Greetings from Melbourne!
Apologies for not updating sooner but it’s been a challenging week for me on my first week of selective. And it’s been really full-on with highs and lows. That I shall now recount.
It’s my first week of living in an apartment with two flatmates. Both of whom are super organised but have been very nice and accommodating. It’s taking a while to get used to. When you live in an apartment you appreciate the value of hot water and electricity. You can’t have the heater on all day, you can’t take a shower for any longer than 15 minutes, you have to wait your turn to use the bathroom in general. You have to get used to the fact that everyone has a different sleep schedule and because you live in such close quarters someone is bound to be disturbed. One of my flatmates has crazy work hours and basically comes crashing in past midnight now and then. However, the following day, I crash around trying to make a cup of tea while he tries to sleep. And you’ve got to preserve electricity for when you need it.
That’ll be for the heaters.
Melbourne is 9 times colder than Auckland. It’s ridiculously windy and I haven’t seen sunlight in 5 days. And my apartment is lacking in insulation so things get extra chilly at night.
But otherwise, I’m super grateful for my little flat. My flatmates are great and I’m finding this new change quite endearing. Hopefully I’m a good flatmate too.
In terms of my selective, I’ve had an interesting week. The Alfred hospital is where I’m based and it’s pretty huge. But the medical school (as all medical schools seem to be), is completely useless.
I walked up to the clinical school on Monday, earlier than I was expected, and waited a full hour to be oriented. The selective coordinator I had been in contact with told me my “supervisor will come to collect me”. Instead, another doctor showed and took me through the basics of being in hospital. Avoid infections, wash your hands, patient confidentiality, don’t kill anyone, etc. After that he left me with the registrar on the gastroenterology team for a ward round. After which, I still hadn’t met my supervisor. So I went down to his office, and he wasn’t at his desk. So I returned to the gastro department and asked my registrar where I could find him. A lady nearby said “oh he’s on leave for 3 weeks”
……..seriously? I have to have a pre-selective catch up, a midway catch up and an end of run catch up at which point my supervisor fills in my final report. I can’t do any of that if he’s away for 3 weeks!! And the most annoying thing was, I had told the lady I was in contact with all of this. So when I emailed her asking if she knew this, she said she had no idea and that I should ask my registrar who the “acting” director was and he/she would be my new supervisor. Eugh.
My registrar didn’t know who the acting director was. Double eugh. But she finally introduced me to a consultant who agreed to be my supervisor but could only meet me for 10 mins at the end of the week. Eugh eughh eughhhh.
So until then, I was stuck following the registrar around on ward rounds. It ended okay. I caught up with the other consultant, he was nice enough, gave me a project to do over the next 5 weeks, so that’s good.
But omg the ward rounds.
The ward rounds on gastroenterology are a minimum of 4 hours. I haven’t been on ward rounds since OBGYN. And those were pretty straight forward. All the women were either pregnant or had tummy pain. So I wasn’t used to the burning pain in my legs and feet as I trudged up to the 7th floor to see more patients after 2 hours and counting. But the horrific part wasn’t even the pain. It was the fact that everything about these ward rounds reminded me of my gen med rotation last year.
The rounds where you have no idea what the patient’s backgrounds were but you have to stand awkwardly in the room, turn the lights on, draw the curtains, and listen as your reg talks to the patient about their ongoing care. And they’re moving at a pace such that asking what this particular patient came in with would be the last thing they want to answer. The house officers are feverishly writing notes, so they’re no good either. So as the most junior person, you stand around and think about how you’re not learning anything.
But I am no longer a lowly 4th year student, traumatised and vulnerable, pushed around by superiors, and intimidated by everyone for no good reason. Crippled by the fear of appearing incompetent that I actually come across as less competent than I am. Yeah nah. That’s sooo last year. If I learnt anything from last year, it’s that you are the only person responsible for your learning. And that means ditch the ward round if you’re not learning anything. Find somewhere else to be. If your time is better spent studying, go for it. Better spent in clinic? Go there. Endoscopy? Hell yeah. Don’t force yourself to be in a situation where you’re not gaining anything just because you’re “expected” to be there. I showed up to all of 2 ward rounds this week. I went to clinic where the one-on-one time with consultants is the best to learn about gastro diseases. I went to endoscopy where I saw some pretty cool stuff, but left early when it was a couple of mild reflux oesophagitis cases being scoped. Time better spent reading up on IBD. Of course someone will always try to undercut you, like a consultant who decides you’d learn more about “acute management” on a ward round on the 4th day where the list hasn’t changed, than go to a liver clinic, but even then, don’t be upset. When I’m on that ward round, I do ask my registrar questions and I do persist in learning. And even if I don’t, in useless situations, even if you don’t learn how to practice medicine, you’ll definitely atleast learn how not to practice medicine, And even that, is good learning.
Taking responsibility for your own learning means that you can’t expect anyone else to care or take an interest etc. But it does give you the freedom to do the things to learn the most you can. And it means you don’t have to care too much about them either. Just make your learning work for you. I’ve been following this. And it felt good. I’m more excited to learn on gastro than I have been on previous runs.
But anyway. I shall make another post about the merits of Melbourne as a city. Not just hospital related stuff. Because this place is huuuge.
And in a big city, when you’re having a tough week, the best way to blow off some steam is go exploring at night in the rain and capture some pretty lights.
This is the Melbourne state library at night. Finally a picture with my canon. It’s been a while. Very good effect with the rain by the way. Even though I was freezing.