Dr Learnaholic, at your service

That's right, I have passed finals and am thus Doctor Learnaholic! Extremely happy and relieved to have got to this point after seven years of pretty hard slog at university. I will be starting work as a very, very junior doctor on July 31st, with a week of shadowing beforehand. This also means that I've got on to my MSc (in paediatrics and child health), which I'll be doing part time over the next couple of years. Well, I need to justify calling myself the learnaholic, don't I?!!!

I was sitting, waiting, wishing...

Waiting for exam results is one of the most stressful experiences there is for students. The revision period, with all the worry and anticipation and studying to be done, is difficult, but I've always found that I can feel at least a little in control by working hard and being as prepared as possible. Now the exams are over, there is absolutely nothing I can do to alter things. Of course, logic would say that worrying is pointless because it won't change anything, but anyone who knows me will tell you that logic isn't always a word associated with my thought processes!

Since before I actually sat my OSCEs, I've been having flashbacks to my A level results day. As I said in my first post on this blog, I didn't get the grades I'd been hoping for, hence taking what I like to describe as the "scenic route" to medical school. I had all but forgotten about results day itself but suffice to say looking at that sheet of paper and realising I had screwed up was one of the most gutting moments of my life. I was lucky that results day for my BSc was a considerably more positive experience, but there's still a part of me that feels like a failure for having to do that degree in the first place (I am aware that someone with a decent degree who managed to get into medical school objectively is probably not a failure at all, but it's far easier to be objective about other people than it is about yourself).

At the moment, I don't really know what I'm most scared of. I could fail, have to decline my job, repeat the year of university, let down all my friends and family... I don't think after my experiences with my high school exams I would cope terribly well with that. The alternative might just be a bit more terrifying though. Maybe I'll pass - which case I'll be starting my first job as a doctor in 7 weeks time. Now that really is scary!

Finals

Just a very short update to say that this little Learnaholic has finished finals! If I've passed Wednesday and Thursday's OSCEs, then I will actually be a doctor. Scary but exciting times!

It's always really difficult to judge performance in OSCEs. There were a couple of stations I felt I really nailed and a couple I probably totally messed up, but overall I'm not sure how I got on. The great thing about medicine compared to my last degree was this is totally pass/fail. There is no grading, I don't have to worry about whether I got a first, 2i etc, which means that as long as I scrape through then I'll be happy.

I get results some time next week, so of course I'll update and let you all know how I got on. Now, if you'll excuse me, I need to get started on all the things I was putting off so I could revise....

xxx

The Final Countdown

After almost 7 years as a student I now feel like I'm into the home strait. One more week of teaching, a few weeks of studying and the small matter of a couple of OSCEs are all that stand between me and entering the big bad world. I am surprisingly calm about this, although provided I pass my exams I will be starting work in 2 and a half months. Possibly I ought to be more nervous about this, especially if day one really is like the bits they show on "Junior Doctors: Your Life In Their Hands" and I take 278 attempts to cannulate each patient.

At the moment, our teaching is all on "professional practise", which is essentially all the stuff that's quite important but noone teaches you. This includes such delights as confirming death, prescribing and fatal accident enquiries. I suspect that actually much of this has been covered in some ilk or other before but I ignored it because it was all "ages away". And now it is not ages away. It is a matter of months. Weeks, really.

This morning we had a session on dealing with "stress and conflict", where we were presented with some rather grim statistics on the mental wellbeing of junior doctors. I was delighted to learn that being female (check) and having a critical father (check - that doesn't mean he isn't lovely) increase risk of suffering burnout during the first couple of years after qualifying. On Wednesday we had a session entitled "support and sanctions" which involved the GMC, MDU and health board HR people telling us not to be naughty or we'd get struck off/fired. Despite these two rather depressing sessions, I'm actually feeling rather positive about starting work.

I had a phone call from occupational health yesterday, and was told they had "no concerns" about my fitness to practise. If you've read my blog before, you'll know that I've had one or two health problems in the past. Although I've played my worries down, I've gone through medical school being a little bit worried that someone would find some kind of loophole which would mean I wouldn't be allowed to start work, so it's a huge relief to know that, from a health perspective at least, I'm going to be ok.

I am keeping myself rather busy at the moment, even though I probably ought to be in the library trying to get the whole of medicine and surgery into my cranium... Last week we had a week off uni and I did absolutely no work at all. I went home to see Mummy and Daddy Learnaholic and had a lovely, relaxing time. Last weekend I went down to Brighton to the National Medical Student Paediatric Conference, which was fantastic. I met lots of lovely people, caught up with some old friends from other medical schools, enjoyed hearing different perspectives on paediatrics and drank lots of wine at the delegate ball.

In addition to uni and revision, I've also started helping out at Cubs (great fun), have a poster to make for a conference in a couple of weeks and applied for a Master's. I suppose I have to justify calling myself the Learnaholic, don't I?!!!

xxxx

Exam Chat

Over the past week, I have spent a lot of time thinking about my exams in June. That sounds a long way off, and it is, but this time last year I had properly started the hardcore revision and I feel slightly weird that I haven't started studying for these exams yet. I think the oddest thing is that because I have no written exams (two OSCEs, one of 5 minute stations and one of 10 minute stations) there are no past papers to go over so I feel like I have no idea what could come up.

We had a "mock" OSCE during my last placement but that was only quite short. I'm trying to remember what came up in that and I recall the following salient points:

- Check the femoral pulses first in a lower limb vascular exam (apparently starting distal and saying "that's there so the more proximal ones must be ok" won't cut it)
- Being able to use a hand-held doppler is useful
- If it feels like a spleen, it is a spleen - not a kidney trying to trick you
- If there is reference material, read ALL of it, not just the first bit you see in your sense of blind panic
- Have a differential for your findings. Even if you know the patient and you know exactly what their diagnosis is.
- Never, ever, ever (ever, ever, EVER) forget the occupational history. Especially if the patient has dermatological or respiratory symptoms.

That's about it - presumably they were the stations I embarrassed myself in, hence why I can remember them. I was, erm, a bit tipsy when getting my feedback so I don't recall that much about it (we went to the pub for a swift pint whilst waiting for the feedback session, but I can't handle booze at all and someone bought shots - I am convinced the consultant knew I was wasted but he didn't let on - I tell myself it's because I did really well in his "pet" area)

I keep trying to work out what could come up and I am totally clueless. Obviously lots of practise at examining and history taking is useful (basically what I've been doing all year on placements anyway) but I also need to do some proper studying. I do recall someone saying a few years ago there was a patient with Cullen's and Grey-Turner's signs coloured on them in felt tip. And no, I can never remember which one is flank and which is periumbilical!

Any suggestions for what to study before a final year OSCE much appreciated!

xxx

End of the year...

So, 2011 is finally drawing to a close. It's been a rather interesting year for me and so I feel compelled to join in with the corny reflective blog entries, and then I'll probably continue with the corniness and make some resolutions of some kind.

2011 didn't start off in any particularly exciting way - my then-bf's uncle died on New Year's Eve and so the first event of any significance in the New Year was a funeral. I suppose that did mean that things really could only improve!

My first placement after the holidays was in general practice. I hadn't really expected to enjoy it much but I had a fantastic time. The staff were all lovely and I've kept in touch with one of the nurses and one of the receptionists. I was also able to do an audit whilst I was there, which was probably pretty good for the CV/job applications. Plus, it was on one of my "favourite" (read "favourite thing to rant about") topics - MMR vaccine uptake.

The rest of the academic year went fairly well, if uneventfully. Fourth year was rather stressful in the sense that, GP aside, we were only on most blocks for a week at a time so by the time we'd worked out who and where everyone/thing on the ward was, it was time to move on. On top of that, as anyone silly enough to have read my blog will know, in June we had our final written exams. From about March time I spent most evenings and weekends studying. Rather sad, but it paid off when I passed. A little scary to know that the next written exams I take will probably be my membership exams - eek!

Over the summer I had two wonderful weeks away volunteering. I won't go into details as I've already blogged about them, but they were lovely experiences and even now, months later, I still smile when thinking about them. I very much hope that I can squeeze in at least one this year.

This academic year has been rather up and down. After something of a dull start (professional practise block - yawn!( I had a wonderful experience on my elective in New Zealand. As well as enjoying the travel and change of scenery, my placement was fantastic and only reinforced my absolute love of paediatrics. After getting back to the UK, my gastroenterology placement was slightly less to my liking. However, I do feel like I came on a lot in terms of my knowledge and clinical skills, so overall I'd say it was successful.

Uni aside, I have of course got my job for once I've graduated. Rather exciting and terrifying at the same time. I'm still waiting to find out the exact details of my contract but it's nice to know that, providing I pass my OSCEs in June, I will have a job to start. After 7 (!!!) years of studying I'm rather looking forward to joining the real world.

Ignoring a lot of trivial and banal things which really don't matter, I'd say overall 2011 has been a pretty successful year for me - I hope 2012 continues in a similar way!

Now, resolution time! These are largely unrelated to work so don't really belong in this blog, but I thought it would be good for me to write them down somewhere so that I felt accountable!

- Get fit again. This is a major one for me because I know when I'm fitter and exercising more regularly my mood, energy and sleep are all much better. I was going to the gym at least 3 times a week until exams started taking up too much time. Then with elective and a placement out of town I haven't really had the chance.
- Start eating properly again. This is another "again" as it's a good habit I'd managed to get into which has lapsed recently. Ideally I'd like to lose weight but my primary goal is to eat properly and stop using food as an emotional crutch.
- Sort out my finances. Rather dull but as I'm now in my 7th year of student life, I am rather skint. This isn't an immediate thing but I'm hoping that if I'm sensible now and start working (hopefully!) in August that by the end of the year I will at least have cleared my credit card and overdraft...
- Attempt to be more positive. This is something I say every year and I'm not very good at it (look what I did there, self deprecation in action!) so I'll have to keep on trying.

Right, those are my little aims for the next year. And to graduate and become a doctor of course!

Happy New Year everyone! xxx

You Win Some, You Lose Some

As mentioned in my last post, I've just spent a week volunteering with Over The Wall and had an absolutely fantastic time. This was my fourth holiday with them and it was every bit as fantastic as the previous three I've done. One of the great things about OTW, aside from meeting a lot of inspirational young people and having a brilliant time, is when the other volunteers write you "warm fuzzies"; these are basically just little notes to say hi and comment on anything they think you did well or which stood out over the week. Anyway, after reading mine (and getting out old ones from previous camps), it occurred to me that I'm perceived in a totally different way at camp to how I'm perceived in "the real world". I can think of two possible explanations for this. Either I'm a completely different person for one week of the year, which seems unlikely, or I actually have no idea how I'm normally perceived and just make it up. This seems somewhat unrelated to this blog, which is supposedly about my academic endeavours, however it just made me realise having such a negative view of myself was probably not going to help my career prospects. So I shall now attempt to be a more positive person!

Moving on to more relevant stuff, on Wednesday I got an email to say my one of my AFP applications had been unsuccessful. I was pretty disappointed, as having read over their criteria, I have all of the "essential" and some of the "desirable" qualities and thought I might manage to get an interview. However, it's a hugely competitive and popular programme and I know that there are a lot of applicants with far more research experience, publications etc than I have. I'll just have to hope I have better news from one of the other two!
On a much more positive note - I passed my exams! Hugely relieved, especially about the OSCE as there were so many things I realised I'd forgotten to do/say as soon as I got out of each station. This means I'm officially a final year, which is a little bit scary but very exciting :)

Hope everyone waiting on exam results has good news soon xxx

OSCE and Freedom!

So today was the dreaded OSCE. I've always suffered horrendously with exam nerves, and although in recent years I've managed to get a hold of myself during written exams, I really struggle to hold things together during OSCEs. For some reason, every examination, history or procedure that I've done numerous times in the preceeding months leaves my memory and I feel like I enter every station completely clueless. This year in particular, things were not helped by the revision day put on for us at uni, where I was not-so-politely told, after one particularly disasterous station, that I was under no circumstances to go anywhere near a sick patient as I was basically completely incompetent... Cue an evening of tears, sickness and panicky phone calls to medical friends. Utter nightmare. However, once that was done I decided to focus on "practise, practise, practise" - the only way to really get through a clinical exam. I spent Friday and Saturday reading MacLeod's Clinical Examination and my Ask Doctor Clarke books cover to cover, then Sunday and Monday both involved practising with friends.

This morning I have to admit I felt rather unwell (ie like I could well vomit on the first patient I saw...), but having seen most of my year group feeling the same way, I realised things could've been much worse. The exam itself was rather hard to judge. I was lucky in that my first 3 stations were all written, as I find the written bits much easier and less panic-inducing, so that meant I started on a reasonably positive note. Aside from forgetting to take the respiratory rate of the patient in the "examine this gentleman's respiratory system" station (schoolboy error!), I can't think of any epic disasters. There were more communication/history stations than I'd imagined, which I think was a good thing, and no limb neurology or musculoskeletal exams - a definite bonus as they're my two weakest areas. All in all, I suppose it went "ok", not amazing, not terrible. I didn't cry when I came out of the exam (unlike quite a few people, and indeed me myself last year) and don't think I had any complete blanks. So I'm just going to try and forget about it until results come out a week on Friday.

This evening I'm going for dinner with some of the people from my ward group, which should be a nice way to mark the end of the year, and then we'll meet up with the rest of our class for some drinking, dancing and general debauchery! We have some lecture thing at uni tomorrow about registering with the GMC, and I suspect I may not be alone in attending with a bit of a headache (or possibly still drunk!); having to be in at 9.30am the day after exams isn't ideal but I'm sure I'll survive.

On Friday I'm going away for a week to volunteer for Over The Wall (http://www.otw.org.uk/), an amazing charity who run holidays for children affected by serious illnesses. It'll be the fourth time I've volunteered with them and I cannot wait! It's usually a completely crazy week involving lots of facepaint, nail varnish, singing, dancing, food challenges and general silliness :) So I may not update until I'm back, by which time I should have my results - eek.

Good luck to anyone still doing exams, and those who are finished enjoy your new-found freedom! xxx

Exams Pt II

Written exams are now done! It feels incredibly odd to know that if I've passed, I won't sit another written exam until I do my membership papers.

There was another MEQ this morning, which was probably on a par with Monday's paper in terms of difficulty/weirdness. There were good psych and paeds questions, and a decent obstetric one too, which I'm happy about. There was a pretty tricky one on burns management, which everyone seemed to have found difficult, but the rest was fine. Once again I was first to leave, which made me a bit paranoid that I'd misinterpreted something that was actually more difficult/time consuming than I'd thought, but I think overall it went reasonably well (although the invigilator did say they were going to make me a more difficult paper so I took longer next time..).

This afternoon was the SBA (single best answer) paper, which is well known for being incredibly difficult because for a lot of the questions, there will be two answers which are correct, but you have to chose the one that's "most" correct. The majority were relatively obvious though, or at least possible to work out using first principles. Funnily enough after a Twitter debate last night (I'm @the_learnaholic) on the relevance of hypoxic drive, a question about an acute exacerbation of COPD came up. I left this exam first too, which makes me think that I read abnormally quickly! I was home and in the bath before the exam was even over...

Well, only the OSCE on Tuesday left to study for. There'a revision day at uni tomorrow which I'm hoping will be useful, as I'm never too sure how to prepare for OSCEs. I also went on the Ask Doctor Clarke revision courses earlier this year, which should prove useful.

Hope everyone else with exams is getting through without too much stress! xxx

Exams Pt I

I had my first two exams today; I have two more on Wednesday and then an OSCE next Tuesday.

This set of exams are a little odd, as they're my "finals" in the sense that I'll only have an OSCE to do next year, no written papers. It feels strange calling them finals when I still have another year at uni, but we keep being told that next year is all about the practical stuff so our knowledge now should be all we need to get through - scary thought!

Anyway, after a near nervous breakdown last night (asking friends to test you less than 12 hours before an exam is never a good idea, especially if they test you on things you've honestly never heard of in your life!) and about 8 hours sleep all weekend, I managed to get through.

This morning was the MEQ (modified essay questions), where there were 9 scenarios with associated short answer questions. A slightly odd mix of topics came up. There was no paediatrics or psychiatry, which is a little annoying as they're probably my best subjects. Cancer came up 3 times (suppose it is common and important) and there was a scenario which was largely about audiology... Bizarre! I was the first person to leave, which often happens in exams as I'm a really fast reader. I'm not sure how anyone spent 2 and a half hours on it, but I definitely answered everything! Anyway, having chatted to other people it seems like we all wrote vaguely similar things, so either I've done ok or the majority of the year have failed. Fingers crossed for the former! We have a second MEQ on Wednesday so if paeds and psych don't appear at some point in that I will be annoyed.

This afternoon was the EMQ (extended matching questions), which is a slightly bizarre format which is similar to multiple choice, but there are 5 questions relating to each set of possible answers. The range of subjects was a bit better (very glad I spent ages on developmental milestones) and there were only a couple where I was really unsure. Again I finished stupidly early, was second to leave (after the guy who left second in the morning - I guess we're both just quick!). I think I'm one of those people who feels the need to change things if I sit there too long, so after checking my answers 4 or 5 times, I have to go before I start changing all my correct answers to wrong ones!

I have written down a list of topics which came up, should anyone be interested.

I'm going to head off and try for a decent sleep tonight, then will spend tomorrow going over the things which weren't in today's exam as they're likely to appear on Wednesday.

Good luck to anyone else with exams at the moment xxx

Busy Bee!

Why is it that weekends seem to go by so quickly?! I had so many things I wanted to get done, but am nowhere near through them. My list looks a little bit like this:

1) Finish neurology revision and start on gp stuff
2) Work on application forms for academic foundation programme
3) Complete pre-elective reading, write up findings and send to host supervisor
4) Work on systematic review for home supervisor
5) Clean kitchen and bathroom
6) Do food shop

So basically this weekend I've successfully cleaned my flat, and bought some food. Useful, but not exactly the top priorities, were they?! I have done some neurology (and covered a bit more in clinic this morning), but I really ought to have finished it by now. I've added nothing recently to my AFP forms - I'm struggling to answer questions such as "explain how your SSM or elective demonstrates your suitability to an academic post" - argh! I did do a little bit of my pre-elective work, but ideally I would have finished it. My host supervisor is very relaxed so there's no pressure, but it'd be nice to have out of the way. The systematic review has been largely ignored, but I'm less concerned about that as there's not a lot I can do until I receive other people's information.

I probably spent too much time catching up on Grey's Anatomy - what a tear-jerking season finale! I actually cried more than I did at the end of season 6, which I didn't think possible! Anyway, it's now finished, so I suppose that's one less thing to distract me this week.

Better get back to the books...