First time in the DR

DR - otherwise known as the Dissecting Room...

It is one of those aspects of learning medicine which strikes a mix of fear and curiosity into the heart of all medical students. I will never forget the first time I ever saw a dead body. I was in a room with other students expecting a talk on anatomy and there was a table with a sheet over something. It was when I saw fingers peeping out of the sheet that I realised with a shock that it was an arm. The skin was old and frail but the fingernails were painted a delicate baby pink. That was unexpected...

I remember too when we were first shown internal organs and passed around a human liver. One of the lads very nearly fainted (the girls were fine!). The smell is quite overwhelming - its sickly sweet formaldehyde that makes you catch your breath and cough with streaming eyes. It has a tendency to cling to whatever you wear so not the best precursor to a lunch date unless you are seeing a fellow medic!

These days there is a lot of discussion over what sort of anatomy teaching should be used. I still think that cadavers have an important role in medical education. Its not easy but it is an amazing thing to see. I don't think I've ever been entirely comfortable with cadavers in the room but its important for a medical student to experience because anatomy books don't show you what things truly look like. In real life nothing is colour coded and neatly separated and labelled. Seeing a real body gives you a sense of the immensity of the surgeon's skill. To accurately dissect through tissue planes, without causing damage, whilst allowing for the vagaries of individual anatomy and to be able to tell everything apart is a mammoth task.


You never really find out much about the people who donate their bodies. They are to an extent depersonalised and I guess that's necessary for the average student to be able to deal with looking at what is beneath the skin.It gets tricky when you see faces and get a sense of their features and expression, it make the bodies more real and then it can be harder to touch and to learn. After a set period of time the bodies are sent for burial and they hold a memorial service which students can attend. Its a lovely idea, a chance to say thank you to those people.


The DR room is a difficult but special experience. It made me feel awed that someone would be generous enough to let their body be used for students to study and learn from.

What an amazing gift.

Becoming a patient: what it's like on the other side...

It is all too easy to forget what it is like to be a patient.

I was reminded of this the other day when I had to undergo an emergency procedure. It was spectacularly painful and I was in a bit of a state. My overwhelming feeling was fear; fear of the procedure failing and fear of the pain itself.  I was made acutely aware that we are all reduced to a state of impotence and childlike reliance when faced with the unknown; when we have to look to another for help.

But when we think about what sort of doctor we want to be it is often the type of work we want to do that is foremost in our thoughts rather than how we behave. Much has been written about doctor stereotypes, for example:

Surgeon: arrogant, lacking in conversation skills and tact
Anaesthetist: geeky, calm in the face of danger, quiet, dismissive 
Orthopod: rugby playing, muscular, not so bright, gung ho
Medic: drug happy, dislikes sudden decisions, always double checking
GP: likes the quiet life, lazy, refers anything tricky, chatty

All of this is a running joke between different specialties and perhaps there is a grain of truth to some of it. After all, if you are going to cut someone open you need supreme self confidence that you can engineer the bits to go back in again. Nobody wants a modest surgeon to operate on them! And if you are going to be on a hospital ward you want to be sure that people are making sure that the right decision is made and checking things and tweaking. When you see your GP you want to be listened to and taken seriously.

You can be many different types of doctor but I know that when I was a patient, the characteristics I wanted most were gentleness and compassion along with strength and confidence. One trait without the others would have made my experience more stressful but that great combination gave me reassurance and trust that it would turn out ok.

That's the sort of doctor I want to be regardless of the specialty I choose.

Where did my free time go?

The first few months of medical school were crazily busy and a steep learning curve but I was supremely happy having achieved that elusive place! Fast forward three years and the enthusiasm is still there but the amount of energy I have to learn things is starting to dwindle. Its exhausting to spend all week continuously concentrating on absorbing information and coping with random questions thrown at you by tough consultants.

The biggest problem is that there is no such thing as free time. As we get closer to exam time those precious evenings and weekends get filled with OSCE practice and revision. Or worse, learning things for the first time! Medicine is just such a huge subject - there's always another gap to fill. All of which leaves you longing for a real job once more just so you can take a night off and not feel guilty.

Of course, all this pressure to study is entirely self imposed but I defy anyone to spend years with other competitive students and fail to get sucked into the mutual peer pressure driven hamster wheel of learning!

Even more stressful than studying is the realisation that everyone you know seems to have been to a revision course except for you. What does this all mean? Am I going to fail because I didn't spend several hundred pounds being talked at for two days? Do they have special insider knowledge now? Maybe I should get a last minute place? Except they are all filled up so now its just me and the books...

Which reminds me, what am I doing blogging? there's neuroscience to learn...

GETTING INTO MED SCHOOL: The first step..

Getting into medical school can seem an uphill struggle but it is achievable. The first and most important step is to make the decision that a medical career is definitely for you. From there you need to tackle the process one stage at a time...

 

1. Making the decision
You have probably thought about it a great deal but do you have volunteering or other work experience? If not, spend some time getting an insight into the reality of helping people. When you have to wipe up vomit you may not feel so sure...

2. Where and how do you want to study?
Research all the courses available to you. If you are trying to get into graduate medicine think about the style of learning on the course - many use problem based learning known as PBLwhich requires you to be a self-starter able to manage your own work - this may appeal to you. Some of the 5 year courses are also using this style of learning too. Other courses may have more lecture based teaching. Pick with care! Look at the facilities and the quality of teaching. Do you want to be in a city or in the countryside? London medical schools certainly have a lot to offer in terms of large teaching hospitals and exposure to less common diseases and conditions but you may have long commutes on public transport all over the city on placements in your clinical years.

3. So, you know where you want to apply - do you meet the criteria?
Now is the time to give serious consideration to your ucas form if you haven't done so already. You will need to meet strict grade requirements and lots of applicants will look impressive so make the most of skills you have gained in other jobs in putting forward your case to be a medical student and find someone who is willing to write an eloquent and persuasive reference. If you get one that looks lacklustre try to find another referee. Having said that, it may be that only minimal attention is paid to your carefully crafted personal statement as some medical schools may place most emphasis on the entrance exam and interview. Regardless, you will need to show commitment and demonstrate that you are not seeing the medical profession through rose tinted lenses. Some courses expect at least a year of experience in a caring role. Some students applying to graduate entry courses have worked as health care assistants and others have done nursing. You may not be in a position to get medical experience. If you need to remain in your current job look into volunteering through your employer; they may have schemes that allow you to take some time out of your day to help the local community in some way. Sacrifice some of your weekends to helping others - coaching, befriending the elderly or helping in a hospice can be rewarding and provide useful insights and transferable skills.

4. Can you pass the entrance exams?
If you are applying to a 5 year course then your A Levels will be crucial but find out if there are other entrance tests. Those opting for graduate entry will need to sit UKCAT (http://www.ukcat.ac.uk/) or GAMSAT (http://www.gamsat-ie.org/). Read about the tests and get hold of past papers and practice a timed test. If you don't have a science background don't despair! You can study by yourself from textbooks, do evening courses (eg. A Level Chemistry) or take a distance learning course. There are expensive prep courses but it is perfectly feasible to do this for yourself if you are motivated enough. It may take a year to study to the necessary level alongside a full time job but if this is really for you then you will manage it.

5. Interview Day
You passed the horrid exams and landed an interview. Make sure you prepare thoroughly. This is the final hurdle and the culmination of all you have worked for so don't let it slip away. With a bit of googling you should be able to find lists of suggested interview questions. Go through them and think about answers. Practice mock interviews with a patient friend and get feedback on any annoying fidgety habits you have when nervous. Many interviews will have a panel of people but try to engage them all and make eye contact. Stay polite and calm. Think carefully about your responses and don't be afraid to pause rather than witter on mindlessly. You may be asked to take part in mock scenarios - take these seriously and use your common sense!

Best of luck!