Friday, 18 August 2017

Year 4 Week 1

I can't remember the last time I felt this shattered.

I get up at 6am, I train (75 minutes weight training), I walk to placement to get there for 9am (40 minutes), I walk back (40 minutes), I eat, I study, I sleep. Rinse and repeat. There's not enough hours in the day. I've had my tired eye twitch all week.

I'm finding it more difficult than I thought having an additional friend stay with us. I'm going to bed later, I'm having to be switched "on" a lot more... she works full time, she doesn't get my whole training and diet or I-really-just-need-to-study-thing. I'm really, really looking forward to being on my own this evening. I really, really value my peace and quiet and at the moment, i'm not getting any. Not before i go to bed, not when I walk through the door, not all day when i'm a headless chicken on i'm quite excited how i've got my evening all planned out.

Today, as I had such an early start, I didn't have time to train before clinic. I was planning on doing it at some point today, but actually as i'm typing this, I think I might leave it till tomorrow morning. I'll keep in my routine of 6am starts, get an early night post-long-bath-soak, may be watch Trust Me in the bath too (oh my god, i've not watched television since Love Island). I need to laundry, clean the flat, have an admin morning when I arrange my whole week ahead. I know, I know, I KNOW, everyone always hammers on about this and every year I'm like, fuck, YES, FUCK WE GET IT. And that's the constant drilling of 'time management' into us, but I swear to God, the only way I can actually get through the week at this rate is if I have every hour of my life scheduled into my diary. I feel like this sounds really fucking boring and I suppose it is, but I am happy. I am busy. I am doing things I love. I don't care if it sounds boring.

I have started on Rheumatology and Orthopaedics for 4 weeks. Basically, I'm sitting in a lot of clinics wondering what in gods name the disease they are talking about is, or watching hip and knee replacements. So far, so fun.

Sunday, 16 July 2017

Reflecting on my SSCP

At the end of third year, your final placement is a 4 week Student-Selected block. You rank your 7 most preferred along with every body else and you are matched to the highest one, depending on how many others have ranked them in a similar fashion. I really, really wanted neonatal HDU, but ended up getting Paediatric Anaesthesia.

Unbeknown to me at the time, I would be spending a fair amount of time with neonates anyway! Anaesthesia appealed to me for lots of different reasons; it's very hands on, lots of one-to-one teaching, it can be quite varied. Saying that, working with young children rather than neonates didn't really appeal to me, spending a humongous amount of time in theatre also didn't particularly lavish me with enthusiasm and so I was fairly apprehensive about this placement.

I needn't worry. I've had an absolute ball. I learnt how to bag and mask tiny tiny babies, attempted (unsuccessfully) cannulation, spent time with some of the most fantastic consultants i've had the pleasure of spending time with and was given loads of advice. It was apparent how hugely varied different doctors career pathway had been to get to become a paediatric anaesthetics. The downside to this placement was being in the middle of the NHS inefficiencies. Surgeries that could have, should have, would have gone ahead are cancelled last minute because of bed shortages; this translated into a lot of time in the coffee room for me. Other than that, I cannot complain. Everyone I worked with went above and beyond to teach me and by the end of the four weeks I had come to get real comfortable with the idea that anaesthetics is something I really want to do.

The difficulty for me lies within teasing out whether its paediatric anaesthesia, paediatrics, or anaesthesia that is providing the attraction. For sure, paediatric anaesthetists as people seem to be my kinda people. It's so nice when you think you find "your people". There are stereotypes of people within every specialty and while I can't put my finger on what it is about paediatric anaesthetists, I think that they are great.

This 4 week block simply set a new standard of what it means to enjoy placement. Are you reading a blog from a future anaesthetist? May be.

Saturday, 15 July 2017

Reflection on juggling a job and third year

Recently, i've been going round and round in circles, trying to figure out whether it is worth keeping this job throughout fourth year. I have just finished third year and as the intensity of fourth year dawns upon me, I am weighing it all up.

When I first started working at Waitrose in November 2015, I don't think I envisaged keeping the job throughout my third year. Knowing full well, I would be on placement and unsure of how structured the timetable would be (but imagining 0800-2000 shifts ha ha!), I blindly just thought i'll see how it goes.

When I first received my timetable, it was clear that I couldn't work 1200-2000 every Wednesday like I had been before. I needed to reduce my hours.

For the first two months, I only worked on Sundays. This was not strictly allowed - the rules were, you had to work at least 2 days a week. So eventually they put my Wednesday shift back in, but halved the hours so it was now just from 1600-2000. I managed to keep this up all year. I rang in sick a few times after some big party weekends, but for the most part, I just kept pulling through it.

 I would always leave early on a Wednesday, i'd drive to placement so that I could drive straight to work from there, making my excuses about "doctors appointments" or whatever. Tutors and doctors never really raised an eyebrow; colleagues knew the score. I got sufficient study leave when I asked for it, even if it was a bit stressful to arrange and so I just managed. Can I continue to "just manage" throughout fourth year? Is it worth it?

I got the job initially because financially, I was struggling. My parents were in the middle of an expensive divorce and paying extortionate lawyer fees, so weren't able to support me as much as they had been. It was incredibly stressful managing being so broke and in fact I distinctly remember it was when I broke down in tears after my card was declined for a £3 purchase in Sainsburys, I knew I had to do something. Being broke was becoming detrimental to my mental health. I got a job fairly quickly and enjoyed the luxury of being financially liberated again. I never worried about my finances again.

Since then, things are very different. The divorce is officially over. I am a year closer to graduating and my mum can financially support me better. It no longer feels like I need this job to survive financially. Fourth year is notorious for being the most difficult year of the whole degree. It will involve longer hours, double the exams, travelling further and wider, it's going to be fast and fucking furious. Should I continue to juggle a job I know I don't need?

1. Would it be possible in terms of time management?
Probably. Waitrose have always been very accommodating, particularly around exam time and i'm sure I could manage. I could get trained doing other things, have my shifts at other time. It might be a bit stressful arranging around two osce seasons, a 4-week GP placement away from manchester and the progress tests though.

2. Do I even enjoy work?
Yes, I do. I love the girls, I love working behind the bakery counter. That being said, I do feel like things are going downhill there and i'm not sure for how much longer i will enjoy it. People are leaving left right and centre.

3. Is it worth the pay?
I am the last cohort to get paid time-and-a-half on Sunday and as I work every Sunday, that is the main reason it is worth it.

I just got off the the phone to my mum and she said something which probably cleared the decision for me. The question needs to change from being "Could I manage" to, "Is it worth managing". Say yes, I could probably manage to keep juggling my part time job with everything else. Is it worth it though? Is it worth the stress? Is it worth missing out on being an actual student and having a student lifestyle? (No-one ever looks back on their deathbed, and says they wish they worked for longer hours). Is it worth jeopardising my degree? Is it worth the energy it takes? And finally, there you have it. No, during fourth year, it wouldn't. It would stop being worth it, but heck, I really will miss it.

guess who's back, back again

Dear all, sorry for my long absence - I got busy and to be honest, I knew I had to do a whopper of a post addressing how I did in the year 3 osce and just felt so daunted and exhausted by the idea that I just stopped writing.

I will address the year 3 osce in more detail perhaps at some point in the near future but the long story short is that I scraped a pass. I would have been more pissed off because I worked my god damn ass off, but some of my close friends actually did fail.

Also I was unsure about how to continue writing while still claiming anonymity. It's important that I do remain anonymous, but I worry that this might all come right back round to bite me so I'm aware of how careful I have to be. This anxiety made me less keen to write. At the same time, it's been a real pity to see the number of other medical student blogs have disappeared / removed. I remember what a joy they were for me to read when I was applying...

Over the next few weeks, i'm going to write some short pieces reflecting on this last year rather than trying to catch you all up month by month. That would be a killer piece that I'd start writing and then almost immediately sack off...

Stay tuned.

Wednesday, 29 March 2017

Dolla dolla bills y'all and on ode to my mama

Student Finance have done the almightiest of fuck - ups. It turns out, they are saying I have a received a £2000 ish overpayment in the form of grant money. And to get it back? They are withdrawing my funding for the rest of the academic year.

This has left me knee deep in shit basically. There isn't anything I can do about it either, from my research - every year, we sign a declaration confirming that if they overpay us we will return it. Happy Days eh?

It's also been a week since the OSCE last Thursday. I celebrated the relief of it being all over and proceeded to be very very unsure about what to do with myself. I was so used to being in bed by 9pm and up a 6.30am that I couldn't snap out of the routine. It's not a bad routine, but it's certainly a little bit boring when you're saying good night to your mates on a Friday night at 2045 because everything in your body is telling you need to be up in 10 hours ready to chant those freakin examinations through.

I went home for Mothers day too which was really nice. There was a time, quite a long time in first year where I flat out couldn't go home. My relationship with my dad has always been strained and I swore when I moved out, that would be it, i'd finally have nothing to do with him. Indeed, Mum then began divorcing him while I was in first year, but that led to a lot of outrage and things being even more tense at home.
During my second year, I was happy enough pottering around up here, drowning in Neuro semester and starting my job letting all the shit hit the fan at home. Now, in third year, things are finally beginning to settle at home. The light is visible at the end of the dark divorce tunnel and going home is simply a pleasure.
I love it and it breaks my heart to leave. It breaks my heart to see it's just my very little (she is physically very petite) mum, sat curled up on our very big sofa, in our too-big-living-room, in front of the man-thats-just-been-paid giant TV, all alone in the evenings. I know it doesn't bother her and she would rather be alone than with my Dad too but it still pains me. The proper, catches your throat, hold back the tears, feel like someones stuck their hand in your stomach and twisted pain you know?
She's got my little sister who's 11 and that's fine but she's getting to that age where she carries so much attitude and hormonal sass around with her that she's becoming real hard work too.

It was bitter sweet then, going home for 4 days. It's been a long time since I've been able to do that and I miss it terribly now. She works really, really hard, my mum. She was never allowed to go to secondary school, she was forced into a marriage she never wanted to be in, had in-laws that treated her in a way I can only liken to child cruelty, filled with rationed meals and disallowed from seeing her own parents. She was married at 19 and had my brother by 21. I shake with grief when I think about how I am 21 now. Having had my brother though, she knew she had to do something. I think despite the worst post-natal depression you could even think of, she was so overcome with love for her first child she wanted to provide him with a better life. She didn't want him to go through this. So bit by bit and in secret a first, she managed to start a course that would allow her to be a teaching assistant, and then they said, hey, you could do alright you know, you should train to be a teacher. So she did. Without a single GCSE to her name, she managed to do an Access to Teaching, she started a Bachelor of Education degree at the University of Birmingham. My Dad at this time, had been sat on his arse, living in the house my mums parents had bought them to help them now they had my brother to look after, on the dole, doing jack shit. She talks about sitting her finals and being pregnant with me and being more desperate to hold me in and just finish the course than anything else and I am so extremely proud of her.
She started earning, she moved us out, twice. She had gone from living on benefits to actually having some significant money very very quickly and poured it into her childrens education so we could go to grammar schools... and well, I suppose the rest is history. I cry as I type this because I wish, I so badly wish that I could have sent her a letter, or visited her when she had just had my brother, was suffering from horrific post-natal depression, was walking across a bridge, seriously and honestly contemplating jumping because she couldn't see a way out.

I'd tell her, "Mum! It's me. I'm your daughter!! And i'm training to be a doctor you know! It's a real dream come true but mum you make it. It gets so much better because you are such a hard worker and you make all of our dreams come true and give us opportunities you wouldn't even be able to fathom right now. You're going to be OK, everything is going to be OK. I know you can't see that right now and I know right now ending your life seems to be the only way out of this forced marriage but you do eventually get rid of him. It takes a while mum, but that's OK because you still provide us with a stable family home and give us anything we could ever possibly want. So know, please know, everything is OK. We never say it to each other because we never learnt how to, but I'm gonna tell you now mum, I love you. I love you so much and through everything, you'll always be my priority. And when I'm 14 and you're struggling to cope with my outrage and my pain, know that I get through it and I eventually find a positive male role model that pulls me through it. Need I say, it's actually your brother-in-law! But anyway, I love you and you look great in the 90's so embrace it."

And that's what pisses me off about student finance. I'm like GOD, just give us a break. We've not even finished paying off the extortionate lawyer fees for the divorce only to be thrown into more financial hardship because of a mistake they have made. We work hard. We just can't seem to catch a break. And do you know what kills me the most? I've signed up to live in this huge flat next year which is extortionate and when I get this news I call my mum, and I say, "I'm really worried. I think you should really think about whether or not we can afford for me to live in that nice flat next year with how expensive it is. I can always find somewhere else. And i'm gonna pick up extra shifts to try and make it easier for you mum, i can always do more work..."
And do you know what? She tells me everything is going to be OK, to keep my money and put it aside in case, but that everything is going to be OK, that we have our health and yea it is a bit like one thing good happens and then something else bad starts but that's OK because we have our health.

I mean, if a woman like that doesn't inspire you, than what could? I don't need beyoncè to tell me I'm a strong independent woman - I've got my mom.

Saturday, 25 March 2017

Year 3 OSCE

So, i’ll do this the way i’ve always done it. Talk you through what I had and how I got on. Originally I tried to give myself a score out of 7, but quite frankly, that's too hard. 

Station 1. Data interpretation 4/7 - a scraped pass.


ABG showed low oxygen, low carbon dioxide, but pH was was within normal range (7.37), HCO3- was in normal range, and so was base excess. 

PMH: Asthma. 

There was some consolidation in the lower right lung but as far as I could see the trachea wasn’t deviated - apparently it was!! The pneumothorax was pretty obvious. But I basically spoke for about 5 minutes straight chatting complete shit and making one diagnosis and then changing my mind to the point where all I really wanted to say was JESUS TAKE THE WHEEL.

Station 2. History taking - Angina. Pass.

So there was I was, revising away, thinking you know what - there is no way that they are going to give me the same station I had in my mock and THERE YOU GO. Literally the exact same situation. She was a teacher that was getting chest pain on her way walking to school. 

At 6 minutes you had a buzzer for 2 minutes remaining and in this station, that meant the examiner had to stop and ask you two questions. I had only just moved onto the past medical history. Hadn’t got anywhere near the rest of the history.  “What do you think she has” - stable angina, of course. “What risk factors does she have?” - I reeled off 6. 
“Okay, you can carry on” - 
“Can I carry on with the consultation?”
“Yes, you have 1 minute”

Bang - I just turned back tot the patient - “Right, i’ve got several questions to ask you now, but i’m going to be quick and most of them will be yes or no. Do you have any drug allergies? No? Do you take any medication? Oh great, a prescription, thank you. (I turned, showed the examiner, and winked - she smiled right back. Yes, yes, yes) So we’ve already spoken about your family so now i’m going to ask you some questions that I have to ask all of my patients - do you drink any alcohol? how much? 2 glasses? OK. Do you smoke? No? OK. Any recreational drugs? No.” *The buzzer for the next station went*

I grabbed my stethoscope, “Thank you thank you thank you!” I shrieked as I went for the door, adrenaline pumping right through me. 

Did I get those extra marks at the end? Who knows.

Station 3:  Examination 1 - Abdominal Pass may be hopefully.

Forgot to do liver flap. Spoke at the speed of light. Think the patient and I had great rapport, there was one point me, the patient and the examiner were all laughing. 

I basically just whacked out the examination as quick as I could, forgetting some pretty major things. “Anything else you would look for in the legs?” he asked. 

“YES. SIGNS OF IBD. LIKE GANGRANOSUM!” I basically shouted with excitement when he asked. “Any abnormal findings?” He asked. “No.” I replied confidently.

Apparently she had the biggest spleen you’ve ever seen. Great. 
The examiner and the patient were both really lovely, but I have no idea if I did OK in this. The only sign I picked up and commented on was the corneal arcus. Can you still pass a station if you don’t find the abnormal findings??

Station 4: Sharing information - AF and warfarin. Pass if they're generous. 
So this patient had been told she had atrial fibrillation and was going to start warfarin. I mean I did a lot of waffling, and not much of it made sense here. Was I meant to explain atrial fibrillation? Wasn’t I?

Hilariously me and my best friend had spoken about how we would explain AF some weeks ago, and we used a demonstration with our hands. Bearing in mind we are in the same cycle of students - we both did the exact same thing. The patient must have thought - what an earth are these magical hand movements students have learnt?! 

I found this patient really difficult. She was a bit aggressive in her questioning and I made an absolute mess of explaining atrial fibrillation never mind the warfarin.

Station 5: Examination 2 for AS. Pass

My best station by a mile. I had the nicest, friendliest gentleman in there. The examiner was just as pleasant. I walked there, shook Johns hand, introduced myself and dare I say it - bossed it. And I say that with certainty because I had a minute to spare at the end where the patient gave me two thumbs up and said I had an excellent bedside manner and after I had answered the examiners questions she said, “Yes you can breathe again, very very well done. Excellent,”

HOORAH. 1 station out of 16!!!!

Station 6: History taking - Hyperthyroid. Pass

I went in with a strong differential. She was having palpitations, had weight loss and tiredness. I was going to rule out anaemia and diabetes within the first few minutes and I did.

Threw in some questions about periods as well to get some extra ticks. 

Station 7: Explanation. Metformin. Pass?
Oh my god, this guy was basically falling asleep. After the OSCE it did just seem like he had a completely different story for everyone he spoke to. One of the girls was saying he was mainly concerned about how he didn’t want to exercise, with me he was mainly concerned about family history and the likelihood of it being passed on.

Considering this should have been a really easy straight forward situation I missed the big worrying side effect of lactic acidosis and struggled to explain it well. I also said he would be taking this once a day and the patient literally had to correct me and remind me it was twice a day. For crying out loud, why can’t I just READ THE DAMN QUESTION.

Station 8: Data Interpretation: CXR Gas under peritoneum. Fail. 
So I spotted this one straight away. Why was there gas? GOD knows. I said a perforated bowel. That was all I had. He had back pain, but kidneys on ultrasound were normal. His urea was pretty high but that was the only thing abnormal.

He had been taking ibuprofen for back pain for weeks. 

One of my friends said she thinks he had a peptic ulcer which has ruptured. I think she’s right.

We had a 15 minute break now and oh my god, if there has ever been a time I had wished I had a severe hearing impairment it was right there and then. Everyone just had so much to say about what they thought each station was and what they found and I was like NONE OF YOU KNOW IF YOU ARE RIGHT STOP STRESSING ME OUT.

Half way, another 8 to go, CHRIST.

Station 9. Medication History. Pass?

Sneaky, sneaky, lil rascals. I checked the name of the patient and instead of giving me her date of birth she gave me her age 58. I didn’t think anything of it at the end - I thought she was literally just saving me from doing the math. Apparently on the sheet that you are meant to write down the medication history, in the corner where you check the name and d.o.b. the date of birth said 1958. 

Fucks sake. How sly! I remember seeing both of these things but then thinking that would be absolutely ridiculous surely. And to top it off she was wearing  wrist band with her actual date of birth!!!
The good news is I think I asked all the relevant questions when it came to this, I checked with the prescription too, and even looked up one of the drugs in the BNF which i’m glad I did because I really wasn’t sure whether I needed too!

Station 10: Examination 3: PVE but exclude the head, the thorax, and the arms. Right so basically just the arms and the legs then, great OK. PASS

I don’t know what the situation was with the foetus child they brought in. Obviously she must have been older than 18 but she looked about 12 and I was really concerned about this. She also had the biggest fake nails on which made capillary refill a little more difficult?! 

I think I went through the motions of a PVE exam in an OK way, but obviously because we had to miss out 4 major parts of it I was just stood at the end chatting shit.

Her questions were what signs would you look for in an acutely unwell arterial limb and signs of arterial disease. I spurted something about how arterial ulcers and venous ulcers were different. 6p’s of limb ischaemia?! Who knows. Who knows.

Station 11. Sharing information - Ethical scenario. Pass, only just.

A patient had been referred for a colonoscopy as part of a two week wait - fine. The ethical situation was that he didn’t want any investigations. He’s had a good life, he’s lived long enough and healthy enough and he would rather not know. The key point of his question was when he asked you, straight - “What would you do if you were me eh?”. I replied I couldn’t possibly know, it was too difficult to say when i’m not in the situation. I think my arse began to hurt from sitting on the fence so firmly. “There you go! There you go you see! Exactly,” He said. “Look, investigation does not equal treatment. Just by having the investigations means you get to make an informed decision about what you want to do.”

“But what if I change my mind later? Can I do that?” - Damn, I thought. I should have covered this already. “Of course you can change your mind we will always remain open to what you want to do when you are ready to do that. Whatever decision you decide to make today, know that we will support that,”

“And what about if I want treatment for something else. Will you still treat me?” He asked. DAMN. JESUS MAN. WHY DIDN’T I THINK OF THAT. At this point, the 2 minute buzzer had gone off and I *knew* that this simulated patient was trying to help me out. He was giving it to me on a platter now, asking me the questions that I should have the mind to cover originally. I knew this SP well, I had worked with him for 3 years already. God dammit. “Of course we will always treat you indifferently, whatever decision you make here today, we will always treat you as well as we possibly …* The buzzer went off to move on. SHIT. 

I still wonder what I should have done. Was I right to sit on the fence? Should I have said I would absolutely have the test done? I just don’t know.

Funnily enough, on the next station I could hear what my colleague was saying to him and when he asked the question, my colleague said, “Look, I would have it done. If i’m being honest with you, that’s just me personally but I would have it done,”
“THANK you,” the SP said. “Thank you for being honest with me,”. 

Damn it.

Station 12. - Prescription review. Pass.
Now there has bene absolute outrage about this lol. It turns out a lot of people had been told that there was no way prescription review was going to come up because it was too difficult to do it well within 4 minutes. Where in most of the other situations we had about 6 minutes to do something and 2 minute for questions, in this one the timer was set for 4 minutes.

The station was you had 4 minutes to review the prescription and then 4 minutes to talk the examiner through what you had done and then answer the questions. I decided to basically not ever stop talking. I walked in there and from the word go, spoke through everything I was doing.
“Ok, so looking at the name and date of birth, looking at the prescription, yes that’s fine, let me look at the indication, going to look that up, yes okay, that’s good, okay so next…” 
So when that buzzer did go off at 4 minutes, she immediately turned it off and told me to just carry on with what I was doing. She said, normally i’d stop you but you are talking me through it as you go along so carry on.

“The nurse said the patient should be on two antibiotics. What do you do?” She asked.
I looked back at the sheets in front of me. Trust Guidelines!!! Give amoxicillin AND clarithromycin. Gotcha! I literally said to my examiner “HA, yes. Prescribe clarithroymycin also for review in 48 hours, etc” She nodded eagerly.
“Ok, the nurse has gone to give this medication to the patient but the patient has said she doesn’t normally have it today. What are you going to do?”
I looked at the prescription. It says start today… it’s for osteoporosis… let me look it up. OH. It says once / week. I looked back at the examiner. “What are you going to do?” She repeated. “Find out what day she does normally take it, write the dates in the prescription, mark them with an X excluding the day she should be taking it!”
“YES. Well done. Okay.”

I raised both my hands in the air. “JESUS THANK YOU” I screamed in my head. Praise to de lawd. Another one.

One of the staff came up to me. “You might need to control your eyes,” she laughed, “You look like a complete deer in the headlights!” Offering me a biscuit. “I bloody well feel like one!” I said, trying to breathe again.

Station 13: Examination 4 - Respiratory. Fail.

So for this one I had to do it focused for a pleural effusion. Obviously, I just walked in and bulldozed straight through. Should I just be looking at the chest? I don’t know. Should I bother with the hands?? Who KNOWS. I just completely ran out of time, never even getting onto the back of the chest and barely managing to vocalise what I was thinking.

“What are the two types of pleural effusion?” she asked. 
“ER. what.?” I blinked - and it was literally like that meme that is currently going viral of that bloke blinking. 
“TRANSUDATE AND EXUDATE” I basically shrilled. As the final buzzer went off.
“RIGHT now quickly GIVE ME 2 CAUSES OF EACH!” She squealed right back at me, willing me, begging me to get the answer.
……….. I got nuffin. “ARGH!!” I basically yelled. 
“Go,” She said. “Just go,”
I left. Tears in my eyes, outside my next station, I could feel myself welling up. I picked up both my hands and put them on my head and tried to breathe out slowly without crying.

Try and forget it. Please, I said to myself, forget it. The buzzer went off for the next station, my final one. Come on, hold it together I pleaded to myself blinking away the tears and pulling the curtain back for the final time.

Station 14: Data interpretation. Fail.

WHAT IS GOING ON. U’s and E’s. Blood and protein in the urine. Glomerulonephritis????
What is this ASO thing??? The questions began at 4 minutes. “What do you think is wrong with him, how would you manage him?” - ER. I HAVE NO FUCKING CLUE.
Look, I don’t think its a UTI. I think it could be glomerulonephritis, nephritic syndrome - no wait, nephrotic, no wait nephritic?! wtf. I’d like to, er , i don’t know Google what the hell ASO is. 

i think one of my friends managed to nail it - it was some anti-streppwto-something or other, and the guy did present with a sore throat. He’s had an infection, it’s spread to his kidneys. 

Station 15: History - bowel cancer. 
Quite straight forward symptoms; weight loss etc - I got it fine. I went a little bit crazy with the investigations and all I really needed to say was a DRE and a colonoscopy!

Station 16: Explanation - COPD. Pass??
Oh look, another one that I had in my mock. Do you think I revised this? Nope. Just as much of a shit show as when I did it in my mock, but I sort of scraped through it then so I hope I can scrape through it again. 

Saturday, 18 March 2017

What the week has looked like

To give you an idea of what my weeks have looked like this is it. It's me getting up at 0630, run through all the possible examinations (e.g. Thyroid, Cardio, etc) and plan every single minute from then on until I go to bed at 9pm. You'll notice I take m y time at the gym and try to have a leisurely lunch to give myself a break from the onslaught of it all. + going to the gym wears me out so it takes a while to build back up again!

Occasionally, e.g. Thursday = rest day, I give myself a few hours to do sweet f a. I really needed it too because I had hit such a strong mental block that a few hours to watch Gogglebox and have a couple of non-dietary-included biscuits was just what worked. When you plan your days like this, there is no level of spontaneity - when you call your mum, when you get your eyebrows done, when you eat and what you eat is all completely planned out. It just means thats a shitload less for me to worry about. I can't tell you how easy it would be to do nothing if I didn't have a clear plan about what I should do.

Saying that - I am now sick of this. While I am now very good at dragging my body out of bed in the morning, I am not particularly enthused to run through how I do a Thyroid examination for the millionth time. If it wasn't an OSCE - I would be concentrating more on the stuff I don't understand rather than the stuff I do completely get but the difference between an OSCE and written exams is that practise literally does make perfect. 

Year 4 Week 1

I can't remember the last time I felt this shattered. I get up at 6am, I train (75 minutes weight training), I walk to placement to ge...