DHAL: June 02, 2014

Highlights:

  • Having a filling breakfast before starting the day. Doesn’t often happen on a day when I’m working!
  • Video chatting with Michael who’s now in Vancouver and staying with my sister, so getting to see and talking to her too!

Lowlights:

Similar to May 30th, I was rostered to sit in on another 4 hr teaching session for the junior doctors (interns). Seeing that I was sitting away from the main table, the interns told me to join them and participate in order to “actively learn.” The module for this session was abdominal pain, which is a very common presentation with numerous causes from simple to complex. Unfortunately, I felt the consultant who ran the session was quite demeaning towards me and by the end of the session, I was infuriated. I remember 3 distinct moments:

  • Someone has come into the emergency department with severe abdominal pain. What kind of pain relief would you consider giving? You would want something strong and quick acting, a reasonable choice is intravenous morphine. The consultant pointed me out and said, “You… maybe others, are probably thinking of the WHO ladder.” I wasn’t, it would be nice to ask me rather than imply. The WHO ladder is more for the management of chronic pain, starting with simple analgesia like Tylenol/Panadol + Ibuprofen and working up to stronger pain killers like weak opioids and then strong opioids. Of course you would not use the WHO ladder in this acute setting, I know that.
  • We then talked about pelvic examinations. Which includes a speculum exam (like when you get a pap smear) and a bimanual exam – when you use your fingers to feel inside a woman’s vagina, trying to palpate their uterus and ovaries for any masses or tenderness. Again, he pointed me out saying, “You’ve probably done one or two? Like during the training session with the volunteers?” Then without giving me a chance to reply, continues speaking. I was dumbfounded. Yes, we were given a training session and had the opportunity to practice on volunteers… back in 2nd year. By now in 4th year, I’ve had the opportunity to do quite a number of exams, even felt pathology. But… thanks again.
  • The last and most upsetting. We were asked what bHCG levels are relevant when doing an ultrasound. After a few seconds of silence, I answered “1500 and 3500.” These numbers are relevant because they’re the cut offs for the sonographer to be able to see an intrauterine pregnancy via the vagina or abdomen, respectively. However, rather than simply saying, “Yes, why?” He responded with, “I can see you’ve done your reading.” No, I didn’t just do my reading, I have completed my OBGYN rotation, I know this because I’ve learned it and applied it clinically.

I work hard to learn because I want to be a good doctor next year. I want as much clinical experience and teaching as possible in order to help me to be the best doctor I can be. And if you want good doctors, then you need to treat final year medical students like the doctors you want them to be. You don’t treat them like first year medical students and/or assume they have no clinical experience or knowledge. Argh!

My rant of the day. Over.

 

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