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! 🙂