Archive for 2015

Hi peeps!

Hopefully you haven't been waiting too long for an 'In pictures' post - apologies if you have, but hope you enjoy!

If you follow me on Instagram you'll know that I no longer have braids! I decided to leave my hair out for a bit and rock a fringe/ bangs. I also went to Cromer over the weekend (pictures to follow!) There's been some major changes in my life that I will update you guys with in due course! In the mean time, my hat is from Topshop and my oversize jumper/ sweater/ cardigan is from Romwe - both came in very handy on a rainy day in Cromer!

Autumn has slowly become my favourite season visually. Usually it just passed me by because of really early mornings and late nights during placement/ internship over the last few years. But now that I live quite close to the hospital I'm in, I'm able to marvel at the lovely autumn colours that are about at the moment!

I bought myself a Vanity Planet Spin for Perfect Skin face brush a couple of weeks ago and its AWESOME! Read a review I wrote about it here.

I posted this on my instagram (@hey_sammiie) so you guys can see just how much weight my lanyard bears on a day to day basis when I'm in the hospital. Usually I have another card, another pen and a pen torch also hanging off it...Surprisingly, everything stays on when I have to run to see acutely ill patients!

A few days ago I came home to this lovely bouquet of some of favourite flowers (lilies) although the white ones hadn't bloomed yet when I took the picture. I love the smell of lilies (and many other flowers).

It had been a while since I went to Nandos, so this was a very welcome visit! I always have the same thing (usually a wrap plus chips) but when I feel particularly hungry, I have the corn on the cob as well and this was one of those hungry days!

Finally - this is how I meal prep. I don't like cooking massive dinners everyday especially as I'm almost always cooking for myself, so one day a week, I take the time to make some meals that will last me a few days. This picture shows just one version of what I make (usually I make three or four different meals so I can alternate and not get bored). I then freeze the meals and eat them over the coming days.

I have been prepping my dinners like this for a few years. I find it saves me time during the week and after a long day at the hospital or in lectures, I'm usually not interested in spending another hour or two cooking.

That's all folks!

Sammie

Written by Sam Forde

It must be elective planning season! I've had a lot of questions about my elective at Tygerberg Hospital so I've decided to do a post about it so the information is out there and in one place. Hope its useful!

Basic details

When did I go there: April 2014 - July 2014

When did I apply: Two years before I had to go there

What did I do: Trauma Surgery and Trauma Medicine plus a few Ambulance shifts

Where I stayed: International Student's Lodge

Would I recommend it: A BILLION PERCENT YES!!

Planning

I applied two years before I had to go. Why? I wanted to do trauma and Tygerberg Hospital is THE place for trauma electives. When I applied, I was just in time. Trauma places went really quickly. The same goes for Obs and Gynae/ General Surgery and Infectious Diseases.

I travelled on South African Airways from Heathrow airport. I had my trusty Nanny State backpack with all my essentials!

Travelling there

I booked my return ticket to Cape Town from STA Travel because they do good deals for students. I got my indemnity insurance (free!) from the Medical Defence Union because I am a student member. I can't remember where I got my travel insurance but I paid about £30 for it. I decided to go by myself because I wanted to challenge myself to be more social (and I succeeded!). My mom dropped me off at Heathrow. I was sad to go, because I hate goodbyes, but once I got on the plane I was so excited!

When I got there

I had a taxi waiting for me at the airport. I booked it in advance because I didn't want to be a lone tourist at Cape Town airport not knowing where to go! The taxi driver was nice (I actually used the same guy a couple of times before I hired a car). I found that as well as working for a company, taxi drivers moonlighted as private drivers. I wouldn't recommend just choosing any taxi driver, I got to know my driver and trusted him first before I travelled alone with him.

From left to right: Entrance to the International Students Lodge; my bed in my single room; my hired car (named Chico!)

Accommodation

I stayed in the International Student's Lodge. I had to book it in advance and it was pretty cheap. The rooms had all the essentials. The flats had at least four bedrooms in them with shared bathrooms and kitchens. There was a common room which had snooker tables, TV, etc. There was a swimming pool on the grounds which some people where brave enough to use (it was coooolllldddd!). The lodge is on the same grounds as the medical students accommodation at the University of Stellenbosh so there was plenty of opportunity to make friends. There was also a students union with a gym, a shop, more TVs, an ATM and a small canteen to get food if you didn't fancy cooking.

The bedrooms came with bedding and towels supplied. There were cleaners who cleaned your room and kitchen daily (except on the weekends). The rooms also had (slow) wifi which you had to pay a fee for.

What I did/ What did I deal with

The Accident and Emergency department was run by A&E registrars and nurses.

On pretty much a daily basis, I dealt with the following cases:

Gunshots
Stabbings
Burns
Road Traffic Accidents (RTAs)
Domestic violence injuries
Trauma from cracked bottles
Drunk trauma

I also helped out with lots of different surgeries (mostly consequences of gunshots) - this could be in the middle of the night or very early morning.

Different days brought different things. On the medical side where patients with end stage AIDS, cardiac events, TB, etc A large population was HIV positive so doing trauma in such a setting was nerve wrecking to start with but I got used to it.

Elective students where treated like doctors. We saw patients by ourselves, clerked them in, examined, did examinations, sutured, inserted chest drains, etc (after consulting with the real doctors of course!). There was no requirement to turn up everyday, you could come and go as you please because the hospital was literally 5 minutes walk from the lodge.

I also arranged to so some shifts with the Ambulance service. I wanted to get some exposure to pre-hospital care and it was awesome and eyeopening at the same time.

I came back from Cape Town having a deeper appreciation for the National Health Service and for all doctors in general. I also came back feeling very confident about dealing with patients (but my intercalated degree afterwards slightly dampened this!)

Just a few of the fun things I did. When the weather was nice, we went out and saw South Africa in all its glory!

Fun things to do

When in Cape Town - do everything, obviously! There are three peaks to conquer (Table Mountain, Lion's Head and Signal Hill - some easier than others!), there is Robben Island to visit, there is Garden Route (need a few days to do this - but essentially if you're up for adventure (bungee jumping, riding an ostrich...) then do this), lots of shops to visit, Waterfront, Boulders Beach, lots and lots and lots of wine tasting, etc

You can literally do one fun thing every day that you are there!

General tips

Apply VERY early
Get indemnity insurance
Get travel insurance
Get a basic phone that can whatsapp - I took my old Blackberry and got a South African simcard which meant I could keep in touch with family
If you hire a car, pay that little bit extra and get it from a reputable source - God was obviously watching over me when I drove my hired car - hindsight is a marvellous thing!
Be sensible - Cape Town is not as notoriously dangerous as Johannesburg but tourists/ students where still mugged if they were stupid. Don't trust anyone at first, even the security guards in some areas because things get stolen
Do what the locals do - the local students know all the best bars, etc so best to mingle with them really
Make lots of friends
If you are not happy dealing with sick patients, just say - the assumption is automatically that you can deal with something, but if you can't the doctors are more than happy to teach you - definitely a see one, do one, teach one situation - this was me with chest drains and back slabs!
If you plan on doing surgery, take some protective goggles (unless you were glasses like me, then you can get away with not having some) - you don't want mucosal splashes in your eyes and the post exposure worry
Take a plug socket that is compatible with SA. Our plugs are a different shape to theirs
Take some warm clothes!
HAVE FUN!!! I'd go back there in a heartbeat!

Hope this was useful for you guys. If anyone has any specific questions, ask away! Hope you're having good weeks!

Sammie

Written by Sam Forde

Today was my last day of shadowing in Obstetrics and Gynaecology (OBGYN). I can't believe 6 weeks have already passed! Anyway, I finished my placement with a week of night shifts. The saying that everything happens at night in OBGYN is true - my night shifts where certainly busier than my day shifts. Anyway, here is a run down of one the night shifts I had. As you all know, things in Medicine aren't routine - there is no such thing as a typical night. Hope you enjoy!

6.00pm

Alarm goes off , Wake up. Jump in the shower. Eat some dinner

7.15pm

Leave the house – just a 10 minute drive to the hospital (I drive for night shifts because the 30 minute walk after a night shift seems like several years). When I arrive, I go straight to the delivery suite and get changed into my scrubs, thermal socks and crocs.

8.00pm

Get hand over for the gynae wards first then the obstetric wards from the junior on call for the day

8.30pm

Ward rounds with the medical team - we see all the acute patients and those who are waiting to deliver on the delivery suite. The team is comprised of one junior doctor who I'm shadowing), one junior registrar and one senior registrar plus a LOT of midwives!

8.45pm

Ward round interrupted by bleep...junior doctor is asked to of the gynae ward to see an emergency patient. She lets me clerk her in and start management.

Note: clerking means take a history, do an examination and formulate a plan which includes ordering some investigations and writing up some medication to be administered by the nurse/midwife

9.30pm

Back to the team, catch up on what we missed on the ward round. Jobs to be done by the junior doctor/ me immediately after the ward round are:

Cannulate three patients
Review a lady who had a Caesarean section a few hours ago with query post part haemorrhage
Write some discharge letters for patients on the gynae ward
Take some blood samples from one patient
Review three emergency patients waiting to be seen

11.00pm

Unscheduled theatre. A lady originally scheduled to have a normal delivery now needs a Caesarean section for failure to progress through labour. The senior registrar lets me be first assistant!

The first assistant role basically is helping with the delivery - usual tasks include holding the retractor, suction, following sutures, 'pushing; the baby out, taking cord bloods if needed.

I always stay to help the nursing staff get the woman cleaned up and moved to recovery (remnant of my healthcare assistant days!)

12.30am

Finish the case (took longer than normal because the woman had undiagnosed placenta praaevia (placenta covering the cervical opening) and there was a lot of bleeding to control)

Grab a quick bite to eat with the junior doctor

1.00am

Bleeped to go to A&E to see a patient with a query gynaecological course of abdominal pain. I clerk her in and start management (with the supervision of my junior doctor of course!)

2.00am

Senior registrar is bleeped to an obstetric emergency - a lady in labour at 24 weeks with a breech baby.

I ask to stay to observe.

Pretty emotional but awesome to see - baby was born okay (weighing 550g!) but needed resuscitation (which was incredible to see - such skilled neonatologists! I hope to be that proficient with babies if ever I have to deal with emergencies like this)

4.30am

Junior doctor asked to see a post delivery lady with query sepsis.

There is an obstetric sepsis protocol that needs to be followed if an obstetric patient is found to have sepsis.

Between the junior doctor and I we start the protocol which includes blood cultures, septic screen, arterial blood gases, fluid resuscitation, antibiotics

5.30am

We have some down time so I ask the registrar if I could have my Case Based Discussion with her. For this, I present a patient I saw and the registrar grills me on the subject! Nerve wrecking (especially at this time in the morning) but good practice!

6.30am

Time to get scrubbed in again. This time its a lady being sent to theatre for a delivery trial with forceps. Pretty straight forward delivery once things got started.

8.00am

Day team arrive.

Hand over to them about the night shift and tell them of any imminent jobs that need to be done.

8.30am

Time to go home!

I get changed and head straight to my car.

These cold nights/ mornings mean I need to scrap some ice off my windows.

8.50am

Home!

Traffic in the morning delays my time to bed!

As soon as get in, I have a quick shower and make a to do list for when I wake up. If I feel particularly awake, I make some breakfast but this happens 50% of the time!

I have another night shift tonight so before I sleep I do some work/ send some emails, etc. I also talk to my familia if I can because night shifts mean I'm awake when they are asleep!

11.00am

Bedtime!

Written by Sam Forde

October means two things for wannabe medical students – UCAS form submission and the preparation for medical school interviews. My interviews were a very long time ago but I still remember, very vividly, how petrified I was.

Having been through the interview process and lived to tell the tale, I thought I’d share some pointers. These are very much applicable to any professional interview situation not just for medicine.

What to wear: Basically something comfortable and professional looking. The admissions tutor will also be looking at how you present yourself even before they ask you your name. Obviously how you look is not the only way to present yourself but at least you can have that box ticked if you pay a little bit of attention. Don’t plaster your face with make up, obviously. Nice sensible shoes (which can be heels if you can walk confidently in them) and a nice bag (although this is not a must). Classy and simple is the way to go. Make sure what you’re wearing actually fits! I remember at one of interviews the boys (cute as it was) wore suit jackets that where waaaayyyy too big for them.

What to bring: All your documents – certificates, interview invitation letter, etc (preferably with one photocopy for each just in case), a notepad and pen (to write down any information you get on a tour of the medical school/ accommodation or any questions you might have), a mirror to check yourself before you go in (I have an issue with oily skin which just needs a dab with a shine sheet now and again) and anything else you normally carry with you.

What to do before: If you’re travelling from far away, make sure arrive in good time – being late never looks good! You will get an itinerary for the day, which you will be asked to follow. Sit down in the waiting area, don’t be shy, be polite, chat to other interviewees, make eye contact, etc. Someone you meet on interview day might turn out to be one of your colleagues in medical school so be nice!

What to do during: As soon as you walk in, smile, greet your interviewers, give them a firm handshake and sit down where you are told to sit. Sit up straight and make eye contact with everyone in the room, not just the person who is asking you questions.

What to say: Unfortunately every medical school has a different set of questions for everyone. Some are interested in how much of a ‘people person’ you are, some want to find out about your extra curricular activities and some want to know how you learn, etc. Nearly every school will ask you why you want to do medicine, why that school, how that school’s curriculum will make you thrive, etc (so make sure you can at least answer these questions).

Most schools will also want to see how you think – they will pose ethical dilemmas like ‘there are two seats on a rocket to Mars, who deserves those seats: a mother with a newborn baby, a scientist, a doctor, a criminal serving life in jail for murder, etc. The important thing to remember with ethical questions is that there is no right or wrong answer – the tutor just wants to see how you think and how you justify it. Think about your answer and talk through your thinking process.

I was also asked what I’d say to a friend who was contemplating suicide, what I thought about free school meals for children in primary school and how I would fund them, if people with smoking related illnesses should pay to use the NHS etc. I was also asked about NICE (National Institute of Clinical Excellence) so I recommend having some idea about the NHS and its structure (but not in too much detail because this is taught in medical school).

How to prepare: Know your CV and personal statement like the back of your hand. If you volunteered somewhere, be ready to talk about it, if you’ve done some research, be ready to talk about that. Have genuine answers for the questions you expect. Obviously you can’t prepare for every single question. If you are asked something you hadn’t thought of – stop, think about it then say something. If you don’t know the answer, speculate. Just stopping at “I don’t know” is not a good look.

After the interview: If you have any questions at the end, don’t be afraid to ask. Thank the interviewers and go partttyy!!! No I don’t mean that haha! But this is the time to calm down and relax – you’ve done all you could do and you can’t change anything now. I came out of my interviews feeling like the world was about to end because I found them so tough, but I got offers soon after. If you think the interview went bad, it probably didn’t. Just wait and see before you stress yourself out over nothing. The admissions tutors will have pushed you to see how far you can be pushed. It will feel horrible but honestly, you’ve done pretty darn well to get this far!

I hope someone finds these tips useful! Good luck with interviews and if there’s anything else you want me to post, let me know!

Have a good week!

Sam

Written by Sam Forde

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