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Reply 2480
Original post by Captain Crash

Original post by Captain Crash
Wonder how they do it?

In Cambridge all the female surgeons seem to have filthy rich husbands so can afford to pay a small army of nannies to look after their children. Aside from this, having a house husband or taking part time training (which still seems to be looked down upon by many senior surgeons) seem the only alternative ways.


You clearly missed the CUSS event last week. One of the speakers is mum of one (for almost a decade) and mum to be of second and until recently was a single mum. She just got get CCT in CT-surgery...:p:

Of the 6 speakers, only one could really afford a nanny ad/or have a "filthy rich" husband. It really was a bit of an eye-opener. (Well, 2 out of 7 if Miss Fernandes could make it :P )
(edited 13 years ago)
Original post by digitalis
I really don't understand the point of this. Barts does it as well, so it's not a UEA diss.


I agree. Aberdeen have just started throwing first years onto the wards this year and they're like bunnies in the headlights. I don't quite see what they're gaining from clinical exposure when they don't know anything clinical yet, except that they can feel like proper grown up medical students?
Reply 2482
Until my 5th year, I was rather annoyed we weren't really given much clinical contact at all in the first three years. Now, it all makes a whole lot of sense. That and having very little to "sign off" at each placement. We're not there to get bits of paper ticked and jump hoops (for themost part) but to actually learn ****.
To me it would make sense that having a decent, broad understanding of the basic sciences covering the whole body is pretty vital for getting the most out of clinical exposure and understanding what's really going on. But then I'm still a baby second year, that opinion may not stand when I start clinics.
"This is a 78 year old gent with diabetes"... Cool, what's that all about? "Err, why don't you just go take a social history instead? It will give you useful communications skills"
I definitely wouldn't have wanted to go out in first year to the wards considering how little I knew clinically. Even now I think my knowledge, clinically, is very basic, and that is after 2 years. Then again thats why I choice a place with a more scientific background first before full on clinical exposure
Reply 2486
I liked going on the wards in first year. I hated lectures and wanted to be in the hospital environment. Yeah I was as useful as a chocolate poker but I did get something out of it.
Original post by digitalis

Original post by digitalis
I really don't understand the point of this. Barts does it as well, so it's not a UEA diss.


However, at UEA the majority of our teaching for rheum + ortho is this module - we are taught everything all at once and then don't really go back to it unless it relates to another disease that comes under a different speciality, so we are actually taught the sciency stuff behind the diseases as well as the social effects etc. So basically, if I see a patient with Paget's/SLE/RA etc etc then I actually know about the disease, know to ask for specific symptoms within specific diseases, so I actually find it very beneficial when it comes to remembering disease for exams and such, as I can just remember the patient and the symptoms they had.
Original post by Mushi_master
To me it would make sense that having a decent, broad understanding of the basic sciences covering the whole body is pretty vital for getting the most out of clinical exposure and understanding what's really going on. But then I'm still a baby second year, that opinion may not stand when I start clinics.


I agree. We do still do the cushy stuff such as have a placement every once in a blue moon in either a GP or hospital (if you're lucky) or somewhere completely random like an Age concern centre or sheltered housing in order to practice "communication" and "social history" and stuff, and also we have a patient come and visit us once every so often and we have to write cushy reflective stuff in a portfolio afterwards, but that's about it really. And I'm glad for it. I remember going to see a lady early last year with liver disease in a ward once, and later on saw a patient with rheumatoid arthritis but didn't know much about either disease so if they went on about their treatment/symptoms/diagnosis etc (with rheumatoid arthritis especially) I didn't know what the hell they were on about. Yeah I knew vaguely how many units of alcohol is supposed to be the limit and stuff like that but nothing else, which meant whilst it was a good exercise to learn how to take a social history, I got nothing else out of it and that sort of thing isn't too hard to do really.

Whilst some of the science we're learning now seems too much in depth to be relevant, I do enjoy having a good knowledge of it as it means instead of jumping through hoops in terms of the science bit and learning things on the surface and why diseases are as they are, we learn more about the mechanisms which makes it all make more sense in the end, even if we don't remember everything we're supposed to learn by the time we're doctors.
Original post by Jessaay!

Original post by Jessaay!
I remember going to see a lady early last year with liver disease in a ward once, and later on saw a patient with rheumatoid arthritis but didn't know much about either disease so if they went on about their treatment/symptoms/diagnosis etc (with rheumatoid arthritis especially) I didn't know what the hell they were on about. Yeah I knew vaguely how many units of alcohol is supposed to be the limit and stuff like that but nothing else, which meant whilst it was a good exercise to learn how to take a social history, I got nothing else out of it and that sort of thing isn't too hard to do really.


See we've been taught all this (for rheum+ortho) in this module. I think we maybe seem to have a different course structure compared to most :erm:
Original post by xXxBaby-BooxXx
See we've been taught all this (for rheum+ortho) in this module. I think we maybe seem to have a different course structure compared to most :erm:


Aye, but our pre-clinical years aren't structured based on disease or areas of medicine etc. We do learn about them, but it's not our main focus. For example, in our most recent module we're doing the GI tract (anatomy/physiology), and a lot of biochemistry. We'll learn about the functions of various parts, for example we'll learn about glucose metabolism, then we do learn briefly about the things that "go wrong", for example, we'll learn about diabetes (treatment, symptoms and why it happens) within the part about glucose metabolism. I think the difference is we have much less of a clinical focus in the first two years, so I would say less of our course is based around disease etc, but more around the science of the body and then when we get to our clinical years we'll look at things clinically (obviously) and say, if we got a case study on a patient with malabsorption for example, we'd link it back to our basis of study, rather than just having learnt the symptoms and treatment itself. So we won't have rheum/ortho module, but they'll come under different, less clinically based headings.

I don't know if I'm making sense but I think that's the main difference. We're so lecture-focused I don't think we'd have time to go on wards.
(edited 13 years ago)
Reply 2491
Original post by Sarky
I liked going on the wards in first year. I hated lectures and wanted to be in the hospital environment. Yeah I was as useful as a chocolate poker but I did get something out of it.
I agree, I quite enjoyed it. Helps keep things in perspective.
Original post by Jessaay!
Aye, but our pre-clinical years aren't structured based on disease or areas of medicine etc. We do learn about them, but it's not our main focus. For example, in our most recent module we're doing the GI tract (anatomy/physiology), and a lot of biochemistry. We'll learn about the functions of various parts, for example we'll learn about glucose metabolism, then we do learn briefly about the things that "go wrong", for example, we'll learn about diabetes (treatment, symptoms and why it happens) within the part about glucose metabolism. I think the difference is we have much less of a clinical focus in the first two years, so I would say less of our course is based around disease etc, but more around the science of the body and then when we get to our clinical years we'll look at things clinically (obviously) and say, if we got a case study on a patient with malabsorption for example, we'd link it back to our basis of study, rather than just having learnt the symptoms and treatment itself. So we won't have rheum/ortho module, but they'll come under different, less clinically based headings.

I don't know if I'm making sense but I think that's the main difference. We're so lecture-focused I don't think we'd have time to go on wards.



It's completely changing though! And will totally affect you. From Sep 2012 we're changing. No more PDS. More patient contact, some PBLy BitS :angry::angry::angry::angry:

Thank god I'm barely affected. Only difference for me as a final year will be the ability to resit but 4 less weeks to revise as a result!
In other news - unless it was one of you guys, a nursie negged me. I'm tempted to subscribe just to get her back :O
Original post by Philosoraptor
In other news - unless it was one of you guys, a nursie negged me. I'm tempted to subscribe just to get her back :O


Don't give into the internet rage.
Original post by Fission_Mailed
Don't give into the internet rage.


But I went over there to give a nice opinion due to Wangers invitation, and they neg me?
How dare they...


How VERY dare they
Original post by Philosoraptor
But I went over there to give a nice opinion due to Wangers invitation, and they neg me?
How dare they...


How VERY dare they


So you're going to spend £4 just so that you can have your revenge?
Reply 2497
Back to acupuncture for a sec... (I don't know if this was one of the papers talked about earlier)

New mega-systematic review out for acu and pain. It was a systematic review of 57 other systematic reviews, lol. Basically, it's not very good for pain, and it's not harmless. Lots of conflicting results in the weaker studies, lots of negatives in the rigorous studies. Surprise.

Also, it is impossible to do double-blinded placebo controls, so that's an issue, and is sufficient in some cases to explain some of the weak positives.

Several cases of site infections, a few pneumothoraces, and 5 deaths. All from something that is no better than placebo.
Original post by SMed
Back to acupuncture for a sec... (I don't know if this was one of the papers talked about earlier)

New mega-systematic review out for acu and pain. It was a systematic review of 57 other systematic reviews, lol. Basically, it's not very good for pain, and it's not harmless. Lots of conflicting results in the weaker studies, lots of negatives in the rigorous studies. Surprise.

Also, it is impossible to do double-blinded placebo controls, so that's an issue, and is sufficient in some cases to explain some of the weak positives.

Several cases of site infections, a few pneumothoraces, and 5 deaths. All from something that is no better than placebo.

Hmm, well massage/acupressure?

I will put my hands up and say that I haven't looked into it - but seeing as I'm doing a Systematic Review as we speak - I think I'll be able to trawl through the evidence pretty quickly when I get round to it.
Early clinical exposure isn't just about learning how diseases present, it's more about building your confidence talking to patients. I've found it useful in that sense. Next year when I start clinical medicine, I'll inevitably feel more comfortable in a ward environment and in talking to patients. I'm actually a better medical student because of it. Yeah, I've not got much in terms of science, but I think people underestimate just how important good communication is.

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