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A day in the life…Ward Rounds

As part of our continuing series, we discuss a day in the life of a medical student, this time focusing on student experiences of ward rounds.

Ward rounds make up a fundamental part of medicine, checking on the status of in-patients, an opportunity for the whole team to discuss with the patient what would be the best management plan for them, and a chance to review medications and the recommendations of the ward juniors and nurses for the consultant.

Ward rounds are important both for the surgical team and the medical team, although the manner and speed can vary greatly between the two. A surgical team may whisk round in under an hour, whereas a medical round can take 5 to 6.

As a student, much of your time will be spent shadowing on rounds and this may be on a ward to which you have been allocated to during a surgical or medical firm, or on a post-take ward round, where the lead consultant will review each of the new patients in the hospital.

When you are a student, you can quickly find that you are a bit of a dead weight, straining to keep focused or living in perpetual fear of being grilled by a moody, tired consultant. For some, this can be the worst part of medical school, the necessary “face-time” needed to get satisfactory attendance and attainment marks from your supervisor.

To make the most of this however, it can be really useful to take on some of the duties of the F1. Writing in the notes and checking the observations in particular, will be useful for exams and useful come your first day on the job.

Each ward round will then generate a whole series of ‘jobs’ for the juniors, and this again is an area you can help out with. These will include bloods, mini-mental state examinations, discharge summaries and liaison with other team members or departments.

The students who put themselves out there, ultimately have the best medical school experience. While these tasks may appear somewhat trivial and divorced from the hardcore library pathophysiology and ‘real’ medicine that you are expecting, they represent the realities of the job, and will make your life that bit easier come the August of your first foundation training year!

Useful Links:

http://wardwiki.com/w/Ward_round

The Role of Good Work Experience

By now this should be quite obvious to you, but work experience is key to getting a place in medicine!

When that spark of interest first begins to ignite and you think that medicine might be the career for you, then gaining work experience is the most sensible route to finding out whether it is something you merely like the sound of, or whether you really see yourself doing it for over 30 years (and even longer as the government look like they will be putting up our retirement age!!)

Work experience will help form ideas in your mind as to what you really want from your career, whether it is interaction with people, an academic challenge, a hand-on approach or an office job tackling public health policy and changing the lives of millions. Medicine is VERY VERY diverse and can cater for almost every taste.

Once you have decided medicine is for you, the work experience will give you examples to talk about in interview (possibly what you are most concerned about at the moment), and interactions with patients and Doctors that you will be able to reflect on and make your own opinions about. What did you think was really going on with that patient? What did you especially like about how the nurse handled that upset patient? Why do you think the patient was rude to the receptionist? You don’t have to know any medicine, just be able to have some insight into the human state.

The best way to get work experience is to contact you school careers network or alumni network, and failing this, speak to your own GP. Some GP’s may not like to host people within a catchment area where they are likely to know other patients, but they may put you on to colleagues slightly further afield.

It’s really important to get as much experience of both primary and secondary care, and hence a stint in a hospital can be really valuable. Contact your local health trust, or even try to ping off a few emails to a consultant or two. One thing about medicine is that most people are more than happy to help. Engrained into the culture of the profession is that you are expected to be nice, and to help teach others who are along the same path. It’s one of my favourite things about it! So when you do find yourself in a medical setting, there are bound to be medical students, nurses and doctors who will be more than happy to give you there 2-pence worth!

Make sure you act and dress appropriately for this time. Be serious and respectful to patients, and remember that patient confidentiality is one of the most sacrosanct values there is in medicine.

When you have finished the placement, write down your experiences, no matter how small, and consider the implications of what you have seen. A 40 year old mum may have come in with what seems to be a simple sprained ankle – that heals on its own right? – but consider that she may have children she has to look after, it may be affecting her home life and her ability to work. Don’t be afraid to discuss your thoughts with other doctors and ask them what they think.

One last thing, no one is impressed if you did work experience with the top plastic surgeon in the country –  that does not necessarily mean YOU are the top plastic surgeon in the country! Hence, a stint in a nursing home, hospice or drop in centre is just as valuable, and it all comes down to what you take away from the experience!!

Good luck and be sure to contact us for any tips

Rob Hull is a Trainee surgeon in Watford.

Related links

If you would like to pass on your own experiences of work experience then please contact us at info@oxbridgemedicine.com and we will post you on the site as a guest blogger

Bursary Scheme

Medicine is a heavily over-subscribed and competitive course. At present,  3% of top independent schools make up 30% of Oxford and Cambridge University places and this is reflected with medical admissions. Students from many comprehensive schools often don’t even consider applying because they are not necessarily appropriately informed of the opportunities available to them, or because they may not know someone who has been to Oxford or Cambridge before to offer guidance.  Others feel that they will simply not fit in.

We believe this is a real shame as many of these preconceptions of Oxford and Cambridge are misguided; this means that there are huge numbers of students who excel in their science A-level subjects and have a passion for Medicine but do not even consider attempting to apply for this fantastic degree at two of the best universities in the world. Medical tutors look for bright, talented students with academic potential and enthusiasm, and the admissions procedure is by-and-large extremely efficient and meritocratic.

Other students struggle financially to access some of the resources that students from bigger and wealthier schools have to offer in terms of support for their applications to university.

At Oxbridge Medicine, we are looking to work closely with students and forge links with councils and schools to ensure that no student is disadvantaged in their application by their financial situation or by attending a school which is not as familiar with the requirements for an Oxbridge application.

We organise joint training days for students in schools in the same area which can be funded, at least partly, by the Local Education Authority. If you or your school is interested in our bursary scheme please email or call us and we will be able to contact your LEA to organise a training day near you.

James, Oxbridge Medicine

What to expect at your Cambridge or Oxford interview…

We wish you all good luck with your BMAT results this week. I remember it being a huge relief to me, meaning that I could focus more on the interviews and the medicine itself. I had already had one interview at Imperial college medical school, something of an intimidating experience comprising a panel of 6, and I felt this probably prepared me well for the interview at Oxford.
It’s now that all that extra reading you have been doing over the last few months starts to pay off. Paying attention to the news, browsing the student bmj and flicking through the new scientist to the relevant pages was invaluable to my preparation. Now, there are even more sources of info including the blogosphere, and the smartphone – my trusty old friend – can provide reams of info for every moment you are bored at a bus stop, waiting on a train platform or have a spare 15 minutes to kill. For, whilst the Cambridge and Oxford medicine interviews have a structure, it is impossible to predict specific logic and science-based questions, making it paramount that you should have a plethora of related and interesting knowledge hidden in the depths of your brain.
My first medical interview was not for the college I had applied to, and it felt more like a physics interview. I came out wondering whether I had stepped in the wrong room. However, it then became apparent that the fundamentals would stand me in good stead for a basic-principled approach to medicine and the physiological sciences.
Now, I want to dispel some of the fallacies which exist surrounding some of the interview methods used. I find that some of the concerns that applicants express involve the methods used by interviewers. They are worried about bullying tactics, judgement over religious view points or ethical views – the most famous of which being the catholic student asked his/her position over abortion. However, both Oxford and Cambridge have taken giant steps and measures to ensure that the interviews are fair and more inclusive than perhaps they were in the past. The interviewer will not be trying to assess whether you hold what they deem to be the correct views, but will be interested to know whether you have the intellectual intrigue, logical capacity and motivation to deal with the Oxbridge medical science course. They will also be assessing whether you would be a good fit, whether you would work well with the other students they already have in mind, or whether there might be another college for which you are more suitable.
The questions may seem random, but from the tutor’s perspective, they are calculated and consistent, giving a barometer of your core capabilities, and pushing you as far as they can. No-one should ever leave an Oxbridge interview feeling that it went swimmingly, as the tutors will try to push your bounds and see what calibre of candidate you are. After all, with most of the applicants having achieved straight A* GCSE grades, and going on to achieve A*’s at A-level, this is necessary to differentiate the good from the very good.
The interviewers will also aim to find out some more about you – your hobbies and extracurricular activities, your views on a topic in the news. Creating this picture will enable them to see whether you will fare well in an 8 week term jam-packed with activity that will rush past in a heart beat. It isn’t just a matter of attainment, but one of suitability.
My final word. Do not be fooled. Just because the mystique of medicine at Cambridge or Oxford, and the renowned interview process has the reputation for the random, the old cliche – fail to prepare, prepare to fail -has never been more appropriate. However, you should also be prepared to fail. You can sit in the interview and take no risks – merely regurgitating a few appropriate facts that you have learnt by rote, and not necessarily answering the question, but the interview is designed to put you out of your comfort zone, to challenge your thinking and for you to enjoy! The competition is tough, but by taking a moment to stop, breathe and think, it might just mean that you are matriculating in October 2012.
Good Luck.
James Tuffnel, FY1 Doctor
P.s. some useful links

Medicine at Oxbridge – what is all the fuss about?

Everyone comes out with a medical degree, they specialise or generalise, and then essentially how good a doctor you become depends on your clinical experiences, your training and how hard you work – so what is the big deal about Oxbridge? This is a common question asked about people who choose to pursue their medical studies at either Oxford or Cambridge medical schools. Is it the glory? Is it the chance to spend time among these towering spires, is it because mum and dad really want to say that you go to Oxbridge?

Unsurprisingly, the human body is indeed the same in Oxford and Cambridge, as compared to Leeds, Peninsula or Cardiff, so what is the big fuss all about?

Everyone knows that Oxbridge preclinical degrees are supposedly more academic. Care to elaborate?

Well it really relates to the style and method of teaching, and the emphasis of what is learnt. As you go through medical school you will become ever more familiar with the term ‘first priciples.’ When presented with a clinical problem or when trying to decipher the mode of action of a drug, can you work backwards to the route of what is going on (admittedly this can be quite difficult when you are being quizzed by a leering gnarled consultant) or does all of your problem solving rely on rote? Whilst there is certainly a need to recall large amounts of information, in medicine your life can be made a lot easier if you master the art of clinical judgement.

Certainly at Oxford, we were encouraged to question, to understand what the background to some of the key medical discoveries in history were, and to focus on the theoretical basis. In the first 3 years however, this tranlates as a vast amounts of essays and tutorials based on you understanding of the physiology – it’s not for everyone.

Whilst the first 2 years are mostly an exercise in testing that you have the required amount of knowledge to pass go and enter into clinical school, in the third year you enter into the world of primary research and the experiments that have led to the foundations of our understanding. It is your chance to question the validity of the methods and assumptions used in the medical field, and one where you could have an influence on a small part of human knowledge. After all, Charles Best – of the Banting and Best Nobel prize winning duo that discovered insulin – was only a fresh faced 22 year old medical student when he made his contribution to Science, so who knows what you could achieve!

At Oxford, I felt that I was encouraged to pursue anything that I was interested in, and that the tutors were happy to put me in contact with the relevant leaders in that field if ever I showed an interest. In the 3rd year, I was given the opportunity to study the history of medicine, chemical pharmacology or biomedical engineering as an extra module, and there were always tutors who made themselves available and were happy to give an extra hour of their time to tutor you. I feel genuinely privileged to have had so many leading intellects at no further than an email away who were willing to impart what they knew. I feel that I developed immeasurably during my time at Oxford. I cannot speak for the other medical schools, but I feel very fortunate to have studied in such a dynamic, facilitating environment. It’s not for everyone, but it was for me!

Oli Arbuckle,

ST1 Doctor. Keble College, Oxford.



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