The Home Straight

/ Sebastian Owczarek

So, here we go. I only have four and half weeks left of medical school. In some ways it feels like it has been a long time coming, but in other ways, it doesn’t seem that long ago that I was in first year going to watch Contagion in the cinema with a large group of fellow medics and the then lecturer in Public Health, Dr Rachel Isba. How times change, she has now only recently just become the Head of the Medical School and I’m a few months away from working on the wards of Dewsbury and District General Hospital.

I count myself pretty lucky to have got the jobs I wanted in a place I wanted to be. I spend my first (FY1) year in Dewsbury and my second (FY2) in the heart of Leeds, placed mainly at the Leeds General Infirmary. There I’ll be the house officer in Emergency Medicine, Cardiology and Neurosurgery. It feels unreal, but after 6 years, my time as a student is drawing to a close.

On Monday this week, the staff at the medical school put on a light afternoon tea as celebration for being given approval by the General Medical Council to award Lancaster degrees (as opposed to Liverpool whose programme we had been following and degree we had been awarded thus far). It was a joyous occasion for all and not least for us fifth years who will now officially become and graduate as Lancaster’s first cohort with a medical degree of its very own.

The only thing stopping me from graduating now is completion of my portfolio, and that just requires time to invest!

First Year – Term Two !

/ Katie Burrell

It is finally Easter break – aaaannd it’s going to be a holiday of studying. It’s 9 weeks until summative exams and everyone is starting to sense how close that really is. We’ve been here 6 months and I think it’s safe to say everyone underestimated how much knowledge and content medical school expects you to fit into your brain. Saying this – term two was so much easier than term one. We have settled in and felt more at ease, both inside and outside of studies. From the structure of PBL to the layout of the campus and city, all aspects of our lives here have become a little more familiar and comfortable – Lancaster truly feels like home now.

The curveball of term two (apart from mock exams and the SSM) – the Community Clinical Teaching sessions. This initially terrifying notion turned out to be my favourite part of the whole term. CCT’s are the first real clinical exposure we get in year one, where we get to talk to real patients and practicing GPs about their lives and thoughts on health care. Considering the most we’d had to worry about up to that point was making sure we introduced ourselves and gained consent to speak to a ‘simulated patient’ (actor/actress) – the prospect of talking to a real person was scary for all of us. We had 3 placements in 3 different GP practices, which meant that for 3 days in February, we got to break out of the Lancaster bubble and discover some beautiful places – Kendal, Sedburgh and Grange–Over– Sands. Talking to patients with chronic diseases was so eye-opening and inspiring. Each brought their own unique story and one patient in particular was the most positive and lovely person I have ever met. She will be somebody who I will remember throughout my career. The doctors also talked to us before and after we met the patient, informing us of what it is really like to be a GP and the vast amount of opportunities open to us in GP land! I also loved exploring the hidden gems that are on our doorstep at Lancaster. Eating chips on the promenade of Grange-over-Sands with some of my fabulous medic mates – you can’t get much more northern or much more relaxed– but the places we visited were serene and it was great to see everyone appreciating the beauty the North has to offer. (FYI – I am a northerner through and through).

Other personal highlights of the term include using the on-campus cinema, Take 2, for the first time. It’s brilliant and it’s pretty safe to say La La Land gained an extra fan! The Medsoc Take Me Out was also a brilliant event for charity, and a night to remember!! (Medics just KNOW how to party.)

So, as we enter what is bound to be an intense last term of our first year of medical school – I can’t wait to see what caffeine-fuelled memories I make with the incredible friends I have made here at Lancaster.

Passing the last exam.

/ Sebastian Owczarek

I’ve done it. Today I found out I passed the last exam of medical school and I’m happy. Sure, it doesn’t compare to sitting medical finals at the end of 4th year but, still, it was a national exam that fifth years across the country were required to sit and pass. With this good result it means, once I qualify in July and start my job in August, I can officially prescribe drugs and treatments. I can be useful on the wards and a real asset to my team.

These past few weeks since the start of 2017 have been fairly busy for a 5th year. Not only did we have the Prescribing Safety Assessment exam to prepare for, we also had our mid-term portfolio review. Just because we have no exams to sit this year it doesn’t mean we’re free from formal assessment! In many ways, we’re assessed more and across a range of different domains.

We were asked to choose 3 cases and 2 clinical incidents that we were most proud of in our portfolio. In a 30-minute interview our assessors would choose one of each for us to present. It gave us an opportunity to showcase our work and talk through the processes we thought of when completing the case/incident report. It was a nerve-wracking time.

And in between all of this, we had our third of 5 clinical placements to attend and this brought with it a new set of portfolio documents to complete. On Friday I finished my 7-week attachment on the Acute Medical Unit at Furness General Hospital. It was the last time I’ll be placed in Barrow-in-Furness. Saying goodbye to the sight of the hospital as I drove away would be another memorable moment for me as I transition from a 5th year medical student to a Foundation Year 1 doctor.

As a year group, we have only a few weeks to wait until we find out which region of the country we’ll be working in come August. Hopefully it’ll be good news for all. In the meantime though, I’ll be counting down the days and waiting in anticipation for an update on what my future holds.

Year 1 Perspective

/ Sarah Bethel

I don’t think I will ever forget that first day. Sunday 2nd October 2016. With two cars packed full to the brim, my mum, dad, sister and I began our journey up to Lancaster, ready for me to start the next chapter as an adult. Completely daunting I must admit! Being the girl I am, I managed to recruit a grand total of 8 people to unload the cars and move me into my lovely flat in Lonsdale – obviously the best college!

The whole first day was a complete whirlwind; from the moment I said goodbye to my family, I was meeting the rest of my flat and house whilst playing ice breakers in the October sunshine (believe it or not, it’s actually a real thing). Everyone hates that moment where you feel like a complete fish out of water but your reps make you feel at ease. From that moment on, fresher’s week had officially begun. It was one of the best weeks of my life, filled with college events and meeting so many new people it was overwhelming – some I know will be my friends for life.

Yes, Fresher’s Flu is a real thing.

I guarantee you will suffer to some extent from fresher’s flu, hopefully not for a month like I did, but you will definitely suffer.

Next it was time to meet my medic family. I was assigned a ‘medic dad’ in second year called Mike and a ‘medic mum’ in fourth year called Lauren (although technically my great grandma) who are both amazing. I significantly remember being given my welcome pack with so much information in it made my head spin and Lauren told me not to panic – and I’ve lived by those words ever since.

Settling into the medical school is like starting anything new – it takes time to adjust. My weekly anatomy sessions are a life saver and are both informative and enjoyable. Clinical skills takes place in the infirmary and it makes you feel very professional I must say! The sessions quickly allow you to get you over any embarrassment you may have and by week three you’re examining your friend’s abdomen!

Medsoc is another part of medic life. In the 2nd week of term Medsoc organised our fresher’s ball which gives you an opportunity to fully mingle with the people you are going to spend the next 5 years with (say it quick!) You also get to meet people from the other years who are more than happy to ‘calm your qualms’ and offer advice.

Being a medical student is amazing, and I couldn’t think of a better place to be experiencing it than at Lancaster.

 

Two down, three to go

/ Sebastian Owczarek

Hello to you! At the time of writing I have just started back on placement after a lovely Christmas period off. It has been my last ever one as a student. This time next year my time-off might not be as generous. Before I broke up, I had just finished my second really great rotation at the Royal Blackburn Hospital in East Lancashire. I was part of the first cohort of Lancaster medical students who undertook placements here, and I can really recommend it! The hospital itself is bigger than the hospitals I’ve been attached to in previous years. I’ve really benefited from seeing how another hospital trust works and also being exposed to a wider number of clinical conditions. I spent the first placement based within the Emergency department which, can be, one of the busiest in the entire country. I had the choice of the whole department to get involved in. It was difficult to balance my time between the Urgent Care Centre (minors), Majors (Emergency) and the resuscitation bay (severely unwell). I learnt a lot from this attachment and I got to experience the stress and pressure of the Emergency department first hand.

For my second placement I was attached to a colorectal surgical team. This was my first of two student-selected (SAMP) rotations. I chose this one because I wanted more experience in General and Colorectal surgery. I had a really enthusiastic supervisor who allowed me to scrub up in theatre, assess patients in clinics and involve me in ward rounds. I was treated with a lot of respect and was made to feel like a valid member of the team. I will miss the place.

As I start 2017, and the 2nd term of my final year, I’m excited to find out what the next few months have in store for me. There are 3 months to wait until I find out which part of the country I’ve been allocated to as part of the FPAS application process, and 7 months until I graduate. It’s scary not knowing where I’ll be as a Foundation Year 1 doctor come August. But, at least I don’t have to worry about passing my final exams!

Settling In – The First 6 Weeks

/ Katie Burrell

It’s hard to believe that it has only been 6 weeks since that oh-so-exciting first day. My flatmates were my main concern – what are the chances of 8 complete strangers getting along? This was followed closely by – wait, hold up a sec. I’ve been working my socks off to become a med student for years and now I’m here, is this what I want and will I be able to do it??

Thankfully those questions were swiftly answered. Fresher’s week melts away any fears about not making friends. Standard cliché line but – everyone is in the same boat, and Lancaster make sure that you have a great time. Flat reps: one thing that I didn’t know about beforehand – so listen up. When you arrive, each flat is assigned two reps (older students) that take you under their wing. They aren’t like controlling parents sticking their noses in, they’re a bit like cool older siblings who are the pool of all Lancaster wisdom and can answer everything; taxi numbers, which bus to get or luckily for one of my flatmates even how to replace a snapped door key at midnight.

For the anxious parents out there, the reps also make sure you get home okay during the first week. Sounds silly now – but trust me, when you’re having a fab time at the paint party (100% would recommend) and realise you’re covered in UV paint, it’s 2.30 am and you’re in a totally new city (maybe had a few too many), you’ll be glad to know there’s someone looking out for you.  My personal highlight of fresher’s was the silent disco – I challenge you to name something more fun/cheesy than dancing the night away to the likes of Mr Brightside and all the S Club classics.

Staying with the guidance theme, as a 1st year med student we are assigned a medic parent (second year) and a medic grandparent (fourth year).  We meet with them during fresher’s and they are there to help with absolutely anything. It’s a brilliant way to get to know the upper years and all the secrets, tips and tricks on how to survive and thrive.

Moving on to the course – it’s definitely lived up to expectations. I absolutely love it, especially clinical skills. We spend two hours a week at the hospital and have very interactive sessions. The first time I used my stethoscope to learn how to examine the abdomen, that’s when it felt very real. Luckily for me, my flatmates are more than willing for me to practice on them. Unluckily for them I’m not quite the doctor they think I am yet and unfortunately don’t know the cure for the dreaded fresher’s flu. (Naps. Naps solve everything. I didn’t tell you that though.)

I’m also a part of Teddy Bear Hospital, a society run by med students who go to local schools and lead sessions with children, aiming to reduce anxiety and fears about hospital. The kids bring their ‘sick’ teddies in and then we work through diagnosis and treatment. (Let me tell you, you soon rediscover how fun toy thermometers and bandages are.) It’s something both fun and meaningful and really gives you some perspective, especially if you’ve been in a little study bubble all week.

I could write pages on how fabulously crazy the past month has been; I can’t wait to see what the next few weeks bring.

 

9th November 2016

The final rotation of third year…

/ Emily Hedley

My final rotation of third year was ‘Neurology and Elderly’. I was really pleased I got placed on this rotation last as I heard from senior years that it involved a lot of pharmacology topics as well as revision of 2nd year topics – perfect just before exams! For this rotation I was also pleased to be placed back at Lancaster Royal Infirmary – so it was an emotional farewell to the barrow bus…not!!

A lot of this rotation involved revision of 2nd year topics such as heart failure, osteoporosis, dementia and arthritis. I soon found that had forgotten so much so it was good to have the chance to revisit these topics just before exams, as we are still expected to know about them and be able to answer questions in relation to them. In terms of clinical placement I spent a lot of this rotation on the general medicine wards and the elderly wards taking histories – a lot like 2nd year! The main difference was that during this rotation we were also expected to attend ward rounds and other ‘Key Clinical Experiences’ such as observing the signing of a death certificate, attending a physiotherapy session and observing an occupational therapy session. We also had to visit the Speech and Language Therapist (SALT) to get an idea of their role. The idea of this rotation was to become familiar with the Multiple Disciplinary Team (MDT) involved in elderly care because as doctors we will work along side professionals such as these and often refer our patients to them too.

Along with elderly medicine, this rotation also covered neurology. Although we had covered some neurology as part of general medicine in 2nd year, as a specialty on its own it was again completely new to me. The neurology rotation involved lots of bedside teaching, which means the doctors come on to the wards with the students and have patients waiting for you to take a history from, examine and then the doctor asks you questions and has discussions with you about the patient’s condition, all whilst the patient is present. This kind of teaching is SO useful as there is a real life patient in front of you to apply your knowledge to, rather than a textbook. It’s also handy to gain the patient’s perspective of their condition, for example how they cope at home with their Parkinson’s disease. The bedside teaching was also great for practicing examination skills ready for the upcoming OSCE, as the doctor we were with made sure my skills were perfect before signing me off!

The neurology aspect of this rotation also saw us travel down to Blackpool for some teaching about EEGs. An EEG is one of the investigations carried out within neurology and is a way of assessing brain waves and brain activity. During my neurology rotation I learnt a lot about anatomy of the nervous system, epilepsy, headaches and weakness. Overall I found neurology very challenging, and although I look forward to returning to the specialty next year, I think I can safely say that it hasn’t made it to my specialty short list.

Following this final rotation, its revision week and then Summative exam time! This year I have three written exams; 2 medical sciences and 1 ethics/sociology/psychology/law/statistics, followed by one practical OSCE. I feel like there has been a big jump in expectations of us since 2nd year, especially in terms of the management of conditions and the pharmacology of drugs.. so with that said, I’d better get revising!

New experiences

/ Emily Hedley

Towards the end of my third year, I had two rotations left to complete. The first was psychiatry. Similarly to Obs and Gynae, psychiatry was a completely new speciality for me. I had of course come across some aspects of psychiatry during my GP rotation  for example anxiety and post-natal depression, however overall it was very new. Unfortunately we still live in a society where there is some stigma attached to psychiatry and mental health. Although this situation is improving, I think it is fair to say that some stigma and prejudice does still exist. This rotation enabled me to see psychiatry from the other side (i.e. from inside the wards, rather than from the outside looking in) and I was really looking forward to seeing what it was all about. My first day on this rotation involved observing a review of a patient who had schizophrenia. The patient we saw had several symptoms that I could not recognise at the time, however after attending lectures I realise now that the patient we saw actually exhibited symptoms such as auditory and visual hallucinations and ideas of reference. ‘Ideas of reference’ basically means that the patient believes that an event or coincidence that they experience or notice actually has a specific reference to them and has a special meaning. I found a lot of the new concepts in psychiatry, such as ideas of reference, difficult to get my head around at first, as they seem quite abstract and hard to imagine. This is one of the reasons why I enjoy studying at Lancaster so much as it allows me to apply my theoretical learning to real-life patients, making the learning a lot more memorable.

The rest of psychiatry rotation involved spending time on the wards taking histories from patients and attending clinics, such as the Substance Abuse clinic and the Memory clinic. I found the Memory clinic particularly  enjoyable as I found the tests and screening tool used in elderly psychiatry, for example to aid making a diagnosis of dementia, really interesting. The psychiatrists use tools that test the patients’ short term memory recall, knowledge of current news, ability to name objects and ability to draw to help make diagnoses. I even got the opportunity to take one of these tests myself and the outcome wasn’t as I expected! (Should I be worried?!). Overall I thoroughly enjoyed my psychiatry placement, especially the weekly teaching we received from Nick (Mullin) – he is fantastic and made every topic so interesting and engaging. I enjoyed psychiatry so much that I would now consider it to be on my short list of potential specialties I may want to seriously look into in the future!

 

2 down, 3 to go!

/ Hannah Kolbe

Happy new year everyone! And by saying that it means we are in January, which means I can say this is the year I (hopefully!) become a doctor. Wow, that is scary! It’s obviously the goal at the end of Medical School, but it doesn’t feel real at all. This year really is flying by. We are now on our 3rd rotation of 5, so are officially over half way through our final year. My 2 placements so far have been 7 weeks in A&E and 7 weeks on Paediatrics and I have genuinely loved both of them for different reasons and they have taught me different things about being a doctor soon.

I am currently on my “ward placement”, and after the Christmas break I think I’m settling back into things. Before we broke for Christmas us 5th years had the ‘SJT’ to do (one of many abbreviations you will encounter in Medicine!) It stands for the Situational Judgement Test, and is meant to be test of how you judge situations (who’d have thought?!) When we applied for our Foundation posts where we will work as doctors, our time at medical school was given a score out of 50 based on our exam results and various other things. This 2hr 20min exam was also marked out of 50, to give us an overall score /100 to be ranked against everyone else in the country for jobs. So it is kind of a big deal! They were all scenarios where we had to basically rank what we “would” do in response to a situation (e.g. you are running late for work what do you do, or the doctor taking over from you is running late what do you do… that kind of thing). It was a toughie, but we find out how we did in March so enough about that for now.

Our next (and final) exam of Medical School is on 1st February (my birthday L ) and is a prescribing exam, so tests our knowledge of medications, side effects, communicating information, drug calculations etc and is 2 hours long. We get to use the Bible of medicines, the British National Formulary (BNF) ß another abbreviation for you, to help us, but the 2 hours goes very quick so practicing and being familiar with common medications throughout this year will hopefully help! We have to pass it in order to progress to F1 and be able to prescribe medications (which is a pretty important job as a junior doctor!!) so wish us luck!

This coming week, on Tuesday 12th is a planned Junior Doctors strike and will affect all of us working in the Hospitals. I’m not going to go into it all on this blog, there is plenty of information about it all out there and why it is necessary etc… but I hope to be able to support my colleagues in the best way I can, as I will be in their shoes very soon and the proposed contracts are something that will affect everyone, so is worth having an idea of for when you start Medical School.

I believe the interviews should be happening very soon for you Lancaster hopefuls, so I wish you all the best of luck in what will hopefully be your first step in becoming a doctor.

Last time I ended my blog with a little anatomy joke, I hope you found it humerus. And that one too..

 

 

The 12 days of Obs and Gynae…

/ Emily Hedley

Since my last post, I have begun my Women and Children rotation. This speciality includes obstetrics, gynaecology (O&G) and paediatrics and it is completely new to me, so I have really been looking forward to it. I have heard from senior years that is it the most challenging rotation as it’s both the busiest and also has the most difficult PBL objectives, so I was slightly apprehensive as well! For this rotation I am based at Furness General Hospital (FGH) up in Barrow Monday to Wednesday for O&G, and then at Lancaster Royal Infirmary (RLI) on a Thursday for Paediatrics. As we are approaching Christmas I thought I would tell you all about my time on this rotation so far but with a festive twist…

On the first day of Obs and Gynae this rotation gave to me…
Return of the Barrow Bus! – With FGH being over an hour away, the university provides a coach every morning for everyone to travel from Lancaster up to Barrow. It leaves the city centre at 7am, so it’s lots of very early starts for the next 7 weeks!

On the second day of Obs and Gynae this rotation gave to me…
2 Gynaecological clinics! – After a swift introduction to the rotation myself and my peers were thrown straight into placement, which for me meant starting the rotation observing some gynaecological clinics. These clinics usually see women with abnormal bleeding, urinary incontinence or some kind of prolapse. I heard some really interesting histories during these clinics and as it was all brand new I found it really interesting.

On the third day of Obs and Gynae this rotation gave to me…
3 days of Obs and Gynae teaching! – So far I have had 3 days of teaching that has been focused on Obstetrics and Gynaecology. We have learnt how to take a comprehensive history from both gynaecological and obstetric patients, which is important as we are expected to take histories during this rotation and present them to consultants before having them signed off as complete. Obs and Gynae histories are different to regular histories as it is crucial to include things such as menstrual history, history of previous births and sexual health history.

On the fourth day of Obs and Gynae this rotation gave to me…
4 hours of Gynae theatre! – To accompany the gynaecological clinics I observed, I also got the chance to observe some gynaecological surgery This was really useful as the procedures being carried out often correlated with the histories I had heard in the clinics. For example the symptoms described by a patient with urinary incontinence were then managed by repairing the pelvic floor muscles, which was actually the first procedure I observed!

On the fifth day of Obs and Gynae this rotation gave to me…
The chance to assist in a C-section! – This was honestly one of the most amazing things I have EVER seen and will never ever forgot! I was expecting to just observe the elective caesarean section however the surgeon was so welcoming and invited me to scrub-in (so that I was completely sterile and could be near the patient) and be the ‘second assistant’! It was nerve-racking but the surgeon and nurses present were really encouraging. I assisted by using specialised equipment to hold the lower part of the open-abdomen down whilst the surgeon delivered the baby. The procedure was much quicker than I expected and was so emotional. I still can’t quite believe that I actually assisted bringing a new life into the world – amazing!

On the 6th day of Obs and Gynae this rotation gave to me…
A day on the children’s ward! – As I said earlier, every part of this rotation is brand new to me and I have little/no experience on the wards with any of it! On my first Paediatrics day at RLI I observed the morning ward round. It was really good to see the range of conditions and problems amongst the babies and children on the ward. There was also a huge age range; from 2 months to 16 years old. The ward round was definitely a useful introduction to this rotation! I saw a lot of children with respiratory difficulties as well as teenagers with psychological problems.

On the 7th day of Obs and Gynae this rotation gave to me…
A day at a Community Clinic! – As part of the Paediatrics rotation, we have the opportunity to attend a clinic based in the community. These clinics often involve children with developmental or behavioural issues. On the day I attended I saw children with suspected autism as well as motor development delay (this meant that they hadn’t learnt to walk or write as early as what is expected). This clinic was different to other clinics I have observed as the doctor often spent over an hour taking the history from the patients and their parents – I learnt that this was because so much detailed information is required in order to make a diagnosis of Autism or of a learning difficulty.

On the 8th day of Obs and Gynae this rotation gave to me…
8 hours of PBL! – As you may be aware, Lancaster Medical School has a problem-based learning curriculum. This means in small groups we use a patient-based scenario (sometimes based on real patients) to construct our own learning objectives in relation to the case, which we then go away to read about, before coming back as a group to explore what we have learnt. PBL continues in 3rd year and during this rotation we have covered topics such as child development, puberty, normal pregnancy, the causes of short stature, the menstrual cycle and the causes of abnormal bleeding. The PBL feedback sessions are conducted with a doctor present and so the discussions are very clinical – this is great for our learning as it means we can apply it to real-life cases we have seen so far.

On the 9th days of Obs and Gynae this rotation gave to me…
9 post-natal baby checks! – So far I have spent two days on the postnatal ward. My time on these wards has been spent carrying out baby checks on the new born babies. Baby checks are carried out within 72 hours of birth, to ensure there are no problems with the baby before they go home. I felt quite nervous carrying out a check by myself at first because I have never actually held a new born baby before! However the doctor I worked with was really encouraging and so I soon felt more confident.

On the 10th day of Obs and Gynae this roation gave to me…
10 children who needed measuring! – The paediatric rotation has also given me the chance to observe several clinics based at the hospital. The patients I saw in these clinics had such a wide range of problems – from abdominal pain to motor ticks. Before any infant or child is seen in one of these clinics they must first be weighed and have their height measured – this gave me a useful opportunity to practice my hands-on skills on children of a range of ages! I was also then asked to plot these measurements on growth charts to visualise how the child was developing.

On the 11th day of Obs and Gynae this rotation gave to me…
11 different histories to take! – As with any rotation, we are expected to take several histories of different cases. A history is basically the patient’s story which described why they are in hospital and what medical history they have. Taking histories from patients not only gives us an opportunity to practice our communication skills, but the different conditions/problems covered also gives us a chance to explore the features of these conditions further, which helps broaden our knowledge. So far I have learnt about endometriosis, induction of labour, prolonged rupture of membranes and intrauterine growth restriction (just to name a few) purely from taking histories!

On the 12th day of Obs and Gynae this rotation gave to me…
The long awaited Christmas break! – After a very long first term back (3 months and 3 weeks to be precise!) my peers and I are looking forward to a break. This term has been SO good; I have been introduced to several new specialities, learnt so many new things, met some inspiring people and had the opportunity to observe and take part in so much! It’s been very hands-on! But of course it goes without saying that everyone needs a break every so often, and a good work-life balance is crucial. Therefore I am really looking forward to spending Christmas at home with my family and friends and enjoying the festive season, before returning in January and continuing where I left off!

Merry Christmas everyone! 🙂