End of week 2, rotation 4. AAAAAHHH!

O. M. G.

Why has time decided to change it's usual pattern of going s-l-o-w-l-y and is instead going superduperquickly? At the beginning of Year 3 I thought that I had LOADS of time. Time to waste, time to knuckle down, time to improve my medical knowledge. Well, as you might have guessed, this has turned out to be a big fat misconception. It's surprising how quickly 5 months can fly by when you should be doing more work.

Anyway, enough of my self indulgent moaning. Or at least enough of my self indulgent moaning on that particular topic. Rotation 4 is, for my sins, Therapeutics.

Semana Cinco

Yes, that's right - a Spanish post title! That's all you're getting in Spanish though, lucky/unlucky for you (definitely unlucky for me, I feel I should be ace at this by now).

As you might, or might not, have gleaned from the extensive title up there ^^^ it's week 5 of 6 on the paediatrics rotation at good ol' Whiston. And just to prove how wrong I can be it's GREAT! Well, "GREAT" might be overstating facts ever... so... slightly... but I'm allowed to be enthusiastic considering how low my expectations were originally. I have now completed 2 clinic weeks and one ward week, and in the magical orange book I'm well over 75% complete. This deserves a loud "WooHoo!" and an air punch. If only I wasn't sat alone in my room, that would have been so much more fulfilling.

As I don't think I previously explained this magical orange book to you I will give you a brief overview now: Liverpool have a lovely way of making sure their students attain the targets they set. It's not by providing relevant teaching (although this occasionally happens by fluke), it's not by giving us a syllabus or course structure (this never happens by fluke, but apparently it should have happened on purpose by today - surprise of all surprises, no syllabus). It is by issuing us with beautifully coloured books, different hue for each year, and making us run around like crazy people, badgering all and sundry until each little space is occupied by a signature (firma if we stick with the Spanish theme).

Even more surprising to note is that, when it comes to kids, I am semi-OK at conversing with them. Not by any means brilliant, but semi-OK is all I ask for. Having spent a reasonable period of my life convinced that all children run from me in fear (yes, I was THAT Brownie leader) it's nice to know that only 50% of children actually do. Haha, of course I jest. It's more like 75%. Ah,  got you again! It's only about 25%, and I'm working on the assumption that at least 25% of children have not encountered me yet.

Moving on from the current rotation, towards SSM 5. This one, so far, is not going to plan. I really should start writing it soon, but I get so distracted when it's only on one day a week. Damn this time management test.

On a more amusing note, we have now got our CTM peer appraisals to do. Either I am seriously deluding myself, or I shouldn't have any problems passing - if we ignore the sample size, which may or may not be a massive issue. Although I feel that now I've permanently revealed that train of thought to the blogosphere I am forever doomed to eat my words and FAIL FAIL FAIL.

And that is as far as life at Liverpool has taken me. This week is once again in the wards, fingers crossed that I'll be pushing 90% magical book completion by the end. And on Monday is my formative OSCE. Eugh. Death. Ah well, for now it's time to stop procrastinating and do some work, sweet work. Adios!

Paediatrics Rotation

So, I've been at Whiston for over a week now on a paediatrics rotation but I have yet to see a child. It's OK, at the moment, because it's organised into "clinic weeks" and "ward weeks". True to the form, after induction last week, I started on a clinic week. The only problem is, due to a lack of capacity, my first clinic isn't until tomorrow. Grrr-arg, as the mutant zombie used to say at the end of every Buffy episode.

In the meantime I've been busily trying to meet deadlines and get an acceptable amount of PBL done (having failed on the latter of those two objectives I should probably be working not blogging right now). The looming deadline of Friday 7th January for our first submission of the CTM proposal has come and gone - despite the plethora of "woe-is-me" FB statuses I haven't come across anyone who failed to meet the 4pm deadline. This may be due to a lack of enquiry, but I'm happy to keep it that way.

After booking flights for my elective, getting insurance and completing (to an acceptable standard) the risk assessment I feel like I have somewhat shot myself in the foot - it was difficult to justify the time spent browsing the Internet for lovely travel information before, now that I'm near enough finished with the preparations its downright impossible. However, in theory this should set me up nicely for free time to spend revising. I wonder if that will happen?

As 2011 marches on, so does the assault on the Bank of Me. What was a nice amount of money, put away to pay for all I could ever want or need on my elective, is slowly diminishing to an amount which barely deserves the term "savings". Factor in my recently increasing level of fancy regarding what I want to do on my elective, and it all makes for very sorry reading. Cue much teeth gnashing and general wailing whilst I contemplate increasing my debt by 24%, the maximum allowed at this stage from a Professional Loan. I agree, I am not professional! But according to the bank, having the promise of becoming professional at some point in the future is good enough. I won't be protesting against it!

So now I think I really do need to wrap this up and try to complete some PBL. It is likely to be a paltry effort in the face of the people in my group who undoubtedly work harder, but at this point in time it is the best I can offer.

Until next time!

Pre- and Post- Christmas Blues

It has been a long time since I last posted, mostly due to utter despair induced by getting NONE of my three top hospitals. Instead I'm being sent to Blackpool. I know, I know - it was only excluded because it meant I'd definitely get it. That doesn't change the fact that I DIDN'T GET ANY OF MY CHOICES! It could be worse, I could have got Southport or Warrington, my two least favourite.  But it also could have been miles better by getting the Royal, or Chester, or Whiston. Still, every cloud blah blah blah. Blackpool is cheap - accommodation, insurance, living. Blackpool has a perfect record for passing finals (so far). In Blackpool I can live on site and be ultra lazy. I like to think of my wish to stay in bed until the last possible moment efficiency, but I can't kid myself effectively let alone other people. And on top of all that it's only an hour or so driving, or £10 on the train, back to Liverpool. In short, I'll cope. But... but... but. You get the point.

And now it's the return to reality after a lovely, but brief, Christmas break. Factor in the entrapment caused by a ridiculous amount of snow and it seemed even shorter due to not seeing much of anyone except the parentals. The first draft of our CTM proposal is due in tomorrow, and of course there was a grand total of 0 words added to the count over the holiday. Thankfully I was organised for once (more due to lack of funds for socialising than anything else) and my word count before the break was about 1000, so the situation could be much worse.

Add to the mix the start of SSM5 tomorrow, and the beginning of a new rotation - this time on paediatrics - and it's all very busy for a first week back. More similar to reality than I would like in truth. I was also very ambitious at the end of last year and elected for a student-led SSM, meaning that the whole thing is down to me. It would be great, if I had the first clue what I wanted to write about! And as this one is spread over 20 weeks, with one day a week dedicated to SSM, it's going to be touch and go whether I get it finished in time for the start of revision. Oh dear.

So there you have it, a short but sweet update on the woes of being a medical student (minus the revelation that we have formative OSCEs in less than a month and everyone is freaking out about it. Yuck). It's a wonder sometimes that we make it through with our sanity and ambition in tact, although of course there are those that fall on the battlefield. Fingers crossed they are few and far between.

Update on recent happenings

Since I last posted, a few things have happened. Nothing particularly exciting to the outsider looking in I imagine, but for those of us in the fray it was all rather stress inducing - now time to relax with a nice glass of mulled wine and contemplate recent events.

Firstly, hospital choices have been made. The allocations will be announced on Friday (two days from now), or at least that's what the grapevine tells me. In the end I opted thus: RLUH 1st, Chester 2nd, Whiston 3rd. At the time it all made perfect sense, but now the reasoning has gone a little bit fuzzy and I'm not really sure why those were the hospitals I preferred, or why I put them in that particular order. All I can say is that I am happy with my eventual choice, and my fingers are crossed really tight that I get the Royal.

Secondly I found out where I'm placed for paediatrics in the new year: Whiston. The upside is: I definitely get Liverpool Women's for ObGyn. The downside is: there are only two paeds wards in Whiston hospital, and I bet most of the kids will be in with chest infections of some kind. Ah well, you win some you lose some. Fingers crossed the teaching will be good and there'll be more time with the docs compared to the busier Alder Hey.

The verdict on my CTM abstract was also passed today. Chagas disease has got the go ahead, with a few caveats, so it's all systems go to try and get that done before the Christmas holidays - the next deadline is 7th January (less than a week after returning to Uni) and it's called a holiday for a reason, that reason being that I will almost definitely do less than a smidgen of work for the whole two weeks.

The second rotation of Year 3, which is Disability in my case, is drawing to a close. The final GP day was yesterday, or should I say half day as that is all that has been required of us for the whole placement - half a day sitting with the GP, discussing cases and consulting patients. It's been fun. Almost enough fun to make me change my mind about how adverse I am to becoming a General Practitioner myself. Not enough fun to make me actively pursue the career however. I don't know if it was an unfortunate coincidence, or whether the stereotypes really are true, but the majority of patients came in seeking a sick note. In fairness, the majority of them got what they wanted due to a genuine illness, but in some cases the decision was a bit dubious (in my oh, so learned, opinion).

It's terrifying to think that in a matter of weeks it'll be 2011, and everyone will start worrying about revision for written and OSCE exams. This will make me feel guilty if I don't worry, and more stressed if I do. There will only be just over five months until summative exams, and time to jet off for elective. On which note, I have also had my first appointment at the LSTM Well Travelled Clinic. The verdict was mostly that I already have the vaccines I need, and that I should improve my risk assessment. Hey ho, I've got aaaaages to get that done and because it's exciting (in a dull, bureaucratic way) I won't count that as my "less than smidgen" of work over the hols.

Now to crack on with the stuff which actually matters to my future career aspirations: work.

LSTM: Liverpool School of Tropical Medicine

Time is running out

Tick. Tock. Tick. Tock. That's the sound of the watch hanging over my head, counting down every second until December 1st, the deadline for choosing fourth year hospital trusts. And with every tick, and every tock, I change my damn mind about where I want to go! The only thing I can say for definite is that I won't be applying to Blackpool. That's not to say that I don't want to go to there, just that I'm hopeful of being able to swap to Blackpool if I do make up my mind at a later date.

Of course, that only strikes one off the list of eight possible allocations. Knowing myself, I can also safely say that a long train followed by a long trek is also off the list, so buh-bye Southport. I know what you're thinking - lazy! Well, I'm not gonna lie, you'd be right. I could of course drive, but then I'd feel beholden to fill the three empty spaces in my car. Sure I could get them to pay me for the privilege, but what if I don't know anyone, or worse - don't like anyone?  So, as I said before, Southport's a no-no.

Two down, three to go! Well, two really, as we're not allowed to apply to both Aintree and the Royal - of those two my money is on the Royal for being the best. But even so it begs the question: "will it be in my top three?" In favour - it's huge (big case mix), you get Alder Hey for paeds and Liverpool Women's for ObGyn, its close to University and town, and pretty much every specialty is represented. Against - it's huge (I'll get hopelessly lost), there's LOADS of second year students around, and there isn't much teaching organised. As I'm still no closer to a definitive decision, the Royal goes into the 'maybe' pile.

Next up for my *cough* expert *cough* analysis is Whiston. Good old Whiston, my favourite haunt from second year - or at least it would have been if the bus journey was easier. So right off we have a big, huge, glaring reason not to apply there. BUT fingers crossed I'll be living in town next year, so one bus instead of two and you're laughing. Or at least you're less grouchy than the alternative. Lot's of teaching at Whiston, lots and lots and lots of other students too. Hmmm, I think Whiston is going in with the Royal as a 'maybe'.

I guess I've got to consider the possibility of Warrington, but I have to admit it is the one place that I dread being placed at. I've not heard a single good review, nor can I think of a single good thing apart from the fact that it's close to Liverpool. It's definitely in the 'no effing way' pile.

So, of the seven options (once the Royal and Aintree have fought it out for their place in the running), I've eliminated Blackpool, Southport, and Warrington from my top three, and stuck a yellow-for-maybe post-it note on the Royal and Whiston. Arrowe Park and Chester are the last two requiring my attention, and so to them I turn.

Judging by the information packs we were loaded up with, the decision over Chester is going to be somewhat quicker than Arrowe Park - one double-sided A4 leaflet compared to 14 or so pages of pure text... Better get a move on then!

I'm putting Chester in the 'top three' pile - I know, a decision has been made! How exciting!!! It has too many pros and not enough cons (even counting my laziness quite highly) to not be in there somewhere. Remember I've still got to put these in order though, we're not quite there yet. Arrowe Park looks good too. I'll need to put more consideration into how to get there, but it's getting a yellow post-it note.

So, my top four (because three just isn't enough right now), in no particular order: Chester, Royal, Whiston, Arrowe Park. I suppose in theory Chester should get the top spot, numero uno, posicion primera, but that's not how it works folks. That's just not how it works.

Introduction to 3rd year

So, it's year three of medical school and it doesn't feel as though much has changed. Despite best intentions we still sneer at the second years, just as they sneer at the first years. Fourth years don't seem to sneer at anyone because they're too busy getting ready for finals in just over 7 1/2 months, and fifth years are so close to being called doctor that us mere mortals who still have undergraduate exams to complete no longer exist in the same world as they do.

Already third year has provided more harrowing decisions that first or second year combined. Sure, we've had to select SSMs previously, but there were finite options and an inevitable eventuality that at some point you'd get randomly allocated to something no-one else wanted to do no matter what you chose. This year the decisions we have to make are limited only by our own sense of adventure and/or knowledge.

The first decision to be made: a subject for CTM. There were only three points of guidance from the faculty: the question must address a serious health issue; the question must make sense in relation to current knowledge; and the question must be currently unanswered by other research. This leaves an absolutely massive subject base which can be covered, making the decision process so much harder. If you imagine a group of people that struggle to select seven options out of thirty, just think how this problem would be multiplied if the same people had to choose one subject from almost infinite possibilities. Stress ahoy!

The second decision to be made: a hospital for fourth year. You may or may not be aware that students at Liverpool Medical School sit their finals at the end of fourth year. There are different options for hospital allocations in fourth year, and we have to choose where we want to go. In theory this is a much easier choice to make than, for example, CTM subject. However every one of the eight hospitals has definite pros, and definite cons. And everyone knows that the subject for CTM is far less important that the way the study is designed etc. But fourth year hospitals... that could be make or break (despite assurances from faculty that everywhere has similar pass/fail rates we naturally don't believe them). A good hospital for fourth year could set you up for a fantastic career as a consultant plastic surgeon (for example). A bad hospital for fourth year could leave you behind as a forgotten staff grade working graveyard shifts in the back of beyond. Of course this very likely isn't true, almost certainly fourth year hospitals have no bearing on future career prospects. But try telling that to my friends. Hell, try telling that to me!

The third and final decision which is currently looming on the horizon for the majority of my classmates is this: where should I go on elective? This is what I meant by "sense of adventure", as the elective placement can be anywhere in the world (on the proviso that they're willing to have you of course!). This of course includes the UK, but even those people who do spend their elective in the UK will usually admit that it wasn't their first choice. This doesn't mean they don't have a fantastic time, just that they had envisaged having a fantastic time in some far-flung destination that they have been dreaming of since year one. The question can be answered in part by breaking it down to smaller, easier questions. Questions like "am I worried about a language barrier?", "do I want to go on my own?", and ultimately "will I have some amazing stories to tell to make everyone jealous?". Of course, once you decide on a continent, you have to choose the country. Then find a hospital that doesn't mind having you. It might sound simple, but that depends on how good you are at making decisions and sticking with it. Thankfully for this one my decision is made, my application sent and the confirmation waiting on a letter from faculty.

More will follow on life at Liverpool Medical School soon!

SSM: Special Study Module, four week blocks in which a particular subject is researched in depth and a 3000 word report written.
CTM: Critical Thinking Module, a "simulated grant application" exercise.