DAY 2267-2288

Nov 16 - Dec 7

1) Four months have passed since I started working here in the UK. And just like that, my first rotation (in gastroenterology) is over. As I walked through the double doors one last time, I couldn't help but reflect on my journey so far. From our first week of shadowing and induction, and not knowing where the antibiotics section was on the drug chart, to gaining confidence in performing my own ascitic drains / taps - it has been a very rewarding journey indeed. 

2) I had previously assumed that being in gastroenterology meant that I would spend most (if not all) my working hours here. Interestingly, that has not been the case. In fact, I have often been called to work in other medical departments including the Acute Medical Unit (AMU), Emergency Department (A&E), and Frail & Elderly Assessment Unit (FEAU). While I definitely appreciate the exposure to other wards, I feel that this has somewhat disrupted the continuity of care towards my patients in the gastroenterology ward. On the plus side, I have now become a bit more confident working in other departments.

3) Now on to my next rotation - trauma and orthopaedic (T&O) surgery. I have recently been attending their Monday teaching sessions, which I have found very useful. Of course, the excellent free lunches may also be part of the incentive to attend. Regardless, I start my first "official" working day in T&O today. Having previously shadowed a fellow colleague, I hope that I have developed enough basic skills to survive the next four months. I'll share my thoughts working here in the next blog post.

4) This brings me to my last update - the formal assessment for the "Research Methods in Health" module, which is a pre-requisite for doctors on the Specialised Foundation Programme (SFP). We have two exams coming up - an online exam (MCQs and SAQs), as well as a 2,000 word essay to write. Fortunately, I have already submitted my essay, so it's just the online exam which I need to worry about. If I'm honest, I had not expected how challenging it might be to juggle between studying for exams and working at the same time.

5) And that's about it for this edition of my blog. As always, thank you for visiting and have a great week ahead. Cheers! 

This is ascitic fluid for analysis - patients with liver cirrhosis tend to present with fluid in the tummy (ascites) which can be really uncomfortable. If it's large enough, the ascites can be drained, and we can do this manually in the ward itself. Whenever we do an ascitic drain, we also send some ascitic fluid to the lab to rule out an infection.

This is blood for blood culture - patients who appear septic / spiking temperatures would require a septic screen, which includes (among other tests) a blood culture. We send a sample of blood to the lab for analysis, to find out if any microorganisms have invaded the bloodstream, and if so, what antibiotics they are susceptible to. This guides our choice of antibiotics.

A very useful 2-in-1 clipboard / file

So you can store notes and use it as a clipboard

Bought myself a sturdy umbrella after my old one broke

Hits a little too close to home XD

Meet Anas - RCSI Bahrain graduate, fellow F1 doctor, and lunch buddy for today :)

Before it was cold, it was foggy

This is the foggiest night I have ever encountered anywhere

Literally can't see 50m ahead

Chylous ascites?

Literally my last ascitic drain for the rotation

Ward 230 - Missed but not forgotten

What I walk into pretty much every morning

DAY 1400-1413

Jul 2 - 15

1) It is difficult to describe the emotional state I am in right now. A mixture of excitement, anxiety, and of course a healthy (unhealthy?) dose of stress. I am of course referring to the two weeks left till I am due to submit my masters dissertation. Looking back, I cannot believe how fast the year has passed by, and how many crazy things have happened since then. It was not an easy decision for me to take a year out of medicine to intercalate, but after going through this course here in UK, I am confident that I made the right choice. 

2) Throughout this course, I feel that I have learnt how to write scientific essays. We had an essay to write for each of the four modules we took, with each essay having a 2000 word count limit. As I've discovered, writing scientific essays is not the same as any regular essay or opinion piece - there are strict rules to follow regarding the use of scientific objective language, as well as proper citations and referencing. 

3) In addition, I've learnt the importance of statistical analysis for literally every experiment carried out. I still remember how difficult I found the concepts of SPSS (a statistical software package) when I was first introduced to it for a summer research project in first year of medical school. After coming here, I've realised that there are a range of other programmes out there (e.g. R, STATA, Prism), which allow more flexibility and customisability options. 

4) Last but not least, the dissertation project has taken up the most time and effort. It has been quite an experience conducting a novel project from start to finish, and learning how to interpret data and troubleshoot problems. Thankfully, I have had wonderful support and encouragement from my supervisor, my friend and colleague, and of course my parents back home. The next two weeks will require a lot of focus and determination, to make sure everything is finalised and that the dissertation is submitted in time. As it is, I'm left with the "Discussion" section to tidy up, and then the references need to be added, followed by an abstract, cover page, acknowledgement, and table of contents, and I'll be good to go. 

5) Thanks very much for accompanying me on this journey, as I finish up the last bits of my project before returning home. And what a journey it has been! Have a nice week ahead, cheers :D 

The last hurdle - quite literally...