September is upon us once again. Despite the Corona virus pandemic, the year seems to be disappearing at an alarming rate. Our medical school managed to make arrangements for us to sit our final written exams whilst observing social distance requirements. I'm relieved to say I have passed those and progressed to my final year. I can't believe I'm here, after 7 long years at university in a row I will finally be applying for my first post as an actual doctor in a few months time. I have spent the summer working in my local hospital in a kind of 'pre registration' role, completing tasks under direct supervision of the junior doctors on the wards. It has been hugely valuable for me and hopefully I've been able to do my small bit to help the NHS in it's hour of greatest need. I've also managed to save a fair bit of money which should just about tide me over until I start work full time. I'm at a crossroads now, almost wishing the days until graduation away, whilst also trying to make the most of my final chance to learn without great pressure. I'm already beginning to feel a bit nostalgic about my time at Keele and I do want to enjoy this last evening before the sun finally sets on my university career. If you're reading this and wondering if you can stomach studying medicine, I can tell you with absolute honesty that you won't regret it. There's times when it seems all consuming, times when it seems that you'll never be ready for that next set of exams, times when you get tired of directly competing with your peers to achieve a good ranking (more on that later), but in the end I've gotten to this final hurdle, whilst also having the most incredible time. I don't have an exceptional mind and there's been times when my motivation has dropped. I've procrastinated, panicked and ground out results by the skin of my teeth, but I've done it up to this point and therefore you can too.
Our final year is spent almost exclusively in the hospital. I start on the acute medical unit (AMU) for 5 weeks. This is an assessment ward, attached to A&E, where patients stay a short time before a plan is made for them and they move elsewhere in the hospital to receive definitive care. This will be fairly fast paced and I have a mixture of day, night and weekend shifts. After this I will spend a week on Intensive care. This is where the most critically ill patients in the hospital are. It's a high pressure area and I'm looking forward to working as part of the team in that environment. Following this I have some time on a liver ward before spending 10 weeks in General Practice seeing my own patients and hopefully planning their care fairly independently. Finally I finish with more emergency medicine and a stint with the orthopaedic surgeons. Our knowledge exams are all done now, but we will have practical exams at Christmas and in May. As well as this, we will sit the situational judgement test early in the new year. This is a huge exam that tests your decision making in certain scenarios. For instance you may be asked how to deal with a colleague who arrives to work drunk, or what to do with a child who refuses treatment. We receive up to 50 points based on our performance in this exam relative to our peers. a further 50 points are available for our academic performance. We get between 34-43 points based on which decile we lie in within our year: Our year has around 120 people left in it, meaning each decile has 12 people. if you're in the bottom 12 students, which is therefore the lowest decile, you get 34 points. If you were in the top 12 you'd get 43 points; the next 12 would get 42 and so on. Your decile is calculated based on how you have performed in exams compared to others in the year throughout the course. up to 7 points are then awarded for extra degrees or writing scientific papers, giving a grand total of 100 available points. When we come to apply for our junior doctor jobs, we make a preference of which area of the country we want to be in and then we rank the jobs in that area from our most preferred to least preferred. Each individual job is given to the applicant with the most points who is still without a job. This means if you score poorly you may be given a job very low down on your list. In most deaneries there are more jobs than applicants, so almost everyone will get a job, but in London and Manchester this isn't the case and some people end up having to move to another part of the country. Phew that was confusing, well done if you're still with us. To cut a long story short, this is the aspect of medical school I hate the most. I wish we could muddle through at our own speed, apply for jobs and go for interviews like everyone else, but it simply wouldn't be possible to fill 3000 odd posts this way. I hate that I am in direct competition with my mates and it breeds behaviours that are not desirable from doctors, but it is what it is. My current plan is to head home to Cambridge, but my chances of getting two years at Addenbrooke's hospital are slim. I'm likely to have to spend a year in Bury St. Edmunds or Peterborough , but that's okay. The junior doctor post itself is 2 years long and is usually made up of six 4-month posts in various specialities. After this you choose what you would actually like to do with your life and start on specific training programmes. I've been inspired by the recent calls for change around the world. Medicine is not without it's racial issues, with black patients still facing worse outcomes than their white counterparts in almost every area. Also, uncomfortably for me, medical schools are still full of students from middle class backgrounds, meaning black students face an uphill challenge to get in as they are often in poorer demographics. I did my GCSEs and A levels at a private school and this is something I always try and hide. I feel guilty that I have had a much more straightforward route to medical school than is available for some. I do medicine as a second degree, which means I get no government funding for the £45,000 fees. Without a wealthy family to support me there's simply no way I'd be where I am. Obviously I can't, and wouldn't, give up this life that I have still worked hard for; all I can do is recognise this huge privilege I have and try and use it to change things. As such, I have decided to help organise a conference this year looking at addressing the racial inequalities experienced by patients in the field of Obs and Gynae and I am excited to continue tutoring again this year. I was very happy at the government U-turn over A level results. If teacher predictions hadn't stood, it would have meant that many exceptional kids at poorer performing schools would have had their grades reduced, such was the nature of the algorithm. Most medical schools require A's across the board to get in, so it would likely have meant an even less diverse cohort than normal. For me, diversity of medical students isn't just desirable, it's essential. If people can't find doctors they relate to, they are far less likely to adhere to treatments. Also some conditions, particularly some psychological illnesses, can be the direct result of trauma. I'd argue that it is very hard to understand how these patients truly feel if you haven't experienced any trauma yourself and I'm sure that's why some conditions, like personality disorders, for instance, are not taken seriously by many doctors. I'll try and update this more regularly through my final year, but I'm sure the months will roll by in a flash, so stay safe in the meantime x
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AuthorMy name is Stephan. I'm a 23 year old medical student. I like to travel, play the odd game of rugby and I'm very vocal on formula 1 fan forums (yes I am a bit of a sports nerd). Archives
April 2021
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