Exams

So I had my exams yesterday which weren't as bad as I was expecting. In the morning we had a multiple choice paper and a DIPSE paper which stands for something about data interpretation and short answer questions- not quite sure how they came up with the acronym DIPSE though. In the afternoon we had an anatomy spotter which was okay although I wrote 'arch of aorta' for several answers. We were reminded several times about remembering to identify if something was a left or a right- to the point I nearly wrote 'right heart' when obviously we only have one- and it's on the left of the body. Get results in about three weeks which is as long as I had to wait for the results of my finals!

Last night there was a big MedSoc night out,which I declined. Instead I watched "Sex and the City" and drank hot chocolate. It was great! Consequently I woke up this morning much more bight eyed and bushy tailed than some of my colleagues for another day of 9-5 lectures.

Study, study, study...

I'm studying hard for my formative exam tomorrow. Formative exams don't count for your final mark for the year (as opposed to summative) so it's a good opportunity to start revising for my summative exams in January. I've got a 4 hour multiple choice and short answer question exam in the morning- although I really hope it's not going to take four hours! In the afternoon I've got a Timed Practical Circuit (also known as an anatomy spotter) where there will be various specimens with a pin stuck in each one and we have to identify what the pin is pointing to. I'll let you know how I get on!

Weekly update

I took to my bed on Thursday as I felt awful but now I have made a full recovery!

Having a really busy week so far. On Monday morning we were introduced to our next 'case'- a man who had been stabbed in the neck. We then had group discussions of the things we would need to know to treat him such as the anatomy of blood vessels in the neck, how to stop the bleeding, how to treat somebody who has lost lots of blood and how to interpret various test results. In the afternoon we had a lecture on the embryology (the study of how the foetus develops) of the heart.

Yesterday morning I was in the dissecting room, looking at the interior of the heart and the upstairs drawing the outline of the heart on each other with eyeliner and listening to the various valves in different places. In the afternoon we had our first hospital visit to A&E where we met various staff members and observed a consultation. It was a Tuesday afternoon and not much was happening.

This morning we had lectures on how the nervous system controls the heart. This afternoon we met our pregnant lady for our family study project. We went to her house and chatted to her for about 1hour and 15mins. She was lovely and talked lots about her pregnancy and her previous pregnancy and birth. Lot's of information for my 3,000 word report. We're going for our second visit next week.

I'm ill! *sniff sniff*

I've got a cold. And they say doctors make the worst patients. I guess that makes medical students pretty bad too. I've got a runny nose and a sore thought and a cough and generally feel a bit rubbish. I haven't missed any lectures though! I had a practical this morning, doing ECGs. At the start the lecturer said "One of the groups gets to be the patient and needs to like down quietly for the duration of the class". I thought that this was fantastic and could have a little snooze and would still be marked as attending. Then she went on to say that this patient for the ECG had to be in perfect health and not be on any medications. As I'd started my day with a crumpet, a mug of hot ribeana and a cold and flu remedy containing paracetamol, phenylephrine and caffeine, this ruled me out. And I actively took part in the practical. I still feel pretty rotten though. I've had this afternoon off because it's Wednesday but it hasn't been too productive with my snotty nose!

I've been for tea now and had plenty of broccoli and carrots!

Bonfire night

This morning we had quite a complex lecture on embryology which is how a foetus develops and how the cells differentiate into tissues. Then we had a lecture on genetic abnormalities related to chromosome number. I made a big pan of chilli-con-carne at lunchtime and we're going to have that for tea when we come back form the fireworks display tonight. This afternoon we had a really boring lecture about public health. Public heath isn't necessarily a boring subject but the lecturer just gave us lists and lists of databases where we could find statistics about public health. And then read the lists to us. My friend actually fell asleep. I think I heard her snore a little bit too. It would be much better to have approached the topic with a question such as "where can I find out how many people smoke in Glasgow?" or "how many people died from heart disease in the UK in 2003?" and then explored the databases from there. But that's just my opinion.

Other tales of Monday

Also on Monday we had dissection and anatomy again. In anatomy we had to paint on the ribs and lungs and it was my turn to be the canvas. I was sat on the examination couch in my bra with my (thankfully) female anatomy partner and teacher prodding at my chest trying to identify my sixth left anterior intercostal space, (just under the underwire of M&S underwear if you want to find your own). All of the other pairs had at least one boy in them so although they didn't have the female anatomy to worry about, I think some of the boys may have got lots of paint matted into their chest hair. And they'll certainly be at a disadvantage after we do ECGs when we come to remove the sticky pads.

I also got a letter from one of the medico-legal societys you have to subscribe to. They are able to provide legal advice and defence if you make a medical error or somebody ties to sue you. Some words in medicine are very similar (such as the cardiac glycoside drugs digoxin and digitoxin) and therefore you would expect medics to be very careful of how they spelt things. However, in my first letter from this society they had inserted a letter 'e' randomly into my first name. I don't really think that gives off the correct impression, does it?!

Routes of Administration

I've left it ages again to write, I know, I know- I'll try to do better. I know some people are actually reading this now too! Thanks for your emails.

So on Monday we had our first pharmacology lecture. It was pretty similar to my first pharmacology lecture during my previous degree on routes of administration- basically all of the ways you can give a drug.

• orally as a tablet
• injections into veins, arteries, muscles or under the skin
• inhalers
• nasal sprays
• eye drops
• the sub-lingual (under-the-tongue) angina spray
• skin patches for nicotine
• various lotions and potions you can apply topically to the skin

(wouldn't have thought of all of those yourself, would you?!)

There is also however, rectal suppositories. Now, when I was at my previous university and Professor A mentioned the above there was a rather silly giggle which ripples at the room and he shouted "That is not funny. It is sometimes necessary to administer medication this way!". but because we were 18 and British, we find any mention of bums a bit silly. (Later in my degree I also remember Professor A, telling us that rectal administration of drugs is much more common in France). Anyway, in our medical school lecture, Dr. H had a picture of the various routes such as a man taking an aspirin with a glass of water or a child taking her inhaler for asthma. However, it wouldn't really be appropriate to see a patient enduring the last route of administration so he used a picture of an alley and exclaimed "up the back passage!". The variation in approach to the subject between Prof. A and Dr. H was very noteworthy.

I got the job!

I got an email at 11.45am this morning and I got the job. I've also been offered the position of student ambassador to help out on open days, tours and summer schools for prospective students. That's paid too. I'm very pleased. I've got to attend two days of paid training the weekend after next. I'm currently celebrating with a cup of coffee and a large milkybar.

Otherwise today hasn't been to great. Our 9am lecture was cancelled when we got there and after 10 minutes the problem with the computer still wasn't fixed. At 10.30am we had to collect our personal KEEpads (the who-wants-to-be-a-millionaire handsets I think I mentioned yesterday. This afternoon we had a lecture on qualitative and quantitative data followed by a session with my tutor group which was a bit flat. Not everyone contributes to the discussions (in fact mostly there was only about 3 of us out of 10 who said much at allg) which defeats the object of the sessions.

Going to read some of the GMC guidelines on "Duties of a Doctor" this evening as our first assignment is based on this.

Blood pressure and things

I actually heard a blood pressure today! We have to learn to measure blood pressures manually with a stethoscope and not just with a digital machine which I've used previously. Firstly, manual BPs are more accurate (especially if they are very low or very high) and also if we go to the back of beyond for our elective in fourth year then we probably won't get a digital machine to use- although I'm still considering the possibility of nipping down to Boots and getting a digital home one to keep, just in case. I've measured BP previously during my first degree, except there were about 100 of us in the lab and the background noise meant we heard nothing. I had a couple of attempts and was struggling and then I tried on another student (who used to be a nurse and was pointing me in the right direction) and I heard it! Very pleased but certainly need more practice.

This morning we had a quiz with our KEEpads (like the who wants to be a millionaire 'ask the audience buttons') for two hours on chest x-rays. Lots of the questions were "what is X pointing to?" or "which condition does this patient have?" with multiple choice answers. Graphs appear on the screen (like in who wants to be a millionaire) to show which percentage of students voted for which answer. I think it was a really effective way to find out what you didn't know and be reassured that you did know quite a bit of stuff. One x-ray showed a baby with Dextrocardia Situs Inversus, which is when the heart is one the right side of the body (as opposed to the left) and other organs (such as liver, stomach, spleen, appendix) are on the opposite side too. This usually causes the individuals no problems ad often isn't detected until later in life. However, having just dextrocardia (a heart on the right) can cause major problems. Isn't that interesting?! It's pretty rare though.

I also had an interview today to be an Aim higher associate. These are undergraduate students who are involved with mentoring and encouraging applications from local school students who may not previously thought of going to university (due to finances, living in local authority care, being a carer for a parent, unrealistic perceptions of university or not having family members who have gone to university). It was a group interview with five other girls where we had to prepare a presentation on "what is university?". I think it went okay. I find out tomorrow and it pays very well.

It's been so long

Apologies folks for not writing for a week! Not good enough for a blogger- me thinks. I had an IT drama on Thursday and I've been in a virtual strop ever since. On Thursday we had the placement provider fayre where various heath and social care charities from across our local area had stalls with information encouraging us to do our community placement with them. The community placement runs from January to December 2010 and during that time we need to complete 60 hours of voluntary service and then submit a 3000 word report on our experiences, specifically reflecting on what we had learned. Most of my previous voluntary experiences have been with children or elderly people. Therefore I'm keen to work with young people who have problems I haven't personally encountered such as addictions, homelessness and living in local authority care. We had to fill in a form online stating which areas we'd like to work in and what we want to gain form the experience and our personal details. I spent ages on this (like about two hours) and when I pressed submit I got an error message and lost everything I'd entered into this form. I was sooooooooooooooo annoyed and hence have been in a huff with all computers since.

Anyway, the week ended better and we had out first patient contact. Two patients with Cystic Fibrosis came in so we could ask them about what it was like to live with the disease. One patient was also with his parents and we asked them about his diagnosis and what that time was like for them, as he was too young to remember it. It was really interesting and definitely puts what we are learning into context.

On Monday we were back in the dissection room for some basic thorax anatomy which was ace. It didn't even feel like a lesson- just like being told about something really interesting by somebody who really knew their stuff. Then we had a lesson on the osteology of the thorax and learned about the bones which make up the ribcage and spine. Finally we had our first go at body painting and had to paint on the clavicles (collarbones), sternal angle, sternal notch and xiphoid process on our partners. This is a bit weird- prodding at the chest somebody you barely know (especially as it was a girl and they have breasts which makes anything to do with the chest more complicated!). I'm sure I'll get used to it though. I must remember to cut my nails before next week so I don't scratch anybody.

Yesterday we had lectures on histology (the tissues) of the respiratory tract and then a quick refresher of how to use a light microscope. The highlight of yesterday at uni was the free lunch in the canteen provided by our tutor. Most of us had roast beef and Yorkshire pudding and it was lush! In the afternoon we had an introduction to communication skills.

This morning I've had a lecture which was revision for me on cell membrane transporters. These are proteins which sit in the membrane of a cell and control the entry and exit of ions and molecules such as glucose.

I'm loving it!

Today is the first day I've felt like a real medical student and it's ace! I got up early (well a little bit after 8am (which would have been really late if I were still commuting in like I did for my first degree) and just as I was leaving one of my flatmates claimed I didn't need to go in for the 9am lecture. Yesterday I wrote a cheque for over £3000 to pay for tuition fees for the year, I intend to go to every minute of teaching whether I perceive that i 'need' to or not! Anyway, it was a pretty useful revision lecture on cell membranes.

We were also shown a video intended for CF patients produced by the local hospital. It showed four young people with CF talking about their expereince of the disease and how it effects their lives. The most surprising thing that I learned form this film was that several of the patients have had spells of very low or non-compliance with their treatment. Although I was aware that cystic fibrosis patients need a great deal of physiotherapy to help them expel mucus from their lungs and take lots of medications (both pills and using a nebuliser),what I didn't really think about is like most teenagers they've had rebellious phases when they haven't wanted to do as they are told. Most rebellious phases involve dressing a bit strange or aquiring bizarre musical tastes (I was a Tori Amos fan for a while back in 2003!) but they don't generally have the consequences of being hospitalised with a severe respiratory infection and requiring IV antibiotics. I guess that made me realise that some of these patients just want to be like normal teenagers and don't always think about the severity of their illness which I suppose in some ways is a good thing.

We then had a session about the importance of completing feedback questionnaires and how our oppinions count and can change certain aspects of the course. Next we voted for student representatives for various committees and I was elected as one of the four Community Placement Steering Committee reps. We meet once per term and i think we get a free lunch which should make it worthwhile!

Finally this morning we had a really interesting lecture about types of clinical imaging (CT scans, X-rays, MRI, ultrasound) and are learning how to interpret chest x-rays. My interesting fact for today is that x-rays of the chest are normally taken in what we call PA, which is posterior to anterior projection (i.e. of the patients back). If the x-ray was taken from the front, the heart would be closer to the x-ray source and hence would appear larger (like a shadow of an object appearing bigger if it was closer to the source of light). Additionally, young mobile patients are asked to bend their arms forwards to move the shoulder blades to the side and of of the image. Fascinating stuff!

This afternoon I've written up lecture notes and then I went for tea. We get our meals here on a Monday and Wednesday evening which saves cooking and so far the food has been pretty good too. After tea I came back to my room and wrote up more lecture notes. I was never this enthusiastic during my last degree. Not even right at the start. But I'm really enjoying medicine thus far.

First Days

We've had lots of introductory lectures during the past two days. Yesterday we had introduction to assessment where we learned that we are assessed on the areas of behaviours, skills and knowledge and medicine is not just about passing the exams but learning to be a good doctor. Obviously the patients safety is the most important thing so we can only pass if we are competent.

Then we had an introduction to the dissecting room (DR) and went there to see a cadaver for the first time. We only saw the upper limb and thorax (that's arm and chest in my previous language but we're encouraged by our anatomy teachers to speak in anatomical terms). It was okay, nobody fainted and the way in which the cadavers are preserved means they do look quite different from live bodies. It didn't smell too bad. Apparently formaldehyde is an appetite stimulant so when you leave the DR it's totally normal to feel hungry. Strange but true!

This morning we had our foundation case lecture on cystic fibrosis which had been re-arranged form last Friday. It included watching a video with John Cleese and a man who presented a science program in the 1970's and a man from The Goodies. It gave some of the very basic details about CF and then we were lectures more about the Cystic Fibrosis Transmembrane Conductance Regulator which is a transmembrane protein in the cell which is often mutated in CF.

Then I attended an IT session on using a program called the virtual human dissector which is a fantastic piece of software which has cross sectional views of the entire body and each structure in the cross-section is labelled. We use this to learn the cross-sectional views through the body and where they correspond on a 3D actual body. The whole thing is based on something called the virtual human project (I think) which was done at Columbia uni in the states (don't quote me) and used the frozen body of a consenting prisoner.

Finally today we had our first sociology-type lecture and was introduced to my tutor group for this module. On the whole everyone was very quiet and our tutor let us go 45minutes early. I bit a bit disappointed by this (sad, I know) but when you're paying £3225 you want every minutes worth! We were all supposed to prepare something to teach the rest of the class in 2-3 minutes. I'd prepared the notes on a musical stave and another guy taught us a few Swahili words as he'd spent three months in Kenya but nobody else had done anything. Which i though was pretty poor. never mind- I hope that our next session is more of a success and we actually discuss something! (I'm very opinionated, don't you know!)

Ooooh, I have a blog!

So finally I've moved into the techno age. The girl who shunned facebook, my space, twitter, bebo and the other online collect-a-friend games has finally decided to go online. It was my boyfriend's idea. I said "I'm going to keep a diary of my medical school experiences" and he said "you should make a blog". Or words to that effect. So I've gone less Anne Frank (with her famous Dear Kitty entries) and more Julie & Julia, which incidentally is quite possibly the best film I've seen this year.

It's my first week at medical school and thought it would be beneficial to record my experiences on the long road to becoming a doctor. And also provide a neat collection of evidence for all of the reflective practice exercises I'm sure to encounter in the coming weeks and months.