End of term, and a surprise result (yay!!)

Yayeeeeee!!! Finally the long awaited 2 week holiday is about to begin!!

I'm looking forward to hibernating under my duvets, eating lots of festive food, seeing some old friends... and generally just having some time off ^^

CSP week 2 was challenging.. not so much because of the content, but more the freezing cold lecture theatre, and the inability to switch the heating on.. or switch the air conditioning off!!!! Everyone is sat here with coats, scarves, and hats still on.. and I've even had to put my gloves on too! It's so cold in here!!!

But yay! That's the 1st term done and almost dusted, ICA results to follow in January, and to end it all on a high note.. I got some fantastic news this week!!

We had an email sent out to us randomly about an exam board meeting with instructions to check blackboard for rankings, deciles and distinctions..... And I checked my results and was lucky to get a distinction for preclinical medicine ^^ - yay!!!!!!!!!!

(One of the best random emails ever!!)

Now ... Xmas and general relaxation till CR in January!!

Zzzzzzzzzzzzzzz

MET3B End of Firm + ICA exams

Last week was incredibly slow at the hospital.

All the other medical students had already moved back to London, and it was just the 4 of us doing Met3b... and to be honest, at this point i was pretty burnt out from all the late night revision for the exam looming around the corner.

I tried to keep myself busy during the day, and made lots of visits to the EAU. I did the usual thing, and introduced myself to the sister, and asked if i could help them take some bloods and put in a few cannulas... the sister was VERY enthusiastic... but her enthusiasm was more towards telling me to sit in the staff room and eat cake (literally - carrot cake).

From experience, bugging the HCAs are the best way forward...they know all these nifty tricks!! I stayed a few hours every day, took bloods, clerked a few patients and managed to bug a respiratory registrar to let me do my first ABG.

Doing my first ABG - i was instructed to find the pulse with the tips of my index and middle finger, to then lift the index finger and insert the needle in its place. It sounds simple..but the tricky bit here.. was not being able to feel or see the vessel (compared to venepuncture). I was pretty lucky and managed to get the needle in on the first attempt, and instantly got the pulsatile flashback (probably the coolest thing i saw that week)!!!!

BUT i did feel incredibly guilty during the procedure, as the patient was moaning quite a bit and telling me how painful it was whilst the blood was being drawn out. However, we took the sample to the blood gas machine.. and whilst i can be honest here and say i had no idea what i was looking for on the print out.. the registrar said the patient was good to go home.. excellent!

Whilst it was fun, I couldn't wait for the end of the week to come, and when it did.. i got my logbook signed off and swiftly moved back to London for the BIG CRAM!!

Met3B ICA EXAM

I was literally freaking out last weekend, trying to cram every bit of information i could get out of each lecture, forgetting it the next morning and trying to learn it again in the evening.... and my room is currently a dump.

In hindsight (having sat the exam this morning)... i could have probably relaxed a bit.... but more importantly i could have revised for it more efficiently!! i didn't quite believe the transition of the ICA papers from pre-clinical to clinical years... it's VERY DIFFERENT!

We won't hear the results till after we come back in the new year... so for now.. it's one more week of CSP lectures... and then freedom!

End of firm OSCE

I LOVE OSCEs!

I panic, worry, and get so nervous just before it, but once the first 2 stations are done, i start enjoying it and just have fun!

Stations:

Cannulation

Radiography interpretation

ECG interpretation

Cardio exam

Respiratory exam

Thyroid exam

PNS exam of upper limbs

First station: Cannulation

- Okay..this was not expected....i just didn't expect there to be a cannulation station! I walked into the room, and was greeted by a nurse stood next to a plastic arm on the bed, and with a tray of random things right next to it (i think some things were there to confuse us.. or er.. i just didn't know what i was meant to do with it!).

I was given the instructions, and off i went to gather my equipment.... and there was a lot to choose from.. i didn't really think much of it at the time, and just picked up what i knew was "the normal stuff".

I was rather lucky with this station, as i've just cannulated 2 patients recently (one patient just the day before!), so i was feeling confident with it. It was a bit of a weird artificial situation, talking to a plastic arm and gaining consent, but i got on with it.. and finished well within the time limit.

Then came a few questions which were quite straightforward.. "what else would you do now?" "how long can the cannula stay in for?", "why did you choose that cannula size", "what is the flow rate?"

Second station: REST station

- This was definitely a lucky draw, i had an easy first station, and my second station just involved me sitting on a chair, reading magazines in the waiting area... !

Third station: Radiography Interpretation

- Again another station i didn't quite expect. I've never had to do this in an OSCE before! I just walked in, and there was a familiar FY1 sat at the desk and a 5th year medic in the corner who was going to record my answers.

I was faced with a computer screen showing a KUB with contrast compared with one without contrast (calculi in the ureter), then one of a pancreas with several calculi within, and lastly a pretty obvious chest radiograph with a huge pneumoperitoneum. I just had to sit there and talk about each radiograph, and i'm sure they've made the exam easier for us, by choosing pretty obvious abnormalities...because i've had to do the same thing on a ward before and never been able to spot anything!

Fourth station: ECG Interpretation

This was a question paper sort of station. I just went in, sat on a desk, and had a list of questions, a pen, and a blank piece of paper to record my answers on.

Thankfully, there were more questions on management of the patient than anything on the ECG in particular, the questions sort of eased me into it, and gave me clues on what to do.. and following from my last post.. the first ECG and set of questions were for a patient with AF! - okay this wasn't so bad, i had a PBL on AF last year, so the management side of things just came from some 2nd year regurgitation...

But with 2 minutes left.. i was stuck with the 2nd set of questions... with an ECG where i couldn't even identify what was wrong >.< .... this went badly. I could only work out the rate and that was about it......... i later found out it was an ECG of a patient showing a complete heart block.. i wasn't going to get that!

Fifth station: Cardio Exam

Everything was going smoothly, until i got to the murmur. I finished off the exam and when presenting my findings to the examiner (one of my favourite FY1s) i just panicked and got so confused. This wasn't helped by the fact that the bell had gone.. and i had to move on to my next station....

examiner: quick quick, tell me your diagnosis

tofu: err errr... er... its an ejection systolic murmur.... er.. er..

examiner: so what is it? quick quick!

tofu: errr ... *first thing that comes into my head..always a bad idea* mitral stenosis?

examiner: are u sure?

tofu: errrrrr errrrrrr errrrrrrrrrr.... no? i dunno!

examiner: so what would you do?

tofu: an echo!

...and then i had to move on!

mitral stenosis is a diastolic murmur, and from what i gather.. it's pretty uncommon >.

eeks! I know this.. but under pressure, it all goes out of my head :(

Sixth station: Respiratory Exam

This was a relatively straightforward station, the patient had a right sided pleural effusion... BUT i found the exam so so so scary, simply because my FY1 was the one marking me! I just got anxious before i started examining the patient!

Seventh station: Thyroid Exam

I walked into the room, and before the examiner explained the station to me, i was pretty confident that it was going to be a thyroid exam. It was probably the first time i've seen exopthalmos in a patient, other than in a textbook.

This was a pretty good station, and i finished well within the limits, and even had time to discuss the findings with the examiner (FY1 from my ward!), investigations and management with time to spare!

Eighth station: PNS exam of upper limbs

This was the first time i've actually done a complete PNS exam on a patient with signs, with slightly reduced tone in all aspects, slightly reduced power, co-ordination was fine, was able to elicit the supinator reflex, but unable to elicit the bicep and triceps even with augmentation. Sensory was fine (tested DCML and spinothalamic tracts).

I gave a list of differential diagnoses.. and the examiner kept asking for more..this was when i mentioned inclusion body myositis.. and then remembered.. i should never mention anything i don't know a lot about!!! Thankfully i was saved by the bell - and didn't have to look stupid again!

-----------------------------------

The OSCE was purely for our learning purposes, and after that OSCE i definitely feel a lot more confident now, and know what i need to work on before i hit the real end of year OSCEs next summer!

One more week left!

Irregularly irregular

I was at my last day of my GP placement yesterday, and i took an observed history of a patient with atrial fibrillation.

I asked about his palpitations, he told me how he feels odd irregular beats across his chest, and with all that in mind, i then did a cardiovascular exam, and what seems logical went out of my head..

i just went with my "routine" comment, feeling for the pulse and commenting: "the pulse is of sinus rhythm, regular, HR within normal ranges, symmetrical on both arms, there is no radial-radial delay.." this was when the Dr looked very worried and stopped me...

"Tofu... are u sure?! this man has AF!"

.. this was when i snapped out of my stupid routine and realised how stupid i was! i was almost day dreaming, and just repeating a routine... so so so stupid >.<

AF - is irregularly irregular! i should have known that from the history alone!

This was embarrassingly stupid, but in a way im glad it happened in hindsight. It annoys me how silly it was, but i guess it's a good time for me to realise i need to REALLY pay attention to things... to look, listen and feel for signs.. and not just assume patients are "normal".

I will take it as a learning experience.. going to never do that again!

---------------------------

Okay.. it's now croissant and coffee time, then off to my ward! (with a more serious approach to clinical examinations, no more relying on my safety routine comments!!)

Random Happenings

Random happenings:

I put in my first ever cannula!

the elderly lady was so lovely, and kept reassuring me the entire time... telling me how she was used to having needles stuck into her arm, and it won't hurt her at all. The fact that she was so nice, really did make a big difference, as i was relaxed and took my time to make sure i had everything where i needed it...and yay it went in first time! As soon as i stuck the cannula in, i got the flashback, and in it went!

I know in a few years time i will probably think "whats the big fuss in putting in a cannula" it might just be second nature in the future.. but for now, it's an entire new learning experience, and i just need to keep practising it.

-----------------------------

Mitral Regurgitation

I heard my first mitral regurgitation with radiation to the axilla last week too, i was pretty excited!!

I've recently been converted to start listening at the mitral valve first, and then move through the different areas...and as soon as i placed the stethoscope onto the mitral valve position i noted the murmur! (this was when i realised i forgot to place my other hand on the carotid pulse to time it!)

I placed my other hand on the carotid pulse and identified a pan-systolic murmur.. i moved my stethoscope more laterally, and there it was! it radiated to the axilla region!!!

- i know it sounds so odd, but i've learnt the cardiovascular exam, more or less as a routine, and ive tried listening to the axilla many many times before, and never heard anything different, and nor did i expect to... but when i heard it there.. i can't explain it.. it was just different.

i told my bf about my experience and how interesting i found it... and he had to kill the moment, and tell me its nothing special and he's heard like 5 on his firm already ¬.¬ !!! ... well it was pretty exciting for me!!

-----------------------------

Met3b OSCE!

My firm is quickly coming to an end, and i'm sadly going to really miss this place!

.... and on that note my firm has organised a mock OSCE for us this Thursday, with real patients from the hospital, with real signs to elicit and present back! This is a big BIG change from my first 2 years of OSCEs, where we've basically been examining healthy individuals.... it's going to be an interesting experience! .. i'm pretty sure i will moan about how difficult it was in my next post!

-----------------------------

Endocrine firm is almost over...

My endocrine firm is almost over.. and in some ways it seems that way already..

My FY1 has nights this week, my reg has nights, the other reg has taken annual leave, and last but not least my consultant is going to a conference abroad on friday too... so it's just going to me and the locum this week.. it's going to be an interesting week..but hopefully.. it means a lot of random jobs for me to do!

the nurses like to joke, and call the medical students "vampires" and i guess they aren't too far off... the other student on the ward and myself always offer to take bloods... and its fun!

-----------------------------

.... ok back to revising for ICAs!

Renal Firm over.. and now Public Health

Just as i've become really settled in on the ward, and struck a nice rapport with the doctors and the nurses, who saved chocolates and lemon sherbets for me.. and promised to find a urinary catheter for me to put in (though this never happened) i'm done with renal and have to move on! :(

.. and what could be worse.. i'm moving back to london for a week of.. PUBLIC HEALTH lectures! (zzZ) BUT i'm glad to be home ^^ - can't beat laying down on my own bed, and drinking tea from my favourite mug at home.... but annoyingly i've left my keys and oyster card in Essex, so i will have to be the annoying bum who needs people to open and lock the front door for me everytime i leave the house >.<

I really REALLY enjoyed renal medicine, and i know i will probably say this for EVERY firm i do... but.. i might even consider nephrology as a future career!! - in fact, i like it so much i arranged an SSC on renal transplant.. i may regret this.. but for now.. i love kidneys!

(i know i should be more open, and i'm sure i only love this so much, because it's my first ever taste of clinical medicine... but meh.. right now.. i'm loving the kidneys!)

Next Week: Public health lectures

Next Firm: Endocrine

Clinical Examination: Feeling & Hearing "abnormal" for the first time

For my year 1 and 2 OSCE exams i more or less learnt a "script" of what needs to be done, without really knowing what i was suppose to be feeling for, hearing out for or eliciting when i do a certain clinical examination.

(Well, i knew the exam, in that i know i can hear murmurs for different valves at certain points, feel an enlarged kidney if i balloted and can percuss the chest to look for areas of dullness etc..But i didn't really "KNOW" the sounds, or the feeling... since we only ever practised on healthy individuals)

BUT, slowly slowly now, i've had the opportunity to feel and listen out for different signs, and have started to collect a small collection of ideas as to what "abnormal" feels or sounds like... and hopefully i will pick up more of these "sounds" and "feelings" throughout the year. It sounds so odd, but i when i do a routine examination as i would in an OSCE exam and feel something for the first time, it really surprises me, and in a way in which i think i will never be able to forget "the first time"

Examples:

"the man in the side room with aortic stenosis"

- i approached the chest with my stethoscope, and first placed it at the 2nd intercostal space on the right of the patient's sternum and listened to the aortic valve (i've been taught to go A-P-T-M) and heard a wooshing sound... i wasn't sure if it was abnormal, and continued to place my stethoscope at the P position and so on, and then all of a sudden i realised.. A was definately abnormal! I timed this with the pulse, and the abnormal sound occured with systole, this was aortic stenosis!

"the lady with malaria, and hepatomegaly"

- i was on a ward round with the team, and when we got to this lady, my FY1 told me they had found something on an abdominal examination, but i had to go find out what it was myself. I started feeling all 9 quadrants, and they all felt pretty much the same to me, soft and non-tender. Then i continued to find the borders of the liver, and this was when i first suspected the liver may have been enlarged, and to confirm i continued to feel for hepatomegaly and there it was, an approximate 3cm enlargement. The first time i've ever come across hepatomegaly.

I've had many of these "firsts" so far, and hope to continue adding more experiences to my collection.

Taking bloods and wearing scrubs

Although we're in hospitals now, we can't really escape the GP placements, and neither do i want to escape from them either.. i actually really enjoyed them last year.. and i think i love this gp practice even more!

Dr D. sat on the corner, and gave me his seat behind his desk, and for that morning, i took the history for every patient that sat in, including a deaf patient which was definitely an experience to remember. I gave a handful of flu vaccinations, did a few examinations, and felt lymph nodes the size of £2 coins (this was a patient with CLL, Chronic Lymphocytic Leukemia). I also had to take blood from an 83 year old gentleman, who despite his age, had lovely veins which i managed to take blood from on the very first hit... Success!

This was however, very different to my first attempt at taking blood at the hospital...

Whilst heading to the doctor's office to grab my bag and head off home, a random FY1 stops me, and asks "are you a 3rd year? wanna take some bloods?".. this was so random.. as i had never met him before, but as i've never done it before so..hell yea! This enthusiasm was however shortlived, as he took me to a very ill patient who was sat up in bed and very short of breath. The patient was more than happy for me to take his bloods, but his veins were very hard to bleed, and after 2 attempts, the FY1 had to take over :( This was a bit of a downer, and i felt awful for having tried to take blood from him and failing twice, when he is so ill.

I'm not going to lie, but on a few occasions, particulary in the first week i did feel really lost and even a tad down. I simply just did not know what i was meant to be doing there as a medical student. However, what they say is really true.. if you don't ask, you don't get. With that in mind, i randomly asked a dialysis nurse if i could go watch a fistula being done.. and it was as simple as that.

Friday morning, 8am i was in some rather comfortable navy scrubs and some comfy crocs, standing in on a minor surgery, but surgery none the less =) I do have a surgical firm at the end of the year, but this was good enough for now, seeing that otherwise i was going to spend friday morning on the ward which i do everyday anyway... this was a nice change!!

Artichokes

I absolutely love love LOVE clinical years so far!

(Fair enough it has only been 2 days in.. but so far, it has been excellent!)

I'm currently on placement on an out firm, and it's been more than i could have hoped for. I'm not even sure where all the rumours about how bad the accommodation for this firm is comes from.. (then again this is my first firm so i have no parameters to compare it too... but so far... i'm really enjoying it!)

First off... the rooms are all ensuite, there is a common room with freeview tvs, on site parking (free), accommodation is on site to the hospital, the entire block is for medical students,.. and albeit a bit of a problem with the internet.. everything is pretty good! Hmmm okay i guess some would be unhappy with how far it is from anywhere... it took us around 20 minutes to drive to the local big tesco for our groceries >.<

When it comes to ward placements.. all the students are allocated to their own FY1 mentor and a consultant each.. and there's only 2 of us to a ward, so no overcrowding!

It's getting a tad late, but i really want to write about the sort of things i've got up to this week, (i will make another post this weekend!!), but just to end this abruptly.. this is a funny random conversation i had today whilst i sat in on my consultant's clinic, where he sprung a question on me:

Consultant (C) Tofu (T)

C: What tests are useful in assessing renal function

T: GFR?

C: How would you do that?

T: Gold standard would be using innulin, a carbohydrate derived from jerusalem artichokes, it is neither secreted or reabsorbed, and is freely filtered and not metabolised...

...a few sentences later....

C: What's the difference between a jerusalem artichoke and the other ones? How do you eat jerusalem artichokes?

T: er... well i like to boil mine and dip the ends in butter..

C: I have only ever had the preserved ones

Packing for my first firm!

YAY!

My first firm finally starts on Monday! - and to kick it all off, it's an outfirm... which means a spot of packing of the essentials to keep me alive for the next 9 weeks - along with a few set of smart clothes, and random bits and bobs to clutter up my room!! AND NO MORE daily 1.5 hour commute to and from uni each day!!!

... and here comes my moaning..

We were originally to collect our keys on Sunday so we can settle in before Monday, but due to some issues with the housing, we now have to register at the hospital at 10am on Monday and attend the intro talks and all.. but we won't be given our rooms until noon on the very same day!

So i will now have to wake up extra early on Monday morning to get myself out of London, and lug my suitcase of "essentials" with me for 10am..and sit in a talk with my pyjamas packed in the case sitting next to me > . < i was looking forward to no more 1.5 hour commutes!

Not really sure what i need to bring to be fair, it's my first time going to do a firm, and i really have no idea what an attachment involves...

- Will i have a lot of work - or should i bring something to read?

- Should i bring some relevant year 1 and 2 notes so i can revise the relevent bits - or will 3rd year be more clinical?

- Do i need a stethoscope (im bringing mine anyways) ?

- Will i be bothered to come back down to london on Wednesday for sports.. or will i just become even more unfit?

- How much coffee should i bring with me?

All very important questions =P

.... hmmm.... i guess i will soon find out!

Yr 3: intro

It's definitely more clinical this year!

I've been back at uni for 2 weeks now, and we're just about done with all the introductory lectures, communication skill classes and clinical skills refresher sessions... and lets not forget the fun bits which came in the form of practical skill sessions!

Practical Skills:

This is where we get split into smaller groups and practice either on models, or.. each other! We had four sessions altogether, and managed to refresh ourselves on previous skills, like taking a blood pressure, and measuring blood sats.. and all the new stuff:

- Taking blood

- Putting in a cannula

- Inserting a catheter

- Opthalmoscopy

- Otoscopy

all in all.. a lot of fun! Although i seemed confident doing it on a plastic model.. i'm sure i will be less so when i actually have to take blood from an actual patient for the first time... only 2 weeks till im off to my first firm!

Clinical skills:

This was embarrassing! On our very first session we got split into pairs within our small groups, and had to take a patient history. I was taking the patient history, and my friend acted as the patient. This was fine, i asked all the appropriate questions starting with his name, age and occupation, and took a full history....

....now here is the embarrassing part...!! >.<

The consultant who was taking the class comes to our group, and gathers the "students" and asks us to present the patient.. I was picked first...and so.. off i went:

T:"This is *insert friend's name*, a 21 year old... " - Consultant stops me here, "NO!, next" and looks at the person next to me.... (eeeks! what? what have i done wrong?!) he goes around the group asking questions, and gets back to me:

C: "Tofu, what is the occupation of the patient"
T: "He is a medical student"
C: " NO! he works in a supermarket!"
T: " But the patient told me he was a medical student.."

- this was when we all looked at my partner...and he fessed up... he basically didn't read the scenario properly, and didn't realise he was meant to be Mr Jones, a 23 year old supermarket worker!!

Haha, in hindsight it was pretty funny, but at the time i was just cringing at getting all the simple things wrong in front of everyone >.<

Communication skills:

In communication skills we learnt how to take a patient history, and then practised doing so with pretty convincing actors! It's a lot harder than it looks!! It seems easy in principle, to go through the checklist and make sure you ask all the appropriate questions, but i found myself closing down my open questions as soon as i've asked them...

The most embarrassing moment was when i had to ask the "patient" if she had recently had sex. I'm unsure why i found it so awkward (Well the tutor and the entire group was observing me) and it went "er..... when was the last time you er..... er..... er..... *10 seconds later*... had sexual intercourse?"

Next Week: CSP

7 lectures a day... every day apart from Wednesday...

coffee?.. YES PLEASE!

Y3: 10 days away ^.^

I can say i want a longer summer and i don't want to go back to uni.. but who am i kidding...

i'm super super SUPER excited about starting 3rd year...

......and it's only 10 days away!!

I sound too keen (and that can never be good), but i am the overly enthusiastic type when it comes to a lot of things, and starting clinical years is one of those things i'm currently really excited about!

I know that i am also the whine-y type, and thus i may moan my way through the next 3 years, but ... hey... for now i am living in bliss, with the excitement of being able to finally learn to put the theory to practical skills ^.^

(i will have to worry about adapting to a new method of learning, scary consultants, and the lack of sleep later..)

To make things even better, my friend is joining my year group (direct entry), and we're even lucky enough to have one placement together!

Roll on the 5th of September............... 8am!
(8am.. why oh why..?!?!?!)

Year 2 Results: 2/5th of a doctor ^^

Have to admit, this was a scary scary wait!

I wasn't sure if i had passed the spotter and i was just constantly biting my nails the whole week! I even woke up at 4am this morning (unintentionally) and decided to check my results!! (..as if any admin staff will be up at that time updating our results..but i had to try!).

I just randomly refreshed the browser every so often until 9am when the random page refreshing turned into an every other minute spam... and finally.. around 10 something ish.. the results were out!!

Paper A - 86%
Paper Bi - 78%
Paper Bii - 75%
Paper C - 70%
Paper D - 74%

Outcome: Pass with Merit
[Edit: Got an email in December, and it turned into a distinction ^^]

The results aren't as great as last year, but i'm not complaining!!
(particularly since i'm now free for the summer and not having to worry about that nasty spotter ever again! ^^)

2/5th of the way there - YAYeeeee ROLL ON CLINICAL YEARS!

Paper C: Spotter

This exam Sucked.

(tempting as it is to end this post here, i think i should probably ramble on a bit more...)


That was perhaps my biggest nightmare... my revision tactics had obviously failed.. as not only were the questions difficult.. they were all completely new images..!!!! DAMN IT!!


i just sat there, half-falling asleep.. thinking:



"oh crap!!!!! oh crap oh crap... what the hell is this blob... why does it look just like the freaking blob right next to it... wait.. am i suppose to be looking at this blob or the weird stringy thing right next to it?" - i hate histology..!



So yes... that didn't go well at all.
Im sad to say.. of all exams ive ever sat.. i've never felt this crap at the end of it..!


Results out --> Friday 17th

*all phalanges crossed*

Paper D: OSCEs

Writing this in a bit of a rush, as i have my spotter tomorrow, and have only 13 hours left to start cramming lots of photos!


(That sounds odd.. but that is literally what a spotter exam involves: sitting up all night and trying to remember what different photos are showing.. and then praying the same photos come up tomorrow on the computer, so i can conveniently scroll down and click the correct answer and scroll on... )


BUT thats enough about my plans for tonight, today... i sat my 2nd OSCE exam.. and i have to say.. i'm no where as excited as i was when i wrote about it last year. Sure it was fun, and it was a little different from having to pick up a pen.. but i guess i'm just too tired to be excited about anything. i've never been this tired ...ever...


i really dont know what it is, but im really exhausted now, i've worked so hard throughout the year, and in a way i feel like i may have let myself down with the exams this summer. Sort of feels like i've worked hard and sort of just not performed as well as i could have when it came to the exams that actually did matter....


hmmmpphhhh... all the whining and feeling annoyed about it can come after, and back onto this osce exams today:



The exam was sat in the same pathology museum at Barts Hospital, as it was last year, and i was in the exact same circuit, but this time they chucked in a whole range of different stations.. this year the circuits involved:


-Thyroid examination
- Cardio. examination
- Resp. examination
- Abdo. examination
- Shoulder examination
- Hip examination
- Cranial nerves examination
- Vision examination
- Upper & Lower limb sensory examination
- Taking patient history


Don't really know what to write about, just really annoyed with myself at the moment, and just going to do some cramming for the last exam tomorrow.

im so tired now. Can't wait to have my first night of proper sleep tomorrow.

Paper Bi: EMQ

HA! Skin and i have had a poor relationship... and it could have got ugly today but luckily C came to my rescue! ^^


She gave me a quick cram session on skin just before i went in, and as soon as the EMQ paper started, i frantically flipped through the booklet to locate those skin questions and unleashed my short term memory.. pure luck! - those questions came up!! Take that liver spots and hemangiomas!


The questions were quite fair, and my pbl write up from HSPH came up as a 5 marker: ethical arguments for Liver transplant.. which was again a bit of good luck, as i was struggling to keep myself motivated to revise HSPH ... ><


So that was EMQs...

OSCEs on Thursday, and the spotter on Friday... ^^

I WANT MY SUMMER HOLIDAY NOW!!

Paper Bii: SAQs

That was it, my last ever SAQ paper at medical school! =)
(let's not jinx it.. but hopefully this will be the last, and not the re-sit in August >.<)

It started with a few predicatable questions on bronchiolitis and miscarriage, and then the SLE ones were sort of okay.. until i got asked to draw a hair follicle..... WHAT?!


- i ignored skin for the last ICA and that haunted me for a good day or two.. and now this for my end of years! ARGHHHhhhh.. dermatology is definately not for me!! I have no idea why i thought i liked it (as i clearly can't spend more than an hour looking at it...). To top the whole poor relationship i have with skin.. i don't know what came over me, but i randomly organised some shadowing with the dermatologists at Barts this summer.. this sounds like torture now!!


It then got worse with the unseen PBL... (according to D, it was on malignant hypertension..i did a google, and he's right! i didn't even know that term)

...thankfully it got better from then!
(but..that was already over half the paper worth of marks!!)


B&B - Migraine
CR - Heart Failure
Met - Steroids
Loco - De Quervain's Tenosynovitis
HSPH - Relative risk calculations and questions on studies

EMQs tomorrow!!
- time to cram all the drugs, infections and random obscure conditions!!

Revision belly + 3rd year firms allocations (oh, and 1week till exams!)

Revision belly... =(

Copious amounts of inactivity sitting at my desk, sugary snacks, energy drinks and altogether laziness has caused my belly to grow... Damn it! I wish I could be more healthy, but apparently the occasional Orange or bit of cucumber doesn't balance it out. (sad times)

3rd year placement allocations are finally out!

2 out firms (one is literally in the middle of nowhere ... I hear the closest supermarket is 30minutes walk away .. I should have done my research beforehand ><), and 1 in firm ... its all getting so real now, I really can't wait to hit the wards! but until then... time to mention the exams.. eeks!

This time next week I will be sitting my first exam... the dreaded SAQ (but to also be 4 days from freedom)! Revision has been slow, and "the fear" is here! This was not helped when my friend called me to initially ask me an obscure BB question I couldn't really answer.. and then tells me he has practically finished revising, and is doing random questions... how?!?!

Left to revise: HSPH, Loco, and met..  ><

11 days till Y2 exams!

Yay the last ICA results came back, and its been my best ICA to date, 86% average! ^^... but then again the entire year average was pretty high this time round with a few indivuduals getting 100% in the HSPH component.. crazy(!!) So really it's not that special BUT on a good note, i calculated my Paper A mark (ICAs, Medsoc, Epc, Essays) and i've comfortably passed the threshold to sit the MBBS Y2 exams =)

Despite that, i think most of us got into a little panic when we received mail from uni subjected "Entry to MBBS Part 2 Exams" eeks! *PANIC OVER* - it was more of a good luck sort of email!

11 days left till finals.. and i've only covered B&B and HD properly.. i now have 11 days to destroy CR, MET, LOCO, HSPH.... and the 2 seen PBLS...this doesn't look good!

BACK TO CRAM!

Ooh... and placement results should be out tomorrow! Can't wait to find out where i'll be placed next year! ^^

Last week of Y2 and Random things stopping me from revision

All the stuff from uni is finally out of the way now, and its just 2 weeks of revision until exam week, and HOLIDAYS!

Manual Handling session:
- This was basically a flash back to my HCA gap year days, learning how to move a patient from one bed to the other.. and being the girl in the corner randomly sipping away at my ice latte i didnt think i would be picked as a "willing" volunteer to demonstrate.. but i somehow was. (This wasn't so bad, im not too shy, and i enjoy getting involved, even though its just a make-belief scenario.) This was all fine, until we had to move the patient, i had somehow forgotten how easy it is to move a person once you have the sliding sheet tucked under them, and forgetting this, after shouting "1,2,3 GO!" i tugged the sheet as hard as i could.. and had the other 3 students involved having to balance it out and not let the guy in the middle slip off my corner. .. this was met with my friend in the corner saying to my bf "Wow, shes macho! you don't want to mess with her"... haha .. oops!

Basic Life Support session:
- This was just basically a CPR session, and to be fair, i wasn't too keen on going, as we've already done it the year before and i didn't think i would gain much from it. BUT okay, in hindsight im really glad i went.. i learnt a lot of random facts, and actually really enjoyed it... it was a good break from revision anyways.

New Printer:

I destroyed my printer during year 1.. i still remember the incident very well.. i came home from uni and made myself a giant mug of citreon tea, a seriously HUGE mug of it... and the size, and more so the quantity of the tea was what went on to kill my printer.

Being a clumsy idiot, i chucked my folder onto the desk, knocked over my mug, and the contents then ran down my desk and into my printer..and yep.. goodbye. After not having a printer for an entire year.. i finally went and got a new printer today! YAY.... and this time i bought insurance for it. I usually don't.. but for £17 this included accidental damage to the printer.. i doubled checked with the store assistant.. tea spillage is covered!

So now armed with a new printer, and a starbucks mocha latte, its time to get started with some revision....

Edit: so i thought... i was about to start my revision, but D came over and demanded i vacummed my staircase (!!).. to be fair he had a point.. it was rather dirty.. but not to justify his point: "You're probably going to get TB if you don't!!".

OKAY... so now finally.. with a new printer, a coffee AND a freshly vacuumed stair case.. its time to crack on!

3 Weeks left till Y2 Finals!

Wishful thinking, but i hope the summer exams go a little like this:





Just 3 more week till i'm faced with this:

- 06/06 - Paper Bii (SAQ)

- 07/06 - Paper Bi (EMQ + SBA)

- 09/06 - Paper D (OSCEs)

- 10/06 - Paper C (Spotter)


Time for 3 weeks of revision CRAM !

But before i can get on with it, we've been annoyingly assigned to have basic life support, manual handling.. and worse of all... progress testing this week!

Progress testing - this was painful, very very painful, over 2 hours worth of 120 questions set at the USMLE level, and not being able to answer any of them.. that sort of painful.

We weren't expected to pass this exam, and its purely formative to monitor our progression through medical school (we sit this exam at the end of every year from Y2). I sound a bit of a geek here, and despite hating every bit of the 2 hours, im intrigued to see how i would do next year sitting the same exam with one year of clinical experience. (YAY... can't wait to start clinical years!)

Just manual handling and basic life support left this week... then thats finals and bye bye year 2!

HSPH ICA CRAM, a likely fail

Why are we meant to remember the name of different theorists?!?!

Argggghhhhhhhhh~ i will eat a PFC chicken wing off the floor of whitechapel the day a patient stops me mid interview and asks me who invented the trait theory!!

I didn't hate the module as much as others, and i thought i could probably blab myself through the exam (most the lectures have been things like "ethnicity and health", "old age and health" etc etc...)

I then took the practice test available to us on the blackboard system last night.. and got a grand score of 3/11....... DAMN IT!

HSPH/LOCO ICA on friday........... I'm simply going to fail.. there is no way i can possibly fit all this extra stuff with just 2 more days to go!

Suturing Chicken Thighs

This was possibly the best practical session to date..!!

To be fair, i say that a lot about practicals, particulary those where i get really involved.. but i can't imagine doing anything more fun with a chicken thigh, than to make an incision and to suture it back up again.. (okay, eating a roasted one could top that).

Here's a shot of my first few sutures:

We all gathered in the MDL @ mile end, and each sat around a placemat with a thigh on it. It sort of resembled a cookery class, with knives (scapel) and other equipment at the ready, all laid out for you. Each table was led by a dermatologist who gave us the low-down on how to get it right.. and we were then given 30 minutes to get as many sutures into that chicken thigh as time would allow..

...before we got kicked out, and the thigh recycled and re-used by the next set of students. (Lucky i squeezed myself into the first session, and got to destroy the chicken thigh first).

All in all.. a nice bit of fun for a friday afternoon, before the last ICA of the year next friday -

Bring on HSPH/LOCO ICA! (eeeeeks~!)

40 Days till Y2 finals

Okay, so 10 days on from my last post, and despite my crazy plans to have finished revising:

Met, HSPH, 2 weeks of Loco and 2 weeks of BB..

i've only just finished revising Met.. so that gives me an efficiency rating of 25%! Damn it!

- some things really don't change... and you would think having been at uni for 5 years now i should be good at setting achievable revision targets.. or actually sticking to them! (Wow.. i never thought of it that way.. but 3 years Bsc + 2 years of my MBBS!! ARghhhhh - i hate making myself feel old!!)

Just a few more days left, until we go back to uni.. and finish off our 2 weeks of Loco, hand in my last essay of year 2, and.............. panic!

Random:

4 teaspoons of nescafe in a mug washing down a huge bowl of rice to keep my energy levels up.. and 15 minutes later i fall asleep at my desk >.< FAIL!

Feeling Old

I'm getting old =(

I know i'm no longer the early tween as when i started this blog, and i was reminded of this when i went to the GP yesterday with my collection of ailments. He suggested i have a routine blood test..

..and thats when it hit me..

"ah you've turned 2x, i think we should start including your serum cholsterol levels too" DAMN IT! - nothing wrong with checking everything.. but i'm not sure why i've always just associated serum cholesterol levels as for the middle aged.. (obviously this is not true!) and i know im not quite there yet.. but ah... it made me feel old.. and i dont like feeling old...

ok.. random note over.. back to revision!

50 days till Finals!

Easter holidays has finally started..... this can only mean .. 2 weeks of BLISS REVISION >.<

Well begining on Monday (i've given myself the weekend off ^.^)... but still.. that's only 50 days till our first exam.... FIFTY DAYS! Eeeeeks!

Scary thought that... but at the same time, it's my last set of exams of my Pre-clinical years...!!

I can't wait to hit the wards, i've worked so hard to get here, and finally i'm almost 2/5 of the way there! So .. it's time to kick my lazy ass into action, and start some revision!!

On an encouraging note, both my friend and i got an email from uni to go to the student office to collect a letter... and when i did open it... yay.. it was a really encouraging letter about our progress from the head of year 2 .. they do care (I LOVE BL!) ^.^!!

Ok it wasn't very personalised.. the letter was a carbon copy of the other, apart from the names where they've changed it, but either way.. it was encourgaing! - Going to cram even more now ^.^

(i am a nerd at heart)!

First day of Loco2 and my dodgy TMJ

1st day of the last module done... and im starting to get scared! Partially scared of the amount of work i need to cover again before finals, and the fear of my dodgy TMJ.

I've had TMJ issue for years now, (i blame my dentist and my wisdom teeth removal! - it's probably not him..but i'll just blame him for now) and i've always just not been too bothered to do anything about it.. it clicks now and then, dislocates, i've been referred to see a specialist and meh.. i've just left the referrel letter at home and continued to let it be..

..and now fast forward a few years.. and finally at medical school i start to get scared about things.. and yeh.. wish i got it seen to now as it seems increasingly willing to take every opportunity when i yawn or take a bite of my sandwich to want to pop out of place and leave my jaw in an awkward position.

This is rather cheeky, but i take the opportunity to volunteer for clinical skill sessions so i can get my different ailments seen to... saves time from going to the GP! Today was no exception, my friend went to ask the lecturer today about his dodgy knee.. and i took the opportunity to ask about what i can do about my dodgy TMJ without having to go visit my GP.. and simply put..

"Nothing..... it's just going to get arthritic in the future, might get some pain"!!!


i didn't see it as a problem until the FY1 started scaring me ... so..Okay.. i hate to admit this.. but Easter i might go to the gp just to see if i can get that referal letter again

End of HSPH , Locomtor Next !

It's a love-hate relationship with HSPH.. i love the 3-week semi-holiday mode, but at the same time it's made me into a super lazy bum.. i feel no urge what-so-ever to do anything!! I could have used this time more efficiently.. but nope i've baked cakes, slept a LOT, caught up on tv, saw some friends and then ate some more cake..

I can see how the lectures could be interesting, but it's just a module so untimely placed.. would have been better right at the start of the new year, or before Christmas... as now with one week left. i've literally just acquired the skills to critique a paper with a bunch of annoying stats., and have until friday to whip up a critique!

(weird as it sounds.. i've actually learnt more on how to critique a paper, and use stats through HSPH on my MBBS course now, than all 3 years of my BSc put together!)

---------------------------------

Locomotor starts on Monday....

(this mean 4 weeks of Anatomy with an Easter holiday in the middle! >.<)

Anatomy has always been my weak point..

.....this is rather embarressing, but the other day my head went completely blank and i couldn't remember which side of my arm my radius and ulnar was on. In hindsight, im such an idiot, as i always used to remember where i would take the radial pulse, and that would be the side where my radius sat.. but i don't know what happened.. i really couldn't remember at the time! Just so happens, like it does, the module lead was passing by whilst i was telling my friend.. and she comments:

"Tofu, i really don't know how you managed to get a merit last year!" haha.. okay that sounds harsh... but really she said it as a joke, and shes by far one of the friendliest lecturers out there! But i do worry myself sometimes.. as i know i really should put some more time into my anatomy... okay.. time to get Gray's out the library!

---------------------------------

65 days till End of Year EXAMS! --- EEKS! Ok in days and months, thats over 2 months... but i like to see the number in days.. it sort of adds to the stress factor, and should hopefully kick me into revision mode soon enough (well i sure hope it does!! only 65 days left!!)

------------------------------------

Update on the pizza... im happy i did well in my last ica, 81% average yay, but..i lost out on the pizza by 0.5%... but then again my friend still owes my 397/400 meals from last year.. so i don't have to worry about buying the pizza just yet ^.^hahaha... we sound competitive.. but we really aren't!! we just like having excuses to eat out and celebrate random things!! in fact today we're going to the have a pub lunch and watch the cricket world cup ...

...................................... i can't choose between the two teams.. as i'm not from either country, and my closest friends at uni are from both... it's like choosing to side with mummy or daddy!

HSPH, and free pizza?

STATISTICS!

ARGHhhhhhhhhhhh.... I thought I saw the last of you at AS-levels,  but alas you have made it back into my life.. and this time you're ten times more boring, and with every little bit of you, there's a whole paper to critique! (>.<) PBL sessions have never taken this long to prepare, and this dry to sit through!

HSPH stands for ... Damn it ... its quite a fail on my behalf really ... can't remember what the H and the S stands for, but the PH definitely stands for public health. (okay, I'm currently in a lecture as I type this and asked my friend .. its Human Science and Public Health) ... 2/3 weeks in ... and yeah .. it's been a lot of psychology, and just general epidemiology .. not looking forward to sitting this ICA!

on the topic of ica, half the results for the recent ica are back, just waiting to hear about the SAQ now, but so far I've not failed ^.^ yay! I have a bit of a bet going on with D, we both thought we flopped the exam, so we put a bet on, the person who does better has to buy the other a large vegetarian hot pizza from pizza hut (okay again .. I just like tofu and veggie pizza, I'm jot a vegetarian!) ... and so far ... unbelievably.. we have the exact same mark for both our spotter and emq/sba papers! So its down to the SAQ ... pretty sure the pizza is mine .... cervical cancer I hate you.. but at least you got me a free pizza ^.^

SSCs, BB+HD ICAs, Firms.... and medsoc

It's been almost 3 months since my last post, and since then.. I've:

-Dissected a cadaver and found what we thought was a giant cyst, but further investigations (poking at it and removing it) revealed a "cc" quantity on it and yep, it wasn't an abnormal growth, turns out to be a very early breast implant (teaching assistant: "they don't even make them like this anymore")...okay we really didn't expect to find that!
Dissection really was an amazing experience though, it was the first time I've ever done it, and I definitely want to do it again! I can't even begin to explain how different things are compared to an anatomy text book.

- SSC2c, okay this was my first attempt at anything arts-y since gcse art, and this time round I'm not even that ambitious! I chose the easier option and took medicine in  photography.. my intentions were a tad cheeky... I have a dslr and just wanted someone to teach me how to use it... and that was that :D

Just sat the BB + HD ICA last Friday and that was a HORROR! Okay I always complain about exams, and the last exam turned out pretty well.. but I'm not too happy this time, I didn't really revise cervical neoplasms and boom... they hit me with a CIN double page SAQ special..... ouchies! Damn it!
It was also the first time they've introduced single best answer question type, and they are definitely a lot harder! All the answer choices seemed plausible, and it was hard picking the best option! >.<

And now...... I'm sitting in an empty gp practice typing this post up on ky phone.. this is exactly why I hate my medsoc placement.. they send me around hackney and expect me to be at these random places by 9am, and 8/10 times the nurse doesn't even turn up till 10am, and then I sit for 3 hours to see 1 patient ... then I have a dirty commute to my afternoon session at some other area.... ! To be fair my medsoc was amazing last year, my friends have awesome medsocs this year ... I've just been really unlucky :(

Ooooooo and to end on an exciting note... I submitted my firm choices last night! Clinical years feel so close now, I really can't wait!! ^.^ it was really difficult choosing where to go for each module...  .

Now the wait for the practice nurse continues ......!

CRAM CRAM CRAM

"A colposcopy, not to be confused with a colonoscopy"

-Ah.. that made me giggle, i'm a little immature, and dead lazy when it comes to scribing down my bits and bobs at medical school....
i'm supposed to read this blog once i've graduated so i can look back at my journey, through medical school, and i've just left a whole big chunk out of 2nd year, since i've been too lazy to write things down, and lately it's just been crazy revision!!

Exam this Friday, and i've never felt this un-prepared!

Chocolate, coffee and redbull....
CRAM CRAM CRAM