TSR Med Students' Society Part VI

Just practice I think. You get used to the common differentials.

It is important to get over though. Your approach might work for exams, but irl patients have atypical presentations and weird symptoms an impressions can be wrong. Just today: guy is SOB, pleuritic chest pain, small volume haemoptysis, active cancer, and a suddenly and grossly distended and oedematous arm on one side that preceeded the SOB. No cough, no fever, no sputum, CRP 10. DVT followed by PE right? Nope, it was infection. Med school exam that answer would be wrong. Real life: it happens. Common things are common.

this stresses me out.

so was it like two diagnosis? did he at least have pain in the arm?

Actually, DVT and PE would be reasonable in this case. So would two diagnosis. I would be fine with that. I guess its just being able to think of it, problem solve a bit more as opposed to just putting all my eggs in one basket.

Huh? I thought it was DVT and PE, it actually was just HAP and ?? for the arm - it just got better.

No he didn't have pain in the arm. Except from the like 10+ cannula attempts to get his CTPA, anyway.

I was saw a guy, post op from abd sx. he was SOB. they treated fro atelectasis--> wrong. Treated fro pneumonia next --> wrong. Once they realised he was in heart failure it was too late. He actually had a past history of angina. But since "post op SOB =atelectasis/pneumonia", no one thought to think heart failure until the last minute.

I know patient present atypically, but its still logical. Patient with chest pain isn't suddenly going to have gout.

hello does anyone know where I can find information on the cutoffs for jobs once you are allocated a deanery
for example if you get into South Thames, what score would i need (EPM+SJT) to get into the London hospitals for example?

Thank you

So one of my profs confused me when he said a 3rd degree heart block is regular.

I thought regular rythms were those were the R-R intervals were the same?

this stresses me out.

so was it like two diagnosis? did he at least have pain in the arm?

Actually, DVT and PE would be reasonable in this case. So would two diagnosis. I would be fine with that. I guess its just being able to think of it, problem solve a bit more as opposed to just putting all my eggs in one basket.

I was saw a guy, post op from abd sx. he was SOB. they treated fro atelectasis--> wrong. Treated fro pneumonia next --> wrong. Once they realised he was in heart failure it was too late. He actually had a past history of angina. But since "post op SOB =atelectasis/pneumonia", no one thought to think heart failure until the last minute.

I know patient present atypically, but its still logical. Patient with chest pain isn't suddenly going to have gout.

Could have an inflammatory arthritis of their shoulder (inc gout) which could easily present with atypical chest pain with radiation into neck and arm, if such a patient was to present then pretty sure classical chest pain causes would be ruled out first

then the presentation would be shoulder pain

Hi, a little concern about my mental health lately. Although i manage to complete logbooks and meet the minimum 75% (attendance is higher but no 100%) I can't help feel like university might throw me under the bus etc. Might have been mistake to discuss my issues (low mood) with uni...

Even if my attendance does become an issue does is it grounds for exclusion?

Hi, a little concern about my mental health lately. Although i manage to complete logbooks and meet the minimum 75% (attendance is higher but no 100%) I can't help feel like university might throw me under the bus etc. Might have been mistake to discuss my issues (low mood) with uni...

Even if my attendance does become an issue does is it grounds for exclusion?

If you, over the period of 2-3 years, fail to attend and take steps to manage your mental health (discussing with uni, arranging time off/sabbaticals, seeing your doctor and engaging with self-management) then you'll end up getting excluded. As you can imagine, though, that's pretty hard to do!

You may end up having to repeat a year or something if you fail to meet the standards due to difficulties with your mental health - as you might expect - but I think universities overall are sympathetic if you're forthright with them. Submit extenuating circumstances now, see your healthcare professionals, and start making positive steps. Lots of medical students suffer from physical and mental health problems that interfere with their studies - and almost all of them find themselves being accommodated, and manage to find a way!

Having students drop out looks very bad for them, they have absolutely no incentive to do that.

Just focus on yourself. There is no need to be paranoid.

Thank you for the support. Biggest concern is that one attachment Psych I have been asked to do remedial work. I do feel a-little anxious/paranoid, but I have been open and been seeing GP/Psychiatrist. I have been waiting for CBT for a year and is key. I think i need reassurance.

You do need to work with the med school on this one, so that they understand where you are coming from, and set helpful goals.
It doesnt stop you needing to remediate, as they do have to assure the GMC that everyone coming out at the end has been properly training. So you may need to do some repeating, it isnt a ‘get out of jail free’ pass. But what it does is ensure they put the right adjustments and support in for you so that you can be successful.
It may be that they can speed up the wait for CBT for example.

Thank you for the support. Biggest concern is that one attachment Psych I have been asked to do remedial work. I do feel a-little anxious/paranoid, but I have been open and been seeing GP/Psychiatrist. I have been waiting for CBT for a year and is key. I think i need reassurance.