You don’t have to have been following me for long to know that I do like putting together those “typical timetable” and “a week in the life of a med student”. I think they’re perfect for giving a true insight into what each year is like and the sorts of things you’d be doing.
For third year however, this is very difficult as no 2 days are the same and each day we have the privilege of being able to decide which ward rounds, clinics or other clinical experiences we want to attend. Since I’ve just* finished my Endocrinology block I’m just going to talk a little bit about what that was like and talk through one of my not-so-typical weeks during this block…
*just referring to 6 weeks ago when I first started putting this blog post together!
So with Endocrinolgy there’s a lot of diabetes, as you might expect. It’s quite incredible how many avenues to diabetes there is from the regular mangement to dealing with complications, managing women prentally and through pregnancy. A good portion of Endocrinology also involved the diagnosis and management of thyroid disorders. Endocrinology is typically an outpatient speciality for this reason so the only time I really saw “endocrine patients” during this block was when I was in the clinics and patients came for their routine check ups.
The endocrine wards tended to be general medicine so there were lots of patients with a cardiology or respiratory presenting complaints, patients presenting with confusion, falls etc. Throughout my 6 weeks on this block I can only recall 2 cases of acute endocrine problems and they were diabetic ketoacidosis (which is when a person with type 1 diabetes starts gets very high blood sugars and starts to produce ketones) and thyroid storm (very high level of thyroid hormones which can be life-threatening).
I feel as though Endocrine was a nice place to start and it’s been able to give me a nice overview of Medicine as we did see a good variety of patient presentations. Here’s a week to show you a little more…
Monday
SPS stands for Student Pastoral Support. At the beginning of 3rd year we all have to have a meeting with them just as a check in, so I had mine on that particular Monday morning.
In the afternoon I had a pituitary clinic which was quite interesting to be in. I saw a lot of interesting pituitary related conditions, things that you definitely wouldn’t normally see.
Tuesday
One of the major advantages of our timetable is that we can pick and choose what we want to go to and essentially arrange our own timetables. Green is compulsory so those sessions can’t be changed, but anything else we can cancel, or swap out for something else as it suits us. We obviously need to have a certain number of “red activities” on our timetable by the end of the block, so cancelling them all and making yourself completely free wouldn’t work.
I decided to keep my Tuesday pretty free as I had pre-arranged my on call that day so I didn’t want to have a very busy clinical day and be too exhausted to stay on till 8pm. I had a bit of lie in in the morning, then did some of the work for this week’s case then spent some time on the wards taking histories from different patients.
At 5pm I had a group meeting with my F2 mentor which was very short and just a get-to-know-the-face-of type of meeting. I then headed off to meet the F1 I had arranged my on call with. We have to do at least 1 out of hours session during our block, so that can be anytime in the weekend or anything out of the hours of 9-5.
I basically spent the on call time on A&E with the F1, watched her clerk some patients in and also followed her to cardiac arrest call. The hospital feels so different at night, weirdly tranquil and serene.
Wednesday
For each block we have teaching relevant to that particular block, they tend to be focussed on clinical elements such as history taking or clinical examinations. This particular session was about presenting histories so we got the opportunity to present a history to a consultant whilst the group came up with differentials and then we discussed how we would manage the patient. This was quite useful as being able to present a history is something that we do really need to get on top of mastering now that we’ve started clinical years.
Each week we have a clinical debrief session that’s supposed to be a relaxed session where we discuss our week, share any concerns, bring up anything we don’t understand. We also work through a patient case (each week a different person in the group brings one to present), again to help develop our clinical reasoning skills and start being able to think of differential diagnoses. Each group has their clinical debrief sessions running slightly differently, at the discretion of their tutor. In our group, a couple of people are given topics to present during the session each week so we also did that. This week I did a short presentation on X-ray interpretation.
Thursday
Had a ward round in the morning. Here we get to follow round the ward team, watch them interact with and make decisions about each of the patients. Depending on the patients, we can go and take a history from a patient and come and present to the doctors during the ward round and occasionally if there’s a murmur or an abnormal sound worth hearing, a doctor may recommend we go and have a listen. Ward rounds are pretty busy, especially on this particular ward so it really is a bit about trying to listen, jotting down anything you hear and want to read up on or ask the doctors about later.
In the afternoon I signed up for a phlebotomy session as I thought it’d be useful to practice taking the blood. Since I’d not done it before on a real patient, I watched a few first then I was given the opportunity to go and have a go. Of course, I didn’t get it the first time, but I did leave the session having taken blood from 4 patients which I felt really proud about!
Friday
TCD stands for Themed Case Discussion. Each week we are given a case that we have to read up and learn about in preparation for this session where we are presented with patent cases to help conclude our learning. This week it was on Diabetes (which is only coincidentally relevant to our block).
SCT stands for Secondary Component Teaching and here we have all the extra bits of teaching. This week we covered Prescription Reviews, practised doing them and then were told how we would go and carry out a prescription review on the wards seeing as it’s one of the skills we have to complete by the end of the year.
This week was the penultimate in our Endocrine block so we also had our “placement sign off” meeting with our supervisor, in which she went through the different clinical experiences we did over the last 5 weeks, and also checked we had enough “sign offs” completed.
So that’s all about my first block (i.e. my first 6 weeks as a 3rd year medical student). Stay posted to here about my next block which is going to be Cardiology…
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Do remember that there are many variants (~300 or so) of diabetes mellitus which makes endocrinology fun to study.
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My first year longitudinal clinic visits were with an endocrinologist (just 6 days in the whole year). She was an academic physician so she actually saw quite a bit of more rare endocrinology conditions, but it was still ~60% diabetes! It’s cool that you have flexibility in the way your rotations are scheduled and can chose a bit day to day as well!
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