Fifth Year

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!

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.

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!

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 beginning of the end…!

/ Hannah Kolbe

So it’s official, this is our last year of being a student! If anyone reading this is a prospective Lancaster Medical School student, this believe it or not will soon be you. I remember being told that 4 years ago as we got our pictures taken together as a year group and thinking they were mad. There was so much to learn, so much to see and so many challenges to overcome…but they were of course right. There is still so much for me to learn and I don’t know if I’ll ever be ready for the big wide world, but it’s exciting to think at the end of this year in just under 11 months the reason I came to medical school will be reality. But there is 5th year to do first, and I can’t wait to get started.

It’s an exciting yet potentially worrying time to be a final year student currently, with all the discussions about what FY1 holds for me next year and the big changes set to come into place. This is the year that applications open for the foundation programme, where medical students from around the country decide where they want to work for the next 2 years. I think I am as prepared as I can be for this huge task, and there is always someone to speak to for help and advice along the way… I’m sure I’ll need it!

But before all that, I’ll re-cap what the first few weeks of 5th year have been like so far. At the end of year 4, after the dreaded finals were over, we were all off on our electives. Electives in Lancaster take place just before 5th year and give us a chance to go anywhere in the world (within reason!) to see what medicine is like elsewhere. It’s a 5 week placement with some travel time stuck on the end if you’re feeling adventurous. I decided to stay in the UK for my elective, and went to a Hospital right at the base of Ben Nevis in Scotland. My friends went to exotic locations like Malta, South Africa, Australia, Barbados, Cambodia – you really can go pretty much anywhere. I can honestly say, although the sun shine was lacking, I’m really glad I went where I did. As you can probably imagine, lots of people climb Ben Nevis each year meaning more people getting involved in traumatic situations. I went with the ambulance team and worked in A&E a lot, and it was sooo exciting! There is lots of advice about planning your elective when the time comes, so really think about what you want to get out of it and where you can see yourself living for 5+ weeks of your summer (you get your exam results while you are away!!) I’ve just finished writing my report about it and would recommend it to anyone!

Aside from submitting our elective reports, the beginning of 5th year so far has involved handing us a huge folder which by the end of the year will be fully complete. For now though, it is a series of things we have to do according to the GMC to become safe and competent doctors next year. Each year you will have a logbook to keep track of what you’re doing each year, and each year the skills advance and you start to feel like you’re becoming a doctor. In order to make sure we are able to carry out some practical skills on patients, we have had 2 weeks of lab-based training on models. I feel quite prepared for things like this having studied at Lancaster, because you are interacting with patients in a Hospital and GP setting from year 2, with log books each year that let you know where you’re up to.

In year 5 you get 5 rotations, each lasting 7 weeks – A&E, Ward placement, GP and 2 areas that you are interested in (I’ve picked paediatrics and intensive care/anaesthetics). I just started on A&E last week and am doing my first night shifts this weekend, so wish me luck! I’ll keep you posted on how it goes and how I find 5th year as I work my way through it – I think it’s going tibia good year….!

Abbey Barraclough

/ Rebekah Fleming

To prescribe, or not to prescribe? That is the question!

So in the middle of our second term of fifth year, we had our final formal exam – the PSA or Prescribing Safety Assessment. It is a national assessment of all final year medical students and dictates whether you can prescribe as a junior doctor. It is a fairly new thing and has only been around a few years, honestly a lot of us moaned and groaned about having to do it. However, on hindsight, it wasn’t all that bad and actually none of us should complain at having them make sure that the patients we will soon be writing out drug prescriptions for are safe. You’re given a BNF (British National Formulary), which is the bible of all things pharmacological, both online and on paper which is a real help. They do everything they can to help you, and it didn’t feel like one of those tests set out to trip you up. It is just a test of the common drugs you see in the various specialities, common interactions, side effects and the different ways you need to monitor them. Obviously there were some harder questions in there but you expect that. My top tips for all of the subsequent years would be, just as Tom Fisher the pharmacist advised, just familiarise yourself with the layout and the style of the questions with the PSA practice papers online. And not to stress out too much, I think it’s easy to underestimate the amount that you pick up naturally about prescribing and drug safety just by being on the wards.

The PSA came at the end of a week called Leadership and Management. This was completely different to any other week you have in fifth year and although full days of lectures can be a struggle – there were some real gems we all gained from it. It started with a simulation day. None of us really knew what we were in for until we got there and then it all became clear… The plan was to stress us all out! Not in a sadistic way I should add but to show you how easy it is to make mistakes when put under pressure, either by the environment or the team you’re working in. It was a real eye opener and an excellent learning point before we all enter the working world. There were then lectures all based around preparing us for life after medical school: pay, banding, qualities of a good doctor, teamwork, handling complaints and making mistakes. The talk on making mistakes and what to do when we inevitably as humans do make them was one of the take home talks. Doctors came in and honestly spoke about their mistakes and how the handled them, the good and the bad. It was an excellent way to remind us that even though mistakes will happen, how we approach them as a professional can make a huge impact on the outcome.

Finally, jobs came out and we all have one! So massive congratulations to all of the fifth year Lancaster Medics – celebrations are definitely in order! I am sure there will be lots of that, we have so much to look forward to, grad ball and graduation, in our final term back in Lancs. Almost at the end now!

Abbey Barraclough

/ Rebekah Fleming

The Situational Judgement Test

We have made it to Christmas! One third of the way through the year already, two fifths of our fifth year placements done and one of the biggies out of the way – the SJT. The Situational Judgement Test, or SJT because we medics love a good acronym, is basically the final years version of the UKCAT. It’s a fancy aptitude test that’s going to tell us if we are going to be good doctors or not. That’s the gist as I understood it anyway – there has obviously been a lot more research into it and that’s probably a massive over-simplification! You’re given a score out of 50 and that’s added to your academic score to go towards your junior doctor application. So it counts for almost half your final points – it’s pretty important! The questions are based on different ethical situations that you will encounter on the wards and how you think is the best way to respond. For example ‘you see a colleague shouting at another, do you a) do nothing b) talk to the colleague about their behaviour c) talk to your senior about the situation’ etc. There are two sections to the paper, the first you have five options and you have to rank most-least appropriate and in the second you choose the three best options from a longer list.

The actual test actually makes a lot more sense than the UKCAT, it’s only the same in that it’s meant to be one of those that you can’t revise for and is more about aptitude than knowledge. But I would argue that and say that revising for it is a good idea. There are practice papers online and it was definitely worth going over them, getting used to the style of questions and running through the timing. Going over the GMC guidelines is another good tip! After a while you begin to see patterns in what they are wanting from your answers, like talking to the person directly before escalating it to seniors was a common one. It is, or should be, common sense but I won’t lie some of them are a bit more tricky. I suppose it’s like anything, we just have to sit and wait now!

Next term we have our prescribing exam, should (fingers crossed) find out where we will end up as F1 doctors and start prepping for life after medical school. Along with helping to sort out things like the graduation ball, it will no doubt be a very busy but very exciting term! However for now, we have a few weeks off to put our feet up and make the most of our last Christmas without the threat of working. Hope everyone has a lovely Christmas and we shall catch up again in the New Year!

Abbey Barraclough

/ Rebekah Fleming

F1 Bootcamp

We have had our first month on placement as fifth years. Hectic is an understatement! But I am so glad that our course is the way it is. With finals all done and finished last year, it feels like placement now is all about focusing on becoming junior doctors and the job that we will be expected to do fairly soon. I’m on a surgical ward placement at the moment, working the hours of the F1 through the week and trying my best to keep up with what’s happening. You get to do loads of clinical skills and it’s great because you are taking the bloods and doing the cannulas but not just as a routine exercise. You’re involved in all of the aspects of the care the patients get, so I feel like I’m getting a better understanding of why things are being done and learning to interpret the results we get from them because I know the clinical history. It’s hard, but when you have a good day it’s brilliant! Plus, what better way to be a good junior doctor than to have seen first-hand the good, the bad and the ugly of the job.

On that note FPAS opened yesterday, that’s the application form for our foundation years. The form itself is relatively straightforward. Ranking the deaneries (fancy word for an area you apply to) is not. You have to list, from your first preference to last, all of the deaneries in the UK and even though you hope you won’t end up with your last choices, you still find yourself umming and arring because ‘what if?!’ We have two weeks to make up our minds and get the forms in, then it’s a waiting game. It seems like a huge thing to be applying to be a doctor but it is so exciting to think that soon we will be graduating and stepping out into the real world. If the rest of this year is anything like the last month has been, Lancaster is prepping us for it very well!

Abbey Barraclough

/ Hannah Crawford Leighton

Our Last Ever First Day

I’m not going to lie, I’m brand new to blogging and very inexperienced in anything vaguely technological, but when the opportunity arose for one of us oldies to share our experiences of 5th year with you it sounded like an ideal way to record our last year and hopefully, if at all I can, help some of you along the way.

We’ve had our last ever first day today. Four summers ago, when I sat there as a fresher, to be where we are today seemed like a lifetime away. Saying ‘fifth year medical student’ seems almost surreal; I’m not overly sure how that’s happened. It’s a terrible cliché but the time has literally flown by. And sitting there and realising that this was our last first day, this was our last start of a year in Lancaster, this was our last induction as medical students was terrifying. One minute you’re starting out in medical school, the next you’re doing finals and then all of a sudden its SJT’s, deaneries, FY1 applications and the prospect of your future life as a doctor. It’s exciting too though. The dream is almost a reality. Even if that dream has lost some of the rose tinting you had at the start and is a more realistic version of that same dream, it’s a dream nonetheless. You work so hard to get into medical school, and then harder still when you get here and it finally feels like the end is in sight. Although, of course, our enthusiasm for ‘life-long learning’ will never cease – I would love a show of hands of people who put that in their personal statements!

We are very well supported here at Lancaster, it’s one of the many perks of a small medical school and that is making the whole prospect of applications less daunting. The staff get to know you, you know where you can go for help and you know that you will be able to get that help if you ask for it. We get to know the clinical and educational staff throughout the years and being able to pick a referee who actually knows you, and well, is something we shouldn’t take for granted. Many of the larger medical schools really struggle when it comes to that bit of the form, or so we hear.
We were also introduced to the portfolio today; the fifth year equivalent of the log book. It is huge! All the things we need to be deemed competent as a junior doctor are there ready for us to get signed throughout the year, along with clinical cases, case based discussions and continual reflection to see how we’re improving. So not too much changes between the years. And it’s good practice for the rest of our careers. Starting out with all the enthusiasm of a new year, I’m very much hoping to keep on top of everything and be meticulously organised. But for someone who organisation doesn’t come all too naturally, I might have to keep you posted on that one!

I don’t want to get too emotional thinking about it being our last this and our last that. I love Lancaster and have had, am having, the best time at medical school here. Now all I have to do is fill in those blank pages of the portfolio and (fingers crossed) manage to get a job somewhere. If only it was that simple! Wish us all luck!