My Story
I remember driving down to Cambridge for the beginning of clinicals refreshed and filled with a sense of “ah new beginnings!” Our first intro week flew by with very chilled out vibes and minimal work in sight. People in the year above were dropping lines like “ah this year is so calm”, “honestly enjoy yourself”, “use first term to get used to the wards”, “a patient a day is more than enough”. Finally, I’d reached the promised land.
But, I still wanted to hit the ground running. So, following advice from a 5th year, I opened up Geeky Medics to get started on learning the clinical examinations and histories. They had written guides and YouTube videos on all the main examinations we needed to learn: cardio, resp, abdo, neuro and GALS (this is true for the Cambridge students, your own uni might vary). So I started learning from here and practicing on each other during the second intro week and felt quite proficient going into the first day in the hospital.
So, my first placement was at Peterborough Hospital and I turned up raring to go. I was a little apprehensive about the whole concept of being placed away from Cambridge and to make things worse, I was placed with mostly randoms from the year whom I had never seen nor spoken to before. However, this apprehension was soon put to rest as I got to know the P’boro bunch very well and even ended up becoming best friends with one of them due to our shared love of the gym @kirankumar. To top it off, P’boro accommodation was amazing; en-suites for everyone and more sofas than we had people. It was fair to say that I settled quite well; with special thanks to @kirankumar and @thegym. Along came, day 1 on the wards. We all turned up to the ward round (WR), smartly dressed and eager to learn with iPad and notebooks in hand. But, things did not go well…
The doctors and nurses were using all kinds of abbreviations, “SOB this”, “TTO that”, it was as if they were speaking a foreign language. We looked on bewildered and confused, with things not getting much clearer with time. Eventually, we plucked up the courage to ask one of the F1s what SOB meant. “Shorteness of breath” she replied with a look of “aw the poor babies”. Soon we realised, there was a lot to learn here.
This certainly turned out to the case. The first few weeks was a steep learning curve, but with persistent questioning and listening out like hawks we managed to pick up most of the clinical slang. I also managed to stick to the “patient a day” mantra and took a history and examined at least 1 patient a day. But tbh, this wasn’t really helpful until I learnt that I need to present my findings to a doctor and get their feedback or even read the patient notes to make sure I got the whole picture. I also learnt that knowing about BAD and BID oncogenes alone isn’t going to quite see me through this term.
So, I decided it was time to start learning some diagnostic reasoning. It’s all well and good being able to take the perfect resp history, but if you can’t diagnose barndoor COPD from history and examination, you’re in trouble. I found the Oxford Clinical Cases in Medicine and Surgery to be a fantastic place to start. It was so easy to read and it talked through a presenting complaint (like headache for eg), starting with the differential diagnosis (list of conditions it could be), history questions, clinical examinations, investigations to order and how each helped to arrive at a diagnosis. The best and main resource I used in the first term.
So, I spent a good mix of ward time, clinic time and bookwork during first term and felt quite happy with myself. Look out for future posts on how the year went downhill from here.
