on increasing the documentation of CURB65 scores for patients with community acquired pneumonia, to improve antibiotic prescription according to Trust guidelines. I presented our findings to the Pharmacy and Infectious Disease teams, which was definitely very intimidating, but it went okay!

And last but most certainly not least, getting my contract as a Honorary Lecturer at the medical school extended till 2024. Yupp you read right, 2024! This means that I will continue to help with the delivery of lectures on racism in healthcare for the health and society module. EXCITING TIMES.

So yeah, what a year. I’ve really enjoyed it and I feel so blessed that it was made possible, because this was definitely a miracle role that was put together for me, so all I have left to say is:

Attending My First Conferences In Person Since Becoming a Doctor

The Patient Safety Conference (my first time in Manchester!) was a lot of fun, and there were a lot of interesting talks, with my favourite being the one from a Cambridge Psychiatrist about their unit’s ‘autonomy’ approach to patients with personality disorders, and how it has increased life expectancy and led to reduced use of rapid tranquilisation/sedation. So so interesting and gave me a different perspective on how patients with PD can be managed.

Had to take a selfie to document my first in person conference, ofcourse:

The second conference this month was closer to home as it was hosted by the BAME Leadership Network at my Trust, and it was particularly special because my Trust has become one of the first in the country to launch a zero tolerance framework to address racism and discrimination towards staff.

It was quite emotional for me because I’ve been working with the BAME Network and Organisation Development team on this over the last two years (sharing my lived experiences to create educational resources, as well as facilitating sessions to hear from staff to help form the basis of the framework), so seeing it all coming together has really been an honour.

FY1 me could never have imagined my little talk on my personal experiences with racial microaggressions going this far, so it makes me very happy to know that my Trust is doing a lot more to educate, support, and take a clear stance re: repercussions for anyone who perpetuates racism or discrimination in any way; this will range from treatment being refused, to Police involvement, or even termination of employment if necessary.

The online reporting system will go live in a couple of weeks, as well as posters like these around the hospital to coincide with the launch:

Other Trusts around the area have started getting in contact with us to see how they can do something similar in their hospitals, so great! Feeling grateful and thanking God, always.

What To Do When a Patient Makes Racist Comments During a Teaching Session

I had my last medical student teaching session this week, and what a week it’s been!

For anyone who doesn’t know, I’ve been working as a Clinical Teaching Fellow this year, which has involved bedside teaching for medical students, in addition to clinical work on the ward. I’ve mainly taught first years, but also done some clinical skills teaching for 3rd years as well, and I’ve really enjoyed it.

I really wanted my final week of teaching to go as smoothly as the rest of the year has been, but sadly it was not meant to be. And it started off so well too. Sigh.

So what happened, you ask? Allow me elaborate.

Bedside teaching for medical students involves taking histories from and examining patients on the ward, usually in pairs or as a group of 4, and the patients are consented before to make sure it’s okay with them, which was the case with this patient.

The students started taking a history from the patient, with me observing and prompting them as necessary, and it was all going well until the patient started ranting about foreigners. It literally came out of nowhere, and then they went into a whole tirade about refugees and people coming into the country and it was just a xenophobic mess.

My first instinct was to get the students out of there ASAP, as the patient was saying some pretty awful things, and that was what I did. I interrupted the patient, telling them that what they were saying was absolutely not okay and we wouldn’t be listening to any more of it, and told the students we were leaving.

I then took them to a quiet part of the ward to check in with them properly, apologising for what they had just heard. As you can imagine they were pretty shocked and lost for words, but were glad that we left immediately, as they didn’t know that that was an option they had.

After informing the Consultant in charge of the patient’s comments, we returned to the medical school for a more indepth debrief, as this was the students’ first experience of a racist patient, and I would need to inform their head of year of what had happened, in case more support was needed later on. It was a LOT.

I had some really good discussions with students afterwards, as they wanted to know how common this was, and how I would have dealt with it if I was on my own and not teaching. I’ve not experienced overtly racist patients before, but I have had patients make inappropriate comments. It’s particularly tricky if they’re an elderly patient without capacity, because I’ve found people to be more sympathetic and willing to do something if the comments were made by a young/middle aged patient who “should know better.”

Each time, I made sure I escalated to my seniors and the nurse in charge as well, making it clear that I did not feel comfortable seeing that patient, and they were able to seen by another one of my colleagues. That is an ideal scenario that isn’t always the case unfortunately, as not every senior will be as sympathetic or even see anything wrong with what was said, and sometimes you might be the only doctor around so you HAVE to see the patient because of a duty of care. I’ve not experienced that yet though, so I guess I’ll have more to say on that if I ever do.

I ensured that the students knew that especially at their stage, they can leave if a patient makes upsetting comments, and that they will need to report it to the medical school afterwards. A lot of my work this year has involved training staff about how to support students and colleagues better when it comes to racial microaggressions and discrimination, so hopefully this will go on to give tutors more direction when it comes to calling out offensive comments and standing up for their students.

Another thing that’s important to add is that people on the receiving end of comments like these usually have to also deal with people making excuses for the perpetuators. Responses like “Oh they didn’t mean it that way,” or “They’ve just never been around ethnic minorities before,” or “That was okay in their day so they’re just ignorant, not racist” are very common. But whether or not their intention was malicious, the IMPACT is still the same, so the focus should always be on how the person affected feels. ALWAYS.

So yeah, it was an eventful end to my teaching year!

Reflecting On My Second Term As A Clinical Teaching Fellow

I’m watching High School Musical for the first time in nearly a year.

Anyone who follows this blog will know that HSM is my ‘comfort’ film, and I tend to watch it when I’m feeling low, so a minor setback from earlier today is what has led to me putting it on. I’m feeling better though, and The Keen One a.k.a. Kenny reminded me about why we fall, so onwards and upwards!

In other news, two terms down as a clinical teaching fellow – it’s really going by so fast! It won’t be long before I start GP training (more on where I’m going will be coming in another post), so trying to make the most of my final months as a CTF. So without further ado, here are some highlights from this term:

• Moving from being supervised by the Improvement Team to directly reporting to the Chief Medical Officer of the Trust. Definitely a lot more pressure because my new boss has very high expectations, but I’m enjoying it so far.
• Completing a quality improvement project aimed at improving awareness of junior doctors of where and how to report racist microaggressions and discrimination – I’ll be presenting the findings at a conference in May, exciting times!
• Helping to put together and deliver a new series of lectures for gateway and year 1 medical students on racism in healthcare, with the plan for this to be part of the curriculum going forward.
• Helping out with finals OSCEs and getting to be ‘The Voice,’ so fun!
• Ongoing work with the Organisation Development team to update the Trust’s zero tolerance framework re: racism – we’ll be launching an online reporting system soon and hopefully it’ll make it easier to report issues and for staff to get support.
• I got through the first module of my PGCert and remember that essay I was worried about? Feedback from it was so good that it’s now being considered for publication! #wethankGod
• Really enjoyed bedside teaching with my year 1 medical students – I also did some 2nd and 3rd year teaching this term and still feeling like a proud mother when I think of how far they’ve come.

So yeah overall it’s been a very busy but productive term, and I’m still so grateful that this year was made possible for me. All by the grace of God! The CTF team are such a great bunch, and working with them has been so much fun so far – students really do (and say) the darndest things…

Writing My First Essay in 4 Years

I’ve been very much MIA with this blog over the last couple of weeks, and to be fair I have been writing somewhere… who knew getting back into the swing of academic writing would be so much effort?

So the summative assignment for the first module of my PGCert is due in exactly 13 days, and I found out this week that I’ve forgotten how to Harvard reference. I always preferred it to Vancouver at uni, so getting told by my supervisor that the referencing in my first draft was wrong was definitely a sign that I’ve gotten a bit rusty. But I have 13 days to correct this so it should be fineeee… right?

I’m writing about microaggressions, a topic that I feel very passionately about, so I’ve actually been enjoying the essay writing process so far. With me having a less clinical role this year, I’ve been able to set atleast half a day a week for PGCert work, which has been very convenient. Here’s hoping it all comes together in time!

Other recent updates on the life of Tai:

• The deadline was GP application preferences was today, so I should be finding out where I’m going to for GP training in August very soon. EXCITING TIMES.
• I gave another lecture (for gateway students this time), and it was part of a longer 3 hour workshop that went really well.
• I did a locum ward cover shift and compared to the horrific oncalls I had during my Gastro and Psych rotations last year, it was very much a breeze. So I grudgingly agree that my F2 experiences made me better and quicker with doing ward jobs…
• Helped out with finals last week and got to be ‘The Voice’ announcing the start and end of stations as the students rotated round them – I definitely enjoyed getting into character!

• Got to do some simulation teaching for the first time yesterday, and getting to control SimMan was very fun.

Anyway, that’s about it with me for now. Back to this essay…

Junior Doctor Anecdotes: Patience Is A Virtue

I am not a morning person.

I don’t like early starts, and I don’t drink coffee, so it takes me a while to properly wake up. This means that it is best to avoid speaking to me until after 9 to 10am, because I am very cranky in the mornings. Because I am not a morning person.

However, there is a colleague of mine at work who doesn’t quite understand this, and not going to lie, it has been really annoying. You know when someone keeps talking to you and you’re not really in the mood but they take your silence/monosyllabic responses as encouragement and keep going? Yeah, this has been my life.

Something I’ve started doing recently is praying specifically before each shift for God to point me in the direction of patients I can help the most. I used to get frustrated working on the wards because I felt like I didn’t have enough time for everyone, as it’s just not possible to do jobs and spend one-on-one time with every patient, so feeling like I’ve made a difference for at least one person is a good start.

How is this relevant to my annoying colleague, you ask? Well about a week ago, after my pre-shift prayer for pointing in the direction of the patient who I could help the most that day, I felt very strongly that it was my chatty colleague that I had to make time for, and that could have only been God to be honest, because I most certainly would not have done what I did next on my own volition… I asked follow-up questions and had a proper conversation with them that morning.

And boy did they have a lot to say! My colleague told me about how they lived alone and had been going through some difficulties in their personal life so didn’t see many people outside work, so they liked talking to people at work because it was their main source of social interaction, and they were glad I was asking them how they were, because not many people did anymore.

That really moved me – I felt so so guilty for not making more of an effort with them earlier, so there was definitely a lesson from God for me about being kind and making time for others. I thought that was the end of it, but God was really drumming that point home that day!

Later in the afternoon, I was overwhelmed with jobs and stressing about having to put in my first nasogastric tube in over a year for a patient – can you guess which of my colleagues took my jobs list from me and volunteered to do the NG tube for me without me asking? Yupp, my “annoying” colleague. They were grateful for our chat in the morning and wanted to help me out with jobs, and ended up inadvertently choosing the one I’d been putting off most.

I cried, ofcourse.

So yeah, patience is very much a virtue that I am working on, and part of it is not being so snappy and irritable with people. Even if I’m still not a morning person.

In other news, the life of Tai has been pretty busy recently. From planning and running teaching sessions, to putting together abstracts/posters for conferences and getting on with my PGCert assignment (writing my first essay in nearly five years, no biggie…), it’s been hectic times. But I’m getting by and taking things one day at a time, and still grateful for this year out. MSRA results are finally out and I’ll be confirming where I’m going for GP training soon, but that’s a post for another day…

Challenge of the Month: I Am Officially a Lecturer

Technically, my title is “honorary lecturer” but I gave my first lecture today!

As part of my year as a clinical teaching fellow, I have been working with the medical school to update their health inequalities teaching, with particular focus on racism and healthcare, and today I assisted in delivering the first of these lecture series to first year medical students. This also ties in well with the PGCert in Health Education that I’m currently doing, as one of the modules is on making curriculums more diverse and representative of society today.

The lecture was an introduction to structural racism within healthcare, with emphasis on the role of unconscious bias and how historical beliefs about the biological differences in races (which usually came from views used to justify slavery) still impact the way we treat patients today. It was so surreal because my medical school self would have never believed that this could actually become part of the medical school curriculum- I constantly felt like I was the one “making it about race” when I used to ask about how conditions presented in patients with darker skin, so yay for progress!

The lecture had to be delivered online due to current COVID restrictions, but we had a great turnout of over 200 students, and it was really interactive because we had so many questions throughout, which made me feel so glad that the students were engaged enough to contribute.

Our next lecture is in a couple of weeks, and I have so many ideas on how to make it even better because I hopefully won’t be as nervous as I was today! So grateful to God for all the opportunities I’ve had so far with being a clinical teaching fellow – I’ve been asked to help with writing exam questions for this module too, even more exciting!

Here I am looking very excited before we went live today:

I’m Home and I’m Happy

A haiku:

Back home for Christmas

My first with fam since finals

Doctors need breaks too.

Wishing you all a merry Christmas, and thank you for putting up with my rambling over the last couple of months – what a rollercoaster of a year it’s been. For me, Christmas is about new beginnings and taking a pause to celebrate the birth of Jesus and the hope that it brought. Whether or not you celebrate it, I hope you get to have some time off this Christmas, whatever that might look like for you, and I guess we all share the hope of a better future.

As always, I leave you with my favourite carol:

Reflecting On My First Term as a Clinical Teaching Fellow

With Omicron cases on the rise in the UK, I’ve been anxiously watching and keeping updated on the news over the last couple of days because I don’t know if I’ll be able to handle another lockdown. In four days, I’m meant to be going down south to spend my first Christmas since I qualified as a doctor with my family, so praying that no new restrictions get in the way of that…

As first term is coming to an end, I thought it would be good to look back on the last couple of months, and how I’ve been getting on with my role as a Clinical Teaching Fellow. For anyone who hasn’t been following this blog, I was miraculously offered this role after I finished FY2, and it allows me to split my time between clinical work in AMU, teaching first year and gateway medical students, as well as working on projects for the Trust Improvement Team to improve support and training for ethnic minority staff. It’s so great because not only is it a role that allows me to do work in areas that I feel passionately about, but the fact that it’s 9 till 5 means no weekends or oncalls! As well as this, I get some university holidays off too, so this means that I can have a whole two weeks off at Christmas, we thank God!

Anyways, here are some highlights from my first term as a CTF:

• Helping to put together an exhibition in collaboration with the local art college to celebrate diversity at the Trust.
• Feeling like a proud mother because my year 1 students, some of who were visibly shaking with nerves when we first started patient bedside teaching, can now confidently take a whole patient history without needing prompting from me.
• Getting involved with the teaching of gateway medical students! As someone who started medical school on the foundation/gateway programme, I am a huge champion of providing more access to medicine, so I’m glad to be a part of it here.
• Starting work on updating our Trust’s zero tolerance framework re: racism and discrimination. I’ve been working with the Organisation Development team, and our hope is to make reporting incidents more clear, as well as to provide more support to staff on the receiving end of both microaggressions and overt racism.
• Delivering a talk on my personal experiences with microaggressions for the third year in a row to FY1s at my Trust as part of mandatory teaching. I’ve been approached by heads of GP schools in the area who are interested in adding it to their curriculum, so that’s been a bit overwhelming but very exciting!
• Working with the medical school to update their health inequalities teaching, as part of their ongoing work to decolonise the med school curriculum. I’ll be helping to deliver a series of lectures in the new year centring on racism as a determinant of health, so I’m really looking forward to that.

And ofcourse, getting to know my fellow CTFs has definitely been another highlight of the last couple of months! I knew quite a few of them already because we were FY1 doctors together, so it’s been great to work with them again and introduce them to #TaieatsThai

Forever grateful to God for all the opportunities I’ve been having, and what a breath of fresh air this job has been so far. I’ve officially sent off my GP application for next year, as I’m now very sure that being a GP is what I want to do, as it’d allow me to create a role similar to the one I have now. Will be updating on how it all goes, but in the mean time, a song to appreciate how great God has been:

Teaching Prep And A Trip To The Fair

I met my medical students this week!

The year 1 students I’ll be teaching over the next couple of months had their clinical placement induction virtually on Teams yesterday, and from next week I’ll be taking them on the wards for the first time, exciting!

This medical school is similar to the one I went to, with an integrated format that means early patient contact from first year. I’ll be teaching year 1s how to introduce themselves to patients and the beginnings of how to take patient histories, so that should be fun.

Ongoing COVID restrictions mean I can only take in two students with a patient at a time, but to be honest I think this is better because it means my attention won’t be as divided, and I can focus more on each of them. Which may or may not be a good thing for the students…

It’s still so wild to me that I’m actually responsible for teaching and assessing medical students- feels like not long ago that I was a student myself, so forever grateful to God for how far I’ve come.

In other news, some reasons to be cheerful from this week:

York Girl came up to visit, and it was so so lovely to catch up with her! We ate too much food at a seafood restaurant and watched the new James Bond film, and it was a super fun day.

Also, Boss and I visited Europe’s largest travelling fair this week, and I won my first ever fair game prize on the rebound game! Best. Day. EVER.