Friday, August 27, 2010

A clinical focus...

So, over the last month or so, me and one of my good friends have decided to stay back after our compulsory ICM (Introduction to Clinical Medicine) tutorials with our awesome doctor, who kindly agreed to letting us tag along for the remainder of the afternoon. Over the weeks we've decided to make this permanent, since we've actually been learning a lot and getting significantly more patient contact than if we just sat on our bums and let all our clinical experience come from our ICM and PCS (Procedural Skills) - a total of 3 hours per week. In addition, the last few weeks have been difficult in terms of integrating the content of ICM tutes and patient contact, as we've been doing all the sensitive topics - the reproductive system and other things like illicit drug histories; so we've only had a couple of patients over the 7 weeks we've had of this semester. A few events that transpired today were quite noteworthy, and I will remember for as long as I live: (a) I was walking out from the hospital after ICM with my friend when I turned my head casually, just looking around, when I noticed a lady lying on the ground, spread out with a car stopped a few metres behind her. Fearing the worst, my friend and I rushed to the lady, who did not in fact get run over (and in this situation I was quite perplexed, for I was sure I didn't hear any screeching or noise generally accompanying a motor incident) but instead was lying down as a protest, determining not to budge as she didn't get the medication she wanted from the docs. I never really followed up on this, as another lady who she knew got her back up and convinced her that this was not the right way to go about it. (b) I was on ward rounds when, a few metres away, there broke an altercation between a patient and her doc, the patient demanding to know why her medication was reduced. The doc tried to explain but was probably a little bit tired or somewhat out of it, accounting for her snappy response and not as-friendly-as-demonstration-doctors-in-teaching-videos are, resulting most probably in.... (c) a MET call on the same ward; at the time we (my doc, a resident, my friend and myself) were attending to another patient in a different room; it turned it out that it was that same patient who probably did not receive a response she quite liked and decided to protest against it by trying to hang herself. From this, I saw first-hand the lessons of PPD (Personal and Professional Development) which included the fact that (a) docs can be snappy, and because of this, could lead to (b) an emotive, distraught patient doing things that are not good for themselves or anyone around them. Reflecting on this, amongst my friends and those who've met me, I'm often considered a very even-headed person who is slow to anger and is generally helpful; but I know that, especially in times when I'm exhausted, I become really apathetic to anything not concerning some shut-eye, and I don't know how or even if I can prevent that. Something to think about, perhaps.

In another related thought, I've started to see myself less of an annoying medical student and more as a part of a healthcare team. The ward rounds have somewhat impacted this shift in attitude, but in addition to that, one specific thing: me and my friend (yes, the same one; we're good buddies, hehe) were on our own, going to interview an elderly patient. Only a couple of minutes into the interview, the patient suddenly displayed signs of distress due to some chest pain. Whilst my friend went to get a nurse (as the patient said she thought she had heartburn), I went into autopilot, doing a pain history just to make sure it was really heartburn. A small and insignificant event, you say? I agree as well, but I think that helped me remember the whole point of being a medical student; in the midst of the studying, the shrieks of disgust when viewing rather horrendous skin diseases, the procrastination and the enthusiasm of discovering new differential diagnoses, I often forget the "medical" part, and I just feel like a uni student, studying to get good grades, to pass and hopefully do honours. Stuff like this makes me feel more relevant when talking or doing exams on patients, and less like a really useless accessory walking around the wards with nothing to contribute.


  1. very interesting blog post! seems like med is the correct career choice for you.

    i am a year 12 student currently, who HAD hopes of getting into uws, but alas, the UMAT had let me am considering redoing the umat again in 2011 whilst partially completing a health related degree. what would your advice be on this? i read in your blog post that you got a late round offer as well...what were you considering before getting into med at uws?

  2. Hi Remy,
    Sorry to hear that - the UMAT does cut down a lot of people who want to get into med, but it's cool that you're thinking of doing it again - it seems that many people improve their scores upon another attempt at it. Regarding the pathway of UMAT + another degree, look to get into a degree that leads to a career path you want. For many people who want to get into med, that seems impossible because all they want to do is med; but I think it's important to explore other related degrees. The importance of this, of course, is that you may end up with a completed degree, and it would be such a waste if you felt like you didn't want to do the job that the degree was leading you towards.

    Personally, my second preference was Bachelor of IT. I have an interest in programming and systems analysis, and I thought it would be good to explore that option whilst thinking of resitting UMAT or instead going for GAMSAT. I later changed this to a Bachelor of Medical Science, but in hindsight I probably would not have done that, and either have stuck with the BIT, or have gone for a B.Nursing. Personal preference only, mind you :)

  3. hello,
    i honestly didn't expect such a speedy reply (especially from a med student cause i know you're all heavily involved with study) but thank you for your very kind advice!
    hrm...i suppose i would be aiming to get into physiotherapy, knowing that such a course correlates to health sciences, as that is what i am most interested in! but its so very true what you've generalised in people i.e. they cannot see anything beyond the scope of med (it applies in my case...somehow!)

    thanks for your kind words once again. will be closely following your blog for more updates!