Today something happened that is hard to get used to. Someone used the phrase “because we’re doctors” to me. Directly to me. Now, usually when this happens I feel a real obligation to say, “Well, I’m still just a student.” But there was literally nobody else around, and the speaker knew fully that I am a student. It felt a bit odd, but I suppose it will be true eventually.
For this year at least, classes are over. I am a little uncertain if we will be having regular classes next year or not. I think it will depend on the rotation. There are five main divisions next year, Rural Medicine, Surgery, Mental Health, General Practice, and Medicine. I think they will all run a little differently, and have heard rumours of PBLs next year as well, but run on one day instead of two (separated by study on the topic) and that there might be days or half days of lecture next year.
Anyway, it’s a little sad to realize that the student life as it is formally recognized has come to a close for this campus, right when I started to feel like I knew what was going on. I am really excited about next year though. It will be a lot of learning as it is a paradigm shift moving into the hospitals on a full time basis, but I’m looking forward to it. Now I just need to get through these next exams. I have three rounds of assessment coming up, called the MSAT, PSA2.1 and PSA 2.2 respectively. The MSAT is a Multi-Station Assessment Task, which is a live exam of five different stations, as the name suggests. There are: Clinical Reasoning, Examination, History Taking, Ethics and Advanced Life Support stations. The idea of this exam scares me, as I feel as though there’s nowhere to hide. Just you and the examiner. And the patients I guess… they usually are actors at this stage, but some might be patient-actors with real signs. This test is on November 8 for me.
Then on the 10th and 11th I have two more exams, the first being PSA2.1 (Progressive Summative Assessment) which is based on material from this last semester. Then the next day is based on all material covered up until now.
Then my plans are to recover a little from the exam, clean up and go check out the Sunshine Coast, as that is where I will be living next year, and then I’m headed to New Zealand for 10 days. I will be home in the beginnning of December. I am looking forward to being home very much.
I know I haven’t updated this in a while, but I have been spending less and less time with my computer on. I have recently bought a few text books that I am really getting into and have printed out my student notes. This means that I have not been updating as much, since it hasn’t been in front of me. But life is pretty good, I am currently preparing for my final exams which are coming up in a few weeks. In the last little bit I had a party for my birthday which was lots of fun, we had a holiday for a bit, and now I have been back at class for a few weeks. My life has settled into a zone where I know what is going on. I know how to be a second-year med student. That has made day to day life feel like it isn’t as report-worthy as before. The adventure is becoming more commonplace, but I am still loving it. I miss everyone at home so much, and am sad for the good times together that have been forfeited. I am living. Here.
All the year 2 med students have a list of examinations that they need to perform for a clinical tutor this year. I finished my list today with a cardiorespiratory examination. I know it’s a small victory but finishing the list was a huge relief, and a little bit of a marker in the sand. I have been previously going through the clinical examinations wondering if that’s really what is done in practice, as it all seemed like a little bit of an abstract song and dance to me. But today I felt like I knew what I was looking for, and why. I felt as though I was, despite being a bit nervous, able to balance talking to the patient as a human being, being aware of what they needed while still doing what I needed to do. And it felt great. The tutor I was with was very encouraging and more than willing to teach while examining. Also, in the actual examination I was able to discern what was happening to the patient, which is one of the first times I have done that without really asking the patient what is going on, or knowing the background from the history. I know that it’s a pretty minor thing, but as I said, it’s a little victory. And with years and years of training ahead of me, I need to take the little victories.
My reward after all this? Three written words:
It’s a small step I know, but I find it pretty encouraging.
Gave blood again. This time I didn’t stock up on fluids before hand as much. It seemed like I couldn’t even feel it last time, so I thought it was no big deal. Within ten seconds of sticking the needle in the nurse growled at me “How much have you had to drink today?”. Umm… some? She said she could tell my blood was slow. You would think that they would want to get as much blood as they can from me, I mean, they can get salt water elsewhere. But it did seem to take longer to get out as well, so maybe that’s what she was annoyed about on a busy day.
Just to put a marker on the day, today is the day that we undertake the first actual procedures on people we don’t know. Up till now we have practiced on each other. When we have been involved with patients, it was more a case of observing their pathology post diagnosis, and nothing remotely invasive. Soon, this won’t seem like an event at all, but right now, I feel like I crossed a bridge today.
Recently I started getting the Canadian Medical Association Journal. It is striking to see the amount and directness of the pharmaceutical ads in there. I suppose I don’t really want them to mess around with weird messages anyway. Indication and efficacy is good enough for me. And it’s pretty handy to start getting exposed to the trade names and full names and doses of things. Maybe I’ll learn something by osmosis. I received the whole year of back issues so I will flick through them. Seeing them here reminded me of a fixture of my childhood memories, a stack of water soaked journals. I think it will be good to get me up to speed, keep me in touch with the Canadian medical climate and hopefully make me better at what I’m tryi to do.
After a long time away I’m back to it. Both here and elsewhere. The last month has been full of studying, feeling helpless and going nowhere, exam writing, time off, trying to rest and trying to make sense of it all. The exam was a gong show, with almost everyone doing poorly. I did hear a rumour of someone getting a grade in the 80s but it has yet to be confirmed. My colleagues around me were surprised when the person mentioned that “they knew someone” who scored like that. That gives you an idea of how the class did.
While studying I didn’t feel like writing much, as each day seemed the same for so long. Then I kinda dropped off the habit and here we are! I am back into class now, even tho the rest of the students at UQ are now on break. It’s great, cause like in January, we have the campus nearly to ourselves. We are doing the nervous system these weeks, which are pretty packed sessions. I’m glad we didn’t have a long break like last time, as it was very hard to get back into it after being away.
This is my 500th day in Medicine. It feels like every other day, except that it’s noon and I haven’t left the house. I got out of bed, put on a hoodie, made a coffee, and sat down to my desk.
My life is exciting. That’s why I’ve been writing so much about it lately.
This year we are seeing a lot more actual patients. It is really interesting, and when you see, touch, smell and talk to a person with a condition, it seems to be much more memorable.
I thought I would just take a few notes of when I see these patients, to help me remember, and to plot my development in understanding the massive field of medicine.
Some of the conditions I have seen this year include atopic dermatitis, bullous pemphigoid, Multiple Endocrine Neoplasia-1, Pityriasis Rubra Pilaris and mycosis fungoides. You may or not be able to tell from that list that my clinical coach for this block is a dermatologist. We have put much effort into elucidating the subtleties in the differential diagnosis for erythroderma.
This past week we saw a patient with Hidradenitis Suppurativa. This is such a horrible disease of the skin in which it is so badly chronically inflamed by a form of acne that over time, scars, tracts and comedoes form such a disfiguration of the skin that it looks like someone had recovered from massive burns. Often the skin remains ulcerated and open. The chronic inflammation often precedes development of cancer. This patient was 43 but it looked like he was in his 60s. It is so severe it destroyed his life.
I won’t be able to forget that for quite some time. Hopefully I never will. If I do, I can maybe look back at this to remember.
Copyright © 2008 - graffiX Publishing All Rights Reserved. 1759.5