UCAS Application!

This post might be a little bit late but I'm still gunna write a little about it -  UCAS application!

The deadline is October 15th (got mine in on time :) ) and you are allowed to submit 4 medical school choices along with your GCSE, A-Level and Degree grades as well as your personal statement and a reference.

Reference

My reference was written by my uni personal tutor and its a good idea to build a bit of a relationship with your uni tutor because they will probably end up writing you a reference for other things once you leave uni. I've been to see my tutor a few times outside "normal recommended" times to discuss medical things and he has also helped me with my personal statement which meant he was able to write a more personalised reference rather than just a generic one! Just make sure you approach them with enough time to write the reference!

Personal Statement 

With regards to the dreaded personal statement a book I found really helpful was this book! "Get into Medical School - Write the Perfect Personal Statement". I am selling my copy on Amazon at the moment for £15! :) But it is full of tips on how to write an effective personal statement as well as tonnes and tonnes of A-Level and Graduate examples.
You want your personal statement to stand out, as the person reading them will have read hundreds, but at the same time you want to make sure you include all the necessary information and to at least sound like you know what you are on about!
The general sections I followed when writing mine were:
Intro - Why you want to study medicine

Uni Experience - Small paragraph on the skills uni has given you and how these will help you at medical school. We are graduates so we should be pro's when it comes to time management and organisation!

Work Experience - This formed the main body of my personal statement, you want to say what you did and then WHAT YOU LEARNT from the experience, how this furthered your understanding of how important effective teamwork/communication etc is.

Volunteering - Another big paragraph on your volunteering experience is essential! Again remember to write what you gained from the experience.

Extra Curricular Stuff - Include societies and sports clubs you have been part of during uni and what skills and stuff this has given you!

Conclusion - Never include new info in a conclusion! Just round off how all these experience and volunteering have given you a better understanding into a medical career and the attributes needed to be a successful doctor. Try and think of a nice punchy ending!

My personal statement took a few drafts but in the end I was pretty happy with it! I was also 1 character  under the word limit - hehe!
I've heard back from all my choices saying they have received my application and now all I can do is wait for my GAMSAT results! AAAAHHH.


As always any questions - comment away! :)

Next Steps

What do I do with my life after the GAMSAT?

well....

• Complete UCAS application
• Get a reference for my UCAS app
• Finish that bloody personal statement! (I'll do a post about personal statements as well)
• Finish my degree with a first (hopefully)
• Try and think of a dissertation topic.
• Enjoy my freedom from GAMSAT! YEY

If you have any questions about what you need to do and when you need to do it by for medicine or student finance crap just post a comment! 

The GAMSAT is Finished!!

ITS ALL DONE!!

Soooo I sat the GAMSAT in Bristol on Wednesday and here are a few comments and things I felt about the exam:

• I felt I did ten million times better on the Humanities section than I did in the Science section! The Humanities section seemed quite a bit easier than any of the past papers I'd looked at, but Section 1 went well!
• There was a really good topic on the first essay in Section 2 and I think I went a little bit to broad because I got so excited it was a good topic I just wanted to write everything I could in one go! So make sure you focus on being really strict on what you include in your essay!
• Section 3 was tough, it was a LOT of Chemistry, a lot of organic Chemistry! Not a lot of Physics and there honestly didn't seem to be that much Biology which I wasn't happy about :( 
• The hardest thing to deal with is the length of the exam, you break up for lunch after section 2 and you think "oohh thats fine only one more section to go!" But the science section is 3 hours in total! And it is SUCH a longtime to concentrate! It really is a lengthy exam!
• My brain felt like mush afterwards, all I wanted to do was go home and watch puppies and kittens on youtube, something that didnt involve a lot of thinking!

I'll post up a proper post with some tips for the exam in a day or two but right now I need to rest me brain and I'm back up to uni on Monday for final year and that means dissertation time! AAAAHH.

Soo it's Monday, the exam is Wednesday....

2 DAYS TO GO GANG!

I'm just spending today and half of tomorrow cramming as much as I can, HARDCORE REVISION STYLE. Only leaving my chair to pee and eat!

I'm leaving for Bristol tomorrow night as I live 3 hours away so I'll be hardcore revising in the car on the way up as well!

I'm just re-writing and re-reading all my chemistry, physics and examples I can use for the written section and hopefully they stick in ma brain.

Keep going and hopefully see some of you in Bristol on Wednesday!

10 DAYS

10 DAYS TO GO AAAHHHHH.

I don't have that much to write today other than the fact I'm stressing.

I've been essay writing this past week and trying to find historical examples I could use in essays, aaaand I will be doing another past paper this week and I will also be doing some crying.


KEEP GOING EVERYONE!!


My revision face

GAMSAT - Chemistry

I have nearly finished my revision for the Chemistry section of GAMSAT (I think)
I've been steadily making my way through a list of recommended topics and making sure I understand them.

Although since I've been going through the practice questions, the chemistry questions seem so much harder than what I have been revising! (cry)

Here is a list of the topics I have covered for Chemistry, and I haven't really done "proper" Chemistry since AS Level and I've basically forgotten it all and I HATE it :(

Atoms

• Periodic trends and the nature of atoms
• Understand common elements
• Balance equations

Bonding 

• Different types and properties of bonds
• Electronegativity and polarity of molecules 
• Effect of electron withdrawing groups
• Electron orbitals and quantum numbering 

Equilibrium 

• Le Chateliers principle
• Effect of heat, catalysts and concentration on rate of reaction

Gases

• Ideal gas laws 

Solutions 

• Apply Ksp values
• Understand how chemical properties effect solubility 

Colligative Properties

• Boiling point elevation and freezing point depression
• Raoults Law 
• Heat capacity and specific heat

Thermodynamics

• Laws of thermodynamics
• Gibbs free energy, entropy, enthalpy
• Predict wether a reaction will be spontaneous
• Will a reaction be exo/endo

Acids and Bases

• Pka values
• conjugate pairs
• Does a molecule act as a base or a pair depending on it's structure
• General acid base stuff!
• Oxidation and reduction 
• Apply E values

Organic Chemistry 

• IUPAC naming conventions
• Draw molecular structures from name 
• Isomers
• Chirality
• Alkanes, Alkenes, Alkynes
• Alcohols, Esters, Carboxylic Acids, Amines, Ketones, Aldehydes etc
• Properties and effects of major functional groups

GAMSAT Mock Exams and Practice Questions

For those of you who are sitting GAMSAT this year, follow these links and you will be able to download the official ACER past papers and practice questions for FREEEEE - sneaky ;)

http://www.slideshare.net/akspar/gamsat-practice-test-v015      This one is a good "warm up" GAMSAT, it's not as hard as the real ones but gives you an idea as to the type of questions you might face.


The following are the official ACER papers that you buy from their website, but here they are for no pennies! They take a few minutes to load!

http://papers.xtremepapers.com/GAMSAT/ACER%20GAMSAT%20Practice%20Questions.pdf

http://papers.xtremepapers.com/GAMSAT/ACER%20GAMSAT%20Sample%20Questions.pdf

http://papers.xtremepapers.com/GAMSAT/ACER%20GAMSAT%20Practice%20Test.pdf 

ENJOY!

Quantitative Reasoning - UKCAT

Just some example questions of quantitative reasoning for UKCAT practice!

I'll probably get sent to jail now for copyright infringement - OOPS

UKCAT Abstract Reasoning - VIDEO!

WE'VE MOVED ONTO VIDEOS WOOAAAAHH!!

haha! I thought I would do a video on how to work out an abstract reasoning question for the UKCAT, if you have never done problems like these then they can come as a bit of a shock!
This is my first every video on the internet, and we all hate the sound of our own voice on video! But here goes! This is by no means a snazzy video, I have no idea what I'm doing when it comes to making fabulous movies on my computer so I videoed this with my iPhone, and I had no idea my hand was that shaky!

Sorry for the size of the video! I didn't realise how small it was gunna be coming off my phone! So I've uploaded a photo of the shapes as well so you can see them a bit clearer. 

I'll try and figure out how to make the video bigger...But I have no idea! haha! 

But please comment if you would like another video on abstract reasoning or on any other problem on the UKCAT. 

Less than 1 month until what seems like exam impossible

The more I think about the GAMSAT the more I think how freaking impossible it is!
I've recently been doing the Humanities Section of the mock exams and they seem to be going better than the science section! (whats is going on there!)

Sometimes I think having studied a degree in Human Biology has almost put me at a disadvantage because we go into huge detail in a few topics and we tend to focus less on GENERAL principles of biology, and when it comes to doing the mock exams I seem to be doing better on the Humanities than I am the Science section because I've forgotten all the bloody general bio stuff! The one thing I have noticed about the Humanities section is that there are always 2 answers that are SUPER DUPER  SIMILIAR, and I'm always stuck there torn between two answers!

Anyway these are the mock papers I have been using:

I've found 3 official ACER papers online - cheeky cheeky, if anyone wants the link to the download link just post a comment and I will put them up! I've also been over one by Prep Genie but that one is a good one to ease yourself into the GAMSAT question style as it is a bit easier than the official ones.
If you are sitting the GAMSAT next year or even this September then go through as many past papers as you can!

New Book - SUPER YEY

So I went shopping with Mum the other day and I was meant to be looking for some winter shoes but instead I spotted this beauty of a book and MUM BOUGHT IT FOR ME.

ITS SUPER HUGE AND AMAZAING AND FULL OF EVERYTHING I COULD EVER NEED TO KNOW IN MY LIFE!!
Here is a photo of me and my fabulous new book haha! It weighs a freakin tonne and I'm never going to put it down.

The Countdown begins - 5 weeks til GAMSAT

AAAAAAAAAAAAAAHHHHHHHHHH 5 WEEKS UNTIL THE EXAM!!

I'm really focusing on my Chemistry revision in the next week or two as this is my weakest part of the exam.
I am actually going to see a private tutor next Wednesday to attempt to go over A-Level Chemistry in 3 sessions! (wish me luck!) I'm gunna take with me everything I have done so far and the mock exams to make sure I am answering them right and how to answer questions like them in the exam etc etc! Hopefully these sessions will give me a bit more confidence in the Chemistry department! :D super yey!

At one point I did want to be a vet! But animals are too cute and I'd want to take them all home with me and I'd cry.

 

 

 

 

 

Hospice Work Experience Write Up

Sozzles about the lack of posts over the past 3 days! I've been away working at a festival for the past 3 days and I've been camping, so no access to internet over there!
Anyways here is the write up of things I've been observing during my work experience time at the hospice.

• The hospice I went to observe only holds 8 people at a time, so it is a really intimate environment.
• I shadowed the Medical Director of the hospice, who went to visit each of the patients on Monday morning to find out how they did over the weekend. The relationship she had with the patients was obviously completely different to the GP - patient relationship. There was a lot of touch, and contact she had with the patients, holding hands, which obviously would have been a bit inappropriate for a GP to do on some occasions! The doctors at the hospice are almost like a friend that is there to look after you, which was lovely :)
• Patient care in the hospice in very intensive and so organisation in key in making sure everybody knows what is happening with each patient every day. The hospice had a huuuuuge board in the staff room with all sorts of codes and colours and keys which each member of staff updates every time something happens.
• It is patient directed, so whatever the patient feels like they want, the staff will try and do for them, such as pain management on a day to day basis. 

There were several patients that had a SUPRA PUBIC CATHETER inserted, as they sadly had a tumour present in the vaginal region that meant they were unable to have a normal catheter inserted.
This involves a tube being inserted into the bladder through the abdominal wall.






One patient also had an INTRATHECAL CATHETER, which is a fine plastic tube inserted under the skin and into the space surrounding the spinal cord (it's called the intrathecal space), pain medication is then given to the patient through this tube, kind of like an epidural! Pain medication is much more effective when taken this way than by mouth as it means pain killers can be given regularly to prevent the pain breaking through, rather than letting the pain get bad and having to rescue the patient from it.

I was also able to observe a PARACENTISIS, which is where a large needle is inserted into the peritoneal cavity to drain excess fluid from around the stomach. This excess fluid can cause discomfort for the patient, is can also press on the diaphragm, meaning the patient may find it hard to take a deep breath and so many be short of breath all the time. The procedure was done using local aesthetic, and this particular patient had 3 LITRES of fluid drained off her stomach! so hopefully she felt much more comfortable afterwards! To the right is a big swollen tum!

 

 

 

 

I asked the Dr how she managed to work around patients that were ultimately there to die :( , here are some of the things she said:

• She keeps her work and her home life in separate boxes, you can't take the problems home with you otherwise you will end up worrying and worrying about them.
• Yes the patients are sadly there to die at some point, but the satisfaction she gets is from making sure that the patients quality of life is as good as it can be in their last days.

More Summer Work Experience! - Hospice!

BOOM MORE WORK EXPERIENCE!
This time I have managed to get some work experience volunteering at a local hospice in Cornwall (there are only 2 adult hospices in the county!)
I am going in tomorrow morning to meet the staff and doctors that work there and to sort out a timetable of what I can expect to do over whatever time period I am there for.

Luckily one of the doctors that works there has a son, and my Dad actually coaches her son cricket so she has been super super kind in doing me a favour and allowing me to shadow her and the other doctors as they go and visit the patients in the hospice! :)

Of course volunteering in a hospice is going to be a massive change in environment to the GP's surgery. My dad said to me "are you sure you won't find it too upsetting going to see all the dying people" - no dad, hopefully not! Obviously I will find some of the patients upsetting, but hell that won't put me off medicine! It's all about seeing the "less glamorous" side of the career, you may see doctors that are saving adorable little babies everyday, but you also have doctors caring for the well being of people that are sadly dying! It will be interesting to see the difference in communication between doctor and patient in a different environment and situation.

I shall just be my usual cheery self and I will let you all know how my first day goes!

Peace out + science love

Written Communication Section Example Questions

(This is copied word for word from the GAMSAT paper I have, my camera is being a douche today)

Task A

Consider the following comments and develop a piece of writing in response to one or more of them.

Your writing will be judged on the quality of your response to the theme, how well you organise and present your point of view, and how effectively you express yourself.

Comment 1
Riches are not and end of life, but an instrument of life.
Henry Ward Beecher

Comment 2
That some should be rich, shows that others may become rich, and, hence, is just encouragement to industry and enterprise.
Abraham Lincoln 

Comment 3
Few rich men own their property. The property owns them
R.Ingersoll

Comment 4
He who knows how to be poor knows everything
Jules Michelet

Comment 5
Wealth is not of necessity a curse, nor poverty a blessing. Wholesome and easy abundance is better than either extreme; better for our manhood that we have enough for daily comfort, enough for culture, for hospitality, for charity.
R.D.Hitchcock. 

Struggling!

AAAAAHHHH

I have been really struggling with motivation for revision this week so sorry about the lack of posts, but I double promise to update them every day now!

Being a doctor is all I have every wanted to do, and I wont stop, EVER,  but after finishing exam period at uni, and coming home to stay with the family over the summer holidays, Im just finding it hard to get back into the hardcore revision mood again.

This week I have been focusing on the Written Communication section of the GAMSAT.
I did study English Literature at A-Level and that has given me a good grounding in how to structure and write essays; and my Dad would describe me as pretty opinionated, and I LOVE to have a good debate!

What Have I Been Doing? 

I have been going through some themes, and then coming up with points, evidence to back my points up, and learning some quotations about really broad themes that I could tweak a little and potentially use in most essays.
Just a little thing I learnt in school like years and years and years ago was to
PEE ALL OVER THE PAGE

Point - make your point
Evidence - provide an example and evidence to back up that point
Explanation - explain what the evidence proves

(Yeah I know it is super simple!)

I thought it might be helpful in structuring the paragraphs in the essays, incase you have a lot of ideas, this will force you to adapt a strict structure to follow in the exam, as you do not have a lot of time!

So far some of the issues I've been essay writing on are:

The inevitability of death - lovely I know, but it's  good topic to really let you get your deep thinking cap on.
Wealth and Riches - the whole, can money make you happy, obsession of wealth and riches etc.

GAMSAT Revision - Physics

I have just finished the Physics section of my revision for the GAMSAT!
Bearing in mind the last time I studied physics was at GCSE level, for those of you reading and not from the UK that is when I was 16! So a good 4 years ago and the level of Physics they say they expect is A-Level.

Here is an overview of the topics that I have covered for the GAMSAT, when I say covered I mean a basic understanding and being able to use the equations associated, as well as doing practice problems for each of them:

Motion - Including Newtion's Laws of Motion
Velocity, Distance, Speed equations
Change in velocity equations and problems
Distance time graphs and how to use them to solve problems

Centripetal acceleration - understanding what it is, what forces effect it, and equations
F=MA 
Tension
SOHCAHTOA - comes in handy for physics problems
Forces on an inclined plane - perpendicular and parallel forces

Work and Energy
Work, Force, Distance triangle
Momentum and its conservation
Gravitational Acceleration
Torque, Force, Distance Equation
Springs - Hookes Law and equations
Harmonic Motion

Fluids - volume of fluid displaced, column of water problems
Density of fluids
Static fluid pressure
Thermodynamics
Magnetism - Coulomb, forces between 2 charges
Electrostatics - Calculating the electric field at a certain point and equations

Circuits - and their components, Ohms Law
Voltage
Capacitance - Calculating the capacitance of a capacitor, charge density, strength of a field
Resistors - in parallel and in series
Joules Law

Waves - properties of different waves, velocity, frequency, wavelength equations
Different types of waves
Construct interference and Destructive interference
Relationships between frequency and wavelength
Diffraction
Dopler Effect and equations
Refraction and Reflection

Radioactive decay - different types and what happens in each of them
Half Life


Bit of a dry post there! :( But I just thought I would write an exhaustive list of what I had covered incase you had no idea where to begin! Oh and all this took me about 2 weeks, on and off revision, not consistent at all because I hate physics!

Now onto chemistry! HUZZAH

Last Day of Work Experience! :(

I've just had my day of work experience at the surgery today! :( Nooooo! :( The Dr I've been shadowing has written me a lovely reference letter for me to add to my work experience record that I will need for my interview for Nottingham med school.

I'll just give you an overview of some of the more interesting cases that I've seen in my last few days:

1- Patient came in with a BAKERS CYST, which is where the joint capsule of the knee joint can burst out into the space behind a knee, with the patient presenting with a large cyst behind the knee. It may be caused by an injury from playing sport or rheumatoid arthritis.
Treatment was undertaken at the local hospital where the cyst was drained using an ultrasounds guided needle as there are major arteries located behind the knee. A steroid was also injected into the knee to provide relief from swelling.






2- It may seem like a boring one but I have never ever actually seen GOUT in a patient before! This elderly came in with gout of the finger! It was looking very swollen and you were able to see yellow crystals underneath the skin. These were uric acid that had crystallized under the skin are are formed under certain conditions such as heat and dehydration which will effect the way the body metabolizes uric acid.




3- a 43 year old overweight  male came into the surgery because he wanted to get checked over after an incidence he had on Tuesday afternoon. He said he had been walking his dog and he suddenly got really severe heart burn that radiated down his arm and shoulder and into the back of his throat. When the Dr asked him to described the pain he described it as "dull and heavy" and that was was "sweating buckets", the patient also had to take the following day off work because he was exhausted. The episode lasted for 10 minutes and the patient was convinced it was just bad heartburn.
BUT, from the patients history, smoker, obese and with a family history of heart attacks, and the description of the pain, dull, heavy on the chest radiating down his arm chest and shoulder, I thought the patient had suffered a heart attack and not realized.
The patient was sent for an urgent ECG in the next room and his ECG showed an ST ELEVATION, which is where the ST segment of the heart activity is abnormally high and is a sign of a heart attack, the T wave was also inverted, which is a sign that the Bundle of Hiss down the center of the heart has been damaged.
We had to straight away send the patient in an ambulance to hospital for an urgent angiogram to locate and treat the blockage in the heart!
IT WAS SUPER COOL

Image 2 shows a ST elevation
Image 5 shows a T wave depression 

An Afternoon in Minor Ops

Now I wouldn't consider myself squeamish at all, I love a bit of blood, guts and pussy wounds, but when it comes to skin things, and skin tags and peeling skin, I feeling like vomiting. So it was my lucky day when I got to observe Minor Ops and all the delights of removing bits of skin haha!

Even though I wanted to vom, it was actually really interesting to watch, and I guess I got used to little bits of skin towards the end!

The majority of the cases in minor ops were the removal of a SEBORRHEIC KERATOSES, which is basically a non cancerous growth of the skin, the skin may have suffered a trauma or infection, causing the body to heal itself, and in the process the body may have produced a little bit too much skin, and so causing this little crusty lump on the surface of the skin. They tend to be removed when they irritate the patient, so if they catch on their clothes, and more commonly in women underneath the bra strap.

Here is a step by step of how the little lump was removed:

1- Inject the site with local anesthetic. The local anesthetic may sometimes be mixed with adrenaline, to prevent excessive bleeding from that area. You can clearly see the effect of the adrenaline on the skin because it blanches the skin (leaves a little white patch).

2- The lump of skin is scraped off using a curette, which is a surgical instrument used for scraping biological tissue. It is a little hand tool with a circular blade.

3- The wound is then cauterized using a hot needle to prevent the skin from re-growing and to stop the bleeding. The smell of burning flesh is horrid by the way! It stinks!

4- Vaseline and a dressing are applied to the wound - all sorted! Above is an example of one! (yums)


The second most common thing that came into minor ops were little round scars that needed to be removed because they bleed when they are caught and itch. This patient had a nice little round scar on her leg, that kind of looked like a little wart, but wasn't.
The process was different to the removal of the keratoses, and involved stitches!

1-The site was injected with local anesthetic.

2- The scar was then removed using a scalpel, ensuring to cut along the skin creases. If you were to cut against the skin crease the skin might not heal as well. 2 incisions were made on either side of the scar and the scar was then lifted up off the skin and cut away!

3- The wound was then stitched up using 6 stitches. It may seem unsual to have so many stitches for such a little wound, but due to the pressure in the legs from constantly standing etc, the skin as to be pulled as tight and as close together as possible or the wound may leak!

4- The patient was advised to rest the leg for a good 48 hours to ensure it healed properly.



So all in all a really interesting day, which as helped me to slightly get over my fear of pulling bits of skin off! Although I think I might feel different when I'm doing it myself, just watching other people do it makes me feel funny!

More Summer Work Experience

Just a quick post about getting summer work experience.
I've literally just got an e-mail saying my interview for volunteering at a hospice went well and I can start in 2 weeks time! :) One of the resident Dr's that works there actually offered to have me shadow her and the rest of the doctors because I'm nearly a graduate and a bit older than a lot of the students that apply for work experience (the students that have just finished A-Levels).
So it is definitely worth send an e-mail to any local hospices in your area to see if they take on students for work experience! I'm sure volunteering in a hospice will be challenging and upsetting at times but I will let you know how it goes! :)

Remember, don't give up on getting work experience! Even if you are unable to get work experience shadowing a GP etc, it's not the end of the world, try your hand at befriending the elderly or young adults with learning difficulties, this will show the medical schools you can communicate effectively even in challenging circumstances. Look for any dementia day care centres that run arts and crafts sessions, or memory cafe's that need helpers.
The medical school want to see you have some kind of understanding  how challenging a medical career can be, and that you have tried a wide range of volunteering roles, not that you have just observed a GP.

Chronic Pain - How Do You Treat It?

There have been a few patients over the past few weeks come in with a complaint of chronic pain, wether it be all over the body, chronic neck pain or chronic headaches. The problem is how do you treat a pain that has no real cause?! (or one that we cant observe).

Patient A
Has had chronic headaches that last from 30seconds to 5 minutes that are felt around the temple region. A common cause of headaches is neck pain, however it's not the case here.
 It could be Temporal Arthritis, which is an inflammatory disease of the blood vessels involving the large arteries of the head, but the patient did not have prominent temporal arteries on palpation of them.
So it was decided to prescribe the patient a drug to help with her chronic pain:

AMITRIPTYLINE - A drug that can be used for tension headaches, migraines and depression. Side effects include drowsiness and a dry mouth. But you would only take the drug at night due to it's sedating effects.

An interesting fact from the Dr - 99% of all headaches aren't brain tumours, and 90% of brain tumours don't present with headaches!


Patient B
Has suffered from chronic head, neck and shoulder pain for 15 years. She is currently taking

PREGABALIN - is an anticonvulsant drug as well as being used for neuropathic pain, and has been shown to be effective in treating chronic pain such as fibromyalgia. Side effects may include dizziness and drowsiness in some patients.
 The patient has found that it hasn't cured her pain, just taken the edge off it.
So it was decided to change her treatment and try a different drug, this time it was DUALOXETINE, the patient will be slowly weened off Pregabalin over a week and then start taking the new drug to see if it helps! :)

Cutting Down On Unnecessary GP Appointments

From what I have seen during my work experience, GP's are under a lot of pressure a lot of time time, from consultants, to nurses and patients wanting time to speak to their GP. Many of the patients that have booked an appointment to see the GP have sometimes, not reeeally needed one. They just wanted to talk to the GP for reassurance, which is where the social and communication side of being a GP.
But in order to cut down on certain appointments, such as just coming in to have you BP taken, the surgery have bought out a new self check BP machine, where you pop in whenever you want, take 3 readings 2 minutes apart and hand your readings into reception, which will then go onto your record. If your BP needs attention (too high or low) then you will then be booked in to see the GP to discuss further options!






















So I thought I would try it out on my break, the staff call it the cows backside, because it looks like your helping a cow give birth :)

There's the machine on the left and my 3 readings on the right which aren't to shabby!

Two Days with the Phlebotomist

I spent Thursday and Friday of this week doing something a bit different form observing Dr B and spent 2 days with with phlebotomist (she was so lovely!).
Basically she runs the clinic and people just come in for bloods all day long! Before I started I had the opinion, "oh I can only watch blood being taken so many times!", I was wroong and I learnt some handy tips about taking blood!

A phlebotomist is a support worker or healthcare assistant (HCA) who collect blood from patients for examination in the lab. 

Things and Tips

• It is surprising how many patients come in with a huge phobia of needles and having blood taken. The blood taking process lasts no longer than 30-60 seconds, depending on how much you need to collect. Patients always say they have had a bad previous experience with having blood taken, and have had nurses that have been rough, left bruises and left them with a really negative experience. A lot of patients also don't like the "idea" of a piece of metal being inserted into their body. But Hannah (the nurse) pointed out that you need to focus the patient on the positives of the blood taking process, such as after it's finished and your chatting away and it wasn't really that bad etc. Otherwise they will just carry on being petrified of needles!
• As a doctor you don't receive a great deal of training in terms of taking blood, so be proactive and take some time to shadow a phlebotomist for the day and improve your blood taking skills.
• Feel for the veins, don't just go for the ones that you can see. Hannah said practice feeling and bouncing and rocking the veins for some fat juicy ones. 
• Problems you face taking blood: the elderly, who's veins have lost their elasticity, they have fragile, weak veins, arthritis may mean they cannot fully extend their arm for locating available veins. 
• Practice makes perfect! 

Now I'm at home practicing feeling my mums veins! 

GAMSAT Example Questions

Sorry about the lack of posts over the past few days, I've been a busy bee! Anyways, I managed to get my hands on some sneaky GAMSAT mock papers and I thought I'd show you what kind of questions you will encounter in the exam. 

 In case you cant read the text:
Newspaper reads: Labour to end something for nothing culture
Caption reads: Don't panic man, they're talking about the unemployed.

Q- The illustration above suggests which of the following?
A-In the midst of movement and chaos, keep the stillness within you.
B- Workers are often paid peanuts.
C- There are people who get paid for doing almost nothing
D- Unemployment gives rise to labour movements.

The speech in the picture reads: " Screaming Eyeball was a good movie but Bludgeon of Death was a great movie".

Q- The joke in this cartoon arises from the speaker
A- comparing good and great films
B- attempting to compare such different films
C- not seeing a greater difference between the films
D- expressing admiration for such bloodthirsty films

I'll post the answers if you somebody leaves a comment asking for them! :) 

Question to My GP - Why Did You Want To Be a Doctor?

It's a biggun - this question will be in your medical school interview, and people will ask you all the time!

WHY DO/DID YOU WANT TO BECOME A DOCTOR? WHY NOT ANY OTHER HEALTHCARE PROFESSION? 

Everyone will have their own reasons of course but I asked this question to the GP I am shadowing and these are the points he came up with:

• He wanted the responsibility for the patients health and the long term relationships that you can build with patients. 
• He was more interested in the diagnostic side of medicine, using your brain to solve a case, rather than doing something like radiography where you are performing a task. He didn't want a task based job, he wanted one where he could use his brain more.  
• Medicine is a constant learning curve, you never ever stop learning new things.
• Not that being a doctor is a superior job compared to roles like a health care assistant, but things like taking bloods, etc just wasn't for him, he wanted a big more.
• As a doctor you receive the clinical training that nurses and other roles don't. 
• He also wanted to get involved in the teaching side of medicine

Another question you might be asked in your interview is "Why not being a nurse?"

DO NOT SAY NEGATIVE THINGS ABOUT NURSES

It takes people with different levels of responsibility to work together to create effective teamwork in order to treat a patient. Also success and ambition mean different things to different people. Somebody might be more than happy taking bloods all day, or undertaking x-rays all day and thats fine! But you might want more, and thats fine as well, you should respect that fact everyones idea of success, job satisfaction etc are different. 

Some Interesting Cases in the Surgery!

Another day of GP shadowing today and I saw some pretty interesting things!


1- Potential Bladder Cancer Case  80 year old male presented with blood in urine, although there was no more visible blood in the urine today, a dip stick test showed that the urine sample was full of microscopic blood drops.
Diagnosis depends on the patients age sometimes:
Somebody of my age (20's) = they would want to exclude infection first
Somebody 50-60+ = You would want to rule out any chance of bladder cancer as it is easily treatable when caught early. The patient presented with 2 kidney stones but they were non obstructive, so the patient was referred for a cystoscopy, which involves passing a flexible camera down the end of the penis to view the bladder and see if there are any polyps on the bladder wall (done using local anaesthetic of course)
If anybody presented with blood in the urine, the first steps are to perform a blood test and an ultrasound of the bladder.

2-Lady With CRAZY High Blood Pressure  47 year old female had been taking blood pressure readings at home for years and failed to bring to the attention of her GP that her blood pressure was dangerously high.
We're talking 200/122! 
She is being seen weekly until her BP in under control.

3-Super Cool Fracture  Male patient came in today about his problems with fully emptying his bladder and problems with the flow of his urine, BUT the interesting things about this patient was that he has a permanently fractured odontoid peg that doctors discovered after he electrocuted himself on his boat a few years ago, and have said it is too risky to operate on.
You can see in the photo an x-ray of a patient with their mouth open and you can see the odontoid process quite clearly. The process is a projection of the axis and allows us to rotate our head.

4-Necrotic Toes 
80 year old female came in a few weeks ago after stubbing her toe, and the nurses thought it was a haematoma, so dressed her and sent her on her way. 2 weeks later the patient was back complaining that her toe wasn't healing, and on removal of the bandages it was very clear that the injured toe as well as the adjacent toe was necrotic. 
The nurses took her blood glucose just as an off chance and it came back as 22.4!! The lady confessed she hadn't been to the doctors in 13 years and that she had a terrible diet of chocolate and sweets, obviously she has developed type 2 diabetes but not presented with any usual symptoms and so went however many years with uncontrolled diabetes! The wound she sustained from stubbing her toe then obviously did not heal properly due to the decreased blood flow to the feet from the diabetes. The lady had both the toes amputated at the local hospital later that day. One of the major complications of diabetes is the development of PAD - peripheral artery disease, which is the blockage or narrowing of arteries, in particular the ones in the legs.
I wont upload a photo of necrosis, it aint pleasant!

Got Me Some Books!

While I was on Amazon ordering my UKCAT books I decided to order a few more books to help with med school bits and bobs:



Medical School Interviews - http://www.amazon.co.uk/Interviews-Questions-Analysed-Includes-Multiple-Mini-Interviews/dp/1905812051/ref=sr_1_2?ie=UTF8&qid=1372946398&sr=8-2&keywords=medical+school






Get Into Med School, Write the Perfect Personal Statement - http://www.amazon.co.uk/Get-into-Medical-School-statement/dp/1905812108/ref=sr_1_2?s=books&ie=UTF8&qid=1372946468&sr=1-2&keywords=get+into+medical+school




I shall you know if they are any good after I've had a read!

Work Experience Day 5 - Whats It Like Being a GP?

GP shadowing is going really well, with a huge variety of patients coming in everyday, but I'm just struggling with the 6am wake ups! I've been going to bed at 10pm (which is super early for me), and then when I get home at the end of the day I need an hour nap!

I also had a good chat with Dr B (Dr I'm shadowing), about the hardest parts about being a GP.

1-Patients expect you to know a lot about everything, compared to a specialist who only has to know a lot about their area.

2-The volume of work to do everyday, the lack of time, and the demands on you from nurses,social services and the hospital, if a patient is discharged from hospital because staff don't know whats wrong with them, they will go straight back to the GP, and a good proportion of people who come in with an appointment don't necessarily need one for medical reasons, they just want reassurance. Which is where the "social worker side of the job" comes in. 

3- The stresses on the GP's to take back working 24 hour shifts. Working 24 hour shifts were originally taken away from GP's, and in the Cornwall area given to a private group named SERCO, and now it turns out they are pretty poor and and government want to give the 24 hour shift back to GP's. Dr B said working from the early morning doing appointments, then doing visits and the huge amount of paperwork, then to go onto working nights you become exhausted and its not possible to work both days and nights. 

4-The demands from patients wanting resources. As a GP you cannot investigate everything because you cant afford to do so. You can't go ordering head scans and every test under the sun willy nilly, and GP's are also under pressure to save money (the NHS has to save £20billion this year).

 For example a 80 year old woman had been on long term drugs as a preventative measure against osteoporosis. The recommended duration of treatment is 5 years, but she has been on these drugs for 10 years and was wondering why she had suddenly been taken off them. Dr B explained the recommended duration but she wanted to go back on them, but she cant, not without good reason. She had already been on them for double the recommended duration, but we simply couldnt given them to her without good reason, and outside of the guidelines,  because it is expensive! Imagine if we put every post menopausal woman on preventative treatment for osteoporosis and to prevent fractures, that would cost thousands of pounds for every fracture you would save. 

Home Visits

Today was quite a sad day for home visits. We went to visit and elderly lady with schitzophrenia and end stage cancer of the gullet, she was not aware of her cancer diagnosis. Upon arrival she was all alone in the house, bed bound and extremely weak and pale. She said she has nurses come in 4 times a day to get her up and feed her, but apart from that she is basically laying bed bound in a dark room waiting to die. The reason for the visit was because her carer said she had fallen and hurt herself. But the patient had no recollection of the fall and was adamant that she didnt need anything else and was fine. (apart from being so weak she was able to move). And so myself and Dr B (after checking her over) had to leave because there was literally nothing we could do. There seemed to be no plan for her care, having her go into a nursing home would be so much better for her because at least she would get the company and the interaction with staff etc. But she literally spends all day laying in a dark room! :( Very upsetting today! 

GP Surgery Day 2 - An Elderly Population

Today I traveled down to one of the surgery's partner clinics in a tiny little village about 10 miles toward to coast in a very wealthy but to a part of Cornwall with a HUGE elderly population.
I sat in on consultations for most of the day as well as doing home visits to patients who were not able to make it to the surgery.

The surgery was tiiiiiny! It consisted of one consultation room, a tiny waiting room and a little dispensary as the town did not have one! (cute)

Few facts about today:

Average age = 72
Most Common Reason for Appointment = Arthritis, chest infection, heart issues and sore knees!
Procedure I Saw Most of Today = Cortisone steroid injections in the knee.
Most Prescribed Drug Today = Amoxicillin + Flucloxacillin
Youngest Patient = 62 female with sore knees after having both half knees replaced.
Oldest Patient = 98 year old man with a chest infection
Most Interesting Case = 77 year old male with an atrial flutter, which can been identified by a "saw tooth" looking pattern in an ECG trace

Example of a "saw tooth" pattern in ECG

The doctor supervising me mentioned that he hardly "cures" anything anymore, it is more managing the wear and tear seen in the elderly that come into the surgery, trying to manage their symptoms and pain.

Aaaaaannd on a negative note, I've managed NO revision today, been busy napping this evening.