Career Stress!

As students, particularly students of a profession, a lot of what we do is a "means to an end". We don't go to university for 5 or more years because we have a deep love for our subject, because we enjoy learning, because we enjoy the challenges posed by essays and exams (although any or all of these may be true). We go to university to become doctors.

As I've mentioned previously, I did a BSc in order to get into medical school. I hated my A levels, but I did them because they were necessary to get into university. I was pretty miserable doing my GCSEs, but I had to do them to do anything I wanted to do in the longrun. You get the picture. In essence, I've spent the best part of a decade doing things that I don't particularly enjoy, but because they are (or were) necessary for me to be able to do what I hope I will enjoy one day. That isn't to say I've hated everything I've done. GCSE drama was fantastic, I loved my Maths A level (seriously) and there were courses I took during my BSc which were fascinating. There have even been bits of medical school that I've enjoyed, although those have been few and far between (I don't hate medicine, I just really miss proper science sometimes).

Today I met with a couple of very friendly paediatricians (yes, we arranged it via Twitter, and yes, they may well read this at some point - hello if you're reading *waves*) to have a chat about career related things. Despite this being a pretty positive discussion, at least in the sense that they think I at least stand a chance of getting into paediatrics in future, I still find myself feeling hugely stressed. I can't pinpoint exactly why, but I wonder whether it's the fact that it's all been brought home just how much longer I'm going to be doing things as "a means to an end". The rest of this year is a given, of course. And then there's my two foundation years, which may or may not be enjoyable (they may also cause me to be killed falling asleep on the drive home from work or to jump off a multistory if recent news stories are anything to go on, but I'm choosing to ignore those particular "risks" for now). Let's be honest, I'm not actually going to have a "proper" job until I'm about 40. That's fine. But what if I get there and I hate it. I've already spent 10 years working towards being a paediatrician. I have at least another 10 to go. That's a very long time for something I might not actually a) like or b) be any good at.

I'm very aware that I'm rambling utter nonsense here. I shall leave you with a last thought: Why is it that even when we can objectively say that we're ok, even good, at something, we can't quite bring ourselves to feel/believe it?

Thoughts on Twitter

I appear to have updated more than usual in the past few weeks. You may blame the uni holidays, and also the fact that I really ought to be doing some preparatory reading for my next placement and thus of course absolutely anything else in the world seems more interesting and appealing than what I should be doing.

It will come as little surprise to most of you to learn that I am a huge fan of Twitter. I joined initially because I thought it might be fun to follow some of my favourite "celebrities" on there (Stephen Fry mentioned it a lot in his podcasts). Having joined, I discovered some of my friends had accounts and thought it was worth following them. As a lot of my friends are medics (quelle surprise...) I soon found myself connecting with medical students and doctors around the UK and indeed the world. Now, this is great. I get to chat to people who are experts in their field. I can compare notes with students at other unis. If I have a question, I can "Tweet" it and most of the time I have a reliable answer in minutes. All of this is fantastic, not to mention that I have made some lovely friends who I probably wouldn't have met any other way. Recently, however, I have started to have a few concerns about how I use Twitter.

As a soon-to-be (I hope!) doctor, I have followed with interest recent discussions on various media regarding professional conduct and social networking. My profile is semi-anonymous, in that if you access it you can probably work out who I am, but I don't think you could find it by searching for me directly. I tend to lead a fairly dull and mundane life. The most "unprofessional" behaviour I engage in is the occassional vodka (ok, a few vodkas) once in a blue moon. I don't do anything illegal and I don't think I ever do anything which would make people worry about my suitability as a doctor. At least I hope not. Thus, I am rather unlikely to "reveal" anything on Twitter which isn't common knowledge. On occassion I have been slightly concerned that a jokey comment could be taken out of context and imply something quite different from what I intended, but for those situations there is of course the "delete" button. If I feel that something I've said has caused offence or annoyance I am generally more than happy to apologise and remove the tweet in question. I also have the utmost respect for my collegues, so if it is suggested that I've said something unwise then I'll listen, take down what I've written and try not to say similar in future. My concerns regarding Twitter, then, are not really related to professionalism.

I have recently found myself in something of an interesting situation. Given the vast numbers of people using social media and the ease with which one can find and follow those with similar interests, I have been followed by (and follow) several doctors who work in places I have been on placements or may work in future. As I stated above, I'm not really concerned by this as I don't say anything online that I wouldn't say in person. However, it got me thinking. I have expressed an interest, via Twitter, in several areas of medicine. One of the perks of social media for me is that if I say I'm interested in, say, Urology, a trainee or consultant in that area is fairly likely to contact me and offer advice and encouragement. Where I begin to feel somewhat awkward (that isn't the right word but it's the best I can think of for now) is when people offer to meet up for chats etc. Now, I've met plenty of people from Twitter, some of whom are pretty senior, but it's always been purely social. I'm starting to wonder whether meeting people for what is essentially professional networking is ethical. Should I be interacting with people who might be assessing me in an OSCE in a few months? On the face of it, I don't see a problem. I'm not silly enough to expect special consideration just because someone's read my tweets - if I screw up, I expect to fail. I very much doubt that any of the examiners are unprofessional enough to be swayed by something so trivial. In fact, if they are I should probably feel more guilty about doing extra work, audits etc for various people as they definitely know me fairly well. So what's the problem? Well, I wonder whether I'm gaining an unfair advantage by using Twitter. I'm not sure whether contacting these people and taking them up on their kind offers of tea and mentoring is being assertive and seizing an opportunity or if I'm doing something somehow dishonest. I feel in some ways like I'm "cheating" a bit - after all, not everyone has access to Twitter. Is it fair that I potenitally benefit in my career because I use a medium not available to everyone?

I would be interested to know what other people think. I'm pretty sure that I'm massively overthinking what is actually not a problem at all ("how unusual" I hear you cry!) but none the less it's been on my mind somewhat so I thought it worthy of a blog post.

Hope the New Year is treating you all well 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

Merry Christmas!

Well, I've made it to the end of term.

I must say that this has been a very up and down semester for me. Whilst I've learned lots and been kept busy (definitely a good thing for me) I've found there have been periods where I've felt stressed and unstimulated in equal amounts. As mentioned in my previous post, the staffing on my ward wasn't amazing. This meant that on more than one occassion, I was the most senior medic present. Given that I'm not qualified and therefore can't prescribe drugs (or even simple fluids) or do most procedures unsupervised, it meant I felt rather useless. At one point I was asked to see a patient who could potentially been very sick when there was no doctor present. Whilst he turned out not to be too unstable, the situation could have been rather disaterous. I'm not entirely sure what the right thing to do in that situation is, but I decided that taking a quick history, doing a brief examination, sending off some bloods and then bleeping my consultant was the way forward. No idea what I'd have done if I'd arrived to find him unstable - probably just skipped the history and bleeped someone asap. Hopefully I don't find myself in that situation again until I'm at least able to do something reasonable about it.

Despite my stressful experiences, there were plenty of good things about this block. I've got far more confident doing and interpreting bloods and ECGs, and I've been able to do an ascitic tap and insert a paracentesis drain. It comes very naturally to me to be negative about things, and in particular myself and my abilities, however if I'm honest I probably did quite well. All the consultants I worked with were very complimentary about me and said I'd make a good junior, which was nice to hear. One of the registrars even said I shouldn't go into paeds (as is the plan) because they wanted me in medicine. He was probably just being nice, but it was still good to hear something positive.

Continuing on a positive note (it really doesn't come easy to me, but I'm trying!), I've won a prize! I'm not actually sure what it means, but it's a student prize from the Royal College of Paediatrics & Child Health. I was nominated by a consultant I've done a bit of work with, which was nice. I'm fairly sure he only nominated me because I've annoyed him enough for him to remember my name, but none the less it was nice to get some recognition that I'm not totally rubbish. I'm getting to go to their annual conference in May, which will hopefully be really interesting as well as a good networking opportunity. I have submitted a paper to present there too, and I'll find out in January whether that's been accepted.

Well, it's now the holidays and a few days in I'm getting medicine withdrawal symptoms - so if any of you need any help researching/writing anything or want a student to analyse some data for you - get in touch!

Have a lovely Christmas everyone xxx

The more you put in, the more you get out...

...or at least that's what we're told about our placements this year. In reality, it seems that what you get out of your placement is down to how lucky you are with your consultants and registrars. I must say before I sound like I'm complaining that everyone on my placement has been really friendly and welcoming, which has been lovely. Unfortunately, I think I was spoiled by being paired with a really confident and encouraging reg in my first fortnight and now I'm not working with her (she's doing stints on AMAU, night shifts etc) I feel like things are a little bit dull. I think it's partly because we've also been very understaffed recently, and of course it's much quicker and easier to just do something than to supervise your medical student through it. I've just felt like recently I haven't had any opportunities to think. I actually look forward to consultant ward rounds because I know I'll get a grilling and will have to think a bit and most likely learn something too. I accidentally started a bit of a debate on Twitter at the weekend when I said this placement was making me not look forward to my FY jobs. 140 characters is pretty limited, so sometimes getting your point across is difficult. I think that what I was (admittedly rather inarticulately) trying to say was that there doesn't seem to be much opportunity to actually use your brain as a fifth year and I'm worried next year will be similar. Hopefully it's just a bad time on the ward with staffing etc and this isn't reflective of what my jobs will be like... Sorry for the rant there!

I'm A Terrible Blogger!

v note with some shock that it's been 3 months since my last update. Time has flown by pretty quickly and I'm now over 25% of the way through my final year in student-ville. I've been pretty busy so here's a brief update:

- I got back from my elective 2 weeks ago. A couple of months in New Zealand flew by ridiculously quickly. I had a fantastic time there, the people are super friendly, the country is beautiful and I learned loads on my hospital placement. I was based in paediatrics and got loads of hands on experience, including sticking venflons in neonates - something decidedly easier than I'd expected it to be. I'm seriously considering moving out there for specialist training. There were quite a lot of British registrars at the hospital and it's apparently pretty easy to get jobs.

- I have a job!! On 15th September I unfortunately didn't get offered a job in the first offers round, but was placed on the waiting list by two deaneries. However a couple of days later I got an offer for an acamic medical job. After briefly considering what to do, I decided to accept. I've already spoken to one of the consultants I've worked a lot with and he said he's happy for me to do the academic part of my job in paeds, so I'm super happy.

- At the moment I'm on placement in gastroenterology ward. I'm actually really enjoying it and it's been really good for showing me what I know and what I still need to learn. I've also got to do a few practical procedures; last week I got to put in a paracentesis drain which was pretty cool. However, what scares me about this placement is that the first two weeks have already flown by and there are only 6 before the Chr!stm@s holidays, when I'll technically be half was through the year. Terrifying.

Anyway, those are the major updates. I shall attempt to blog more regularly from now on, although no doubt my posts will be more medicine and less job related now the AFP is secured.

xxx

Somewhat Overdue...

Greetings from Kuala Lumpur! I'm currently here for a couple of days en route to my elective placement in New Zealand. Staying in a rather basic (but clean!) hostel, exploring a new city and chilling out so that hopefully by the time I arrive in Hawke's Bay on Friday morning I'll be nicely rested and relaxed :)

The lack of updating recently has been due, in no small part, to me deperately trying to get organised for my elective. However, I also had my last week of work at my job (summarising medical records in a GP surgery - just can't commit a reasonable amount of time to it this year), 2 weeks of uni and an interview for the Scottish AFP. I'm hoping that justifies my silence in the blogosphere!

Having got back from my Sense holiday, I had 2 days at my parents' house before returning back to my uni flat and working for the final week of my summer break. It was quite odd finishing as I've been there over 18 months and actually really enjoyed it. I would happily keep it up, particularly as the money would be handy, but with elective, placements, finding an FY post etc I just don't think it's realistic to pretend I can hold do a job. Once I was done with work, I had 2 weeks of (pretty dull) classes on professionalism, communication skills, careers and all the other dull stuff you have to do at medical school aside from the actual medicine. It does feel quite strange knowing that, after all this time, I'm actually in my final year of medical school and if all goes well I'll be a doctor in less than a year...

As I mentioned before, I had an interview for the Scottish academic foundation programme on Thursday. It was a really difficult interview to prepare for as I genuinely had absolutely no idea what to expect. The interview was in 2 parts, a 10 minute interview with 2 clinicians (in my case a GP and a liaison psychiatrist) on clinical issues and a further 10 minutes with 4 academics on the more academic side of things. The clinical stuff was ok, largely about communication, professionalism, good qualities for a dr to have etc - really quite similar to the kind of things they were asking when I applied to med school, but looking for more specifics as I actually know some medicine now! I did screw up a bit when they asked how I'd treat an insulin overdose because we've never been formally taught that so I didn't have an answer to hand the way I would if they'd asked about, say, DKA or acute asthma or paracetamol overdose, but I'm hoping that I managed to come to the right conclusions eventually, and if not, the fact that I said "call for senior help" will give me some credit! The academic part was really difficult as it's a bit strange trying to talk to 4 people at once, but the questions themselves were easy enough to answer and the panel all seemed really nice. I hear either way on September 15th so just got to keep my fingers crossed until then - although it's not the end of the world if I don't get it, it would be nice.

Right, it's 11.30pm here and I'm hoping to fit in a decent amount of sightseeing tomorrow as it's my last day here, so I'm going to sign off and head to bed.

Hope everyone's keeping well and I'll update about New Zealand once I get there :) xxx

Makes Sense!

Yesterday I got back from a week's volunteering with Sense (http://www.sense.org.uk/), who are the UK's national deafblind charity. A group of volunteers took 5 young boys with multisensory impairment (as well as other needs/difficulties) away to the Cotswalds for a week, where we swam, ice skated, go-karted, ate, drank, laughed and generally had a fantastic time. This was my third holiday with Sense (those of you who also read my OTW-related posts may have gathered that I'm a bit of a volunteering addict), although my first with children as I'd previously worked with adults. I cannot describe adequately what a special experience this kind of work is. It is, however, rather tiring, thus I have spent most of the time since I got home sleeping. This got me thinking - I am exhausted after just a week. How on earth do parents/carers who look after these kids full time manage? I have the utmost respect for anyone who looks after someone with these kind of complex needs.

After such a good week, I'm feeling pretty positive. This is in no small part due to the fact that on Monday, I received an email inviting me to interview for an AFP at the end of the month. There are two short interviews, one regarding clinical issues and the other on academic/portfolio issues. I am absolutely terrified as I have no idea what to expect. I'm going to make sure I've read over my application and know everything there is to know about anything I've mentioned. The last time I had any kind of serious interview was when I applied to medical school so I feel a bit out of practise... Any tips greatfully received!

Hope all the students reading have had exam success and are enjoying the summer and all junior docs are settling into their new jobs :) x

The Waiting Game

Today is, according to their website, the day when the one of the AFPs I applied to are due to finish shortlisting of applications - which means that by the end of today, someone, somewhere, knows whether or not my application form was good enough to convince someone to interview me. I'm not entirely convinced it will be; of the three forms I filled in, I felt I made the best job of the other one, and I didn't get an interview there. That said, I don't know how much emphasis each deanery put on different components of the application. Unlike a lot of applicants, I don't have a single publication yet. I have got something which has been approved and is currently with the editors, but that doesn't count for much. I am hoping that my BSc, having some lab experience and the audit I did during my GP placement will go some way to compensating for that, but we'll just have to see. I hope I hear soon one way or another - I can cope with disappointment but the not knowing is frustrating!

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