Monthly Archives: March 2009

A Week in the Life (Thursday)

8.30am: I have a free day — the only one in this whole block, actually. Of course, that doesn’t mean that I have the day off, it just means that I have nothing on my timetable. In a fit of optimism, I had set the alarm for half-past eight, thinking that I would get up and go in and finish the coursework. It takes about three seconds of consideration before I reset the alarm for a more humane time and go back to sleep.

10.30am: It’s almost ridiculous how good it feels to have had a lie-in, and to be able to take a nice, unhurried shower and not bolt down my breakfast as I rush out of the door.

11.45am: I arrive at the Wolfson and find a spot in the SL.

12.05am: A friend who has the mock OSCE this afternoon turns up, and I spend some time practicing comm skills with her and running through the components of some of the examinations.

1.25pm: As she leaves to go to the exam briefing, I get myself a cup of coffee and finally turn my attention to the still-not-finished coursework for which my enthusiasm is definitely starting to wear thin. I have two questions left, and, unlike the debacle of last night, I’ve at least done all my research for these two and just need to put everything into some kind of coherent structure that actually answers them.

4pm: I’ve spent a stupidly long time trying to reduce my word count for the last question — it’s easy enough to discuss the changing incidence of oesophageal adenocarcinoma and the reasons for it, just not in 250 words — but I’m finally, finally done with the writing portion of this.

4.20pm: I’m armed with fresh coffee and I turn to the business of making it look nice. This year, the faculty are obsessed with encouraging us to use hand-drawn diagrams in our coursework and they’ve had plenty from me, but not for this one. It’s histopathology. Obviously, I could sketch what I might expect the cells to look like in adenocarcinoma and I could draw the tongues of columnar epithelium that you would most likely see coming towards the proximal end of the GI tract in Barrett’s oesophagus, but, quite frankly, it wouldn’t be much good and there are lots of very nice people who have taken actual photographs of these things and put them in journal articles, so, rather than spend three hours trying to draw a picture of some pink mush, I’m using those.

4.55pm: And now the referencing. I’ve kept track of the resources I’ve used and when I’ve used them, so this should go quicker than it has in the past, and, aside from running downstairs to get the actual publishing information for a couple of textbooks that I’ve been using photocopies from, the whole process is relatively painless. Although, I’m not at all sure how I ended up with eighteen separate references.

5.30pm: The coursework is DONE. I want to go home and take the rest of the evening off, but I have PBL tomorrow morning and I’ve not touched it yet. I’m fairly sure that most of my group will be every bit as unprepared as me, so I make a deal with myself that I’ll do as much hepatitis as I can for the next two hours, enough that I can at least talk about something tomorrow, and then I’ll go home and take the rest of the evening off.

7.25pm: I have made myself summary sheets with the structure, epidemiology, mode of transmission, clinical features, diagnosis, complications, and risk factors for each of the five different kinds of hepatitis and that is going to have to do.

8.40pm: After getting home and feeding myself, I end up reading the SIGN guidelines for the management of gastric and oesophageal cancers to look for a reference to a very specific piece of information that the flatmate has got in her essay and can’t remember where it came from.

9.15pm: I put in a DVD and get out the cross-stitch that I’m working on for my goddaughter. Yes, this is my night off. I am quite the party animal.

11.10pm: I say goodnight to my flatmate, who is still organising diagrams and references, and crawl into bed with my book.

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Posted by on March 31, 2009 in Blog, Medicine


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A Week in the Life (Wednesday)

7.50am: I roll out of bed, find my matric card and stethoscope, and make coffee for myself and the flatmate.

8.50am: We arrive at the Wolfson to find one-third of our year waiting around in the cafeteria. Eventually, the doors open and we troop into a seminar room to get a pre-exam briefing. We’re asked to volunteer as patients for this morning’s exam, and I agree to have my limbs examined in the session after mine. At one point, the briefing turns to discussion of the procedure for the real OSCE, which does nothing for my nerves.

9.45am: The first group are sent upstairs, and the rest of us go to seek caffeine. Having established that we’ll have to do some kind of examination on a limb, we spend an inordinately long time trying to decide whether it will be muscoloskeletal or neurological. We hope for neurological, as none of us can remember how to do GALS properly.

10.10am: We proceed up to clinical skills and spend a long, long time waiting for the first group to finish. I find my partner and, by a coin toss that I lose, we decide which of us will be going first.

10.35am: *PHWEET* My station is a cardiovascular examination. I introduce myself, gain consent, and wash my hands. I’m instructed to miss out the examination of the hands, which throws me off my rhythm so that I end up missing out the face, too. The examiner is nice and tells me what I’ve done wrong, and I go back. I suppose this is the point of a mock.

10.41am: *PHWEET* I watch my partner do a musculoskeletal examination of the upper limb, grateful that I’m not doing this station.

10.47am: *PHWEET* I’m asked to take a history from a patient with chest pain. This is the first time I’ve really done a communication skills station under exam conditions — the mock OSCE in first year, which absolutely nobody took seriously, does not count. I’m very aware that I do not have all the time in the world, and I feel as though I’m rushing through the history. I summarise and finish with about fifteen seconds to spare, and I leave with my mark sheet. I’ve missed a couple of simple things, but I got most of the points and the patient has scored his impression of me highly.

10.53am: *PHWEET* My partner gets the urinalysis station. It’s a bit weird, we haven’t really been taught how to do this in VS but it’s so quick that there’s plenty of time to read the instructions on the dipstick container!

10.59am: *PHWEET* It’s my turn again and I’m confronted with a plastic bum. I introduce myself and ask it for consent, and then I find gloves. I distinctly remember the time in first year when I was an examiner for this station at the third year mock OSCE and one of the students forgot her gloves. So far as I can tell, I do everything right but I can’t find the prostate.

11.05am: *PHWEET* The second communication skills station, and my partner is doing it. This is a fiddly one to get all the points on — it’s about the Access to Medical Records Act, and you need to know a lot of detail and be able to give it to the patient.

11.11am: As my colleagues start leaving, I pick up the card that identifies me as Limb and head back to the musculoskeletal station. I wait around for a few minutes until someone comes in to tell me that I won’t be needed.

11.30am: I take myself and my laptop to the SL. I need to make a dent in this bloody coursework.

1.50pm: I’m finally in the essay writing zone and I’ve managed to complete one of the questions, but I have to abandon it for two hours and run across the street to a two-hour lab on digestion. The lab is quite dull and involves a lot of pipettes, and I end up having an argument with one of the demonstrators about the correct way to put a cuvette into a spectrophotometer. I don’t often get all I Was A Biomed on people, but when they’re doing it wrong

4.15pm: After stopping to make myself a cup of tea, I head back into the SL and plough on with the coursework. The last piece didn’t get finished until 3am on the due date, and I’d prefer not to do that again. I complete a second question in reasonable time and I’m hopeful that I’ll get at least one more done before I go home.

6pm: In the whole of the universe, there does not seem to be any information on the third question.

8.20pm: I’ve gone through PubMed like an obsessive person on crack and I’ve looked the topic up in the index of every book in the SL that looks as thought it could be remotely relevant, and I have had no luck. I decide to give up and head home, where hopefully my flatmate will have done this question and I can at least ask her which books she’s used for it.

8.22pm: As I’m shutting down the computer, I find the answer to the third question in an article that I’ve had open on my desktop this whole time. I manage not to scream, but it’s close. I think about staying until it’s done, but that lasts for about two seconds. I’m so tired that my eyes feel like they’re about to fall out of my brain and I want something to eat.

8.30pm: There is momentary terror when my swipe card fails to open the doors, and I wonder whether I’m going to be locked in the building all night. Before it has a chance to develop into full-blown panic, someone else leaves and I’m able to get out. Note to self: ask security why my swipe card doesn’t work.

9.05pm: I arrive home and make dinner.

9.40pm: Back to work. I’m painfully aware that this has now been a thirteen hour day, but deadlines are deadlines. The question that I want to finish has a word limit of 150 words and is quite straightforward now that I’ve found the information, so it doesn’t take too long.

10.35pm: The question is finished, and, although the coursework is by no means done, I feel as though I’ve made enough progress that I can pack it in for the night.

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Posted by on March 27, 2009 in Blog, Medicine


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A Week In The Life (Tuesday)

8.30am: I’m missing PBL this morning, so I get to sleep late — only a very little bit, but at this point in the term I’ll take whatever I can get.

9.25am: The queue at outpatients reception is almost back at the main entrance. It wasn’t so very long ago that I was coming into this hospital all the time, but this morning I’m here as a patient. It’s a busy clinic, so I sit down with my book and settle in for a long wait.

10.40am: I escape from the consulting room, released from the clutches of my dermatologist for another year. I take my appointment card to the reception desk and I’m asked when will be the best time for me on 30th March 2010. I only wish my schedule was that predictable!

11.20am: I arrive home and start loading up the washing machine. There is work I should be doing, but it’s been a busy couple of weeks and the day-to-day things have got a bit neglected to the point where I now need to do laundry as a matter of urgency. I can’t really turn up in pyjamas to my mock exam tomorrow. Soon, every item of clothing I own is either washing or drying or being put away.

11.40am: An email from my PBL supervisor with the objectives from today’s scenario.

12.15pm: Lunch.

12.45pm: Another email, this time from the SSM secretary to tell me that my SSM supervisor has marked my project. B. Excellent — especially considering I hated almost every minute of my SSM!

1pm: With a marked lack of enthusiasm, I start to do some reading for the essay due on Friday. It’s slow going and I keep catching myself thinking about other things, like chocolate and all the things that need to be done over Easter and how lovely it would be to have a nap. I make endless cups of coffee and count it as a victory that I manage to not actually have a nap, but I still only have a title page and 28 words of essay.

4.45pm: One of my friends arrives. I make her tea and welcome the excuse to abandon my laptop.

6.50pm: I collect my music and leave for choir practice.

7.07pm: The PA system informs me that the Inner Circle is temporarily out of service due to a ‘defective train’ at Govan, so I get on an Outer Circle train and go the long way around. I’m going through subway stations that I don’t see very often. I always forget how horrifically clashing the colours of the platforms on the South Side are.

7.35pm: As the warm-up finishes, I sneak in the back entrance to the lecture theatre we use for choir practice. I’m not too late, then. It’s the final rehearsal for a concert that we’re performing on Saturday, and everything is going reasonably well. It could all still go horribly wrong at the weekend — there is huge potential for technical hiccups, once we’re at our venue — but that’s part of the fun!

9.45pm: I make a brief detour to Tesco on my way home. Grocery shopping is another one of the day-to-day things that I’ve been neglecting, and I haven’t eaten dinner yet and I’m not convinced there’s anything at home to eat except maybe cereal.

10.20pm: Home! Warmth! Shower! Food!

11.15pm: In preparation for the mock OSCE we have tomorrow, my flatmate and I quickly run through the GALS exam to make sure we remember all the bits.

11.45pm: Time for bed.

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Posted by on March 25, 2009 in Blog, Medicine


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A Week In The Life (Monday)

Well, I’ve been wanting to do a week in my life and I realised this morning that this would be the last time I’d be able to do a normal week for my ‘preclinical’ years (if we can call them that). It’s the end of term on Friday, and I’ll come back after Easter to panic and lots of coffee and crazy crazy revision, which is inevitable but not quite normal, and if everything goes as I hope it does, my timetable will look very, very different by the time I next have the chance to do this.

I’m at my least productive on a Monday, and it shows…


7.15am: The radio starts talking into my right ear. I wake up for long enough to locate and smack the snooze button. This argument goes on for forty minutes — the absolute latest that I can actually get up if I want breakfast and coffee and to be on time.

8.40am: I leave the flat in a rush, thoroughly unimpressed with the wind and the rain.

9am: Pharmacokinetics FRS. It relates to last week’s PBL and would have been a lot more relevant if it had actually happened then, but I’m glad I came. The notes made precisely no sense when I was reading them through by myself, but the concepts are fairly straightforward once they’ve been explained and it all seems much simpler now that I’ve done some examples. The facilitator is cheerfully pointing out that we’ll do very little if any of the maths that we’re learning today in real life — we’ll look it up in the BNF! It’s true, but, as we all know, written exams rarely bear any resemblance to real life, so I need to understand it anyway.

10.50am: I’m free for a couple of hours, so I take the subway into the city centre. I lost my phone at the weekend, and I need to get a new SIM card from my service provider. I’ve been practically uncontactable for nearly 48 hours and I’m starting to go a little bit nuts.

12.15pm: Time for a quick lunch and email check.

1pm: A lecture on viral hepatitis. According to the block outline we’ve been given, this will help with PBL tomorrow. It’s an interesting subject, and the lecturer keeps it mercifully clinical and doesn’t labour over the molecular pathogenesis of anything.

2.20pm: I reach the SL, where I plan to do some research for the coursework that’s due in at the end of this week. I’m particularly looking for a journal article that I’ve not been able to get into from home, but it quickly becomes clear that I can’t access it even on campus. I start going through PubMed to see if there’s anything else that looks useful, and I find a decent amount of information that should help.

3.45pm: I become distracted by a message about a political issue that means a lot to me, and time slips away…

5.05pm: I left this morning without my swipe card, so I have to pack up and go home before the building gets locked.

5.50pm: My flatmate is in when I get home, so we have coffee and catch each other up on our days and make dinner.

7pm: Unfortunately, back to work. I’ve done most of my PBL, but there are a couple of objectives still left to finish, and, even though I’m not actually going to be in PBL tomorrow to do the feedback, my to-do list for Easter is already as long as my arm and I really don’t want to start adding more catch-up to it. I pull Kumar and Clarke off my shelf and start looking up information about obstructive jaundice and gallstones.

7.45pm: Our internet dies and no amount of poking or rebooting will bring it back to life.

8.41pm: I’ve been on hold with Virgin Tech Support for the past hour or so, trying to fix things. It worked for a brief, shining moment and then died again, and I had to go back into the hold queue. I have now got Gymnopedie on an endless loop in one ear while watching The West Wing on my laptop to pass the time until someone answers the phone.

9.30pm: Finally, the internet is working and I get back to PBL. It turns out that gallstones are more complicated than I thought — for one thing, I didn’t know there were two kinds, which is probably quite an important thing to know.

11.30pm: Shower. Bed.

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Posted by on March 24, 2009 in Blog, Medicine


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Restoring My Faith in Humanity

There must be something that medics recognise in each other.

(I spent a good chunk of a recent Sunday morning trying to convince my priest that we do not wear sandwich boards and are not identifiable on sight, but it turns out that I may be wrong.)

Today, I was hunting through the short loans collection of the university library for a couple of public health books. There is a list of essential reading in my VS notes and I am supposed to use these books when I write my Family Project. There is a list of essential reading in everyone’s VS notes and we are all supposed to use these books when we write our Family Projects and the deadline is two days from now, so perhaps there was an element of foolish optimism to my search. The computer was claiming that one copy of at least one of the books was left in the library, so perhaps not, but the shelves were telling a different story.

As I started to go through the piles of recently returned books on the check-in desk, a girl who I don’t remember ever seeing before came over from the self-return machine and said,

“Are you looking for Family Project books? Here, take these!”

I don’t know how she knew that I was a medical student. It might be the very particular brand of insanity that appears in our eyes when there’s an impending deadline or an approaching exam or a PBL that hasn’t been done. It doesn’t really matter how, but it was an awfully nice thing she did for me. It seems like such a tiny thing when I write it down like that, but it’s the kind of niceness that doesn’t happen very often and is going to make my weekend so much easier.

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Posted by on March 14, 2009 in Blog, Medicine


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*brain melts*


I’ve managed to thoroughly confuse myself with this PBL. It’s not that it’s conceptually difficult, and it’s not even this PBL so much as it’s how this one relates to the last one. My facilitator wouldn’t like that — she’s the kind who starts turning interesting colours every time we try to bring something from ‘outside the room’ into the brainstorm, which led to a deafening silence on Tuesday when she didn’t want us talking about the Helicobacter pylori lecture in the brainstorm about Helicobacter pylori. Anyway, leaving aside the fact that she would start twitching if I said this in front of her, there are times when one PBL is a logical continuation of the last and this is one of them. In the last one, we had an objective about the control of gastric motility, and it’s sort of tangled up with the control of gastric secretions (which makes sense, a nerve going to the stomach is a nerve going to the stomach!) and it all got put into my notes together. In this one, we’ve got an objective about the control of gastric secretions. So, in order to keep from getting in a worse knot than I already am, I’ve gone back to my notes from last week and I’m trying to sort out which one is which.

And since neither Vander nor Tortora have bothered to differentiate them particularly well…

My brain has melted out of my ears.

On the other hand, I’m rather proud of having come up with the term ‘gastric anticipation’ to describe the cephalic phase of digestion. I blame (or credit) the gastro consultant who took us yesterday for an FRS and demonstrated it on me by asking what I was having for dinner and then talking (and talking and talking and talking) about fish and chips.

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Posted by on March 11, 2009 in Blog, Medicine


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Quick Breather

I’m taking an hour of downtime in a day that involves an awful lot of running back and forth across great swathes of Greater Glasgow and Clyde.

This morning was a visit to gastroenterology at the outlying hospital that my VS group is assigned to this year. It took a wee while to figure out where we were meant to be, as we hadn’t been given a ward number, just the name of the doctor we were supposed to report to (and it’s a big hospital!), but the teaching was good and it was nice to be getting a little bit of clinical practice again. And scary, too, to think that unless this summer goes really badly and not counting the OSCE, it was the last time I’ll be in a hospital as a second year.

Although, the possibility of this summer going really badly is not something that I’m ruling out. They returned our mock exams last week, and –- well, I seem to know the cardiovascular bits of Block 9 reasonably well, and it was before all the work that I got done over SSM, and, anyway, I didn’t think for a minute that I’d come anywhere close to passing it, but. Suffice it to say, I have work to do.

I’ve come back to the West End for a couple of hours, and then back on the road to visit the babies who we’ve been seeing for our family project. This is important, as it’s due in ten days and my group members all agree that our current progress looks very much like a blank Word document. But, for now, I need to find some caffeine before heading off to the plenary that I’ve got in twenty minutes.

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Posted by on March 4, 2009 in Blog, Medicine


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