Cecilia Vinchenzo

/ Lauren Kennedy

Arriving at Lancaster on move-in day I was simultaneously very excited and very nervous . Upon arrival at my college we were greeted with friendly reps who showed me to my new room. I felt very out of my depth and it didn’t feel real moving away from home for the first time, but quickly my flat mates and college reps helped me settle in within hours, all my fears and nerves about moving to university were gone!

For me Freshers Week was a very memorable week. Every night my college hosted a different themed event – ranging from Casino Royale fancy dress to a UV paint party. A highlight for me was the university campus bar crawl as we got to see every college bar and meet so many new people. It was fun getting to know my flat mates and becoming friendly with lots of people in my own college and the other colleges on campus. There were all sorts of events going on during Freshers Week – medical and extra curricular. I went to the Freshers fair midweek, which was great, and I got to check out many of the societies the university has to offer – there are so many it was hard to choose what I might like to join!

My first clinical skills session at the Royal Lancaster Infirmary education centre was daunting not just for myself, but also for my classmates – we didn’t know what to expect because it felt like ‘real doctor stuff’ and it was only our first week! It turned out to be a lot of fun, alongside being a necessary educational part of the course, and it is now something I always look forward to on a weekly basis. Keeping it simple and basic we were taught the globally used Ayliffe hand washing technique – something we will need to use for the rest of our careers. We thought we knew how to wash our hands, but we were wrong! The essentials of personal protective equipment and correct waste disposal were also discussed.

The entire first year class were invited to attend the Medics Society Freshers ball. To put a twist on the event it had a masquerade theme. Everyone donned their best suits and dresses and enjoyed a lovely meal, getting to celebrate surviving our very first week of medical school! Many medical students from other year groups also attended which was great, they imparted some brilliant advice and were eager to meet all of the first year students. The ball was an amazing way to meet my classmates outside of the lecture room environment.

I am so glad I chose to study at Lancaster – I’ve had a brilliant start and I can’t wait to see what the rest of the year brings!

Mel Sarigul

/ Lauren Kennedy

First term complete, bags packed, presents wrapped and I am ready to return home after a busy semester.

I am now more comfortable with PBL. I still have the odd feelings of being left to drift alone in a vast, empty ocean worrying that I have missed something important but these pass fairly quickly. The learning objectives we come up with as a group on the whole match the intended learning objectives and the lectures continue to give us guidance on depth. Our group has really learnt how to work effectively together and we have a great dynamic. Aside from the educational perspective PBL has meant that students get to know each other and I have made great friends. I will be sorry to change my PBL group but also excited to work with a range of people.

I was quite late in ordering my stethoscope because I had to make the very important decision of what colour I wanted (turquoise or classic black? Smoke or brass tip?) and what to have engraved (should I include my full name or just my surname? Would ‘Life is short’ be inappropriate? Why isn’t ‘Laughter is the best medicine’ 24 characters long?!)  I was glad I waited though as often you are given a discount voucher at Fresher’s fair.  My stethoscope arrived as we were learning to do a cardiovascular examination and I got childish pleasure listening to a friend’s heartbeat. That’s one of the great things about Lancaster – medical students start their clinical training early on. Since you are practising on healthy individuals usually you can’t feel/hear much but the emphasis in first year is normality. The idea is that if you know what normal feels like you will immediately be able to identify when something is abnormal later on in your studies.

We have started Communication skills which teaches how to effectively take a history from a patient. It is nerve racking to have to get up and interview a stimulated patient with a camera and 5 sets of eyes focussed on you! Trying to uphold an image of calm and reassurance when in reality your mind is desperately searching for the next open ended question to ask all whilst nodding and maintaining eye contact. As embarrassing as it is to watch yourself back it gives you an opportunity to evaluate what you could improve on.

I feel that I am in a better position now than I was at the same time 4 years ago when I was doing my first degree. I have been practising clinical skills on anyone I could get my hands on, annoying friends with open ended questions and PBL means that I have made most of my notes already and remember the main concepts. Now comes the hard bit of learning the nitty gritty stuff in time for exams in January.

Mel Sarigul

/ Lauren Kennedy

Walking up those stairs I was nervous but excited about meeting my new flatmates. Opening that kitchen door and seeing the fresh faced bright eyed 18 year olds for the first time my first thought was… Oh my God they look so young!  I applied to Lancaster after completing my Biomedical Science degree and taking a year out so I was anxious about being the oldest in my flat and course. We soon bonded over some lasagne though which was compliments of Furness College!

The way Lancaster’s freshers’ week works is that you go out to events your college has organised for you. Furness being the best college (obviously) had a paint party, glitter party, on and off campus themed bar crawls and also events such as ‘Top of the Blocks’. At this stage I had not met many medics but used this opportunity to bond with my flatmates and the block over a couple of drinks- or more.

Medsoc is a society especially for medical students. They organise socials and also provide revision material and mock OSCEs nearer exam time.  During Fresher’s Week there was a meet and greet at Revolutions which had a great vibe. Lancaster’s Medical School is one of the smallest in the UK meaning that the medical community is very close knit. The older years were really friendly and first years were able to meet each other in a relaxed environment. Other societies such as Medsin provide volunteering opportunities such as SKIP or Teddy Bear Hospital.

The first PBL session was a shock to the system. Having being used to a lecture based course previously, I was not prepared for the freedom that comes with PBL. We had to read a scenario, pick out key points, discuss them, then make learning objectives with the focus being on the upper GI tract.  Our group initially struggled with constructing learning objectives but eventually came up with a workable list which we had to go away and research. The feedback session was useful in that not only do you reinforce your own learning by explaining concepts but can also ask about any areas you found challenging. It can be difficult to gauge how much detail we need to go into a topic but the recommended resources gives us an idea – so don’t worry if someone decides to learn some random cell pathway and you’re sat there completely lost!

I went into my first anatomy not knowing what to expect.  As it turned out the sessions were quite informal and very informative. Every week you have two hours of anatomy which are organised as 3 stations. There are lots of models to use, books and more importantly friendly and approachable demonstrators. The small groups are great as you have more contact time with the demonstrators some of which include Radiographers, Doctors and Anatomists.

So far I have enjoyed being part of Lancaster University and its Medical school. I look forward to the challenges ahead of me.

The beginning of third year…

/ Emily Hedley

As I write this I am coming to the end of week 6 of my first rotation of my third year at medical school. Year 3 is split into several rotations including; Managing Long Term Conditions (MLTC), Women & Children, Psychiatry, Neurology & Elderly, Sexual Health & Therapeutics and finally a third Special Study Module.

For the last 6 weeks I have been on the MLTC block. I have been on placement in General Practice 5 times and I have REALLY enjoyed it! As well as observing many consultations at the surgery, I’ve also accompanied the GP on home visits where I assisted taking patients’ histories and observations such as blood pressure and temperature.

Back at the surgery I had to also complete 8 ‘hot seat cases’. For these I sat on the GP’s chair and took the histories from the patient as though they had come to see me. I then had to examine the patient if necessary and suggest a management plan before getting feedback from the GP and discussing my ideas for the differential diagnosis. The first couple of these cases were really nerve racking and it felt a bit strange that real patients trusted me to listen to their story and examine them as though I was a real doctor. The GP was really helpful and so I become more confident so that by my 8th case I felt quite comfortable! In addition to my GP placement I’ve also been to some Ear, nose and throat clinics – I enjoyed this a lot more than I expected as they were really hands-on as the consultant had us practice using the equipment to examine the patients. Overall the MLTC rotation has enabled me to see such a variety of patients and conditions, which is why I think I have enjoyed it so much.

I am really looking forward to my next rotation – Women and Children, because it is something completely new to me as we did not go onto the maternity wards last year, nor did we spend much time in paediatrics. It’s also been months since I’ve been on the wards, with having GP placement first, so it will be good to go back!

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….!

Huz Khojani

/ Lauren Kennedy

Starting 4th year

You would imagine that starting fourth year of medical school would be a daunting experience, knowing that your final university exams would be at the end of it. But as it turns out, that isn’t the case. There is a tremendous amount of confidence that comes from passing exams at the end of a medical school year, and so by the time that you’ve done it three times, you feel unstoppable. “Bring it on!” you declare to the challenge that lies ahead.

The first day of fourth year starts very similarly to how every other clinical year does; an entire day dedicated to talks that reinforce the principles of that we have been taught from the beginning, such as how to keep patients safe as well as ourselves. Then, during the final segment of the planned day, we are given the information that is most important to us; how fourth year is organised and which groups we are placed in.

In a nutshell, fourth year consists of a whistle-stop tour of the entire hospital (excluding the Accident and Emergency department). Four weeks are spent on each specialty except Medicine and Surgery, which get double the time. This makes sense, as these can be argued to be the “meaty subjects”. Because there are so many specialties to see, the year group is divided into groups that would rotate between the specialties. The concept of having “rotations” has been persistent since second year, however this year the groups are as small as five students. This means that a majority of the academic year will be spent with the same four people.

The first big change of the year that is quickly noticeable is the higher level of respect given on wards by doctors and more junior students. Along with the respect comes an expectation that we are able to perform more and better clinical skills on the wards. This means that we are given more responsibility in clinical practice, which I very much welcome. So far, the year has had me and my clinical partner running our very own GP clinic, as well as clerking patients in on a paediatric ward. Clerking a patient means that you are the first person that a patient talks to once they are admitted to the hospital. This can seem incredibly challenging as there are no patient notes and you are left with nothing but a stethoscope and your own clinical knowledge to determine what might be wrong with a patient. However, having a hands-on experience to this degree does make you more emotionally invested into the patient’s condition, resulting in remembering the features of the patient’s diagnosis for a long time in the future.

Not all clinical experiences have been rewarding however. The most frustrating time that I have had this year was when trying to examine a child who refused to let me go anywhere near them, but managed to pull at my ID badge and undo the lanyard that is attached to it from around my neck. Being particularly fond of my picture, the patient decides to put my badge into their mouth and starts chewing on it. The next half-hour is spent trying to get it back, which was a lot harder than expected.

As eventful as fourth year has been so far, I look forward to the challenges that it will definitely bring in the future. By this point in medical school, instead of seeing these challenges as problems you see them as opportunities to continue growing

Beth Stockton

/ Lauren Kennedy

First day on the ward

Our second week in hospital was the first time we were sent to the wards to speak to real patients. It was scary because there was nobody with us, and we had to approach nursing staff and the patients ourselves to ask to speak to them. You feel bad bothering them, but most patients are actually happy to have someone to speak to, and the nurses give advice on who might be better to speak to as well which was really helpful. It’s difficult to write notes the same way as we practiced in the OSCE because you can’t control what order patients tell you information. There tends to be a lot of stories that, even though they can be interesting, they aren’t what you need to write in your history. It can be hard to steer patients towards what you need to find out, but I’m hoping that will come with practice.

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!