Category Archives: GP Training

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Challenge of the Month: Singing At An Open Mic Night

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It’s been a while since I’ve done one of these, and even longer since I’ve sang in public, but I was asked to be a last minute stand in for a friend from church and I’m glad I did it because it was so much fun!

We did Valerie, The Scientist and Can’t Help Falling In Love and I was super nervous to be first, but relaxed as it went on, and even felt confident enough to invite the audience to join in at the end of our last song.

Highlight of the evening was definitely my Psychiatry Consultant turning up to watch me sing! I’d mentioned it in passing during ward round that day, but never in my wildest dreams did I think he’d actually come, so kind! He sat right at the front and recorded all our performances to send to me afterwards – it really made my day.

I also convinced my team to do a bring and share lunch in honour of a rare day when all the doctors were on the ward and it was so so wholesome. Yay for making better Psych memories because it is well documented on this blog how much I suffered in F2, but now I find myself smiling and laughing a lot more at work and feeling much happier, so I thank God for that!

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I Still Don’t Like Psychiatry

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I didn’t have a great start to this rotation because I was told 10 days before I started that it was changing from a community to an hospital based post, but the upside was that I didn’t have to do on calls. I was also told that I could do outpatient clinics weekly if I wanted to, and I agreed to do one a week under supervision of a Consultant Psychiatrist.

3 days before these clinics were to start, I received an email informing me that I was now doing two clinics a week. No explanation or apology for the late notice; it was pretty much a ‘For Your Information’ thing. Ofcourse I was not having it, and refused to do the extra clinics because this wasn’t what I’d agreed to, it hadn’t been discussed with me, and it was unprofessional and just plain RUDE that this was being sprung on me like this.

I feel like this just sums up life as a junior doctor because you’re made to feel like a name on a spreadsheet being moved for service provision, without any consideration of the inconvenience or unfairness of it all. I have a life – being a doctor does not define it! It’s very unfair and I think I was absolutely justified in responding with emphasis on my disappointment in the poor communication and how badly it had all been handled. I am a doctor and deserve to be treated like a professional – the infantilisation and how junior doctors are treated in the NHS is really not okay.

So what was the resolution?

I decided to do the extra clinics because they’d already booked patients for them, and it would have been unfair on the patients to have their slots moved. If they hadn’t already booked these appointments, I would have definitely fought it more, but I chose to let it go.

Psychiatry 2 – 0 Tai

If they backtrack and say I have to do oncalls though, it is definitely NO and I’m ready to escalate to the BMA if necessary. Enough is enough!

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Why Being Back In a Psychiatry Job Makes Me Feel Anxious

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It is a truth universally acknowledged that my F2 rotation in Psychiatry was the worst job I’ve had as a doctor. Those 4 months I spent in acute inpatient psychiatry back in 2021 were awful, and for anyone who wasn’t following this blog then, here is a recap of some of the things that happened:

  • Draining 16-24 hour residential weekly oncalls that saw me covering the adult inpatient wards, old age psych wards and eating disorders unit on my own. I’d work a normal day, be on call from 5pm till 9am the next day, and be expected to come back to work from 9am if it had been “quiet” – WILD.
  • I got hit by a van whilst walking home from work – I’d finished late (a usual occurrence) and was in a rush, so to this day I still firmly believe that if I’d finished on time it wouldn’t have happened.
  • Having to be hidden from a patient on the ward because my presence was triggering them.
  • Learning that racist hallucinations are a thing, and being expected to still clerk in / see patients who were racially abusive. I didn’t mention it on this blog, but I had to stop going to our mandatory psychotherapy sessions because when I tried to talk about how the racist comments made me feel, the Psychotherapist said I was being overly sensitive and that the patient would have made similar comments if I had red hair. Because ofcourse someone making fun of your hair and abusing you because of your skin colour are the same thing. The absolute worst.
  • Seeing first hand how creative suicidal patients can be in attempts to hurt themselves, and dealing with the aftermath of two patient deaths that happened during my time on the psych wards. Horrific and awful; remember that I stopped going to Psychotherapy so that made things even worse.

So, yeah. To say that I was upset about being back in acute psychiatry would be an understatement. I had chosen Community Psychiatry because getting to spend time with the CRISIS team would have been so useful for GP, but 10 days before I was supposed to start, I received an email informing me that my rotation had been changed to acute inpatient psychiatry. I cried lol.

2 weeks in, and a massive silver lining has been not having to do oncalls, as I made it clear that my initial rota was 9 till 5 and I would prefer it to stay that way – so yay for that. My ward is better staffed than the one I worked in when I was an F2, so again, YAY for that. This job change also means that I have to do weekly outpatient clinics seeing new patients and following up known ones, so it gives me some guaranteed time off the ward – another silver lining!

Before starting I prayed that I would have atleast one person I worked with that would make me look forward to coming to work, because oh the tears I used to cry on my way to work in F2 haha, I really hated it there! So just imagine the absolute JOY I felt when I found out that one of my pals from church has been moved to this ward and now works here as an Occupational Therapist – I see her most days at handover and around the ward, and what a difference it makes to have a familiar face; yay for answered prayers!

Here’s hoping these next 4 months allow me to heal from the trauma of my F2 psych job and to make happier memories – looking forward to getting to know the rest of the team better as well.

In other news, I was in Cambridge last weekend visiting Louis a.k.a The Little Engine(er) That Could, and Ruth a.k.a The Vet, and it was so great to see their new home and how much usage they’ve been getting of the guestbook we got them. Looking forward to seeing all the pictures they’ll now start taking with their polaroid camera…

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The End of My 2nd Rotation of GPST2

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I start my last rotation of GPST2 tomorrow – time is really flying by! As always, I try and book leave at the end of my rotations so I have a break before moving on, and this time changeover coincided nicely with Easter, so I’ve had an extended time off which has been really nice.

This rotation was in a county GP surgery that was definitely different in terms of patient demographics – in my first week a patient came for their appointment in a Jaguar, so to say this was a more affluent area would be an understatement!

I saw a lot of patients who asked for private referral letters when faced with NHS waiting times, so we’re really seeing the beginnings of a two tier healthcare system and that makes me really sad.

Anyway, a recap of this placement:

What was I good at?

Heart failure annual reviews! I got to do QOF Clinics as part of my time at this practice, and they really improved my confidence with management of heart failure patients.

What made me nervous?

Seeing patients who wanted to start on HRT, as there’s usually so much to cover before prescribing. A great tip I got from one of my Supervisors is to split it into two consultations – initial assessment/history and examination, and then a separate appointment to prescribe.

Useful thing I’ve learnt?

If a patient is struggling with hair loss and no other causes can be found, aim for ferritin levels greater than 100.

The last time I cried at work was?

The day I wrote this blog post. It had been a very overwhelming day of complex patients and feeling out of my depth – imposter syndrome was hitting HARD that day!

My happiest work memory?

Our weekly teaching sessions with my Clinical Supervisor were always a laugh – a highlight was a session where we spent some of it going through my previous clinics to find a patient I’d seen, to confirm that I hadn’t gotten them mixed up with someone else. I was absolutely sure that I hadn’t, so it was very satisfying to be proved right.

Would I work here again?

Absolutely! Everyone from the Reception team to the Admin team, Secretaries and Partners were so so nice and approachable. One kind gesture that I won’t forget is how the rota managers went out of their way to make sure I had home visits that I could walk to, as they found out I was taking Ubers to my visits, and were adamant that I shouldn’t spend money. So nice of them, and just reflective of the atmosphere of the practice, because everyone really looked out for each other and it was great being part of the team.

So watch this space; this time next year I might be sending them my CV to consider me for a salaried GP job…

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I PASSED THE AKT!!!!!!

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The Applied Knowledge Test is one of the compulsory exams of GP training in the UK, and anyone who follows this blog will know that preparing for it has been a big part of my life over the last few months.

So what a RELIEF to find out this week that I passed, hallelujah! I took the exam last month and waiting for results has been excruciating – I’ve been unable to fully relax or make social plans from March onwards because I was so worried I’d have to retake.

Still doesn’t feel real that the AKT is DONE and I am freeeeeee – all glory to God! I most definitely could not have gotten through the last few months of stress, anxiety and reduced confidence without support and encouragement from all the wonderful people God has put around me; I am so so blessed and grateful for them all.

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Some Ways I’ve Made a Difference For Patients This Week, To Remind Myself That I’m Not a Bad Doctor

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  1. The patient I saw on a home visit and fought to get an ambulance to bring him to hospital, because I was concerned that he had bowel obstruction and his wife couldn’t drive him in. Spoiler alert: He had bowel obstruction.
  2. The 1 year old I saw in clinic and referred urgently to Children’s A&E because they had an injury that didn’t add up with the explanation given. Safeguarding monitoring has now been put in place.
  3. The patient who was embarrassed about her prolapse and cried because she was worried it looked “really bad”. My clinic overran by half an hour because I spent extra time reassuring and explaining it all to her, because she needed more time to settle for an examination of the prolapse. She was very grateful and shook my hand at the end to say thanks.
  4. The teenager I saw for a follow up of her heavy, painful periods, who got embarrassed when her Mum told me that she said I was her favourite doctor because her periods were the lightest and least painful they’d ever been since starting the medication I prescribed.
  5. The patient who made an appointment to speak to someone about her fear of dying, because she’s recently been referred on a 2 week wait pathway for suspected endometrial cancer. I sat with her as she cried, and she was grateful that I had asked her about her children, because no one else had considered how scary the thought of leaving a 7 year old and 11 year old without their Mum would be.

Today was not a good day at the office, but I am not a bad doctor, and though some days of GP training are harder than others and I feel like my brain will burst from all the things I need to know, God is good, and tomorrow is another day.

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I Stress Read When I Feel Anxious

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The week before my A level results I read Harry Potter. As in, all 7 of them. I barely slept that week because of nerves so I just read instead.

I was 18 and it was the long summer before university so it wasn’t too bad, and my results were okay in the end so we thank God for that.

But reader, it’s happening again. My AKT exam is in 12 days and I have spent the last week reading the Percy Jackson books. I am a doctor working full time, who should be revising when she gets a chance, and I have been reading Percy Jackson.

The good news is that I finished them all in five days and can now go back to focusing on revision. So here’s hoping that this bout of stress reading is done for now because revision revision REVISION.

#prayforTai

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Junior Doctor Anecdotes: The Thoughtful Security Guard

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As part of GP training we have to complete at least 72 hours of out of hours shifts as trainees, and these can include home visits, telephone triaging, or seeing patients with out of hours GP services.

I’ve now completed 42 hours, so I only have 30 left to do, which is quite a good position to be in, thank God! As we can only do these out of hour shifts in GP rotations, I can meet the requirements in my current job, or when I get to ST3, where I will be spending the whole year in one practice.

I did a 12 hour night shift with the home visiting service last night (so much for no more nights lol), but overall it wasn’t too bad – my GP Supervisor and our driver were very nice, so it went quickly.

On my way home from the shift, I found myself thinking of an encounter I had had after one of my previous out of hours shifts. I had finished around midnight and was waiting for my lift home, and was startled by a knock on the sliding doors of the building I was waiting in front of.

I turned around to see a security guard, who immediately apologised for startling me, and told me that he was looking after the building overnight and had seen me on the security camera, so wanted to check I was okay.

I told him I had just finished a shift and was waiting for my Uber to pick me up, to which he replied that he could wait with me if I wanted, as it was dark outside. I thanked him for the offer, and told him it was fine as was my ride was less than 5 minutes away. After confirming that I was okay, he then said that he would be keeping an eye on me on the security cameras with his team until the Uber came, as an added reminder that I wasn’t on my own.

Maybe it was tiredness after the long shift, but this really moved me. It was a much needed reminder that people can be kind and considerate of others, as the security guard could have just ignored me and got on with his job, but he went out of his way to check on me, and kept an eye on me until I was safely on my way home.

2023 has been a year of many highs and some lows, and it can be easy to become cynical and disillusioned by the state of the world. However as we step into 2024, I hope you remember that there is still good in the world, and that a single act of kindness can go a very long way.

Happy new year, everyone, and God bless – here’s to a better 2024.