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Module 6 Placement (Renal, Urology & Endocrine)

The last four weeks of placement have been very draining. Early buses and days filled with teaching, ward rounds and clinics have made it difficult for me to find time to revise for end of year exams, so my hopes of being able to post more frequent blog updates were dashed. Apologies to my keen readers, I can still see how many people are reading my posts, so I appreciate the views!

Anyway, how was placement? Well I’m still not a fan of the kidneys, but I don’t hate them as much as I did before. Nephrologists are pretty dang smart and seem to just have all the knowledge, so they’re pretty cool. One of the consultants we had teaching with spent one session going round the group, asking us questions individually, so that was very intense. The same consultant also put me on the spot during a ward round and asked me to take blood from a patient. I haven’t practised venepuncture since last year, so I was quite nervous, but luckily the patient had good veins, YAY.

Urology was very … meh. So many testicles and penises, and just no. Definitely not for me. I finally know the function of a scrotum though, so yay for that? Highlight of urology was getting to catheterise an actual patient in theatre, which was quite cool. Again, I was put on the spot by the surgeon, so I was very nervous because everyone was watching, but I got it in the urethra in one go, YAY.

(P.S. Shout out to the clinical skills tutor at the hospital I was in for being such a total babe, and I will explain why in another post, stay tuned x)

Finally, diabetes and endocrine. I really like endocrine – all the different axises and feedback mechanisms can get quite confusing not going to lie, but it all makes sense when you sit down and think things through. I find it similar to haematology in how it involves a lot of data interpretation and it’s a bit more chilled out, so I really enjoyed it. Diabetes was more dull because the diabetic clinics got quite repetitive, but the antenatal diabetes clinic was a particular highlight. SO MANY CUTE KIDS.

In other news, today was my end of module OSCE, which included stations on catheterisation, cannulation, data interpretation, as well as a shared decision communication skills station on dialysis. Overall it wasn’t too bad; there was definitely one station that I know I could have done better in, and I made some silly mistakes in other stations, but I’m glad it’s over and I can focus on written exams next week. Jesus, take the wheel!

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Module 8 Placement (Gastro) & End of Term

In the four years that have passed since I started this blog, I think this is the longest I’ve gone without an update.

To say this semester has been busy would definitely be an understatement, but I’m home now (YAY), and now have more free time (YAY again), so I can go back to blogging; I’ve really missed it.

A lot has happened in the last month, so I’ll start with some highlights from gastro secondary care placement:

Getting to scrub in and help out in theatre was really fun! It was useful to practise scrubbing in properly for the first time since first year, and the consultant we were with was very patient, such a nice man! The procedure was a panproctocolectomy (removal of the whole colon), and it was quite the procedure- so. much. blood.

I was absolutely grilled on CT interpretation during one of our sessions, and I never got to thank one of my colleagues, who sneakily whispered answers to me, saving me from embarrassment in front of everyone. The person probably didn’t think much of what they did, but it was much appreciated, and meant a lot.

We got to clerk patients from A&E when I stayed out of hours, and this put us on the spot because we had to present our findings to the consultant, and come up with management plans. I felt more junior doctor than medical student that evening, and it made me so excited to graduate and start doing it properly!

In a liver disease clinic, I watched the consultant give a fantastic explanation of Hepatitis C to a patient, and it was truly the best information giving I have ever seen. SO GOOD. The clinic also made me realise that I’d been quite judgmental about IV drug users in the past, so meeting an actual drug user completely shattered my misconceptions and prejudice.

I’m definitely not a natural at suturing- I struggled initially, and it took me a while to get the hang of it, but I’m think I’m there now… well, sort of.

Suturing

We received the results of our OSCE today, and I passed, HALLELUJAH. I’m just so relieved, because the OSCE was the toughest one I’ve had to date; suturing and ERCP interpretation were particularly not great, and not going to lie, there were definitely some tears afterwards, so I’m just grateful to God that overall it was okay.

What else have I been up to? Well the annual charity fashion show was last month too, and I modelled for New Look and the Nigerian Society, and it was so much fun!

New Look 2017Nigerian Society 2017

I’m also finally done with being a student caller for the year, and we managed to raise over £180,000 for various programs across the university, so I was honoured to a part of it all.

Boy am I glad the term is over though! With work and placement and volunteering and revision and well, socialising, ofcourse, it’s been very draining, so looking forward to relaxing over the next week at home 😀

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Why Am I So Accident Prone?

So, I’m walking with a limp again, and just like last time, it was caused by netball. Sigh.

For anyone who doesn’t know, my last week of neurology placement last semester involved me limping around the wards because I sprained my knee. This time, it’s my ankle that’s the problem, and I twisted it while playing netball with my housemates in the park.

It was a spontaneous decision to have a “throw about,” which is like a kick about but much better because it involves netball, and it was very cute and fun, even though I hurt my leg. Just look how happy we all were!

House Netball

On a positive note, I went home this weekend, so I was able to get some much needed TLC and food from Abs (my mother). My ankle is feeling better too, so here’s hoping I don’t do any more damage to it…

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Module 7 Placement: Neurology

NEURO IS VERY HARD.

You know what makes it even harder? Spraining your knee during placement so you’re walking with a limp around the wards. Not fun. Neurology placement was just a bit peak for me health wise to be honest- numerous headaches and waking up with a nosebleed weren’t fun, but I’m fine and got through it, so I thank God!

As someone who struggles with anatomy in general, neuro anatomy has been quite the challenge. To prepare for teaching sessions and clinics, I did pre-reading like I’ve never done before, because I was so scared of being picked on to answer a question and not knowing the answer.

I watched YouTube videos to revise/learn anatomy and physiology, and I highly recommend Handwritten Tutorials and Armando Hasudungan, because they break things down really well. Khan Academy is brilliant as well- forever in awe of people who got through medical school before the internet was a thing, because I would definitely not have made it this far without it.

What got me through the two weeks of neurology placement was the fact that I find it all so interesting. The brain is really amazing, and when you have a basic understanding of the different parts of it, you can start to understand the pathology behind the conditions that affect it. The same thing applies to radiology of the brain; familiarising yourself with normal anatomy is important because it makes it so much easier to pick out abnormalities. Radiology Masterclass is great for easy to follow tutorials and scans.

I had more free time during neuro, as I was back in our main hospital, which gave me more time to catch up on my logbooks and practise examinations. Cranial nerves, upper limb and lower limb; I went through them so many times and it got a bit repetitive, but that’s the best way to get good at them, in order to be able to do them quicker in OSCEs.

One of the best parts of neuro placement was a retired consultant who we had some teaching sessions with. He taught us without using PowerPoint slides or notes, and he’s one of the best lecturers I’ve ever had- engaging, knowledgeable, and just a really nice man! He retired many years ago, but still likes to come in to teach because he enjoys it so much. Not going to lie, I may have cried a bit when he gave us his phone number after our final session, and asked us to let him know how the OSCE goes. What a cutie!

The highlight of neurology was definitely my time on the ward. I got to speak to many lovely patients with a wide range of conditions such as epilepsy, Guillian Barre Syndrome, Myasthenia Gravis, Progressive Supranuclear Palsy, Parkinson’s Disease, and even meningitis! It makes such a different seeing these conditions in real life, and I learnt a lot from the patients.

I’m home for Christmas now, and what a term it’s been! I think I’ll do another post summarising the ups and downs of the first term of third year, as this one has gotten a bit long haha, so if you’ve managed to get to the end of this post, I appreciate the read!  😀

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Module 4 Placement: Vascular

Secondary care placement is over, HALLELUJAH! It has been a really long month, even though it also feels like it’s gone by really quickly as well? Weird.

Vascular week was tough. It involved being grilled a lot by consultants. Like, a A LOT. As in so much that I almost cried in theatre because the consultant I was with just wouldn’t stop, and everyone in the theatre started laughing at me. It really was awful.

Now, you’re probably thinking, “Wow such a crybaby, get over yourself?“, but I cry when I’m angry, as well as when I’m upset, you see, and when the consultant kept asking me questions about dialysis and the kidneys, I just couldn’t take it. I tried to tell him that we haven’t done the renal system yet, and he just laughed and said that his 8 year old son could answer the questions he was asking me. Cue even more laughter from the theatre staff. Not nice.

It was really unfair because I understand him having a go at me for not knowing things we’ve been taught, but when it’s questions on a module we don’t do till next year, WHY DO THIS? A lot of consultants can be so unnecessarily harsh sometimes, as if they don’t remember that they were medical students once too, and this has just made me so determined to be nice to students when I qualify (by God’s grace!).

Maybe I just massively overreacted, but he was mean, it was early in the morning, and I was really tired, okay? Just look at how happy I was in my scrubs before going in to theatre:

Scrubs
Ahh, if only I’d known what was to come…

It wasn’t all tears in vascular week though! Learning how to do ABPIs was fun, as was finally learning how to put on gloves properly in our sterile technique session. If only we’d had this teaching before last year’s end of year OSCE- I dropped the gloves on the floor and put them on anyway, so I really wasn’t that surprised when I failed the station to be honest… Yeah.

The week ended with time on the ward, where I got to take blood from a patient. The junior doctor had to help me find the vein, but I got there in the end! I also got to educate a patient on the meaning of my name, as his first response to me after I introduced myself was, “Your name is quite an odd one, isn’t it?” No, it really isn’t. Uncommon here? Maybe, but Taiwo means “tasted the world first,” and it’s a traditional Yoruba name for first born twins in Nigeria.

He found it all very interesting, and realised his faux pas in calling it odd, so we had a nice chat after that. This was a lesson that some patients are just ignorant and don’t mean to cause offense; all they need is some education on different cultures, and they will think twice before saying something problematic in the future! It was a lovely end to secondary care placement 🙂

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Module 4 Placement: Stroke

Stroke week was less busy than I thought it would be, but stroke is so so interesting! Two words: Homonymous hemianopia. This is when someone loses half of a field of vision on the same side in both their eyes, and it is also quite the tongue twister. Try saying it a couple of times really fast, and brownie points to you if you can, because I still have to really think about what I’m saying to get the words out.

I got to examine patients with homonymous hemianopia, as well as  patients with left and right sided weakness, depending on which part of their brain was affected by the stroke. One of the patients I saw was a painter, and my heart broke for him when he told me how he can’t paint anymore, due to not being able to use his left hand. He was optimistic about learning how to use his right hand though, so I really hope that works out for him.

Learning how to do a stroke examination was fun, and a nice throwback to last year, as it brought back examining reflexes, sensation, power and tone in the limbs. Yay for spiral learning!

As always, anatomy is my Everest, but the brain is SO COOL, and I find its anatomy really fascinating. Fun fact: The frontal lobe was the site of lobotomies in the 20th century, and as the frontal lobe is involved in cognition and social interaction, lobotomies often had a very negative effect on the personalities and functioning of patients. Notable people who had lobotomies include Randle McMurphy in Ken Kesey’s One Flew Over The Cuckoo’s Nest (a great book that I highly recommend), and Rosemary Kennedy, the sister of JFK, whose failed lobotomy at the age of 23 led to her being put in an institution for the rest of her life. So sad.

I could go on for ages about how cool the brain is, but I’ll save some of my enthusiasm for next year, which is when we do neurology properly. BUZZING.

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Module 4 Placement: Cardiology

I’ve always found cardiology quite intimidating. The heart is really important, you know, and kind of a big deal, so the fact that this year is all the teaching we’ll get on it before we’re doctors is a bit scary. Also, as I didn’t do A Level Biology, I still feel like there are some gaps in my knowledge, so I think that’s why I was bit nervous going into this module.

Placement has been really good so far though! This module has been the most organised because it’s split into two weeks of cardiology, one week of stroke, and one week of vascular, which works really well because those are the four weeks of lectures that we’ve had.

I started with cardiology, and for the first time this year, I’m in a group on placement with someone in my PBL group, yay! It was an intense two weeks, but I really enjoyed it, and there were many highlights, such as:

  1. Getting told by a consultant that I show a lot of empathy (we had just seen a patient who cried because she was scared to have surgery), and that I shouldn’t lose that. It was the first time I’ve been told that being so empathetic is not a bad thing, and that really made my day.
  2. DEFIBRILLATION. So. Much. Fun.
  3. Being in clinic with one of the best consultants I’ve shadowed so far. I was scared/in awe of her for the majority of it- she grilled me a lot by asking me to interpret ECGs and diagnose patients after examining them. I didn’t have a watch, and there wasn’t a clock in the examination room, so instead of telling the consultant this, I asked patients to count 15 seconds in their head for me, in order to calculate their pulse rate. Lesson from this? Invest in a nurse’s watch!
  4. ECGs are not as bad as I thought they were, but I definitely need to practise going through them more. Proud moment was correctly diagnosing 1st degree heart block in clinic with the tough consultant- I even did a happy dance when she left the room, but managed to compose myself before she came back, ofcourse.
  5. Our SimMan sessions were really good- I now feel more prepared for it possibly coming up as an OSCE station. SimMan is used for patient simulations like cardiac assessment, respiratory failure, and anaphylaxis, and even though I was told that I’m a bit bossy  (I prefer ‘assertive’), it was a very fun session; we didn’t kill SimMan yay!
  6. Finally, hearing murmurs and not having to pretend that I did lol (The struggle was real at the start of this module…)

It’s cray that we only have one more week of placement left! Stroke week finishes tomorrow, and then we start on vascular, fun times ahead 🙂