2 months?!?!

2 months since last post? Really?

Damn I"m slack.


Summary:
GP land is awesome. Lots to do, lots of hands on, lots of fun.
ICCU is ok. Not much to do, not much hands on, not too exciting. Did CPR and saved a life though. So I guess that counts for something.

On things to come...

Because everybody else is doing it, I thought I might as well too.

So most people in my year have just found out their rotations (well, "just" being 2 days ago) but I"ve been one of the totally lucky ones who knew over a week ago. I was one of many who was left with a missing term 1 due to the totally fair and perfect algorithm the magical School of Medicine computer uses to allocation rotations. Working fast, I managed to get what I thought was the best of the worst, but others were not so lucky. My heart weeps for the two people who had to do Chronic Condition Self Management, and my Respected Associate who had to do Neurological Rehabilitation.

Outlined below is what I like to call (for the first time) The Grand Plan:

Term 1: Musculoskeletal Rehabilitation
Location: Repatriation General Hospital
Probable job description: Fractured hips, femurs (heads, necks) and knee replacements I should think.
Personal thoughts: Could be hit or miss but its ok, I have company for this term and we"ll make the most of it. *sigh* At least the year can only get better...
Career opportunities: Physiotherapist, Masseuse

Term 2: Urban (Legend) General Practice
Location: My new favourite GP's practice. 
Probable job description: Being Awesome!
Personal thoughts: Very excited about this one, I"ve been having my GP placement here and from previous posts, you can probably tell I enjoy it very much.
Career opportunities: GP, Batman

Term 3: Critical Care Medicine
Location: Flinders Medical Centre Intensive Care Unit
Probable job description: Watching and waiting. Then waiting more. Also watching. 
Personal thoughts: Should get some good physiology and medicine knowledge here. Maybe do some management things.
Career opportunities: Intensive Care Specialist, Dr Robert Chase

Term 4: Emergency Medicine
Location: Flinders Medical Centre Emergency Department
Probable job description: Running around like a headless chicken.
Personal thoughts: If rotation quality was proportional to number of people wanting to do it, this would probably be the best rotation ever. It should hopefully be exciting. Alternatively, this could be so much work I might lose my mind. We"ll see.
Career opportunities: Alcoholic, George Clooney

Term 5: Unconfirmed
Location: Hopefully, Singapore General Hospital
Probable job description: Messenger boy
Personal thoughts: Hopefully I"ll be doing anaesthetics and general surgery.
Career opportunities: National Service, Ending sentences with "la"... la.

Term 6: Cambodia
Location: National Pediatric Hospital
Probable job description: Picking on little kids, stealing pocket money, etc.
Personal thoughts: This one should be fun! I like paediatrics :)
Career opportunities: Paediatrician, Nobel Peace Prize Laureate

Term 7: Vacation
Location: Asia
Probable job description: Being on holiday
Personal thoughts: This will be a lot of fun, aiming to go to China, Hong Kong, Taiwan and Japan.
Career opportunities: Dumpling King, Communist

Term 8: General Surgery
Location: Mt Gambier
Probable job description: Generally surgerising. Some surgery on generals?
Personal thoughts: Surgery is the topic I"m least excited about, but who knows, rural general surgery may be more exciting than urban general surgery (which consists of hernia, hernia, laparoscopic cholecystectomy, hernia, colonoscopy, colonoscopy, colonoscopy, colonoscopy, endoscopy, endoscopy AND colonoscopy).
Career opportunities: Obnoxious Pretentious Twat Surgeon

There we go. The plan is out.

So who"s excited?

Lucky sevens!

So I"ve just gotten the seventh (acceptable) miniCEX done.

Maybe I should explain myself in classic style.

-fzztwhirkdsafh;gssssssooooooooooooooooo-

The year is 2010, the month is January. We"ve just started 3rd year. Things are exciting!

Of course, to pass 3rd year, there are some small things to do. One being the dreaded miniCEX. I forget what it stands for (What"s that you say? It"s written on the top of the form? Don"t be silly.) but it seems that the powers of be have decided we must get these done.
A minimum of 8 of them.
From 4 different assessors.
From 4 different disciplines.
In the fires of Mt Doom.
Naked.
Without a spoon.

Anyway, basically the assessors grade us on basic skills such as history taking, examination skills, communication skills, clinical judgement and barking like a dog.

This is marked out of 7 for each category (7 in all) and that mark is averaged to give us a score of which they will take our best 8 (Why not another 7? Why suddenly 8?) and that average is worked out of a measly 10% of our final mark.

Hooray for jumping through hoops.

-fzztwhirkdsafh;gssssssooooooooooooooooo-

Flashforward, its August 30th, 2010.
I"m at my GP clinic for placement. Its great here! I"m enjoying a peppermint tea while slamming down a double coated Tim Tam (Amazing! Its choc-mint-melty-glory in my mouth!). My GP decides to brief me on the next patient. Briefly.

"Punch biopsy, its all yours!"

I try to appear cool, calm, collected as I"m licking the melted chocolate from my fingers and looking for a safe place to put my antidepressant branded mug.

My GP calls in the next patient.

I do what I have to. I ask my GP to kindly prepare a trolley while I clean my hands and find the necessary materials. Only moments later, I"m ready. I glove up and take a look at the patient"s back. There is a nice little mole in between some feathers. Wait. What?

"Don't ruin my tattoo!"

Oh goody. I clean the area and allow to dry. The gloves are off. Well, now they"re on again. Sterile this time.

As my GP supervises, I clean, get a biopsy and begin to suture.
After one suture is in and trimmed, I pause and see what the wound is like. I decide that it probably needs another suture (Well, I don"t really get the chance to suture all that much, so maybe it was more for my benefit...) due to the slow oozing of blood out of a tiny area. Moments later, I step back and start putting the instruments away for cleaning, the sharps in the sharps container and the rest in the bin.
My GP is still wiping the betadine off the patient and examining the wound. He says nothing.

After we send the patient off and tell her to call in a couple of days for results, he turns to me.

I almost flinch. Almost. I"m enjoying my cup of tea too much.

"How did you do that? The wound fit in with the tattoo perfectly!"

"Buh?" I eloquently replied.

"Natural talent!" He exclaims and pulls out the miniCEX form.


-ooooooooooooooooossssssg;hfasdkrihwtzzf-

And so that gives me lucky miniCEX number 7. Well, I think its the 11th in total, but lets not talk about the Unworthy Four.

Ears

Just thought you"d all like to know that I think you are all disgusting.

Was at my GP placement yesterday (which is generally good fun), but a man came in to get his ear syringed. He had tried to clean out his ears using cotton tips but had only managed to compact things more. So out came the warm water and water gun. It"s really a lot of fun in theory if you manage to ignore what you"re actually trying to achieve. The wax that does come out kind of reminds you that you"re degunking someone"s ear, and not just playing with a squirt gun.

Ugh.

Lazy day of SUPER STABBINGS!

Ah, clinics. Those little rooms where, as a student, you sit within and are expected to be quiet while the grownups are talking.
I managed to, out of sheer stupidity, fail at signing up for clinics (as mentioned previously). Oh, I did put them down in my timetable, I just managed not to write my name in the clinic sign up sheet.

Good work.

So instead, I slept in.

It was wonderful!

Wednesdays, like most Wednesdays (well, like most Wednesdays from now on) involve whatever I manage to get done in the morning, followed by my GP placement in the afternoon.

I was quite excited about my GP placement, though also a little nervous as the GP mentioned after our first session, that he would be having me helm the remaining consults. He seemed to think I was ready for it, but I certainly didn"t think so.

In order to calm myself, I decided to do some reading and revision. After making this decision, I went to the kitchen and cooked myself an elaborate pasta dish. It was delicious and I now have lunch for the next few days... By the time this was done, it was time to leave. In fact, I was late. Instead of a nice leisurely stroll to catch the bus, I sprinted and found that the bus was late anyway. Hooray for Adelaide public transport!

On arriving at the GPs, I found that he indeed wanted me to sit in "the big boy chair" and take charge of the consults. Using all my training as a Flinders medical student, I managed to look confident as I said "No problem!"

Surprisingly, it really wasn"t a problem.

Covering crazy situations from musculoskeletal causes (?tricompartmental osteoarthritis, carpal tunnel, whiplash injury) to inflammatory causes (plantar fasciitis, peritonitis, dermatitis) to simple surgical follow-up for workcover (inguinal hernia). I managed not to stuff things up too badly. Probably the most difficult was the young lady who came in with tiredness (who knows, she was tired!).

I even managed to do a few procedures, seeing as I was in charge. With an experienced GP as my personal assistant (he gave me examples on what I could tell assistants to do, such as cut things, pick up things, shine my shoes and get me coffee), I again made use of my super Flinders training and made myself appear to be a seasoned veteran, as I did my first flu vaccination.

The practice sessions at looking confident helped even more when I had the chance to do my first punch biopsy (just like an apple corer!), as well as my first suturing of something that wasn"t the refrigerated amputated trotter of a pig (oh my, its so much easier!).

All in all, a successful day of firsts.