DAY 2343-2381

Jan 31 - Mar 10

1) Another day another dollar - or pound here in the UK. It's been just over a month since my last blog post, and if I'm honest, not much has happened since then other than the fact that I've been rather busy with work. Reflecting on the past seven months, I have learnt a lot about medicine as a career. While medical school tends to place emphasis on book knowledge and passing structured exams, the real world is a completely different kettle of fish. Everyday, I find myself challenged by different scenarios, many of which require me to actually apply knowledge rather than regurgitating it out on a test paper. 

2) Spring is just round the corner, and yet this week we received a weather alert warning us of possible snow. Indeed, in these past few days most of the country has seen sub-zero temperatures, with Scotland recording a freezing -16C yesterday. If there's one thing I've learnt since coming here, it is that "as unpredictable as the British weather" was meant to be taken literally. Thankfully, the winds here are nowhere near as strong as they tend to be in Ireland - so I can get off with just a winter jacket.

3) So I have an exciting announcement to make - I'm coming back after seven months working here in the UK. It will be my first time home after as many months, and I cannot wait. Frankly, I'd used up all my annual leave for this rotation in planning my holiday. I am therefore looking forward to maximising the measly two weeks I have with my family and friends back home. It goes without saying that food will play a huge part in this. Recently, I had a shock after weighing myself - I had lost almost 10kg since coming here! Even more reason to replenish some of the lost pounds back home then.

4) I should probably finish packing up now. Thanks for visiting my blog as always, and hope you have a great week ahead. Take care and stay safe, cheers!

Nothing better to do on an off-day

This is the lightest I've been since high school - not sure how to feel if I'm honest XD

Looking forward to a haircut back home

DAY 2218-2239

Sept 28 - Oct 19

1) Finally some time off to manage my blog - it's been a while since I last updated this. Anyway, I've been busy these past few weeks, starting with my first set of night shifts (from 21:00-09:00), then switching back to regular day shifts, then back again to nights. Night shifts are quite interesting in that generally, the management is less curative than it is supportive. For one, the management plans have already been laid out by the consultants on the day team. As the night team, our aim is to ensure these plans are actioned throughout the night. We'll also adjust any medications / intervene according to the patients' condition, and basically keep them going until the morning handover.

2) Conversely, patients also tend to do poorly at night. Whether this is sundowning in patients with dementia, or diurnal variation in patients with asthma, patients tend to deteriorate easily overnight. Given that there are less staff in each ward, the burden then falls on the night team to prioritise patients who are the most unwell first. During my short stint in the AMU (Acute Medical Unit), we would clerk and examine all newly-admitted patients that had not been seen in the ED. Over the course of the night, some patients would desaturate, some would spike temperatures, yet some others would self-discharge against medical advice, and some would unfortunately pass on. Come morning, we would post-take (i.e. see) the new patients with the consultant, before handing over any outstanding jobs to the day team.

3) In addition to ward work, doctors on any training pathway are required to maintain a portfolio. At the end of each year, this portfolio is reviewed by a committee that decides if the doctor is allowed to progress to the next stage of training. To fulfill the criteria set out in the portfolio, we are required to engage in a variety of supervised learning events, including case-based discussions (CBDs), direct observed procedural skills (DOPS), and mini clinical evaluation exercises (mini-CEXs). In addition, we need to log in a minimum of 60 hours of learning, write some reflections, and get involved in an audit / quality improvement project. In short, there is always something to do throughout the year. 

4) All in all, while it is indeed challenging, there are many good learning opportunities working as a junior doctor in the NHS. And with that, I'll end my blog post here. Thanks very much for visiting as always, and have a great week ahead. Cheers!

An apple a day might keep the doctor away, but a cup of coffee keeps the doctor awake

(My first set of night shifts was brutal if I'm honest)

Privileges of being a member of the doctors' mess

Stocked up on some white boards - very helpful in penning my thoughts or for doodling...

Doodle exhibit A: One can dream XD

View from home

Hearty breakfast after a long night

Still happy as always :)

Full moon tonight

DAY 2181-2203

Aug 22 - Sept 13

1) Just over a month now into my job as  Foundation Year 1 (or F1) doctor in the UK. A brief overview of a typical "normal working day" (NWD) for me would be as follows: updating the handover list before 9am (if not already done), prepping the patient notes as much as we can after that, starting ward rounds with the consultant at 9am, updating the jobs book as we go along, delegating the jobs after the ward round (usually around 12 or 1pm), completing some jobs before going for lunch, then coming back and completing the rest, or handing over to the night team if there are any outstanding jobs at the end of the day. 

2) A typical normal working day is a 9-5 job, however I had only one normal working day yesterday, before having long days for the next three weeks. Essentially, "long day 1" extends from 9:00-21:00, while "long day 2" is from 9:00-19:00. Most of the time, long days (for me at least) are split between two departments - my day job in the gastroenterology ward (from 9-5), and thereafter in the acute medical unit (AMU), emergency department (ED), or frail and elderly assessment unit (FEAU). Every department sees different types of patients, so I've been exposed to a variety of interesting cases especially outside my day job.

3) These past few weeks, I've been really busy preparing for the Prescribing Safety Assessment (PSA) - which we have to pass before the end of Foundation Year 1 if we are to progress in our training. There are three exam dates in a year, and I sat for mine last week. While it is an open book test (you can search the British National Formulary or BNF), the main challenge is time constraint. There are 60 questions to answer in 2 hours, with the first two sections counting for the majority of marks. After an initial scare in setting up my laptop for the exam, I managed to barely finish in time. According to the website, results should be out in two weeks - so I'm keeping my fingers crossed.

4) In summary, working as an NHS doctor has been really rewarding - I've learnt a lot and have a whole lot more to learn. Time to keep working on building my portfolio then. Thanks very much for visiting my blog, and have a great week ahead. Cheers!

A sunny day today :)

 Made sunnier by the fact that it was my off-day

Back to work then I guess...

Trying out authentic Thai food at the "Art of Siam" in Newcastle

Sharing life stories with my good friend Clarence

Massaman curry with rice was stunning -

rich and creamy curry with just a hint of spiciness on a hot bed of rice

Sticky toffee pudding with vanilla ice cream to end the meal

Apparently the Doctor's Mess organise an official event once a month - this evening we were at the Orange Tree, and in front of me is a massive beef skewer

A ginormous dish of chocolate brownies with vanilla ice cream

The Clinical Education Centre (CEC) - where we have most of our fortnightly teaching

I've recently discovered the library at the Clinical Education Centre - perfect for some quiet time

What I've learnt from the hospital cafeteria is that they do Curry Thursdays and Chippy Fridays

Can't remember what this was called but it tasted really good

I pass by this area on my way back from work every day 

- it's most likely a park but I've never entered yet XD