15 Sep 2016

year three's medicine placement reviews all in one place

Now that final year is underway, I thought it would be a good time to do a Medicine-related post with a brief review of each placement I had in the last two years. Please bear in mind that I'm the sort of person who gives 110% in each placement, regardless of whether or not I'm interested in that specialty. If you're about to embark on clinical placements, I would recommend doing the same - it can be tiring but you get so much more out of things this way :) Plus, when you're actually working as a doctor, you may never get the chance to see some or do some of these things ever again.


Respiratory Medicine
This placement was in my second year and it was my first ever clinical placement. I felt like a deer in the headlights for the most part but the steep learning curve was great. The whole clinical team were absolutely lovely and I got a lot out of this placement. Whenever there was nothing to do, I'd go and clerk a patient and then compare my clerking to the patient's notes to see if I had missed anything. This medical firm was great for learning about a wide range of conditions because the patients tended to be on the older side and had many co-morbidities.

General Practice
General practice was not a career I'd ever considered and this still rings true now. However, I still had a good time on this five week placement. During this time, I was placed at a medical practice that had a great set-up. It was a large practice and with appointments only scheduled for ten minutes each, there was a high patient turnover and I saw a lot of different things.

Neurology
This was one of the placements I was dreading the most (as I have zero interest in neurology!) but I still got a lot out of it. The best thing was doing on-calls with the registrar in Accident & Emergency. During one of these shifts, I even offered up an important differential diagnosis the registrar hadn't thought of himself :) Being able to see brain surgery was amazing too.

Psychiatry
Again, another placement I wasn't exactly looking forward to but still got a lot out of! Psychiatry is super interesting and I met a lot of fascinating people on this five-week block. The work-life balance is definitely appealing and wearing an alarm on ward round was exciting (at least for me) but I don't think I can deal with the emotional ups and downs of this specialty. Plus, those ninety-minute clinic appointments would really test my attention span (which currently stands at an estimated ten minutes).

Obstetrics and Gynaecology
Even before medical school, I had a huge interest in O&G and this placement did not disappoint. It helped that I was given two consultants who were absolutely lovely and did a lot of teaching. I loved that there is a decent amount of medicine but also a lot of surgery in this field. The best part was being present for a number of births and I'm not going to lie, it was a totally emotional experience. This placement was full of long twelve hour day shifts, night shifts and often involved a lot of running around in order to clerk a patient straight after clinic, grab a snatch lunch and then go to theatre but it was totally worth it.

Paediatrics
Another amazing placement :) The best learning opportunities for me were in Paediatric A&E where I was allowed to clerk in new patients and then present to the registrar. Because no one had seen the patient previously, it meant that I was going in completely blind which helped build my confidence when I'd get the likely diagnosis and management plan right. I also learnt that I'm not actually that bad with children and parents and though it is highly unlikely I'll go into paediatrics, I got great feedback from the doctors on the team. One even suggested I'd make a great paediatric doctor...?!

Surgical Specialties
Plastics - Amazing week. Great opportunities to see some cool surgeries and I scrubbed in loads this week. I spent a morning in trauma triage where I saw patients first and then presented to a doctor. I also helped with admin tasks such as booking patients in for theatre - something I may be doing as a foundation doctor in a year's time anyway so a great learning experience. Full of hand surgeries and skin grafts and not so much of the tummy tuck or face lift surgeries ;)

Ear, Nose and Throat (ENT) - Unfortunately, I didn't get to see any cool head and neck surgeries during this week. ENT is quite paeds heavy so I drew on my experience from my paediatrics block. Not the best surgical week I had but still very interesting.

Ophthalmology - This was a really light week where we only got to see cataract surgeries (which you can do on Youtube and is super quick and quite dull). Not my cup of tea but the clinic experience was great.

Trauma - A fairly good week but didn't live up to expectations. It was mainly orthopaedics and no interesting traumas came in when I was scheduled to be in theatre. That's definitely a good thing (as I don't want anyone to be hurt in any way, shape or form!) but not so good for my learning! The team were also very friendly and I could potentially see myself being seduced by the adrenaline of a fast-paced specialty such as this one.

Urology - This week was so good, it's rocketed to the top of my 'want to do' list. Urology is super interesting and with so many organs included in this specialty, I'll never be bored. It didn't hurt that urology is one where the work-life balance is pretty decent! During this week, I was scrubbed into nephrectomies (kidney removals) and if you get me scrubbed into surgeries, I'm pretty much going to automatically love your specialty... I also had a consultant who was cool as a cucumber and I pretty much want to be the female version of him. Also met quite a young, female consultant who is someone else I want to be like in the future.

General Surgery - Ended up seeing a lot of hernia repairs, haemorrhoidectomies and laparoscopic things. However, on-calls and A&E shifts were very interesting and I definitely enjoyed the super short ward rounds :) The clinics I attended were also very good and the consultants in them did a lot of teaching.

Orthopaedics - This week made me realise that my anatomy knowledge isn't as bad as I thought it was! Managed to answer some pretty probing questions about the anatomy of the knee in theatre which impressed the surgeon but at the same time, I realised that I may not be strong enough for this specialty! I'll either need to go to the gym more often from now on or just accept that this isn't the specialty for me (even if I really, really enjoyed it).

Breast - I loved this week. The team were really funny and we had a laugh in clinics and theatres. It was a super packed week but because I was allowed to see patients first in clinic, it helped me learn how to present a patient succinctly. Another surgical specialty I loved - they are fast mounting up!

Overall - My advice would be to get stuck in! The best thing to do is to be scrubbed into surgeries - standing at the back seeing nothing is no fun. Also, surgeons love it when you ask questions (and I have plenty as I want to do surgery!) so don't be afraid of them - they don't bite if you're polite :)

Geriatrics
I was placed with an awesome team who got me really involved in all aspects of the placement. I was writing in patient notes during ward round, doing junior doctor jobs (e.g. taking blood, inserting cannulas) and doing new patient summaries. It ended up being an amazing placement where I knew that I would learn something every day (which I did!).

Cardiology
This was only a two-week block but that ended up being plenty. Spent time in clinics, cardiac catheter lab, cardiothoracic theatres with plenty of bedside teaching scheduled in too. Learnt loads, not least the fact that I don't want to be a cardiologist.

Medicine (Gastroenterology)
My last placement before exams was on a Gastroenterology ward. Again, my best time was spent in A&E or on-call. Are you starting to see a trend...? I saw a wide variety of things on this placement and though the ward was fairly quiet with a low rate of patient turnover, I still found enough to do. Medicine placement is the perfect one to practice practical skills such as blood taking, cannula insertion, learning how to prescribe, insertion of urinary catheters, etc.

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So there you have it; all of the placements I've had all reviewed in one mammoth blog post. I'm not sure how interesting or useful this is to those of you at medical school/thinking of medical school. If you have any questions, leave me a comment and I'll try and get back to you as soon as possible :)

3 comments

  1. This was so helpful! I start on rotations after Christmas, if you have a post of tips for when on rotation that'd be amazing!

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  2. I am thoroughly impressed by your enthusiasm in throwing yourself into what you are learning at the moment. Think you will do well in whatever you choose to specialise in :)

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  3. This was an extremely interesting insight. Im wondering did each placement merge into the other or did you have breaks in-between?

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