Welcome to our new series, A Day in the Life of A Med Student. In this series, we ask a current med student to write about a typical day at medical school – whether this is on placement or in lectures to give you a flavour of what studying medicine is like!
In this blog, we catch up with Mariam, a final year medic at Lancaster.
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I am fortunate enough to have completed my final examinations in fourth year, leaving my fifth and final year to concentrate fully on preparing to be a “real doctor”.
As such, my placements are entirely clinically orientated, allowing me to gain as much real-life experience as possible. In this blog, I will describe a typical day in the hospital as a final year medical student.
I attend my allocated ward for 8:30, and we begin the ward round. This involves traipsing round as a large team of doctors and nurses, reviewing each patient one by one. My role is to check the patients’ “observations” – the heart rate, blood pressure, temperature, etc – and identify any abnormal findings to the consultant.
I also check the medication chart for each patient, which allows me to answer any questions the consultant asks about it, and I make notes in the patient records when required. These jobs are typical of what an FY1 would do on a ward round, and other responsibilities include checking the patients’ blood results and x-rays.
I used to feel nervous about getting involved in the ward rounds, in case I made a mistake. I spent many a ward round as a younger medical student, simply observing – and this does serve some educational purpose up to a certain point.
However, at this stage, it is important for me to start performing some of the duties which will be expected of me in a few months time. I have realised that the only way to learn anything properly is by doing it. It’s better to do it for the first time as a supervised medical student, than to be faced with it for the first time as a doctor!
The ward round takes several hours, and by the time it’s over, lunch is definitely needed to regain energy. I take my break, meeting up with some of my friends in the student common room. As usual, there are several funny stories to share from the morning’s work. Maintaining confidentiality of course, we compare what we’ve been doing. I tell them about the patient on the ward round who, when asked what her main problem was, replied: “I would love a back-scratcher, if you’ve got one!”.
One of my friends is on a paediatrics rotation, and tells me of a child on the ward whose favourite game is to see how far along the corridor he can push the blood pressure monitoring machine. Feeling refreshed, I return the ward ready to help out with the afternoon jobs.
Jobs have been accumulated from the morning ward round. This includes blood tests, cannula insertions, ordering investigations, making phone calls and writing discharge letters for patients who are ready to go home.
To ensure that I am competent in performing all of these tasks, ready for next year, I have a logbook detailing what I need to achieve in each placement, with each one needing a signature from a supervisor. I ask the FY1 what I can do to help, and he tells me which patients I should perform some blood tests on.
I go to do this, but on the way, spot a patient who had seemed a little anxious in the morning ward round. I decide to see if he wants to have a chat, and if I can help him in any way. I draw the curtains, and ask him how he is. He immediately bursts into tears. He is extremely frightened about what is wrong with him, and doesn’t understand what the plan is for his treatment. He’s an elderly, frail looking man, and my heart really goes out for him.
Fortunately, I remember what was said on the morning ward round, and explain it to him carefully and slowly, repeating it several times until I feel he has understood. He stops crying and thanks me profusely, and I feel a huge sense of achievement. My actions did not contribute to his medical care, but he looks infinitely happier than he did when I first saw him.
I tell myself that I will always make time for patients in this way, no matter what level I reach as a doctor. He tells me I must think he’s silly, not understanding what’s going on. My answer makes him laugh – I tell him I’m going to be a doctor in 3 months, and I still don’t know what’s going on!
After this, I carry on with the rest of the jobs. I have not yet written a discharge letter, and the FY1 teaches me how to do it. The afternoon is busy and passes quickly; soon it is time for me to attend a scheduled teaching session.
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At 17:30, I head to the teaching session that has been organised for us by one of the FY1 doctors. It is not compulsory, but at this stage, I am keener than ever to learn as much as possible, as the reality of being a doctor gets closer and closer. “Simulation” teaching is growing in popularity, and we certainly have done a lot of it this year. This involves being given a scenario with a “fake” patient, and being asked to manage it as if we were the doctor.
In this teaching session, the FY1 doctor tells me that I have been called to see a patient who the nurses are worried about. In role, I ask for more information – who is the patient? What has he come in with? What are the nurses worried about? Asking these questions allowed me to build up a picture, before I go to see the patient.
I approach the mannequin – an expensive piece of equipment called “Simman” who breathes, and has a pulse. Role plays are always awkward, particularly when you are talking to a mannequin and receiving answers from someone else, but this is something we’ve had to get used to.
I begin to assess the “patient”. As I perform further examinations, I begin to request tests and investigations, which the FY1 gives me the results for, allowing me to form a potential diagnosis. She asks me how I would manage this patient, and I explain my answers with reasoning.
She prompts me if I miss anything important out, and this allows me to learn further from the experience. All in all, I think this is a great method of teaching, and I am greatly appreciative that doctors will take time out of their days to do this for us.
Teaching those junior to you is integrated into the job of a doctor, but some will go above and beyond their duties. I make another mental note to always make time for medical students, as I have seen what a difference it can make.
My day is finally over, and I head home. I have learnt a lot today, and reflect on this as I sit on the bus. Unfortunately, learning things for exams is not the same as learning for real life.
If I’m honest, I have learnt more in my placements as a final year medical student than I learnt in the last four years. This was a typical hospital day for me, and I am glad that I have these learning opportunities, as I am finally starting to feel somewhat prepared for life as a junior doctor.
Words: Mariam Al-Attar
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