Work Experience, QE Hospital

I have grown up with many joint problems, encountering numerous rheumatologists and physiotherapists. It was natural, therefore, to be curious about rheumatology as a subject area. I managed to secure a week of work experience with my grandmother's rheumatologist (I am a carer for her) at Queen Elizabeth hospital. I was fortunate enough to be in contact with the doctor in question via email beforehand, so that I could arrange to visit other departments, too.

Rheumatology
It did not take me long to realise the systematic approach to clinics run there. I was struck at how repetitive the work seemed at times, but also at how grateful patients were to receive this kind of specialist help. The patients' desires were fully taken into account: if treatment was uncomfortable, it would be changed; if they suspected a problem, tests would be done. Trust is key from both sides. After every consultation a voice recording was made about it, verifying information and suggesting treatments- this would then by typed up and sent to those concerned (namely the patients, GPs, etc). After only about half an hour on my first day, I was made aware on the hierarchy at the hospital. Every senior member of staff was also overseeing juniors, providing advice and support. I like the learning-teaching aspect.
I found out about the intertwining of social services; most common was the unemployed that were 'looking for a reason not to get back to work by coming here', wanting to be deemed not capable- even though they may well be. I found this very interesting, my mother being a social worker herself, I have an interest in this mixing with medicine. 'Saying work is harmful has no evidence, but unemployment is bad for your health...you can see that' I was told. I was made to reflect on a wider societal contact with medicine.
Most commonly occurring cases I saw, were: vitamin D deficiency (I have this, too- supplements are prescribed) and osteoporosis- I was given information handouts that patients were also given, which proved to be very insightful. I knew that I wanted to pursue medicine as a career.

Ultrasound
I was lucky enough to be taught how to use an ultrasound machine, as well as shadowing a specialist in radiology. I was enthralled by the application of physics in this specialism; able to use my A level knowledge to explain the image produced. Depo- Mendrone was used- this injection contains methylprednisolone as the active ingredient, and is a corticosteroid; it was a number of uses. Upon arrival here, I was told the reasons for using ultrasound- it is: cheap, dynamic, and live. It was also emphasised to me the importance of sharing knowledge and understanding in a hospital setting; there is a 'complex multidisciplinary team' and  many junior doctors were about and senior staff helping where possible.
Using a small (transportable) ultrasound machine was great fun; I was able to look at my own joints and was taught how to look for inflammation as a marker of rheumatoid arthritis. Fortunately, no arthritis for me!

Dermatology
The morning I spent in a children's allergy clinic here, showed me quite a different practise of medicine. I was made aware of the pressures of managerial and administrative responsibilities of senior members of staff; sitting in on a meeting about funding opened my eyes to the NHS as a business as well as a service.
On thing that particularly concerned me, was the use of paper work instead of using computer systems...'it's 2013, why can't we use computers like everywhere else?' one of the doctors remarked; I agree entirely, but this just showed me that there is always room for change. I did, also, find the constant referrals quite frustrating, as you would never see one patient though the entire process- however I realised that it was this teamwork that lead to effective management and treatment for the patients.
Witnessing consultations with children present was interesting, to say the least. It was a more complex procedure due to the number of people responsible for making decisions about the child... as well as the noise levels of certain individuals in the room. But it was obvious how much the doctors enjoyed working in paediatrics. I was left alone on a mnuber of occassions to speak to the famiies, getting to know personal stories and accounts of allergies and their lives; this was very enjoyable.
Ordering tests was a major component in this clinic. HISS (hospital information support system) and WinPath (laboratory information management system) were used frequently. But these old computer systems seemed to me, over-complicated when one universal system could be used for the entire NHS... But funding, of course, is an issue.

Fracture Clinic
My time spent here, was my favourite of the entire work experience.This was probably thanks to the incredibly enthusiastic senior orthopaedic surgeon that I was shadowing. He taught me so much anatomy and background information of patient's conditions in between consultations- I spent the whole day frantically making notes on everything I could. The passion shown was truly inspirational to me. I was shown how to interpret basic x-rays and spoke to patients about their various conditions. He was giving me a day in the life of a medical student- lectures and shadowing and tutorials all in one. This day alone assured me that studying medicine would be the best choice of my life.
Here, I was also displayed the gratitude of the doctors toward the nurses; they seem to be an irreplaceable part of the team, doing so much of the groundwork.  It was highlighted to me, the new pressures that an ageing population is putting on the NHS- would more doctors need to go into fields such as geriatrics and in the future? There is a 25% chance of me living to 100. And 20 000 neurones are lost per day after the age of 25!

My time at the hospital did nothing but confirm my passion for medicine as a vocation. I gained so much knowledge of day-to-day life as a doctor and met real patients to discover their own stories. I am just so looking forward to studying at university! (Hopefully).

The Rise and Fall of Modern Medicine

This book really set-in-stone my desire to study medicine. Providing much information on the major surge in medical achievement in the post-war years, it provided a perspective to view the practice of medicine today. Not only the achievements themselves, but also how they came about, such as by chance or drug screening. The latter part of the book focused on the possible limitations of medicine in modern society, and that it's future cannot be certain. And that the perpetual advance of medicine, that many believed would continue in the 'age of optimism', has come to barriers more recently. Resulting in a changing subject of both social and intellectual integrity.