growth

Elective Reports

Abiola Adeogun – Medical Elective – Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria


1 Comment

 

Name: Abiola Adeogun

Country of study: United Kingdom

Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Elective Period: 28/03/16 – 22/04/16

Duration of Elective4 weeks

Speciality: Cardiology, Diabetes and Endocrine, Neurology and Respiratory Medicine

 

 

  • What was a typical week like?

A typical week included attending ward rounds and clinics attending occasional teaching with the doctors.

 

 

  • What 3 things did you learn?

1) Making a diagnosis without relying on e.g. imaging and test results.

2) Management of tropical diseases.

3) The structure of the healthcare system in Nigeria.

 

  • What were your most enjoyable moments during your elective?

Being able to go to theatre.

 

  • What similarities and differences did you notice whilst on your elective in Nigeria, in comparison to the healthcare service you have witness whilst at medical school?

Differences in doctor patient relationship, communications skills, organisation and resources.

 

  • What were your goals? Where you able to achieve your goals, and how?

To have a better understanding of healthcare system in Nigeria and be able to compare team dynamics. To identify medical ethical challenges in the hospital and their implications. To explore the possibility of working as a Doctor in Nigeria in the future.

 

  • If you had the opportunity to reorganise or redo your elective, what would you change and why?

I’m really glad that I had the opportunity to work in a state hospital and I have no regrets. If I had to redo my electives, I think I would prefer to work in a smaller hospital or private hospital as I feel I would have been more involved and the experience would have been more hands on. I felt the environment in the state hospital that I worked at was sometimes too busy and lacked organisation.

 

 

 

  • Looking forward, how has your experience impacted your career and personal life?

A lot of communication with patents was in Yoruba. As I don’t understand the language I had trouble following some of the consultations. I realise that if I decide to work in Nigeria in the future, I may need to learn the common languages. My cousin was admitted to a private hospital whilst I was in Nigeria. Visiting her at the private hospital enabled me to see what practicing medicine is like in a private hospital, observe doctor-patient interactions and the general work ethos. I think I would prefer to work in a private hospital in Nigeria in the future.

 

Elective Reports

Wumi Oworu – Medical Elective – University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria


1 Comment

 

Name: Wumi Oworu

Country of study: United Kingdom

Elective Location: University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria

Elective Period: 04/04/16 to 27/05/16

Duration of Elective8 weeks

Speciality: Obstetrics & Gynaecology

 

My experience in Nigeria was a wonderful experience, although I have visited Nigeria several times before, this elective period was my first experience of living in Nigeria independently and working in a healthcare setting. Starting at the beginning, I arrived in Gwagwalada on Monday and met with my supervisor Professor Ekele, who briefly described what was to come while at AUTH. I was introduced to the head of the O&G department and the senior class representative from the University of Abuja Medical school, a young man called Etuk, who assisted me with settling in. Etuk showed me to my accommodation and was kind enough to take me to a few places to buy some food, utensils, etc. My accommodation, was a 2-bedroom flat in a block of flats containing only medical students, I had my own bathroom and I shared the kitchen and living room with my flatmate. The accommodation was a few minutes from the hospital, but still on the hospital grounds. The flat was clean and well kept, with good space and the basics. Later that day I met my flat mate Tolu, who was a lovely young woman in her penultimate year of medical school.

                                           

During my 8 week placement, I was allocated to one team for 4 weeks, where I joined them on their ward rounds, gynaecology clinics, antenatal and post-natal clinics, theatre sessions and on-call duties. Every week day morning began with a morning meeting, cases that were managed the day before were discussed and assessed. I spent 2 weeks in the labour ward, observing and assisting in the management of labour and Caesarean sections. I spent a total of 2 weeks in the gynaecological emergency unit and special care baby unit. During my elective I was taught how to perform vaginal examinations and perform a pelvic examination using a speculum. During antenatal clinics I had the opportunity to examine numerous women at various gestations. I attended to a few patients independently under the supervision of consultants in the gynaecology clinics. I performed investigations such as pap smears, endocervical swabs and high vaginal swabs. I observed cases that are uncommon in the UK, such as large uterine fibroids, primary presentation of metastatic endometrial cancer and the management of labour in a patient with sickle cell disease. I understand the Nigerian Healthcare system consists of both a private sector and national health service insurance scheme, both with their own advantages and disadvantages. The use of traditional medicine also had an impact on health, I often observed patients with advanced disease because they delayed their presentation to the hospital because they sought cheaper traditional alternatives. I had theopportunity to complete a cross-sectional study titled, ‘The Perception of pregnant women about Caesarean section at the University of Abuja Teaching Hospital, Gwagwalada’. It consisted of 131 pregnant women presenting to ante-natal clinic. I was granted ethics approval for this study. I used interviewer-assisted structured questionnaire to collect data. The acceptance rate was 70%, other literature quoted acceptance rates of 7-30%. The study showed a higher acceptance rate amongst pregnancy women who were older, married, multiparous, educated and have had a previous Caesarean section. This developed my research skills; it also exposed me to the difficulties of international research such as language barrier and limited resourced such as electricity, internet and time constraints.

                    

 

I enjoyed the food to the absolute maximum, I probably ate grilled catfish at least twice a week and utilised the hospital canteen and ate pounded yam with egusi (my favourite) often. I definitely ate well while in Nigeria. The heat Gwagwalada was a different experience entirely, one I have never experienced before, I learnt to avoid being outdoors between 9am-4pm, to be well stocked up on bottled water and bought a mini-fridge as soon as I arrived (to the manifold wisdom of my mother).

 

                                                 

 

When not working at the hospital, I often enjoyed myself in Abuja with my cousin and the new friends I’d made. I appreciated the order and subtleness of Abuja, in comparison to the hustle of Lagos.

I also had the opportunity to visit Kaduna, which was just a 2 hour drive away from Abuja, or an hour flight from Lagos. I also visited an orphanage a couple of times and gave some assistance.

            

I wish I had taken the opportunity to visit Jos, a popular city known for their cool climate, internationally known for their medical education at the University of Jos, as well as other things. Once my elective was complete, I travelled to Lagos to spend some time with friends and family.

                                      

 

My elective has enriched my undergraduate education, I developed basic obstetric and gynaecological skills which will be useful throughout my career. I have improved my knowledge and skills in maternal and foetal medicine. It has also given me an appreciation for the healthcare system available to patients in the UK. I have experienced another element of medicine that I will always be  grateful for.

My experience has made me more passionate about pursing a medical career in Obstetrics and Gynaecology. It has also exposed me to potential opportunities in the Nigeria, especially for someone like myself – young, ambitious and open-minded.

Blog

Poem: At the Forefront


No Comments

At the forefront

They say that whatever doesn’t kill you makes you stronger

Say that to the oncology patients, the pain in their eyes, wishing not to remain any longer

My heart tremors as I walk down the corridor

The palpitations of my index fingers are too persistent to ignore

My trachea collapses every time my beeper goes off

I sweat and sweat, I try to replenish it with water, but it’s not enough

Hours on the ward seem to be long days that make me weary

I think I’ve caught what the patient was diagnosed with in bed three

Although I’m told not to, I self-diagnose

Lists of symptoms and signs I compose:

  • Fears of not being able to supply their demand
  • Suffocating my thoughts with predictions and plans
  • My imagination runs wild as I begin to contemplate
  • Mistakes and devastating actions I could make
  • That leaves someone who trusted me in pain
  • Scribbling my signature at the bottom of their records – shame
  • Blood stained resume no longer fit for practise

(A disgrace to the Medical Council, incompetent and useless)

  • These notions come to greet me every moment of the day
  • They’re absent at breakfast, present at lunch, occasionally there at dinner, they never go away
  • Making me question my ability and sanity in this field
  • I’m no longer in control of how I feel

But since I’ve started sharing the content of my mind

Something has been fertilised inside

Teamwork introduced me to ‘Mechanism to cope’

These thoughts of the day seem to be replaced with hope

Lately I’ve befriended a new angle of view

It is a subtle friendship because those that know about it are few

The budding beginnings bring about brand new brainwaves

Constantly contemplating and constructing confident considerations which are crucial

I think I’ve come to understand that I’m not the superhero the world has been waiting for

This fight isn’t over; battles are being won every day but we all remain in war

Nevertheless it is the daily combat that keeps things ticking

The persistent resistance against invasion

The inconsistent resilience that makes us human

And the hope of tomorrow that keeps us going

 

 

 

This poem is titled ‘At the forefront’ because it expresses the thoughts of a doctor who is struggling with the harsh uncontrolled reality of death and disease. They are constantly faced with patients who look to them for help to overcome their terrible disease they battle. At first it is all too much for Doctor A, the mental and emotional problems are presenting themselves physically, or so he believes. This portrays the first big idea in Whole Person Care, ‘Illness and its remedies lie at many levels within a system’; although the pathology can be explained through the activity of adrenaline in the body there is an emotional level that suggests a the trigger for the release of adrenaline, it is more likely that clinical signs have emotional factors are their trigger. This also addresses idea seven, “We can learn from different philosophies of health.”; the psychobiological relationship presented by Doctor Amid shows that his mental health affected his physical health, hence the physical manifestations of his worries. Integrative Medicine is employed by many practitioners to focus on the patient as a whole and to make use of all appropriate therapeutic approaches; if Dr Amid presented his physical symptoms to a fellow doctor it would be easy for his colleague to be absent-minded towards Dr Amid’s emotional symptoms and only treat the physical issue.

He comes to a point where he is emotional attached to the patients he cares for. In order for a practitioner to relate to their patient they must be able to empathise, it should be something that is constantly applied throughout a consultation. Although, being human means a doctor is often subject to emotion, empathy can consume a doctor, leaving them in a dysfunctional state. “…I think I’ve caught what the patient was diagnosed with in bed three. Although I’m told not to, I self-diagnose. Lists of symptoms and signs I compose…”. But this is something that we can all identify with, when we’re too attached to a vulnerable person we become we bear their burdens as if we were them. Empathy should be a costume doctors wear when needed, but in order to make rational decisions this costume must be taken off, it is then put on again when appropriate.

‘…Effective relationships are central to effective care…’ is the fourth Big idea, kit wasn’t until Dr Amid shared his fears and used the support system around him that he was able be released from his prison of negative thoughts. It was through teamwork that he was able to know about these mechanisms.“…But since I’ve started sharing the content of my mind. Something has been fertilised inside. Teamwork introduced me to MOC ‘Mechanism to cope’. These thoughts of the day seems to be replaced with hope. Lately I’ve befriended a new angle of view…”. The effective relationship between Dr Amid and his colleagues lead him to effective care.

The poem ends with Dr Amids new thinking; it is evident that the new technique adopted by him has created resilience. This ending does not paint a safe, comfortable and nice image of life as a doctor but accepts the reality that death is painful and despite human intervention, is inevitable. “…The inconsistent resilience that makes us human…” this shows that Dr Amid is still on a journey, like many us this journey may last for a lifetime. In practise resilience can be hard to define because people are different therefore their resilience will manifest differently; there can be no time allocation, characteristics criteria, physical duties or a check list to be ticked off. Resilience in intrinsic, it is a characteristic that can only be activated by yourself, which confirms the sixth Big Idea ‘…Self-care helps create resilient practitioners..’.

Dr Amid is a fictional character that represents the thoughts and worries of medical students and doctors.

 

Photo Credit: PhotoPin

Blog

Hard Work


No Comments

A subtle change in a phrase will change your outcome.

 

For one to succeed, one must work hard – this is a misunderstanding.

The word hard suggests the anticipated task is difficult, tough or problematic. Although, we may just be playing around with a thesaurus, let’s use the word challenge instead. The word challenge suggests the anticipated task is a trial, test or experiment that hopes to yield success, growth, development and change. Sometimes, a subtle change in a phrase will change your mindset. A subtle change in your mindset will change your actions. A subtle change in your actions will change your outcome.

Try using the word diligent instead, diligent means, showing careful and persistent work or effort.

Diligent Work.

 

A subtle change in a phrase will change your outcome.

 

Share your thoughts with us.

Blog

Repeating The Year – Some Words of Wisdom Part 2


1 Comment

To be told you have to repeat the year to remain in medical school is a scary thing, but having the option to repeat the year is an opportunity that is not provided to all medical students. Medics’ Inn have provided a few pearls of wisdom for our readers, we have gathered some advice from several medical students who repeated a year of medical school. Have a read of Repeating The Year – Some Words of Wisdom Part 1.

 

 

*Sigh*

Let yourself feel rubbish for a while, your feelings are valid. Repeating the year is a big deal and it is not easy. Let yourself go through the journey. Failure is part of the human experience.

 

 “My family are not supportive…”

It’s difficult to not take it to heart, it’s not right but it’s not your fault. They will come round eventually, but mean while find your support from elsewhere. Don’t bottle it up, there are other people who are genuinely concerned and there are lots of places to get support from.

 

“Is medicine still right for me?”

Talk to people about your concerns but make sure you frame your own thoughts first, the pros and cons. Intercalating or taking a year out may be beneficial. Give yourself as many options as you can. Have a think about these questions:

  1. What were the reasons you initially chose to do medicine?
  2. Could you see yourself working as a doctor several years (or decades) from now?
  3. What is stopping you from pressing on? Fear?

 

“I don’t want to be judged by colleagues, lectures, friends, family…”

If you’re being judged, that’s their problem, not yours. You cannot control what other people think about you, but you can control how you respond. Don’t hide away and don’t be scared of making friends in your new year.

 

“It will just be the same thing, and another year wasted …”

Use your old notes to help you. Try new things, join a new club, etc. It may be scary, but new experiences will tell you who you are as a person and not who you should be. With the right attitude, you will have a new found sense of freedom and there will be open doors of opportunity if you’re looking. You will develop resilience and courage. This experience can stop you from fearing failure.

 

At the end of your repeated year, ask yourself these questions and really thinking about your answers and what they mean to you. (It might help to write your answers down on a piece of paper)

  1. How did you feel when you first received this information?
  2. What was your greatest motivation?
  3. How have you used your repeated year to better yourself?
  4. What did you learn about yourself that you did not know?
  5. What were your greatest fears and how did you overcome these fears (if you have)?

 

 

Medics’ Inn

Blog

Repeating The Year – Some Words of Wisdom Part 1


No Comments

To be told you have to repeat the year to remain in medical school is a scary thing, but having the option to repeat the year is an opportunity that is not provided to all medical students. Medics’ Inn have provided a few pearls of wisdom for our readers, we have gathered some advice from several medical students who repeated a year of medical school. Look out for Repeating The Year – Some Words of Wisdom Part 2.

  • Feelings of the following are normal: embarrassment, failure, shock, fear, loneliness, insecurity, pain, inadequacy, etc…
  • Stop trying to rationalise why this has happened.
  • Accept help, correction, advise from others, other students, teaching fellows, there is no shame in that, nor in repeating itself.
  • Don’t become obsessed with the numbers, e.g. things like “rankings” – ranking is surmountable, and you will still get a job, top or bottom decile.
  • Don’t be complacent, e.g. complacent with only making one change, or no changes, or just doing what you deem will get you just the 50% or will match the bare-pass you achieved last time!
  • Mentally prepare yourself and even practise how you may or may not wish to explain your position, about why you are in this year group, and who you may or may not care to tell, because the most tactless to those with the best intentions may ask at the least convenient times. Not everyone needs to know your business, and similarly you don’t need to be ashamed. Remember that in a year or so, people will no longer care/ know about your detour
  • Don’t compare yourself to others ever, whether they have or have not intercalated, know all the answers in teaching, get 100% in every e-biolab or quiz, are years younger than you, are first authors in the Lancet – don’t compare
  • If you are ever, for any reason experiencing difficulties (health-related, personal and emotional) beyond the work of revision, during the year – do not miss the opportunity to submit extenuating circumstances before God-forbid, you may find yourself repeating anything!
  • Don’t burn-out by setting unrealistic expectations of yourself. Seek help from friends, Faculty, GP, student advice service, if necessary!

Now, answer these questions and really thinking about your answers and what they mean to you. (It might help to write your answers down on a piece of paper)

  1. What is your greatest motivation in life?
  2. In the past, what were your greatest fears and how did you overcome them?
  3. What do you want to achieve in this year you will repeat?

Medics’ Inn