Today I’d like to share some brief thoughts on previous work experience. I am lucky to have been able to achieve a wide variety of work experience over the course of my late secondary school years and also currently in year 12. For instance these include GP surgeries (with HCAs, doctors and nurses), the local hospital (consultants and physiologists), primary schools, occupational health centre, volunteering and part time occupation. From all of this experience I have gained a great amount of knowledge to start building the foundation of skills that will help me in my aspirations for a future career in medicine and I hope to express just a snapshot of what I learned to you.
One day shadowing a GP:
This was no ordinary day in a surgery, of course that is a one of a kind experience that I will get to later, however now I am going to talk to you about something different. On this day we travelled to the offices in Abingdon at Doctors.net.uk. It is a small company which aims to provide education services, networking for medics and advising others, whilst promoting certain drugs. Here, the particular doctor has incorporated this alternate role into his duty as a GP. I found this really eye opening as most of us assume that in the future you choose one particular specialty which itself may be filled with wonder and excitement, but you might not have vastly different daily experiences with regards to the environment you are in.
The doctors can advise and promote drugs and the proper use of them. GPs are required to update their knowledge on certain issues. I have found that they receive data for the most common drugs, which is useful to identify those that are the most important for the company. Moreover, various types of media are used. For instance social media, what should the GPs do and not do and how to target this by arranging GP training programme appraisals. It is very interesting to note that the media’s role in medicine also is quite prominent and it allows us to be influenced based on our demographic.
Later I was taken around to meet the other departments such as the Market research team who try to ask the doctors meaningful questions to receive responses that make scientific sense as well as offering a slight incentive. Why would a doctor be interested in a drug unless they see it as a relevant addition? There is a balance between working with industry and working with the community of doctors.
Following this we worked on an article the GP was involved in for Women’s Own magazine, it highlights the methods in which people self- diagnose their illnesses using technology and how these searches can be successfully refined. Must adjust the language style of this article in order to make it more understandable to the general public.
Another day with a consultant at the general hospital:
I shadowed Dr R in the outpatients section, he is a Consultant Physician in General and Respiratory Medicine who deals with multiple cases and events in this speciality. From this day I learned to appreciate the level of activity and hard work all members of the hospital do to keep the internal mechanics running smoothly.
For example with one patient the consultant begins the appointment with some friendly conversation about similar languages to be friendly when introducing himself to new patients, I found this comforts them and the sense of having something in common with your doctor enables you to feel more at ease in the appointment. So this patient had a chest infection, started taking Clarithromycin which unfortunately gave them stomach aches for a Haemophilus influenza. Now they are on Amoxicillin. A longer interval between the return of the infection is not good, the key is to hit it hard when it returns. The infection in airways obstructs easy breathing. Advises them to have some burnt toast at night because the carbon in the burnt parts absorb things in the stomach to improve sickness. Has lots of bacteria that have eventually colonised her lungs so this illness will not ever go away unfortunately.
The following patient has recently had a chest scan due to having had a bad back pain. Goes through the CT scan with them and finds the large lump in the lungs. Pressing on the spinal cord. Need to work out what this growth is. Must extract the tissue to test it, can use a needle to extract it/ could be coming from the gland. Must find what is as the origin and how far it has developed. Pain is radiated due to nerve line. Can put a bronchoscope with a camera down the throat to examine what is inside, in order to find some answers as to what is going on in his chest. Informs him that they don’t really know until they carry out more tests and that they are actually worried about it being a cancerous growth. Asks about any medications that they take (Paracetamol/ibuprofen/tramadol) to control his pain. Then prescribed medication to see if he can manage his sickness symptoms better. Now listens to chest. This person still smokes, will give him some help for this. Has been smoking since 15 years old. Previously a painter/ decorator so it is possible he has been exposed to many fumes, it is important to consider many of the other factors their lives that contribute. Full extent of breathing and expanding the lungs is inhibited due to the pain. Recaps plan of what they should do / which treatment they need. Asks how far he can walk on a regular day. Acknowledges that it may be a worrying time for the family, there is no point looking backwards. The pain he feels is generally as a result of something else and they need to find out what this is first. Will then do a breathing test, may need Radiotherapy. Bronchoscopy will happen, it enters up the nose, past the voice box and then down the trachea. Takes a small piece of tissue to assess the extent of the disease.
With this patient I learned that the doctor displayed a number of essential qualities of a good doctor. Such has having the empathy, sensitivity and the ability to communicate your plan of action clearly and in a way that reassures the patient that they are in good hands. Moreover I found it fascinating how the consultant was able to quickly sort through all the relevant knowledge to then make the right decision as to what the best route for the patient’s treatment should be.
The doctor then records a review of the clinic of previous patient in the morning so the secretary will dictate it. In Dr R’s opinion, some good qualities of a doctor include knowing how to prioritise, being hard-working, having the ability to make quick decisions, have good communication, to really care about others and be organised. Difficulty of being a doctor is trying to get through a lot of tasks in one day and feeling as though you didn’t do it properly. A lot of pressure and expectations on people in the NHS to complete everything or check the patients and make the correct decisions when pressured with time.
Then I spent the afternoon at the wards with some of the junior doctors. Dr W and Dr E. They check up on the elderly patients in the beds that have to stay in the hospital for a long time. First patient has an aspiration pneumonia, checks for breathing, tripod positioning, also muscle movements in the neck. Has a scoliosis and a curvature in the back which could obscure her breathing. Checks their oxygen saturation / urination. Status of wellbeing meant that she will stay here till she settles or until she has completed the course of antibiotics.
Moreover, people in hospitals are assessed on their risks of having a blood clot in their legs/lungs from not moving around enough during the day. So they weigh up the risks of having a venous thromboembolism and also the bleeding risk. They then enquire with care homes about having any relevant information passed on to them about a specific patient.
Doctors must document most things that they discuss with patients on the ward round. Look at the results, observe how other people present the patient / if they have improved since having stayed at the hospital.
Evidently there is very effective teamwork between the different departments of the hospital and the links with junior doctors which I found to be useful when they are dealing with different cases. The consultant met with such a wide variety of patients, all with their own individual stories and outlooks that allowed me to gain a much bigger picture of the responsibility of a senior consultant. There is a lot of expectation from the patient on you as a doctor, but having the ability to listen to the patient well and use the time effectively to gain sufficient information from this history seems to help you in making a clear and coherent diagnosis.
I am extremely grateful to all members of staff that made these experiences possible. During each unique opportunity I was able to meet a range of exciting people, including the patients and staff who all shared a little bit of knowledge with me that shall hopefully go a long way in the future.
Although I haven’t gone into too much depth about all the things I was involved in, I hope that this can give you a background as to what my experiences were like.