Skip to content

Diary of FY1 – Med Students

February 18, 2015

This month, I’d like to spend some column inches talking about one of the more overlooked aspects of life on the wards. Something that no ward should be without, like a working printer. Something you will find mostly everywhere, if you know where to look, like patients’ casual racism nestled between The Sun and The Daily Mail. Something that is quintessentially twinned with the hospital experience, but oft overlooked until present, like glycerin suppositories. Of course, I am talking about medical students.

Medical students, as a species, have long been one of my favourite subjects. Ever since my first day as one, I was fascinated by medical students – Not quite people, more a process of becoming. They enter medical school, awkward and immature and pupate as doctors in utero. That metamorphosis from gauche uni students into the imago of a physician is far from a smooth transition, as the Daily Mail are wont to remind us. Wearing stethoscopes and impossibly creased pastel shirts on the wards – playing dress-up. I find them hilarious.

Now that I am all grown-up, allegedly, and a doctor, I get so excited when medical students come to the ward. For one thing, it means I finally have enough hands to hold the obs chart, bedside folder and write in the notes on the ward round. But more than that, I have someone that I can pass on my hard-won wisdom to (Thought, after only six months, it might be a bit early to be building a legacy of enlightenment). So far, this has been confined mostly to mnemonics and nuts-and-bolts stuff on common drugs and diseases in the spare few minutes while the other doctors are otherwise engaged. I say mostly because six years of medical school has garnished me with a somewhat eclectic corpus of knowledge. For example, having taken blood, a recent medical student and I were loading the bottles into the pneumatic pod system that wound invisibly through the bowels of the hospital before inevitable arriving at the Pathology Lab:

“So what’s in the purple-top?”

“Uh, sodium EDTA.”

“Right! And do you know where else you’d use EDTA in medicine?”

A pause, and a curious, desperately searching but ultimately blank look.

“Lead poisoning. EDTA is used to chelate heavy metals.”

“Wow, that’s really interesting, Rhys!” This script is verbatim. The students actually said that. “I’m not sure how useful that is for me to know though.

“I’d rather be interesting than useful any day!” I declared boldly. It is statements like this which make the Trust reconsider their investment in me. Fortunately, medical students at St Elsewhere’s are kept so busy with real teaching that I probably only cumulatively see them for about half a week. I try to make it count. You’ll have to take my word that I’d be the kind of doctor who buys his medical students coffee if only I were the kind of doctor who had the time to buy himself coffee.

There are still anachronistic dinosaurs practicing surgery who will opine that medical students are best seen and not heard. I swing to the other end of the spectrum. While I’m running around worrying about low potassiums and INR levels and oral antibiotics for pseudomonas, I’ve found that medical students can be getting on with the stuff that matters. Case in point, I was preparing a trolley for all the kit that I would need to insert a chest drain. When the registrar thought we were ready, I paused to get the final piece of equipment – I asked the medical student to hold the patient’s hand. It was an awkward, painful procedure but I was so glad that my patient had someone to comfort her. That medical student did admirably. Didn’t know a thing about endocarditis when questioned by the consultant on the ward round next day but hey, ho!

There’s still as much medical school bureaucracy as I remember. A myriad of forms, DOPS, CEXs and sign-offs cling to the medical students that pass through my ward like a miasma. I sagely nod and extend my pity – As a lowly FY1, there is not much demand for my signature. But now that I have arrived on the far shore of medical school, I can see how valuable paper-based paranoia really was. While all those assessments ostensibly track students’ progress, either on paper or this new-fangled tablets the kids are turning up with these days (He writes like an antiquated grandpa, despite his medical school cohort pioneering tablets), they prepare medical students for a life of “playing the game.”

From my first day as an FY1 doctor, I have been wedded begrudgingly to ePortfolio. This is a website filled with somewhat clunky forms to record and measure my progress through this foundational year. Advancing to the dizzying heights of FY2 and beyond depends on successfully completing various competencies, CEXs, DOPS and various meetings with clinical and educational supervisors. Does this sound familiar?

When I was a teenager, I struggled with unruly hair, rebellious emotions and the sheer bloodymindedness of what I overgeneralized as The System. There were so many things that I wanted to do and they all required three months of paperwork and bureaucracy – Why couldn’t I just get on with it?! (I was not a patient man) My dad told me that paperwork is self-evidently dull, but without it, I’d never get anywhere. My best option to “play the game” and tolerate it so I could do the things I wanted to do. Like study medicine. ePortfolio is the rule against which I will be measured as a doctor but it far from the only measure of a doctor.

Another recurring theme is the blur of hope and anxiety for the future. My sympathy goes out to all final year students waiting to hear where the fickle UKFPO gods will fling them. I would never have dreamed of coming to St Elsewhere’s and yet here I am – where you want to be for FY1 and where you need to be for FY1 do not necessarily intersect. I bring this up as I have finally heard where I am being flung for FY2. I am being sent to the south coast – apparently I need to work on my tan to look more like my Platonic illustration.

Diary of an FY1

Sadly, I am not this tan.

I’m looking forward to it, even if the jobs don’t feature paediatrics or psychiatry. But it means upping sticks and moving once again – out of London! The life of a junior doctor is a nomadic one. But this I do know:

New medical students!


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: