Train your trainees

I’ve been spending a lot of time in labour ward anaesthesia this past month. It’s great, because I get all the gratification of the caesarian sections (I remember it well from internship), without having to wade through blood and amniotic fluid and human excreta myself.

This tweet in part inspired this post.

Another thing I remember well, is the tension in theatre when the intern is cutting. I had such difficulty getting my ten caesarian sections for our logbook signed off, because so few seniors were willing to let an intern cut. It’s not only the obstetrician – often, it’s the theatre nursing staff. To be fair, nobody likes to be scrubbed in for a routine caesarean that lasts ninety minutes. Other times, it’s the anaesthetists. Because nobody likes to worry that their spinal anaesthetic might wear off before the surgery is over.

I have had a taste of the same with my new position, too. Not having done anaesthesia in four years, there is a lot I have had to relearn. My “teachers” have been great, and I seem finally to be finding my feet, but there have often been grumblings from surgical teams when I was slow. As an intern, I might have minimised myself and declined to perform the procedure. But now, I need to learn, and quickly. So I have been pushing back harder (when not to the patient’s detriment) – and to my new colleagues’ credit, they have supported me.

Check the replies on this tweet – they made me feel so much better.

Having experienced this, I will always be the annoying medical officer who encourages the intern/student/newbie to perform procedures. Not because I think I’m so wonderful, but because I want trainees to feel as nurtured as I have felt these past few months, and not as burdensome as I sometimes did as a student and an intern.

Sometimes, I think clinicians forget that they were inexperienced and under-qualified juniors once, too. There is nothing admirable about learning to place an intercostal drain on YouTube, without senior supervision, as many of us like to brag. That is a sign of a failing system. We should be taught and guided by others with experience. We deserve that. Our patients deserve that.

I also know that it is a system that fails not only interns. I know that demoralised doctors have little interest in training juniors. (But that is a discussion for another day.)

Interns who are not competent become dangerous medical officers, wherever they may go for ComServe. They have both the right and the responsibility to be trained. We have the responsibility to ensure that they attain their very best, even if they are afraid while doing so. We do it to pay forward the teaching we have received. Or if we were not so fortunate, we do it to improve where others failed us.

Train your trainees. It kind of goes without saying.

Read This Book: In Shock by Rana Awdish

“If empathy is the ability to take the perspective of another and feel with them, then, at its best, the practice of medicine is a focused, scientific form of empathy.”

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For the past few days I’ve been devouring In Shock in every spare moment I could find. In her narrative, Awdish recounts the experience of severe illness and near-death on the background of being a physician herself. She shares almost “crossing over”-esque insights into how and why medicine is failing its patients, as well as its doctors.

In Shock is definitively part-memoir, succinctly conveying the many complexities of Awdish’s illness and survival. True to its intention, it avoids the traditional stiff-upper-lip clinical retelling, and allows for range of emotions experienced by the critically ill individual. It is a narrative not looking purely outwards, but also in. What Awdish distills from her experience is both poignant and pragmatic.

“Illness is viewed as an aberrant state. It is a town we drive through on a journey home, but not a place to stop and linger.”

In Shock is about medicine’s broken telephone. It is about our inherent, but often unintentional, disrespect for patients and ourselves. It is about seeking comfort in the wrong ways, and about righting our bad medical habits. Continue reading “Read This Book: In Shock by Rana Awdish”

Tips and Tricks: Planning Your Elective [Part 1]

Screen Shot 2018-11-20 at 14.17.59Since I’ve kind of started paying more attention to the blog again, my friend Caroline asked me to share some tips on electives. (Hi, Caroline!) You may remember the elective series I ran a few years ago. I haven’t exactly stopped the series, I just am not really in the position to seek out medical students for interviews anymore. (Guest posts welcome, hint-hint, nudge-nudge.)

I’ll give as much advice as I could gather from myself and friends, over a few days. Today, I’ll start off with the process of choosing your elective.

Disclaimer: This will be written with South African medical students in mind. For international students, note that some things might not apply to your program.

First: Start. Early.

If you think you’ve got plenty time, you’re wrong! I have a colleague who went to Oxford for her elective, and she booked her space for the program more than a year in advance. If you have a holiday between exams and rotations, use that time. Do not rely on the hope that things will just fall into place. (I speak from experience.) Continue reading “Tips and Tricks: Planning Your Elective [Part 1]”

The “Good” Intern

The October issue of the South African Medical Journal (SAMJ) published an article, ‘Going the extra mile: Supervisors’ perspective on what makes a ‘good’ intern (De Villiers, Van Heerden, Van Schalkwyk). The paper assesses the opinions of supervisors on interns’ practice readiness, which differs from most research on the subject, which has predominantly researched the interns’ own perception of their preparation.

The study reported on the results of interviewing 27 intern supervisors – a small, but diverse group of consultants, registrars, and medical officers.

What stood out for me was that the interviewees displayed a keen awareness of the challenges faced by interns. They recognise three areas of particular difficulty: transition from student to doctor, adjusting to a new environment, and long/hard working hours. Continue reading “The “Good” Intern”

Anatomy: my big mistake

I had a little giggle to myself while charting the notes of a patient with shoulder pain the other day. Specifically, I was thinking of this post of yore, and my belief that I could get by just knowing what anatomy looked like, and not necessarily its various descriptions and qualifiers.

Boy, was I wrong. (And young. And obstinate.)

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Image via dentalbuzz.shop

Continue reading “Anatomy: my big mistake”

Can I Be A Depressed Doctor?

Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.

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When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated. Continue reading “Can I Be A Depressed Doctor?”

Mental Health Begins With Medical Students

Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.

I think we are the missing link. And by “we”, I mean qualified doctors. And also, you, the older doctors. Continue reading “Mental Health Begins With Medical Students”

FAQ: Will I Get Into Med School?

Ever since I first posted tips for applying to medicine (in South Africa) in 2014, I have received multiple questions from aspirant medical students.

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The hardest to answer (and thus one of the most popular) is DO I STILL STAND A CHANCE? – usually prefaced with the person’s failure to achieve the desired grades for medical admission, or some other stumbling block. Continue reading “FAQ: Will I Get Into Med School?”

A Key To Disillusionment In Work And Play

disillusionment2The phenomenon of disillusionment is well-discussed in the world of medicine. Roundabout third year of medical school, students begin to realise that the medical world simply does not live up to what they envisioned.

It is easy to say, “Just don’t have such high expectations,” but in reality a doctor without vision becomes a mindless drone. Disillusionment is discussed so widely because even though by definition it seems simple, its origins and characteristics are complex.

Funnily enough, I began to really understand disillusionment when I started club-running. Don’t be mistaken: joining a club was the best decision I could have made. It introduced me to many like-minded people and provided ample opportunity to amp my mileage.

I joined a club because I felt that I loved running enough to do so, but not long after joining I started experiencing an emotion I recognised from the medical world. I was feeling disillusioned. Continue reading “A Key To Disillusionment In Work And Play”

[Guest Post] From Nursing to Medicine

While the best-known route to medical school in South Africa is the “conventional”: finish high school and enter med school the next January, it is by far not the only route followed by medical students here.

The journeys are numerous, like Tash’s journey of an older medical student, which she graciously shared here.

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Today, Roxanne shares her journey from nursing to medical school. Roxanne is a fourth year medical student at the University of Stellenbosch. We lived across from each other when she was a first year and I in my fifth. She impressed me from the beginning, with her humility, passion and eagerness to learn. This is her story: Continue reading “[Guest Post] From Nursing to Medicine”