Consulting Placement!

We all have returned back to university! And by "we", I simply mean the medics! All of my friends don't actually start their lectures for another two or three weeks, so as they enjoy their final bit of summer, I'll be on placement.

Placement began at Southmead Hospital where we got involved in hands-on experience. Like I have said previously in a historic post, it's the most "doctory" we have felt so far on the course!

We were in hospital for three weeks. Each one was dedicated to a particular system: cardiovascular first, respiratory second and then the final week was gastrointestinal.

Waiting in the staff room!

The teaching was structured like this:

• We had tutorials and small hospital-based lectures that taught us how to take a full medical history from a patient.
• We had a practical tutorial which taught us the clinical skills for each individual system during their case week. For example, we learnt how to perform an abdominal examination (from keeping an eye out for tremors and visible clinical indicators on the body to being able to auscultate and percussion of the abdo). 
• We learnt how to perform other clinical skills such as taking a manual blood pressure and completing a full cranial nerve assessment.
• Each of the weeks had a dedicated 'patient' case associated with it. This was very similar to the case-based learning we have embarked all year. However, there was more information provided with these cases: from radiology findings (X-rays, MRI scan images etc), blood results and examination findings. This provided a more 'clinical' feel to the teaching we were receiving.

This was so far the highlight of the degree because of how 'medical' we felt. The teaching was more clinical which showed us the important of different disciplines when it comes to both diagnosing and treating a patient. For example, one 'case' was a female with pulmonary embolism. Her X-ray appeared normal but her CT scan showed the 'polo-ring' mass occluding one of her pulmonary arteries. Her blood results further supported our potential diagnosis and her history. This is why we were taught such greater detail about taking a history from a patient, because this can help support a certain hypothesis you may have (and help you exclude others).

The best part of the cycle was being able to go onto the wards and actually apply what we had learnt in the clinical skills room and our own independent learning. I was able to go on the wards and perform a cardiovascular examination and sit with patients and understand their full story to why they had been brought into hospital.

The hardest part of the cycle was probably trying to come up with differential diagnoses. These are the 'back-up' ideas you may have about a patient's condition but you may want to run more tests to help support for or against your other diagnoses. At the end of the day, there is a million and one things that could cause breathlessness - so you can't just jump on the first thing that you believe is the strongest diagnosis.

In case you are interested, this was the kind of clinical work we were completing in our tutorials before going to practise on real patients: https://geekymedics.com/cardiovascular-examination-2/ 

Speaking at Villiers Park Fantastic Futures Event

I then had the opportunity to speak at the Villiers Park Fantastic Futures event that also celebrated the hard work of its student participants this year.

The Fantastic Futures programme exists to help provide support to students of Year 10 - Year 13 in the Swindon area. The programme includes the mentoring scheme I was part of and has the opportunity to have an e-mentor who is studying the course and/or is studying at the university a student is interested in applying to. They also have exhilarating opportunities to go to universities as part of residential trips to engage in set tasks and practice those teambuilding and leadership skills!

It was amazing to hear all of the great student stories at this night too! I had a fantastic opportunity to speak to some parents as well who wanted to know more about the work of Villiers Park from a student alumnus because at the end of the day, I don't work for Villiers Park but individually endorse them so much! Thank you so much if you did come and speak to me at the event! If you were interested in the blog and I sent you in this direction, thank you for visiting! If you are interested in keeping updated on my journey, please do submit your email on the right hand side of this page under "Follow by Email!" to get updates when I post (which isn't too frequent, but usually when I have something to post!). Feel free also to read back on my journey for advice from Year 11 and onwards!

Photo credit: Villiers Park

In this speech, I discussed my struggles again throughout A-Levels but how rewarding it was to secure my place at university. I have included my speech below in case you wanted to read this also. It is slightly repetitive compared to the last one (but remember I did only go through school once so the experience is the same! haha) but I did adapt it to tailor for this evening.

Villiers Park logo.

My speech:

Hello! My name is Josh and I am a student who worked quite closely with Villiers Park to fulfil my aspiration of studying medicine at my first choice university. I have been part of Villiers Park for the past five years when I went into Year 10 at Lydiard Park Academy.

The journey into university unfortunately wasn’t a straight and narrow path. But Villiers Park helped either eliminate or reduce every obstacle that I encountered.

Through mentoring sessions, I would meet with my mentor to discuss my recent activities. I would explain to Julie how stressful I’m finding things, how I’m worried I’m not going to get the grades and how I cannot find a balance. I was struggling very much through Year 13 as I still wasn’t reaching the entry requirements of my offer from Bristol University. I suffered in silence from the beginning and telling myself that I could deal with the issue independently because I felt quite embarrassed and ashamed that I wouldn’t fulfil the expectation of going to university this year. However, when I spoke to my mentor about my situation and how I was on the verge of giving up, she gave me that confidence again that I could do it. And by talking and developing plans of actions, I knew I could cope for another two-three weeks before the next session. I found the mentoring sessions as an opportunity to vent about my struggles but find solutions to them. My mentor would have open ears and be a voice that provided that guidance and support I needed. As soon as I had opened up about not coping with the change in learning style and needing to adapt my revision regime in A-Levels, my grades improved!

Before this, Villiers Park helped me decide on which university I wanted to apply for. I attended sessions of ‘MedSoc’ from Year 10 which was a group of aspiration medics who wished to study medicine, like me. Here, I could hear from guest speakers directly about their experiences, ideas for placements and even how to construct the perfect personal statement. When it came to exploring universities, I went on many open day trips to different unis. It was fantastic having the mentors with us at the open days because their experience and advice meant that we were asking questions at the open days which I may not have thought of if I had gone with my parents. For example, when going around open days with family, you mostly think of cost of living, student loans etc. Whereas I was asking questions about the course structure, unit content and about placements because we had been informed about the significance of asking these questions. For this reason, I was able to eliminate my long ‘perfect’ uni list to just the five I was going to apply for – with Bristol being my first choice because I felt that course would suit me the best. I have also been running a blog that follows my journey throughout my medical training which I hope has been helping the current prospect medics with their decisions to pursue the degree and what to expect.

The residentials I have been on with Villiers Park has allowed me to develop skills which have benefited me throughout my school years and I’ve carried it on into university. We would learn investigation skills, how to be involved participants and how to manage time appropriately. Anyone can practically work in a team, but I feel that through Villiers Park, it taught me how to work in a team effectively. Three years on, I am still in contact with a lot of my peers and it’s interesting to discuss the differences in the medicine courses in Bristol to Nottingham to Liverpool.

University has been an amazing experience so far. I’ve learnt how to balance my priorities and juggle the time I spend on work and learning with maintaining a social life! My course has been everything I expected and more! I have had fantastic opportunities to become more stuck-in and enjoying placements so much, I am now working as a healthcare assistant in Southmead Hospital! I have made great friends while at university. You are surrounded with people from diverse backgrounds that differ from your own but you all share similar passions and interests! I would recommend university because I feel it is an experience like no other! You will enjoy studying more when it’s in a subject you’re actually passionate about. You meet likeminded people and grow an exciting social life while developing yourself as you grow independently.

As well, before Villiers Park, I would not be stood here in front of you now speaking. I learnt ways to become more of a confident speaker all through the events and activities that I attended throughout the year.

University has been such a challenge but a reward for all the hard work it was worth! It’s so much better finally learning content that I am passionate about and enjoy reading. I am really happy that Villiers Park are still in contact with me because I feel I owe a lot to them. From the staff in Foxton to the mentors, past and present, who have helped me – thank you. And I say it every year but it won’t add up to how grateful I actually am. The skills Villiers Park have taught me has made me the person I am today.

Thank you for listening.

Speaking at Villiers Park Scholarship Programme Celebration Evening

Haha. Why am I smiling like an idiot?

I had the pleasure of being asked to speak at two Villiers Park events this week, one being for the programme I am a scholar for and the second for being a recently set up sister programme, "Fantastic Futures".

At the scholarship celebration evening, it was amazing to sit and hear all of the stories the scholars have created and shared from Year 10, all the way up to Year 13. It was a shame hearing all of the activities they had taken part in, and not being a part of it anymore! From the residentials and trips to the luxury of having an amazing mentor...!

In my speech, I exclaimed about how much Villiers Park really did help me begin my journey into medicine and I cannot preach how incredible their work is. Villiers Park is made up of a great group of people who are so loving and encouraging and want the best for everyone they are supporting.

My speech was delivered during the celebration evening at New College, in Swindon.

The following abstract was taken from the article from Villiers Park's website (as was the photograph in this post). The original article can be found by following this link.

Josh Drinkwater, 19, from Swindon, is studying his first year of medicine at University of Bristol. He returned to speak about life after his four years on the Swindon Scholars Programme.  “I can stand here today and talk to you because of Villiers Park,” said Josh. “My A-Levels were horrible. I tried to sail through but I found I couldn’t cope with managing my time or my stress. A simple review with my mentor, of how I was studying and learning to prioritise helped me through. I still use the skills I developed on the programme, such as communication skills, in my training – for example when I’m talking to patients in clinical settings.”

Villiers Park logo.

My speech, because there were some important things in it I wanted to highlight to you guys, the readers, too!

Hello! My name is Josh and I am a student who worked quite closely with Villiers Park to fulfil my aspiration of studying medicine at my first choice university. I have been a Villiers Parks Scholar for the past five years from when I went into Year 10 at Lydiard Park Academy.

My first year of uni has been very eventful! I have been on many placements from inside Southmead Hospital to doing home visits in Yate, just outside of Bristol. My course has involved lectures on maths, sociology, law, anatomy and biomedicine and even involved going into dissection rooms for a hands-on way of learning about the body.

But I can stand here today and talk to you because of Villiers Park. If it hadn’t been for being a scholar, I probably wouldn’t have achieved my goal.

Firstly, there was trying to become the ‘perfect’ candidate that universities desire. Villiers Park helped me through that by teaching me skills that I thought I already had within me. Instead, I learnt how to apply my skills in different applications. With the communication skills that I learnt in masterclasses throughout the years, I have applied these to my part time job at John Lewis but also even today when I talk to patients in a clinical setting.

Residentials helped build-on pre-existing team working skills. We were all close friends in my cohort so we worked well anyway, but the residentials taught us how we can work effectively. But I could demonstrate all of these skills in my interview for medicine.

I was part of a group called MedSoc which was put together by some of the mentors here today with the aim of helping prospect medics reaching their goal of studying medicine. The workshops would include interview practices, how to select the university for you and what exactly medicine consists of – delivered by presentations and guest speakers throughout the year. MedSoc catalysed my passion for medicine and gave me a driving push which I never knew I needed. I am now privileged to say that I’ve had the opportunity to be on the other side of that table now in the workshops as I delivered a presentation in January to students who were looking at studying a Health Science after they have completed their A-Levels. I have even set up a blog to help inform the students on what studying medicine is really like to help aid them in their decision to pursue it and prepare them for their interviews.

After briefly mentioning it, A-Levels were horrible. I can tell you now that A-Levels are probably the worst thing that you’ll encounter on your path into university. It is completely different to GCSEs so you need to adapt quickly because the “gap” between the two are definitely as big as what the teachers make it out to be. I struggled with my A-Levels I’ll admit and I found them extremely challenging. But that is the beauty of having a mentor as a scholar. At the beginning of the year, I tried to sail through making out to Julie that I was coping. But as it progressed, I realised I couldn’t deal with managing my time and stresses on my own. My mentor was not only open ears that wouldn’t judge me for admitting I was struggling, but was also a handy friendly voice of guidance that provided that support and advice that I needed. Just a simple review of how I was studying, what I was struggling with and possibly implicating a new method of prioritising the content I needed to learn helped me through. It was at that point I admitted I needed the help that I could change the way I worked. It allowed me to then start making progress that was apparent in practically the very final mocks before my summer exams of Year 13.

So I owe it to Villiers Park really. Not only did you help me with finding the university that I really wanted to study at through mentor meetings and workshops, but you helped fuel that passion that I had for medicine. You helped prepare me for my interviews which I was luckily successful in to then receive three out of five offers. The next challenge was achieving those grades, which I have already explained was tough. But, you picked me up again and put me back on the tracks and the support given was enough for me to then sit my exams, more confident than I was a few months before, to then reach those entry requirements and get into Bristol University.

But it didn’t all stop there. Even this year, I am still using the skills and foundations that I had learnt throughout being a scholar. I passed on the tips I learnt from doing a literature ‘dissection’ on a residential to my friends as we were completing an assignment based on three science papers that were in the New England Journal for Medicine. I use those team working skills practically all the time in clinics and facilitation sessions when I am with my group. And finally, I have built on those communication skills and have used them when I’ve been delivering presentations to small groups, speaking with patients on wards or even preparing speeches for presentation evenings! So I would like to say a massive thank you to Villiers Park, as I do every year, but I can’t put into words exactly how grateful I am and how proud I am to call myself a scholar of such a great programme.

As some quick words of wisdom to current scholars, just remember you are the one in control of your destiny – which actually sounds really cheesy but it’s true. Your teachers teach you the content, the past papers help consolidate the knowledge and your mentor is there to provide some guidance and support. However, it is your hard work and determination that will get you to your end goal, whether that be an apprentice or university. Use the resources around you but try your best in everything you do and you’ll have that sense of pride when the outcome is what you intended. Don’t blame the teachers, don’t blame the paper but I’m not saying blame yourself!! But take it as a stepping stone of learning and the best way to learn is through making mistakes. 

I wish you the best of luck in the future. Thank you for listening.

Summary of Year 1

Let's do an overall summary of Year 1...

• I arrived at university and met my flatmates. I had to make all new friends from my course and my student accommodation, who thankfully remained by my side throughout the whole year!
• I did house viewings and decided on my accommodation flat for next year!
• I learnt soooo much! From anatomy, to law, to sociology, to ethics, to histology, to biomedicine to biochemistry! There has been so much content on each individual system in the body which you can't help but feel excited to turn up to lectures.
• I have handled a lot of cadaver specimens and have been exposed prematurely to death. I have also taken part in shadowing a pathologist during a post mortem.
• I have taken part in clinical shadowing at GPs, where I did some clinical skills and did individual home visits. Here, I learnt how important communication is when it comes to talking to patients.
• I have also shadowed doctors at Southmead Hospital and have been taught by both patients and the teaching fellows about body systems and some clinical skills - such as taking blood pressure, blood glucose levels, auscultation and palpation.
• I completed an essay project, as well as an art project. This is based on medicine being both a science and an art.
• I have worked as HCA as part of the course, where I worked four shifts of 7 hours and one 12 hour shift.
• I loved being a HCA so much, I then went on to apply for a job as a healthcare assistant in Bristol. I went for the interview and then received my job offer. I then attended the training and now awaiting some shifts to sign up to!
• I have completed my exams, January and Summer and passed to progress into Year 2!

I can't believe how much I feel I know ever since starting just less than a year ago!

Year 1 has been filled with some very exciting moments and I have enjoyed every second of university life. You are so independent and have so much fun which is incomparable to any other experience I have ever had! I would say I would love to do it again, but I'm really excited to go into Year 2!

I hope all of your exams go well and you receive the results you both want and deserve. Have a great summer, and I will speak to you in September if not before!

Postmortem?!

I had an amazing opportunity to observe a postmortem this week! I am lucky that my facilitator is a pathologist who works in a coronary court to carry out postmortems on patients who have died 'suspiciously' (not like forensic murder!)

So what is a 'suspicious' death? According to my facilitator, this is where a patient has died unexpectedly, but hasn't seen a GP in the past two weeks before their death. This tends to be when a body has been found at home, and the death has come as a shock.

I was really shocked to how the postmortems are carried out. They are nothing like how they are portrayed in the media. The body is examined in a brightly lit lab - there is no small light dangling in a dark room with four people surrounding the body with their tools. In fact, there are four bodies being examined at the same time with one person doing it.

I won't go into the details in my blog, as I understand there is a line. But I would recommend you look at how they examine the body. They remove every organ from the body before examining each organ in detail. This is important to identify any health issues which may not be directly obvious from the outside as you are after all identifying the cause of death. For example, it is hard to look at a body that has been found, and see that the person died of a cardiac arrest. A postmortem will reveal hard crunchy coronary suggesting atherosclerosis that could've resulted in a myocardial infarction that killed the person. I would recommend you looking at the method they use to remove these body parts as I found it particularly fascinating.

This is an experience I was delighted to have the opportunity to take part in. I feel it endorsed my anatomy, as it was the most recent view I have seen of the internal anatomy of a human. Especially when the organs were removed, it was amazing to relate them to how close they appear in standard anatomy labelled diagrams! The liver is that red/purple colour in real life, despite it appearing greyer in the anatomy labs.

Drift to Shifts!

Stress from the exams are now in the past and now I drift to concentrating on my shifts as a healthcare assistant on the ward of a hospital I have been allocated to.

That is the best thing about the course structure at the university I'm studying at, we have the opportunity so early in the year to be exposed to the work on the ward! We have completed the training and the induction in December before we broke up for Christmas, which meant we learned many important skills for working in the hospital as a HCA. This included how to make a bed, the importance of safeguarding, what is dementia and the correct communication skills required.

I have had two shifts at the hospital I am in, working as a HCA. I am on the Stroke/Neurology ward, where I helped care for patients who have had strokes or suffer from neurological diseases.

I'm trying to work out the best way of writing this post without writing a long chunky essay that's saturated with paragraphs. Therefore, I'm going to break it up into the typical cheesy questions you usually get on a feedback form that school gives you:

What was it like working as a HCA for the first time?

• Very different, it is nothing like volunteering at all!
• As a HCA, you are allowed to handle patients where you have completed manual handling training. This is different to volunteering, which means you are allowed to help move patients from beds to chairs, help move them into comfortable positions or help manoeuvre patients while they are being cleaned.
• It is true, as a HCA you do help clean patients who may have soiled themselves or need aid in their daily washing routine. I didn't actually realise this was the case until I was on the ward.

What did I enjoy?

• It was probably the most "doctor"y I've felt so far in the course ... and ever!
• I did enjoy helping the nurses take observations of patients and learning how information is collated, kept and stored in the hospital setting in more interesting.
• In a way, you did feel a sense of reward after you have cleaned up a patient as they were grateful and you could now see they were happier and more comfortable. This is what made the cleaning job.

What were the challenges I faced?

• I will make it clear for you, as a volunteer you are not expected to handle body fluids at all. I know in my training as a volunteer, I was told that if a bed was soiled I wasn't allowed to touch it. As a HCA, you are exposed to the different body fluids. In my shifts, I cleaned up vomit, faeces and urine - but in my opinion thinking about it is definitely worse than when you're actually doing it. And you'll realise that. It isn't that much of a great deal and you do adapt to it after a while.
• As a volunteer, I found myself speaking mostly with the nurses and the other volunteers as we made the teas and distributed the meals. After this, I was sterilising medical equipment or help cleaning the ward. As a HCA, you are more patient-facing, meaning you do see pain and discomfort on a greater level. You are in situations that do make you feel uncomfortable, I was saddened by the news on my later shift to how one patient I had became close to and exchanged great chat and laughs with had unfortunately died the morning of my next shift.
• You do feel quite nervous when you are allowed to carry out observations on patients. For example, one nurse let me carry out a pupil examination on a patient, where I would shine my torch into their eyes to hopefully see a change in pupil size as a response to the bright light. I will admit, my hand was shaking as I did it. You are nervous, but by the end of the week I was more confident and did it more 'naturally' if you like.
• The long hours?? In fairness, as I groaned about the seven hours I was enduring, the nurses laughed as they were doing the hardcore twelve hours! You do need to realise that the shifts are long, and that there isn't always something to do. But it gives a great opportunity to speak with other members of the team or learn from patients.

Working as a HCA, it was interesting to observe how the ward was structured. I found that the healthcare assistants and the nurses were the main members of the multi-disciplinary team on the ward who were responsible for the primary care of the patients (providing comfort, meds etc) and recording the observations. The doctors made brief appearances throughout the day, analysing the observations and speaking with nurses about the progress or reviewing medication. This was quite an eye-opening observation, as you learn how the 7 or 8 patients that the nurses and HCAs are allocated each means they have more time with the patients so more of a presence, whereas the doctors could have around 30-40 patients on this ward, the next ward and maybe another ward in the hospital so their encounters with these patients can be more confined and brief.

Working four hours, I was dying for this cup of tea!

The nurses I was working with were absolutely amazing. When there was nothing to do, the nurse went through my handover sheet with me and explained the conditions to me. For example, she explained what a "thrombectomy" is and what "abx" means on the sheet. So I would recommend that as you complete your shift work (if you do it), do speak with your nurses and gain a better understanding of the patients you are dealing with and you can apply this knowledge to your studies!

The best thing about working as a HCA though is that when you're talking to a nurse about yourself, you're no longer saying "I hope to go to university and study medicine" as you did whilst volunteering, you're saying "I AM at university STUDYING medicine"! The dream has come true!