I Still Don’t Like Psychiatry

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!

Module 1 Placement: Week 2

“I really enjoyed that mortuary tour!” said no one. Ever. You know what’s more fun than being shown counselling rooms, the labs where post mortems happen, (note that I said where they happen and not watching an actual post mortem), and the fridges where bodies are stored? Anything. It was a not-so-exciting tour that was only surpassed in tedium by last week’s pathology labs one.

On a more positive note though, today was my last day of secondary care placement till next year! This week involved more work on clinical skills like blood pressure, TPR (temperature, pulse and respiration rate), and basic life support (CPR). We got taught how to fill in a patient’s observation chart, and I was very lucky because the health care assistants on a ward I was on, allowed me to do observations on actual patients! So I got to take and record their blood pressure, pulse, temperature, resp rate, oxygen saturations, and score them using the Early Warning Cascade. COOL.

We also had a session on how to use the BNF, which I found very helpful. The BNF is the British National Formulary, and is a guide to prescribing. It is updated twice annually (monthly online) and lists recommended doses, side effects, indications, contraindications, drug interactions and so on, so it was quite a useful session.

I had shadowing sessions in neurology, rheumatology, respiratory, and diabetes outpatient clinics, which were quite interesting. The consultant I was with in the diabetes clinic kept asking me questions that I didn’t know the answer to. It was only when he said, “You’ve just had teaching on this!” that I realised he thought I was a 3rd year. I explained that I’d only just finished Module 1, and he apologised for being so harsh. Lesson learnt? Don’t be afraid to say “I don’t know;” you’re not expected to know everything!

Managed to take more patient histories this week, and have quite a few to choose from for my logbooks*, yay. I also finished my SSS presentation about 15 hours before the deadline, so that was a relief. Now I just need to practise it for the presentation in January, yaaay…

*Logbook= Collection of patient cases that is presented and assessed in an 11 minute OSCE station, and must have a balance of primary and secondary care patient cases.