my week #198

What a difference nine months can make! Nine months ago and on my first surgical placement as a medical student, I really didn't enjoy it. Fast forward to now and having done a week on plastic surgery (ironically the same one from last year), I'm seriously considering a career in the surgical field. The surgeons have really got me involved in theatre and the fact that surgical ward rounds are super brief and short are another positive.

Funny how things change! I mean, I'm still not loving the 7:30am starts and late finishes but compromises!

How has your week been?

my study week #8 : usmle step 2 notes

Now, I'm not thinking of taking the USMLE anytime soon - just want to set that straight - but I find their various revision books really useful. They condense everything and though it may not all be applicable to medical practice in the UK, I have used them as a springboard for this academic year. Therefore, these notes were all taken in April - June of 2015. Having already come across the majority of topics within the book I used (Master the Boards Step 2 by Kaplan), it felt much more like light revision than a heavy study session. And this was what I was aiming for.

These notes will ultimately be re-written and edited according to UK guidelines so they are just rough notes! And just to warn you, it's mainly all pictures from now! I may do an updated post of how these were re-written if I have time :)

the secret garden by frances hodgson burnett, illustrated by lauren child

Looking around, it seems that everything is now digital. Back in 2012 when I first acquired a Kindle, I was guilty of only having electronic books. However, fast forward to about six months ago, I realised that I missed holding a book in my hands. However, with space limited on my bookshelves and with space likely to be limited when I move out (possibly in eighteen months' time, exams permitting, eek!), I need to carefully choose which books I want physical copies of.

In essence, this meant I ended up choosing books that had cute covers and spines that I would be happy to read time and time again and would also look pretty on my bookshelf. Therefore, it's a good job that a lot of classic books have been re-fashioned into beautiful hardback editions!

A few weeks' ago, I talked about these adorable Rifle Paper versions of four literary classics and today, I want to introduce this edition of The Secret Garden by Frances Hodgson Burnett. It is illustrated beautifully by Lauren Child - a name you might associate with Lola and Charlie.

Now, I'm ashamed to admit that I never read this book when I was a child. I read Heidi, Little Women and Alice in Wonderland but I never picked this book up. We definitely had a copy but for some reason, it never appealed to me and that may be, due in part, to the cover design which was just of some greenery with a brown wooden door visible through all of the leaves. However, this copy has no problems in the aesthetic department whatsoever and I was eager to see what The Secret Garden was all about.

This copy boasts beautiful illustrations dotted about at regular-ish intervals and I can definitely see it appealing to children of all ages. It is a copy that a parent could read to a child without the child getting bored due to the illustrations that help break up the text.

The Secret Garden is a long book for a child to read but I guess when you compare it to the latter books in the Harry Potter series, it's not so bad! Having now finished the book, I can see why I may have struggled to get past the first chapter. It's a bit of a slow starter if you're a kid but I found the pace fine as an adult. The plot is definitely aimed at a younger reader but even so, it didn't feel too juvenile and it had me wanting to know more at each stage.

I would say the main characters are Mary, Dickon and Colin and I loved the dynamic between them. Dickon is a good egg and then we have a complete contrast in both Mary and Colin - both of whom are kids who have been a little too pampered in their lives up until the point where they meet each other. Dickon instills a bit of humbleness into both of them without getting much in return whilst Colin and Mary both mellow significantly!

Overall, I'm glad I read this as an adult as I know for sure that I wouldn't have finished it when I was younger. It was more of a slog than I remember Little Women to be but it wasn't as tedious as some other books I've read, both as a child and an adult.

And one last thing... Isn't this spine just beautiful?

my week #197

This week was a week full of lectures in preparation for ten weeks of surgery placement. Through these ten weeks, I'll have nine weeks where I experience nine different surgical fields and then one week of palliative care. I'm quite excited for it, not least because some of the specialties now use robots but also because I'm now considering a surgical career. It's funny how a week sat in lectures actually feels a lot more tiring than a week on placement.

How has your week been?

antibiotics: the bane of my pharm life

There's always that one topic that no matter how many times you make an effort with it, it'll still evade becoming a permanent fixture in your brain. Pharmacology is a topic that I'm usually okay with but for some reason, antibiotics are my Achilles heel. As a result, I've used a variety of methods to try and tackle this mammoth class of drugs.

Firstly, I broke each class down and then limited them to two post-it sized notes. I also colour-coded each one. On each post-it (or two for the beta-lactams and cephalosporins), I would have examples of them, a brief bit on mode of action, major side effects and common uses of them.

I then made an A4 image of how each class of antibiotics attacks the different elements of a bacteria cell. This helps a bit as I do learn quite well from images! And to go even more overboard, I also made a mind map (but this didn't help me so much if I'm honest). 

Finally, I have an A5 sketchbook which I've used to make longer notes on different medications used. I'm not sure the below layout is the best one for me so I'm still experimenting to see how I can best learn and retain all this information! Being on the wards definitely helps though as seeing it in practice means that it goes into my brain that bit easier and quicker.

I genuinely think there's only so much I can learn from the books when it comes to pharmacology. A lot of my existing knowledge came from being on ward round during placement and also looking at drug charts and testing myself. It's also good to have a junior doctor who questions you about the drugs on the chart too (I had one last year who did this on ward round and it helped immensely). 

Antibiotics are still a little bit hazy in my mind but they aren't so scary when you break them down and actually sit down and spend some time with them. Try and relate them to a patient who you've seen on the wards as that seems to have worked for me. I guess that's why they say experience is invaluable! 

Any tips for learning about antibiotics and all their different modes of action, indications and cover?!

in search of the perfect blue-black ink #1: platinum blue-black cartridges

Early last year, my fountain pen obsession really kicked off and by August, I was trying to find the perfect blue-black ink. Cue a mad amount of research about the current options out there! I originally decided to try out cartridges and one of the first ones I decided to give a go were the Platinum ones.

And this is how they look in my notes:

Overall, I do like this shade but the price is a bit off putting. Bizarrely, it also looks completely different depending on what paper I use. As mentioned in the scanned image above, I do like the convenience of cartridges and this is a pretty decent shade of blue-black so I think there will be a repurchase of these when my current stock is depleted. 

my week #196 (plus a little about the junior doctor contracts)

Last week of paediatrics placement done... I'm now officially halfway through my penultimate year! This is super scary. I'm already getting a slight feeling of fear about being a foundation doctor next August (eek!) and this sort of thinking isn't helping. Deep breaths!

Although I originally said I wasn't overly excited by it all back in December but actually, paediatrics was really good! It's so diverse and it's almost like general practice but much more fun and with the same, if not wider, variety of conditions seen. However, there were a few safeguarding issues that came up during the placement and I still can't comprehend how anyone could abuse a child (or anyone for that matter). For that reason, paediatrics probably isn't for me but never say never!

Junior Doctor Contracts

One thing I want to talk about this week are the junior doctor strikes here in the UK. Essentially, the media have portrayed doctors as 'greedy' people and as a medical student who will be a junior doctor in 2017, I want to just say this. Doctors aren't in it for the money - my starting base salary will be in the region of £23,000 (however, it'll be 'topped up' if I work unsocial hours). Let me put this into perspective for you: I'll be graduating with about £70,000 of student debt and upon graduation from medical school, I'll have to pay GMC fees, for my own insurance, for BMA registration, etc and that's even before we talk about rent, food, bills, petrol and the like. If the social hours are moved, I'll be paid even less and am not even sure I'll be able to afford to be a doctor in this country.

If we were in it for the money, trust me, we'd all be doing something else. Not to blow our own trumpets but we are all intelligent people (more so at times, less so at others!) and there are probably many other better paying industries we could all be working in. As a graduate entry student, I've seen people in their 30s and 40s who have given up extremely well-paying jobs to come to medical school. Let me say this again, we are not in it for the money. However, that's not to say we don't want to be paid fairly. Re-classifying social hours is not only unfair, it is unrealistic. Anyone who tells you 9pm at night is the same as working at 9am in the morning is just ridiculous.

With regards to a 24-hour NHS, it already is operating 24 hours a day, 7 days a week, 52 weeks a year. My best personal example of this is an emergency caesarean section I saw at 4am in the morning during a night shift. The consultant was present, the senior registrar was present and the senior house officer were all present, as was the anaesthetist, the midwives and the scrub nurse! Even the cleaner was in the corridor mopping the floor!

What we are fighting for is the future of the NHS. If these changes go ahead, there will be a mass exodus of healthcare personnel because not only will junior doctor's pay be cut, nurses, midwives, consultants, etc will be next on the agenda. Our skills are transferable - we can move abroad (healthcare personnel will always be needed around the world!).

Furthermore, reclassifying social hours to 7am to 10pm will result in overworked and tired doctors making increasingly poor decisions. This is a compromise to their own safety when commuting but even more so to the patients they will be treating. Would you like a doctor treating you when they are in their 13th hour of their shift? The current government also want to remove any financial penalties local trusts would have to pay if they overwork their doctors and this will further compromise on patient safety and allow them to overwork already exhausted doctors.

You might argue that there is a European Working Time Directive at play which caps our work at 48 hours per week but I can tell you this: I've rarely seen a doctor leave work early when I've been on the wards and this is especially true in some of the surgical specialties. And to add to this, my mum is a midwife and the number of times she has finished work on time in the last ten years can be counted on one hand. Healthcare workers cannot guarantee the finish time of their shift - how many jobs do you know of that can also say this aside from those in the public sector?

To finish, I want to say this. I want to work for the NHS. I went into medicine because my goal in life is to have as many days as possible where I've made a difference for someone else other than myself. I want to be paid fairly for what I'll be doing (factoring in the level of responsibility I'll have) and that's essentially why I chose medicine. I know I'll never earn megabucks as a doctor but that's ok as long as I am paid fairly. Essentially, the new contracts are not fair and more importantly, they are not safe.

How has your week been?

different handwriting styles

I feel that on this blog, you get a false representation of my handwriting style because I only ever show the best examples of it (which I guess is a natural human trait - to only show the best and hide the worst) but today I thought I'd let you all see what it can look like in other situations. I'll start from my neatest to my messiest.

1. Quite Neat - this example definitely isn't my neatest but it's up there. My revision notebook is filled with this type of handwriting because I can't learn from joined up handwriting or notes typed up on a computer.

2. Still Fairly Neat - revision time is one where I need to write quicker than usual but also keep things neat. This is a good example from when I wrote notes from model answers for some practice questions I did and were written with my Pilot Coleto.

3. Messy - Again, revision time. This time, I wrote this during a break when I watched a bit of Grey's Anatomy. Grey's always has the best music (though The Vampire Diaries is pretty much up there too) and I didn't want to forget a song I heard during one of the latter episodes of season 11. This was written with my Kaweco Skyline Sport - isn't it weird how different pens can result in different handwriting styles?

4. Messier - Again during revision time - this is messier than the previous sample and was again, written with my Kaweco Skyline Sport. My writing goes all loopy and joined up when in a hurry and this is the proof.

5. Messiest - Finally, the messiest my handwriting can be. These notes were taken during an multidisciplinary team meeting I attended whilst on placement. I write things down about a patient that is interesting, explains something on the handout or something I need to look up in the future.

Again, my handwriting goes all loopy and joined up and it is messier than the previous example. Biros bring out the worst in my handwriting!

Hope you've enjoyed this post on what my handwriting looks like in different situations and even with different pens. Does yours change and if so when?

book review: the book of tomorrow by cecelia ahern

At the tail-end of 2015, my book reading rate slowed down dramatically but I'm okay with that. I'm still reading on a daily basis though and I had the pleasure of reading The Book of Tomorrow by Cecelia Ahern in November. Having read most of Cecelia Ahern's books before, I know her books are right up my street so I had high hopes for this one. Although it's been out for a few years' now, my to be read (TBR) list is so long, this one was pushed quite far down!

The Book of Tomorrow is about Tamara Goodwin, a girl who was born into a life of luxury and has been spoilt beyond belief by her parents. However, when something unexpected happens, everything in her world changes and this in turn causes her to also change as a person. As a result of these changes, she comes across a travelling library where she finds a mysterious book which appears to be completely empty. Secrets start to slowly unravel and everything turns a bit sinister towards the latter half of the novel.

In terms of plot, I thought it was pretty good. The pacing was good and there was enough mystery throughout for me to want to find out what happens next. Tamara isn't very likeable at the beginning but as more and more of her character is revealed, you begin to see the real version of her and she's actually not that bad a person. For me, it was quite obvious from the beginning who was good and who was bad and my thoughts were confirmed at the end.

 As with most Cecelia Ahern books and stories, there is a moral and for me, the one here is that we can change the future even if it is mapped out for us. And that's not a bad thing at all. There are other bits too but for me, they are a bit too personal to share but that's what I think is so great about Cecelia Ahern as a writer. You can always relate to her books on a personal level.

Overall, 7.5/10. 

my week #195

The holiday period went by so quickly, it was a bit of a shock to be back at university already. Even the consultants were surprised we were back so soon! This week, I was placed in the Paediatric Intensive Care Unit and it was pretty interesting. Having been in most days at 8am, it was a shock to have to get up early again after lying in until 9-10am on some occasions during the holidays (no judging - I'm usually up at 6am for uni during term-time!).

In other news, I'm putting myself on a spending ban until the 1st of April but I have written a list of three items that are excused from this ban. This way, I can hold myself accountable if I don't stick to this list. (Is that cheating?!)

How has your week been?

a new year, a new journal: courtesy of my sister and christmas!

I'm nearing the end of my current journal now and it was almost like my sister knew this. For Christmas, she got me the cutest journal ever and if you want the pictorial proof, here it is:

The journal is adorable: it has a clothbound mint fabric cover and at the front is a beautiful illustration of two foxes surrounding the letter 'A'. Foxes are a big thing in my family so that makes the gift extra special. At the spine, there is a gold-embossed 'A'. 

The page edges are a lovely coral pink colour which completely clashes and compliments the mint-green cover at the same time. The ribbon is a lovely cream colour too.

This is an absolutely beautiful journal and I can't wait to get stuck into it. She bought it from Anthropologie and I haven't linked to it because it's a little bit cringeworthy to look up how much someone spent on a gift. If you're struggling to find a present for someone who loves stationery, does a fair bit of journaling and also loves pretty things, a journal like this may well be the thing you're looking for! And if you're not looking for a present for someone else, there's no shame in buying something as pretty as this for yourself too :)

handwritten: 2016 resolutions and goals

Last year, my resolutions were quite broad and not really measurable quantitatively. However, I think I managed to achieve them - I've definitely met more people this year and with it not being as heavy a year as my first, there was more time to spend with friends. It did make me realise one thing though - even though I love spending time with friends and other people, there are times where I just want to be in my own company with some music in the background, curled up in bed in my pyjamas with a good book. This year, one of my aims is to find this balance between the two.

Other aims of mine include:

- to read at least thirty books this year (I was tempted to try for forty but I think that's too ambitious in hindsight).
- pass all exams (and pass them well!).
- keep blogging! Sharing is caring :)


What are your aims and goals for 2016?

my week #194

This week has been such a boring week, I debated about whether or not to even post this picture! Anyway, as you can see, I had virtually no plans all week and with my mum working New Year's Day, we pretty much spent this week like any other holiday week. This week also marks the beginning of another three month shopping ban (there are only three items that are exempt and I've written them down in my journal so that I'm held accountable if I buy anything other than these items!).

I hope you've all had a lovely holiday season and I wish you all the best year yet, full of laughter, joy and happiness.

How has your week been?