I really enjoy getting to be hands on and putting the theory we’ve been taught into practice. I thought I’d share with you my typical day. If there is ever such a thing in medicine…
8am: Ward round with my consultant. In obs and gynae this consists of seeing any new admissions that my consultant is leading the care of to make plans for them as well as any patients that have been in for a while. On general medical wards this often takes most of the morning and frequently social issues, such as care at home, are the main discussion points for patients that are nearing discharge. Surgical ward rounds may be considerably quicker so that the surgeon can get to his morning theatre list.
This morning we see a lady who has been admitted for lower abdominal pain which could be an ectopic pregnancy, a woman who is 8 weeks pregnant and has been having some bleeding and a woman who is 36 weeks pregnant whose blood pressure is very high. These are all potentially serious problems and so we come up with a plan for each of them which for some include an ultrasound scan and for some a drug treatment.
9am: Theatre list. Now time to get into my scrubs and join the theatre team for a hysterectomy and removal of an ovarian cyst. In obs and gynae, surgery can be laparascopic (keyhole) or open as well as elective or emergency. This gives a good mix and can be exciting if you’re on call for the emergencies. I’m interested in anaesthetics so as well as scrubbing in to help with the surgery itself, I spend some time with the anaesthetist who talks me through the difficulties he expects with one of our patients who is very overweight.
1pm: Surgery finished now off to lunchtime teaching. One of the other consultants is going to talk to us about gestational diabetes to cover the learning objectives set out for our knowledge exam in June. Teaching varies between hospitals and between rotations; it might be in the form of lectures, seminars, case discussions or bedside teaching where you go as a group to see a patient on the ward. All have their pros and cons and a good mix is vital for getting both the theory and practical skills up to scratch. Unfortunately today’s teaching didn’t involve a free lunch but it has been known to happen!
2pm: Antenatal clinic. Most pregnant women see a midwife throughout their pregnancy and don’t need to see a doctor however some have more complex needs and so are referred to the antenatal clinic. This afternoon I will have my own consultation room and will take a history from all of the new patients then present this to my consultant. She will then ask me what I think we should do for the patient then give me some feedback. This can sometimes be a bit scary but is definitely the best way to learn!
5.30pm: Clinic finished and I’m off home!
Not all days are quite as busy as this one but the clinical phase of placement gives lots of opportunities to get involved with patient care and the teams you’re working with. I really enjoy getting to be hands on and putting the theory we’ve been taught into practice so I don’t mind being busy!