nine days in the life of a third year
Table of contents
nine days in the Life
sorta like one of those week in the life things you see on youtube. so this will stink a bit. at the time, i was a third year medical student at newcastle university.
Its Reading Week! In seven years of university, never had anything quite like this. So why not return home - kick back and relax and run over some people on Grand Theft Auto V! And once we’re happy with that, how about a time to reflect.
Monday 21st October 2019:
Its MOSLER day. Our first ever Modified Objective Structured Long Examination Review - just as daunting as it sounds. But to take-away my nerves before my 11am timeslot, I decided to head to the base ward - Elderly Care. Asked the doctor if he was a foundation doctor? He was a core medical doctor. Lesson #1: Don’t assume the training level of a doctor. After that shaky introduction, felt comfortable looking at patient notes, X-rays and blood results. Just remember structured frameworks and we’ll be more fluent in reporting results.
11am. The time has come. Sprint upstairs to meet my patient and examiner. History was going strongly - a couple of repeated questions but more to help lock-in my differential diagnoses. Examination was about to kick-off before a member of the nursing team pops in to say ‘We’re ready for your ultrasound.’ And lights out - MOSLER over. Examiner explains the examination findings and we’re off for our debrief.
How did I do? Well, I whiffed completely on the patient diagnosis - only one symptom was present - shortness of breath worsening over four weeks. Asthma? Right-sided HF? But a core condition that could present in this way could be a sub-massive PE. That was the patient. Hard luck for my first MOSLER. Great learning experience to focus on the core presenting symptom and branch out from there. Consider conditions that need to be ruled out before steam-rolling your way to a finite diagnosis.
Tuesday 22nd October 2019:
More patient circuits! Myasthenia gravis.Transient Ischaemic Attack. Stroke. Eye diseases. Multiple sclerosis. All presented in ways you might expect but pleasing to pick up on these diseases - even if examiner questioning did prompt a slight re-ranking of differential diagnoses.
In the afternoon, headed back to the Elderly Care ward to spend more time improving my diagnostic, examination and clinical reasoning skills. Visited a patient with neutropenic sepsis - confirmed to AML after a MDT meeting. Patient was yet to be told but will be soon once acute symptoms subside. Timing is crucial.
Wednesday 23rd October 2019:
GP visit! Met a patient with an extensive history of being systematically unwell - shortness of breath, cramping abdominal pain, burning on urination, back pain moving to the flanks. Possible pyelonephritis, persistent STI, renal colic. Routine Bloods, Ultrasound, Chest X-Ray - all ordered for her as an outpatient. A complete constellation of symptoms - further confirming the diversity of how patients present.
Thursday 24th October 2019:
Simulations Day! ‘Please take a history from this patient in AMU.’ There must be a catch here. There’s no way we’re taking a history from a patient for a full simulation. Instantly when we walk in, it’s a tonic-clonic seizure. Oxygen, start the clock, manage the airway, find protocols / IV lorazepam / PR diazepam / phone a relevant senior. Handled the emergency well. Credit to the team here - airway was so well-managed. Made my job as the end of the bed inspector fluid. Other stations were headache, stroke, meningococcal septicaemia - not too challenging overall.
Friday 25th October 2019:
Last day of Essentials Block! Clinical teaching fellows are excited because we’re playing articulate. Of course, its articulating various types of eplileptic seizure. Great end to a great start to the 3rd year.
Saturday 26th October 2019:
Edinburgh University Oncology Society Conference Day! Only around 15 in attendance but presenters were highly engaging and informative. Midday - presented my poster on machine learning classification on patients with a high-risk of tumour relapse subtype of ALL. Went smoothly - zero questions. In the afternoon, time to present my work as an oral presentation. A key question - that must be expected with bioinformatics-based projects is - ‘what is the principal focus of the project moving forward.’ Afterwards, I find out I’m the only oral presenter - the other two pulled out. Perhaps they were ill? Perhaps I was the only presenter to submit as an oral presenter? Perhaps they saw my project title and were put off? Either way, I’m walking home with the Oral Presentation Winner prize with a celebratory KFC in hand.
Sunday 27th October 2019:
Night shift back in A&E Epsom as an HCA. After my last shift over December on the wards, its great to be back and see some familiar faces. Also great to have a full team available, the difference it makes made the night run very smoothly. Not too many patients but the patients were handled smoothly and effectively. Pleased with how my first night shift went - great practise for life as a junior doctor in two and half years time.
Monday 28th October 2019:
Recovery day. A well-earned roast for dinner.
Tuesday 29th October 2019:
News comes rolling in.
I am writing to let you know that the judges have now assessed the entries for this year’s Paola Domizio Undergraduate Essay Prize.
Could it be? My midnight four hour piece to win the essay prize?
Unfortunately, your essay has not been selected as the winner for this year’s competition.
Not too disappointing really. I knew the essay was a last minute job but I was happy with the output in that timeframe. Previous failures - missing expectations in January exams, NSAMR ambassador role in 2018 have been overcome. This will be one to return to.