Monday, 31 December 2012

Thoughts on 2012

As obvious as it may sound, something which I've needed to be reminded of occasionally over these recent months is that medical school is that it's not an end in itself, it's a means to an end. I think a lot applicants to medical school (myself included) either forget this or are just ignorant to it in the first place and assume that once they get into medical school and start doing medicine, that the next four or five years will make the application stress totally worth it and that medical school will ultimately be the antidote to UCAS stress.

I'd like to alter that statement somewhat. Medical school is not the antidote to UCAS stress; getting into medical school is the antidote to UCAS stress. Applicants can't be blamed for this naive optimism either: the UCAS process is so stressful, competitive and pervasive that it's not surprising that so many people tie their hopes and feelings to finally getting that offer and getting to start medical school. In recent years it really has become an all-consuming affair which takes at least a year of decent planning and several months of drawn out stress and hanging on the edge of your seat. When you're going through all that, the only thing you can do is hope that what you're going on to do next will ultimately make all those sleepless nights and nervousness worth it, so much so that you forget that what you're hoping to do next is going to be very intense and unfamiliar in itself!

Perhaps it's the exam nerves talking or revision which is taking its toll, but what I'm trying to say is this: I knew a lot about what medicine would be like before I started the course. I knew that there would be a lot of information to take in, I knew that there would be a lot of rote learning and memorisation and I knew that there would be exams to deal with. I wasn't an idiot, I knew what I'd signed up for. I'm not disappointed either, this post isn't about feelings of disappointment.

However, in my naivety, I had assumed that for some reason (see below) I would no longer experience those particular feelings which I had experienced during my biomed days once I started medicine. Constantly feeling behind, the insomnia in the weeks running up to exams, always feeling like I'm missing something out, and generally being overwhelmed. I had somehow seen all those as being linked to "life as a biomed" rather than "life". Despite being, on the whole, a rational and logical person, I had somehow fallen into the old trap of tying all my stress last year to getting into medicine.

Well, I got my wish: I got into med school, bang! and the stress was gone. I then assumed that since, after a great deal of stress, I'd got the right exam grades to make it into medical school (hitherto the biggest source of stress in my life), that somehow nothing else would compare with that particular level of anxiety, so everything would be relatively less stressful after that. Yes, there would be a lot of information to remember, exams and so on, but surely nothing could be as stressful as before...could it? I wasn't being cocky here, I knew medical school would be tough, I just didn't think something which I genuinely really like would cause me the same worries (sleeplessness, etc) as something which I didn't like i.e. biomed.

This was what was illogical, I'd failed to remember that medical school is a learning experience in and of itself. That it's not just about lots of new information, but having to remember it in a particular way for the integrated style of questioning which medical school exams make use of. Yes, I've had a month to revise, but unlike my BSc exams which were staggered across a few weeks and split into individual modules, over here I have two papers which will have questions drawn from all the modules we've covered up til now. In short, I need to remember a lot of information...and all at the same time. Not like before when I would cram, do the exam, forget what I'd learned in a matter of hours and move on to the next module (with a handy few days in between for further cramming).

So with just over a week to go til my exams, I'm feeling much the same way as I've always done in the run up to exams: slightly manic, rather overwhelmed and very on edge. Perhaps some things will never change. However, there is a difference in that this time that these are exams for something I really care about and genuinely want to do well in i.e. don't just want to do well in so I can get into another degree. I'd be so gutted if after waiting so long to do medicine I ballsed up these exams. Yes, I know these exams "don't count", and that it's supposed to be a good opportunity to see how I'm progressing...but I'd still be so disappointed if I didn't do well after several months of trying my best.

2012 was a memorable year in many different ways. It was an extremely tumultuous year where my life changed forever, where I moved across the country, left familiar climes and people, and began training for something I intend to do for many decades to come. Perhaps someday an older and grumpier me will look back on 2012 as the most significant turning point in my life. Certainly many of my desires and ambitions were met, or are on the road to being met, but at the same time a whole new set of challenges are being posed to the present grumpy me - though I feel quietly hopeful that I'll be able to get to grips with these problems during the course of this new year. I'll certainly try my best to at any rate.

(Also, I realise I've been moaning about exams a lot lately, I'll try to be less boring just as soon as it's all over and done with...only a week and a bit to go!).

Happy new year, and best of luck to all you applicants and fellow students with exams!

Friday, 21 December 2012

Visions of revision that conquer my mind

Sleeplessness has been an on-off problem for me over the years. The insomnia reached its peak during my MSc when I physically just could not get to sleep most nights, and especially the nights before the days when I had classes (we had classes a few days a week) - but on those two or three nights, I genuinely felt trapped in insomnia hell.

At first I wasn't entirely sure what was causing this sleeplessness, it was genuinely baffling for me - was I waking up too late in the day? Was I having too many cups of tea throughout the day? Was I secretly in love without knowing it? Pretty soon however I worked out that far from it being a case of Visions of Johanna which kept me up past the dawn, the reason for lying in bed with eyes wide open for several hours a night was simply because I was dreading having to go in the next day and face having to feel totally thick in a lab where I had no clue what I was doing.

Anyway, once I got into medicine, things settled down and I began sleeping like a baby - no stress, genuine contentment, what more could you ask for? Even during term time, with all its early starts and the feeling of being constantly overwhelmed what with starting a new course in a new town, I still didn't find getting to sleep to be a problem.

Of course, I hadn't taken the influence of exams into account (see previous post) - something which over the past week or so has taken insomnia to whole new levels. Last night I could not get to sleep til past 5 AM. Woke up at 11:15 this morning and I feel rough as hell. I'm not even sure why I'm being kept up: logic tells me that formative exams which do not count do not carry any sort of lethal consequences with them (getting kicked out, etc) and that furthermore that I am, for the most part, on target with my revision plans. And I've still got 2.5 weeks til exams, which isn't bad.

But I still can't kick the feeling that I'm not doing enough, that I'm unwittingly missing out details, that I'm just working on the wrong lines, that there's too much to revise and it'll never be done on time. That's what's keeping me up, and whilst the logical side of my mind knows that these are all normal concerns, my scumbag brain still won't let me get to sleep.

But there's one small bright side: at least now I'm being kept up by something which I genuinely love doing, as opposed to something I dislike. That's not too bad. But I certainly wish I could sleep at night all the same.

Wednesday, 5 December 2012

Taking stock of things

It's been nearly three months since my last update on here, which is a very long time for me to go without writing. If truth be told, there were a couple of abortive attempts to write a post, but for some reason I just found myself being unable to explain what I wanted to say regarding what I've felt and experienced over the past few weeks at med school. This is because, with no exaggerations whatsoever, it has been one of, if not the most, intense and at times overwhelming experiences of my life. It's very hard to take stock of things when you're totally in the thick of it, you don't have the brainspace or hindsight to consider things in an objective and measured way the same way you would if life was proceeding in a slower and more orderly pace - and the one thing these past few months has not been is slow.

So where do I stand currently? Having finished term one of medical school I am now one third of the way through pre-clinical medicine. That's a pretty scary thing to look at written down, it almost suggests that by now I ought to be a fine young clinician-scientist in the making, a suggestion which I feel is just a tad premature at this stage. I have exams in a month and whilst they are formative (i.e. don't count), they're still important for two reasons:

Firstly, habitual perfectionism means that I can't take any exam not seriously, even the ones which don't it's only day 2, but I'm already in revision mode. Admittedly, I'm not taking it to the same extreme as I would for summer exams i.e. 4 hours sleep a night and a diet of Red Bull and whatever's in the library vending machine, but I'm certainly not having a holiday either. And secondly, whilst failing these exams won't see you getting kicked out of med school, it will still lead to an uncomfortable meeting with the Dean and other med school kingfishes, again something I want to avoid. So that's where I am currently, but how did I arrive here? Let's break it down into subheadings:

Feeling overwhelmed

This has been a pretty common feeling for me this term. No matter how well you did in your previous degree, how great you did in your dissertation or however many letters you have after your name, I think most people end up feeling considerably overwhelmed during the first term. There is a lot to learn: I don't think it would be an exaggeration to say I've learnt more in one term here than during all three years of my BSc. I've also forgotten more than I thought possible, something which is producing a degree of alarm as I start revising the notes which I made during the first few weeks ("wow, did I really know this stuff at one point? Why does it seem so unfamiliar now?!")

Practical learning is fun

Social events organised by medical unions and societies generally revolve around getting everyone as pissed as possible. Aside from being a good way to relieve stress (what better way to pretend that that embryology lecture didn't ever happen than drinking til you pass out?), getting pissed is part of the whole settlin' in process. Fair enough, but another good way to become more comfortable with your classmates is to strip off in front of them once a week and take turns to perform practical skills on eachother. Learning clinical skills and examinations has definitely been my favourite thing about this term: it's great fun and helps motivate you during the boringer side of things: just think, if you persevere through embryology, one day you'll get to be a doctor and do this stuff on real patients! (But interestingly enough, everyone keeps suspiciously quiet when asked just how relevant embryology is to the day to day work of most doctors...).

Medicine involves a lot of hoop jumping

I have about as much experience of medicine right now as the comedians on Holby City, but I've already managed to register just how pointless and plain annoying some aspects of this course and job are. For example, having to spend 45 minutes at home filling in worksheets on health and safety law (as requested by one of our teaching hospitals), having to do two library tutorials despite having four years experience of using university libraries, or best of all, having to participate in an online discussion group with allied health professionals just so the med school can tick some box which states that we have an appreciation of the different roles played by members of the mutlidisciplinary team (well, we might do, but it certainly won't be due to those three weeks of utter pointlessness). Still, I'm also acutely aware that this time a year ago I was monkeying around in a lab, so this is really just a minor annoyance as opposed to something I'm genuinely upset about.

The future

This kinda relates to point number 1, i.e. feeling overwhelmed. This term has, objectively speaking, been pretty laid back. We've had a lot of nice n' fluffy modules like public health, medical sociology, etc and usually one whole day off a week. That's been pretty sweet. Next term will be a whole new reality. The fluffy modules will be replaced by hardcore systems modules i.e. actual medical sciences, and there won't be any days off. By all accounts (speaking to students in the year above, people repeating, etc), next term is not really much of a cakewalk. And the exams in the summer actually do count i.e. if you screw up and don't pass the resit, you'd better hope that your old lab manager still likes you enough to give you your old job back. The ominous and persistent worry in my mind is that if I found this term the hell am I going to cope with next term? And let's not even talk about term 3, having seen the vaguely shellshocked looks on the 2nd years' faces last week, I'm just pretending it doesn't exist.


I'm very happy to be doing medicine, but there's no denying that it's one helluva learning curve. And damn it feels good to get this stuff off my chest, I think I'll do some more writing again soon. Words of wisdom on how to feel less overwhelmed are very much appreciated too. Hope everyone else enjoyed their first term back!

Tuesday, 11 September 2012

Work hard, play hard

I had originally planned to make this post on Sunday night, but I don't think I can even begin to describe just how busy I've been this week. Still, I'll take a stab at it.

The moment when you cross the threshold and walk into medical school as a graduate medic is pretty special. In that brief step is contained the hopes, aspirations and efforts of at least three or four years, though for many people even more. It is the culmination of a lot of determination and planning which ultimately results in an amazing feeling: that of relief and contentment. Pure, unadulterated relief, that you've made it and you're where you want to be. So even though it was early morning, and I was walking into an unfamiliar university where I knew no one, my overwhelming feeling was one of excitement to starting induction week.

That first day was something of an anti-climax as far as studying textbook medicine goes, but fun for lots of other reasons. Once the faculty had finished welcoming us and giving us intro talks (most of which in one form or another also involved reminding us that the GMC would not be impressed if we were caught pissing on a war memorial or committing similar acts of "unprofessionalism"), we went off to collect our ID cards. I thought this would be a fairly quick affair, but I hadn't banked on who else had turned up aside from the admin staff. When we walked into the room, we were greeted by a whole host of different organisations and reps who appeared to be there only to (almost) literally throw free stuff at us....and not rubbish stuff either, some very cool/useful things too! I came away from that encounter with a free Oxford medical dictionary courtesy of the MDU, a memory stick thanks to the GMC, a clinical examination handbook from the MPS and enough pens to last me well into my foundation years. From the looks of surprise on some of my classmates' faces, I could tell that I wasn't the only one who hadn't expected this to be part of the first day experience.

That first day carried on with another few talks about what's expected of us as med students by the university, the GMC, the general public, etc, who we can go to for help and support, how the course is structured, etc. It's a systems based course so instead of a traditional pre-clinical course with individual subjects entitled anatomy, physiology, pathology, etc, these subjects are weaved into modules concerning body systems. E.g. in the gastrointestinal system module which I'm doing this term, I'll do the relevant anatomy, physiology, etc concerning the liver, intestines, etc but not, for example, the heart or lungs.

However, since anatomy and physiology are pretty complex subjects at the best of times, let alone if you don't have a life sciences background (which quite a few people on this course don't), the induction week was comprised of sessions to introduce (or re-introduce) us to the foundations of these subjects. There's not much point talking about the anterior abdominal wall if you first haven't told people what anterior means in an anatomical context. So last week was spent covering the basic principles and terminology of anatomy, physiology, cell biology, embryology, etc in daily sessions. This was basically a recap of biomedical sciences for me, and nothing taught was particularly difficult. However, I particularly enjoyed learning about acid-base disorders and arterial blood gas tests as part of the introduction to physiology course, as I had that test a few months ago, and it was very interesting gain an insight into the doctor's thought process which led to her telling me the test results were alright. Indeed, it was a damn good moment when I realised I'm now using scientific knowledge to learn how to interpret a test to eventually treat someone, and not simply to pass an end of year exam.

And for the best bit, we were finally introduced to some clinical skills! Yes! Finally, something practical which doesn't involve a Gilson pipette or an Eppendorf tube! I now know how to take blood pressure manually, how to test for reflexes, use a pulse oximeter and an ear thermometer. Pretty basic stuff which any medical student learns early on, but very fun nonetheless because it really felt good to do something practical involving real people instead of bumbling around in the lab and pretending to care about the spectrophotometer. I realise I keep mentioning the lab, but this entire week has felt very times it's felt like someone's going to come in and tell me actually there's been a mistake and I have a massive PCR write-up to complete...but slowly I've gotten used to the fact that that's no longer the case.

Studying aside, the first week was also very hectic due to the social side of things. Whilst lecturers were telling us to knuckle down from the first week, MedSoc had different ideas and seemed determined to get us pissed every night (with success, I might add). So once classes were done each day, I was going out and trying my best to live up to the medic stereotype of "work hard, play hard". So much so that the inevitable happened and after 6 days of non-stop classes/clubbing/pubbing with nearly 200 strangers from all over the country, I caught fresher's flu for the fifth year running and have spent the past two days with a sore throat and runny nose.

So with that, induction week finished and as of this week I've started the proper timetable i.e. my regular modules which I will be doing from now until the end of term in November. There's a lot to take in, and the sheer amount of anatomy which will be covered seems immense...almost impossible to learn...but I can only assume like everything else, it's simply a learning curve and requires a bit of time to fall into place. The first week has been pretty exhausting and tough with so much new info to take in, but I had a lot of fun too so it didn't feel like a drag at all. And due to a quirk in the timetable, I get tomorrow off, so I can catch up on some all important sleep...very important considering today's classes started at 8 AM!

Monday, 3 September 2012

A note on anonymity

 (If you're short on time, skip to the final paragraph)

I enjoy writing blog posts for several reasons. Firstly, it's genuinely a fun thing to do. Seriously, I encourage you all to give it a try, you'd be surprised! It's actually quite a creative endeavour and being creative is something I'm not normally good at. Like, at all. I can't draw to save my life, I hated having to write stories in school, I can't play music well, etc. But I can write in what comes across as (hopefully) an engaging and mildly interesting manner. Also, blogging is very's amazing stress relief. I spend about 30-60 minutes on each post and by the time I've uploaded it, I already feel like a small weight has been lifted off my mind. The opportunity to reflect on recent events, make sense of what's happened and opine on the future is something I really cherish. So as you can see, I write for many different reasons.

The thing that makes writing on here possible, however, is knowing that I'm anonymous and that my audience are anonymous to me. I'll try and explain the importance of this two-way relationship. The way I write on here is different to the way I speak with my parents, grandparents, friends or anyone else. It's a pretty unique aspect of my life and possibly one of the few arenas where I'm very open about some things which are normally only resident in my own mind. However, this only happens because you, the reader, are not my mum, granddad or best friend. You're someone I don't know at all and have not met. It is therefore easy to write in an open way without feeling judged. So as you can see, it works because you don't know who I am and I don't know who you are.

In this day and age however, it is very easy for anyone with an internet connection, too much time and stalkerish tendencies to do a bit of "digging" and unearth everything about me (or other bloggers) from my real name and hometown right down to my academic timetable! To be fair, I haven't made any attempt to totally anonymise this blog...if I did that I wouldn't be able to give away any details and that would be a bit boring wouldn't it? So therefore, I put some stuff on here which I know full well can give me away...but I do it with the (perhaps naive, given past experiences) hope that people aren't looking to "expose" me.

I've never made a request of my readers before, but now I'm going to break with tradition: if you think you know who I am, please keep it to yourself. Please don't do what some people on my BSc did and organise a "let's find out who the guy behind that blog is" hunt or similar. It made me feel extremely uncomfortable and meant I had edit out a load of stuff...and worst of all, I felt watched and like I could no longer write openly on here. I only feel comfortable writing when I know that I'm able to do it anonymously, so please heed this request and don't ruin the fun for me!

Much appreciated.

Tuesday, 28 August 2012

...and I say hello!

Still can't quite believe I've made it to this point. Here I am, writing in a brand spanking new blog, which will no longer be filled with moans about how much I hate the lab, how much I hate the UKCAT and how I really wish interviewers wouldn't look as if they're about to die from boredom when they're grilling me (you bastards). That chapter in my life is officially over, and I am getting ready to embark upon the journey through medical school: the next stage in my life, which, (finals permitting), will allow me to qualify as a doctor in less than four years time. To put this into perspective there's less than 48 months to go before "Black Wednesday", the first Wednesday in August when I'll join the bewildered ranks of newly qualified FY1 doctors in what has been affectionately dubbed "the killing season". So, in the summer of 2016, coming to a hospital near you...this med school fresher will (assuming all exams are satisfactorily passed) actually emerge as a competent medical professional.

Now for the tricky bit which comes between now and 2016: getting through the next four years in one piece and doing well enough to be awarded the joint degree of Bachelor of Medicine and Bachelor of Surgery by my medical school, who judged me promising enough to grant me a place on their ultra-competitive graduate entry programme. With more than ten times as many people applying as there are places, the odds were very long indeed and many competent candidates fell by the wayside...and someone, somewhere in the med school hierarchy made the decision that I was cut out for this course. So I'm determined to prove them right and this blog will chart my attempts at doing so.

I must admit, I am not the innocent blog virgin you might think I am. I maintained a blog throughout my undergrad and postgrad days studying in London and it was a source of great comfort to me. It was a neutral space where I could write, reflect and bitch about how much I disliked biomed drudgery and how I wished I was in medical school. Well, my wish was granted so here I am, six days away from starting classes and I'm positively buzzing with excitement (and also with a tinge of nervousness, it must be said).

Right now I feel like I'm right at the top of a diving board, poised and ready to jump. I have no idea what this jump will be like, how cold the water below is and whether or not I'll pull it off successfully. But something within me has driven me to this point after so many years. So next week I'm going to make the jump and in four years time I'll resurface with a reasonable idea of whether I pulled it off to gold medal standard or not. I don't know what the next four years will bring in terms of grades, friendships and new experiences, but I know one thing: that for the first time in my life I'm starting a course I want to do as an end in itself, not as a means to getting to some other course. And that feels very good indeed. Amazing actually. So when I do dive next week, I'm going to really enjoy the descent!